PART II Management and Stress: Making Workers Sick

PART II

Management and Stress: Making Workers Sick

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The lack of protection for workers’ health and well-being in the form of work-related accidents, illness and stress, lack of workers’ compensation and paid sick leave, lack of maternity protection, excessive hours of work, etc. – remains one of the worst aspects of economic insecurity around the world.

An estimated 2,000,000 workers die each year from work-related accidents and disease.

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Workers’ health information limited, unreliable, systematically understated

Economic liberalization shift away from statutory regulation worse working conditions, increased stress, declining health

Flexible labour relations worse working conditions hazard exposures, work-related stress, disease, injury rates

Work intensification management practices are the norm today: increased commuting time, growing insecurities - “time insecurity” is a growing problem.

Socio-Economic Insecurity, Stress & Disease

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Globally heart attacks, suicide, strokes expected as top occupational diseases of the 21st century (physical stress & psychological distress)

Globally depression important cause premature death/disability (WHO, 2001) including death from overwork (karoshi), much of which is stress-related

ILO Enterprise and Household surveys show: Transition countries’ industrial enterprises lack safety

depts./committees workers more vulnerable to occupational accidents & diseases

Over half of workers in Indonesia have no workplace OSH department/committee


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Workplace Safety

0

10

20

30

40

50

60

% r

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Brazil

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Ghana

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Unsafe workplace No safety committee/department/specialist

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ILO Household and Enterprise surveys show:

The poor report extremely poor working conditions Majority in developing countries bear costs work-related

accidents/illnesses, no benefits for incidents (least able to afford it)

Sick/injured workers work without taking leave (fear income or job loss)

Workers in African countries, rural women workers, & casual workers least likely to have insurance against work accidents or injury


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Agricultural workers suffer work-related health insecurity disproportionately:


Agricultural workers suffer much higher rates of accidents and fatal injuries than workers in most other sectors;

Agricultural workers figure disproportionately among over 160 million workers estimated to become ill as a result of workplace hazards/exposures. Ill health/disease prevalent in agricultural communities;

Overcrowded/unhygienic housing perpetuates spread of infectious diseases among agricultural workers (including TB, cholera, diphtheria, STDs, HIV/AIDS).

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ILO Enterprise and Household surveys show: Social support based on informal networks are

protections during economic shocks Informal networks/social support are the glue holding

people together during increasing insecurity

But: Informal systems declining in developing countries Many workers have no access to such networks Informal networks depend on culture Who can give when more have less?


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(Lack of) Social Support

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Not union member at work

Negative attitude to trade union

Trust management to look afterworkers' welfare

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Relying on Whom During CrisisCountry Urban Rural Whom % Whom % Bangladesh 1. Relatives 66.9 1. Family/siblings/relatives 53.4 2. Friends/neighbours 18.6 2. Moneylender 20.8 3. Moneylender 4.6 3. Bank 13.1 Ethiopia 1. Friends/neighbours 25.7 1. Family/siblings/relatives 21.7 2. Relatives 19.2 2. Friends /neighbours 20.8 3. Officials/government 5.2 3. Officials/government 11.3 Russia 1. Support from relatives 34.0 1. Support from relatives 33.2 2. Other household members 18.8 2. Social payment from State 20.8 3. Social payment from state 14.8 3. Other household members 15.6 Indonesia 1. Relatives 61.9 1. Relatives 61.2 2. Friends/neighbours 21.0 2. Friends/neighbours 27.0 3. Employer 4.3 3. Bank 2.1 Ghana 1. Friends/neighbours 35.3 1. Friends/neighbours 41.8 2. Land or asset sales 25.9 2. Land or asset sales 25.7 3. Money lenders 2.9 3. Money lenders 2.5 Tanzania 1. Relatives 50.3 1. Relatives 44.1 2. Friends/neighbours 30.9 2. Friends/neighbours 33.5 3. Employer 3.4 3. n.a. n.a. India 1. Relatives 66.1 1. Relatives 72.5 2. Friends/neighbours/mayor 12.8 2. Bank 16.0 3. Bank 6.2 3. Friends/neighbours/mayor 4.8 South Africa 1. Friends/neighbours 21.2 n.a. n.a. 2. Bank 20.9 n.a. n.a. 3. Employer 3.8 n.a. n.a.

