Introduction to Psychological Hazards at the Workplace

1. Introduction to Psychological Hazards at the Workplace Dr. Emilia Zainal Abidin Faculty of Medicine and Health Sciences, UPM

2. Work: When risk outweigh benefit Throughout the world, most adults—and many children—spend much of their waking hours at work Work provides a number of economic and other benefits In recent decades significant changes, closely linked to the organisation and management of work, have taken place in the world of work and resulted in emerging risks and new challenges in the field of occupational health and safety Changing of pattern – workers being introduced to pressures of increased production, faster machines, newer chemicals, continuous work, shift work at speeds determined by demand of production Example Hewlett-Packard inkjet-printer factory in Malaysia – increase production up to 250% on some months

3. Psychological risks related but not limited to • Work-related stress • Workplace violence • Bullying • All types of harassment • Work-life imbalance – example death from overwork - karoshi • Differences between • Psychological risk is more related to individual’s perspective while psychosocial refers to impact of work environment on health • Psychosocial hazards are defined in terms of the interactions among job content, work organisation, environmental conditions and management, and the employees‘ competencies and needs on the other (ILO)

5. Psychosocial Impact or health indices • Psychosocial impact in the workplace is linked to: • Increased absenteeism • Poor work performance • Health problems • Staff turnover • Depression, anxiety, sick leave and propensity to leave • Reduced job satisfaction and motivation • perceived difference between what is expected as a fair and reasonable return-job satisfaction

6. Simplified Pyschosocial impact STRESSORS PRODUCTIVITY PHYSIOLOGICAL PSYCHOLOGICAL WORKER WORKER ORGANIZATION SICKNESS TURNOVER PRODUCTION INDIVIDUAL NEGLIGENCE REPUTATION COUNTRY

7. Definition of Stress • The Emotional state which results from discrepancy between the level of demand and the person’s ability to cope • Job Demands • Time Pressure • Deadline stress • Excessive workload • Conflicting demands Lazarus and Folkman 1980

8. The Size of the Problem: Globally 1 in 3 of Europe's workers report that they are affected by stress at work The Fourth European Working Conditions survey (2007) showed that 20% of workers from the first 15 European Union (EU) member states (EU-15) believed that their health is at risk because of work-related stress In UK, 15% of all working individuals thought their job was very or extremely stressful ILO (2006) produced a list of occupations which equal or exceed the rate of 6 on a stress rating scale of 0 to 10 

9. Stress Rating Source: ILO (2006)

10. Stress level Boredom from understimulation Optimum stress load Conditions perceived as stressful Distress from overstimulation Yerkes-Dodson Law – Not all stress are bad Performance arousal High Low High (distress) Optimum (eustress) Low (distress)

11. The Job Strain Model by Karasek Psychosocial functioning at the workplace, based on psychological demands and decision latitude Job strain hypothesis fatigue, anxiety, depression and physical illness

12. E.g. Causes of stress at work among young doctors Demands that work places on personal life, excessive workload, and long hours Covering for colleagues on sick leave and insufficient provision of locums is one of the most important factors contributing to excessive workload Fatigue which can result in decreased concentration, inadequate patient care and potentially serious clinical mistakes Bullying or harassment Feeling powerless and uninvolved in determining one's own responsibilities Continuous unreasonable performance demands Lack of effective communication and conflict resolution Excessive time away from home and family Office politics and conflicts among staff Feeling that reward is not commensurate with responsibility Work-related stress in terms of personal suffering, patient care and medico-legal liability High public expectation

13. Work environment Conceptual Frame Work of Stress Home environment FAMILY & SOCIO DEMOGRAPHIC STRESSORS OCCUPATIONAL STRESSORS Work load Work environment Health status Family Conflict Financial Time and System Management ACUTE AND CHRONIC EFFECT 1. Physiological 2. Psychological 3. Behavioral OUTCOMES OF STRESS Organizational relationship Personality Training MODYFYING VARIABLES SUPPORT Knowledge Skill Social Interaction Coping mechanism Emotional support PERCEIVED STRESS

14. Instrument - Personal Stress Inventory (O’Donnell et al 1984) • Consists of 52 items from 11 subscale • Based on a four-point Likert scale • Score of more than 40 or 36 (ROC curve) were considered stressed (Rokiah 1994, Mohd Ridzal 2006)

15. Assessing Occupational Stress among Malaysian Workers

16. The chemistry of stress E.g Fear of a car accident E.g An argument E.g Taking an examination 1. Chemical messages are carried to the hypothalamus 2. The hypothalamus produces corticotropin hormone releasing factor CRF 3.CRF goes to pituitary gland which releases the hormone

17. 3. CRF goes to pituitary gland which releases these hormones 4. TSH in thyroid gland increases metabolism 5. ACTH via Bloodstream to adrenal glands 7. Medulla produces Adrenalin and noradrenalin 6.Cortex produces cortisol Increases blood sugar Increases heart beat raise blood pressure 8. Chemicals return to the pituitary glands

18. PHYSICAL Fatigue Sleep disturbances, difficulty getting up, stomach ailments, tension headache, migraine headache, GIT problems, backache, nausea, muscle tensions, shortness of breath, Malaise (general discomfort), weight loss, weight gain, Frequent flu/colds Signs and symptoms of stress