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Causes of Absence from Work

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InjuryIllnessStress

Note: The above findings on stress refer to time off due to stress at work or stress outside work

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Workers’ Health and Well Being

Only small fraction of stress-related lost work time ever recorded as such. Yet: in 2002, over 500,000 people said were affected by stress at work (13.4 million working days lost due to stress).

Stress affects workers in industrialized economies who have been subject to work intensification management practices

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A national work security index measures how well countries protect workers’ health and well-being


OverOver two-thirdstwo-thirds of countries have unsatisfactory of countries have unsatisfactory levels of worker protection levels of worker protection

MostMost critical casescritical cases include most deprived countries include most deprived countries of Africa, Asia, eastern Europeof Africa, Asia, eastern Europe

Laws & mechanisms aloneLaws & mechanisms alone insufficientinsufficient to protect to protect workers’ healthworkers’ health

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Self-regulation & weak forms of collective voice erode workers’ health and safety


Strong voice representation is associated with strong protection of workers’ health and well being.

Strengthening collective voice is key means of improving working conditions & protecting workers’ health.

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Workers’ Health and Safety

The trend away from statutory regulation toward « self regulation » causes:

increased stressworse working conditionsworse health among workers

OpportunismOpportunism, , inertiainertia, , self-exploitationself-exploitation

Lack of safety committees/departments globally:Lack of safety committees/departments globally:still very weak in developing countries (no workplace safety still very weak in developing countries (no workplace safety committee for most Indonesian workers)committee for most Indonesian workers)weakweakeningening in industrialized countries in industrialized countries

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Work-related Stress:a 21st Century Disease

Causes include:labour intensificationcompetitive pressurestime-squeezerapid technological changelack of workers’ control in jobsflexible labour relations (downsizing, contracting out) higher injury rates, hazard exposure, disease and work-related stress

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The Breakdown of Costs for Work-related Injuries and Diseases

“Other” diseases include cancer, skin diseases and mental disordersSource: ILO, 1999

Heart diseases16%

Injuries14%

Central nervous system

8%

Other13% Musculoskeletal

40%

Respiratory diseases

9%

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Musculoskeletal Disorders

MSDs are associated with physical stress and psychological distress

Stress higher in jobs with high demands but where workers have little control over their jobs

Stress and illness outcomes higher where social support low

Stress higher in low skill level jobs with repetitive, boring, mundane tasks.

Tight reign of control to make workers productive?

…the appearance of non use of control? (the ultimate manipulation?)

Such practices have risks…Ouch!

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Management practices contribute to stress

Some management practice are risk factors for stress and ill health: total quality management team working job enrichment lean production process re-engineering just-in-time policies (Japanese management) benchmarking or continuous improvement

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Some management methods cause more mental & physical ill health than others: Taylorism neo-Taylorism Fordism techno-bureaucratic management style management based on competitiveness management by stress


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Taylorism, neo-Taylorism, Fordism: repetitive and monotonous task work intense time pressure high work demand/low worker control absence of autonomy


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high speed work de-humanized work tasks low-skill work lack of recognition for work performed lack of management support unrealistic deadlines long work hours poor communication responsibility without authority

Management practices contribute to stress from:

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downsizing dead end jobs lack of input in decision-making hierarchical management conflicting demands repetitive tasks insufficient breaks low pay and benefits shift work (especially rotating shifts) poor supervision


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workers doing meaningless jobs with low decision-making die younger than other workers. (B. Amick et al, Psychosomatic Medicine, 2002)

overwork affects all income groups heart attack & death from overwork is a

global problem (USA, UK, India, New Zealand, Australia, China, Philippines, Italy, Indonesia, Rep. Korea)

major health problem: suicide from overwork (Japan 1997-2000 100 suicides everyday!)


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Known outcomes of stress workers with stressful jobs more likely to die

of heart disease than those with non-stressful (M. Kimimaki et al, British Medical Journal, Oct. 2002; A. Spurgeon, ILO 2003)

increase in workload with low control leads to mental health deterioration (Whitehall II Study, London HSE, 2002)

long-term job strain is worse for your heart than gaining 20 kg. or ageing 30 years (Landsbergis et al, Amer. J. of Epidemiology, 2003)


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End Part II

Documents

PART II Management and Stress: Making Workers Sick