19. Feeling: Anger boredom frustration depression discouragement disillusionment anger, anxiety suspicious, irritability hopelessness Attitudes: cynics indifference self-doubt Loss of empathy, difficulty concentrating low morale, moodiness, decrease sense of self - worth Psychological

20. fault finding blaming others defensiveness apply derogatory labels to people unnecessary risk taking workaholics conflict with co-workers Suicide, drug/ alcohol abuse etc absenteeism making mistake Behavioral

21. Sexual harassment The participation of women in the nation's labour force is significant - 44.2% With increased participation of women in the workplace, there will inevitably be more incidences of sexual harassment Women who now hold more jobs which were traditionally dominated by men are also likely to face sexual harassment in the workplace There are also incidences of same sex harassment and men being harassed, but generally, it is a problem faced mostly by women

22. What is sexual harassment? Sexual conduct which is • Unwanted and Unwelcome to the recipient • Imposed-on and Unsolicited or Unreciprocated by the recipient • Any unwanted conduct of a sexual nature having the effect of verbal, non-verbal, visual, psychological or physical harassment • Perceived by the recipient as a sexual nature, effect on her/his employment • Perceived by the recipient as an offence or humiliation, or a threat to his/her well-being, but has no direct link to her/his employment

23. 5 Forms of Sexual Harassment • Verbal Harassment • e.g.. offensive or suggestive remarks, comments, jokes, jesting, kidding, sounds, questioning • Non-verbal / Gestural Harassment • e.g. leering or ogling with suggestive overtones, licking lips or holding or eating food provocatively, hand signal or sign language denoting sexual activity, persistent flirting • Visual Harassment • e.g. showing pornographic materials, drawing sex-based sketches or writing sex-based letters, sexual exposure • Psychological Harassment • e.g. repeated unwanted social invitations, relentless proposals for dates or physical intimacy • Physical Harassment • e.g. inappropriate touching, patting, pinching, stroking, brushing up against the body, hugging, kissing, fondling, sexual assault

24. When and How Does Sexual Harassment Occur? • The target of harassment as well as the harasser may be male or female • Parties may be of the same sex

25. Bullying • What is workplace bullying? • Workplace bullying is verbal, physical, social or psychological abuse by employer (or manager), another person or group of people at work • Personal insults • Invading one’s “personal territory” • Uninvited physical contact • Threats and intimidation, both verbal and nonverbal • “Sarcastic jokes” and “teasing” used as • insult delivery systems • Withering e-mail flames • Status slaps intended to humiliate their victims

26. What Is Workplace Violence?(Note the subjective nature of 2--4) • Physical Assault • Threatening Behavior • Verbal Abuse • Harassment

27. Four Categories of Workplace Violence • Violence by Strangers Committing Robbery • Violence by Customers, Clients, or Patients • Violence by Employees and Supervisors • Violence by Domestic Partners or Relatives of Employees (new category)

28. How to measure Psychosocial Risk? • Self reported questionnaires containing questions regarding presence of risk factors in the work environment – cheap and easy • Example Copenhagen Psychosocial questionnaire, burnout inventory, general nordic questionnaire • Objective measures are based on observational approaches, including archival data (e.g. sickness leave, performance measures, accidents), and biological measures • Since stress activates the pituitary-adrenal cortical system, biological markers are commonly used • Measurements of heart rate (variability) and blood pressure, biochemical measures of uric acid, blood sugar,steroid hormones (i.e., cortisol), serum cholesterol, catecholamines (i.e., adrenaline and noradrenalin, epinephrine or norepinephrine), are also considered robust and reliable ways to measure stress responses

29. Assessing job satisfaction Interview Observation Questionnaires Job enrichment program Direct feedback New learning Personal accountability Schedule their own work Improving the quality of work The work environment Task performed Reward structure PSYCHOSOCIAL RISK MANAGEMENT - Organization strategies

30. Reactive support Listening Referral Confrontation Control rewards Resolving of interpersonal conflict Issue conflict Role conflict Personality clash Support systems Staff support system Managerial approaches

31. Organization development program Increase level support and trust among individual Increase open confrontation Open and genuine in interpersonal communication Increase personal enthusiasm and self control Positive reinforcement Money Positive work environment Promotion Managerial approaches (cont.)

32. Self monitoring Manage self talk Alter irrational beliefs Take it less seriously Take the treat into opportunity be okay no matter what Utilize available coping resources Social support Money Belief and Faith Control physical stress responses Breathing methods Muscle relaxation Mental method Manage actions Be assertive Use effective listening Maintain health buffers Exercise Nutrition Sleep Avoid maladaptive reaction to stress Alcohol &drug abuse Smoking Overeating Blaming others Individual strategies managing psychosocial risk

33. Types of health promotion programme • Awareness programmeswhich aim to increase the workforce’s level of awareness in relation to specific health topics. Typical activities include health fairs; posters, newsletters, educational classes; and health screening • Lifestyle change programmesdirectly aim at changing employees’ health behaviour through a variety of approaches such as skills training and self-help • Supportive environment programmesaim to promote a sustainable healthy lifestyle through creating a workplace environment that supports and encourages healthy choices Peersmanet al. 1998

34. Are there people with no STRESS? • Thank you for your attention