(Psychology, Self-help) Enough Workplace Stress - Organizing for Change

8/11/2019 (Psychology, Self-help) Enough Workplace Stress - Organizing for Change

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EnoughWorkplace Stress:

Organizing for Change

H

E A L T H

A N D

S A F E T Y

G

U I D E L I N E S

Canadian Union of Public Employees Health and Safety Branch cupe.ca


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Table of ContentsForeword 1

Part 1

1.1 Introduction to stress 2

1.2 What is stress? 3 Stress: a health and safety hazard 4 Normal and toxic stress 4 Physical reactions to stress 5

Stress myths and clichs 6

1.3 What causes stress? 7 Work organization, lack of control and

excessive demands 7 Overwork and work shift schedules 10 Physical working conditions 11 Job insecurity, cutbacks and reorganization 12 Bullying, harassment and violence 12

1.4 Who is affected by stress? 13

1.5 What are the stress outcomes? 14 Psychological disease and social and

behavioural changes 14 Heart disease and other physiological outcomes 15 Personal and family-life conflict 16

Workers divided 16 Work-related musculoskeletal disorders 17 Burnout 17 Synergistic effects of stress and other diseases 18 Critical incident stress 18

Enough Workplace Stress: Organizing for Change iii


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Part 2

2.1 Is stress a health and safety hazard for you? 19

2.2 Identify the problem 19 Surveys and questionnaires 20 Mapping 21

2.3 Taking action 22 Right to refuse 22 Take your breaks 23 Report stress health and safety hazards 24 Joint health and safety committees 24

2.4 Solutions and strategies for change 26 Workplace reorganization 26 Worker control 27 Stress policy 28 Stress health and safety contract language 28 Stress legislation and regulations 29 Workers compensation 30

Union involvement 31

2.5 Summary: stress dos and donts 32

Conclusion 33

Fact sheet 35

Health and safety stress questionnaire 39

References 45

iv Enough Overwork: Taking Action On Workload


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ForewordThis guideline written by CUPEs National Health and SafetyBranch is part of our unions broader efforts to eliminate workplacestress. It is largely based on ideas developed by members whoattended CUPEs 8th National Health and Safety Conference, andparticipated in the workshop Enough Workplace Stress:Organizing for Change.

The guideline is designed for use by CUPE members acrossCanada to help address and solve workplace stress problems ashealth and safety hazards. It has two main sections:

Background information on workplace stress: what theproblem is, what the causes are, who is affected, and whatthe hazards are.

Actions, solutions and strategies to eliminate workplacestress and the health and safety hazards associated withstress.

This guideline Enough Workplace Stress: Organizing for Change is a tool for action. It contains concepts, solutions andstrategies that can effect meaningful change in CUPE workplacesacross the country. Equipped with this guideline, members canidentify and eliminate workplace stress hazards.

Enough Workplace Stress: Organizing for Change 1


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Part 11.1 Introduction to stress

We hear a lot about stress. People talk about being stressed out,how this or that situation is stressful. Stress affects us at home,work, and even on holidays.

We also hear too often that we should learn to deal or copewith stress at work. This implies that workplace stress is normaland that we need to manage or handle stress and just get onwith the job. This view of stress is wrong.

Workplace stress is a serious health and safetyhazard that can have devastating effects.Stress can lead to psychosocial illnesses, suchas anxiety and depression. Stress can alsocontribute directly to physical illness; forexample, tense muscles can worsen ergonomic

injuries. Stress makes workers more susceptibleto hazards, injury and disease.

While it is true that there are sources of stressother than the workplace, this does not mean

that workplace stress is not a hazard or that itis the product of a workers imagination. CUPE members knowthat the changing nature of work has increased workplace stresshazards. Reorganization, layoffs, job insecurity, acceleratedpaces of work, along with many physical work hazards (e.g., hot

or cold conditions, poor ergonomic design, poor ventilation,noise, etc.) can all contribute to stress. These causes of stress areall firmly rooted in the workplace. Also, stress that is experi-enced outside of work for example within the family oftenhas a workplace component to it, or is in some way caused byworkplace factors.

2 Enough Workplace Stress: Organizing for Change


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This guideline is focused on workplace stress stress that is caused by and comes from theworkplace. The word stress is used with thephrase workplace stress almost interchange-

ably, but it is used mostly as a more generalterm.

Stress is closely related to control. Many CUPEworkplaces have changed, resulting in less con-trol for members to direct their work. Less orlow control over job tasks is associated withhigh stress levels.

This guideline outlines the scope of the stressproblem as it affects CUPE members, assessingthe issue, the causes, who is affected, and thehazards. It points members towards actions thatcan be taken, specifically outlining how to iden-tify stress hazards, where solutions lie, andwhat strategies can deliver real change.

1.2 What is stress?

How can I care for my residents properly when I have 42 assigned to me at once? Stress

thats what I call stress.Bonnie Snyder, CUPE member, 8th National Health and SafetyConference

We know when we feel stress or stressed. Itmight seem the concept doesnt need to bedefined. It is also true that stress can affectpeople differently.

But part of the hurdle of addressing stress as ahealth and safety issue is to define the hazard:

Stress is a combination of physical and psychological reactions to events that challenge or threaten us. In normal circumstances, the stress response is a powerful protective mechanismthat allows us to deal with sudden changes,

dangers or immediate demands. In abnormal (i.e., highly stressful and/or prolonged stress)circumstances, stress overwhelms our protective mechanisms, leading to serious negative healthoutcomes.

This definition makes a key point that stress isoften a result of combined factors both physi-cal and psychological. Similarly, the EuropeanCommissions official definition of work-relatedstress is:

A pattern of emotional, cognitive, behavioural and physiological reactions to adverse and nox- ious aspects of work content, work organization



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and work environment. Stress is caused by a poor match between us and our work, by con- flicts between our roles at work and outside it and by not having a reasonable degree of con-

trol over our own work.

According to this definition, stress occurs whenthere is a poor match between workplacedemands and a workers degree of control. Wefeel stress as a result of demands that areplaced upon the mind and the body. Our reac-tion is called the Generalized Stress Response.Factors that cause this response andmake us experience stress are calledstressors.

Stress: a health and safetyhazardStress is a health and safetyhazard plain and simple.Employers might like to

believe that stress does notexist. They might argue thatstress is in your imagination, apersonal problem or a result of workers lifestyle choices. Or they mightregard stress as just part of the job. Thoseemployers who do acknowledge stress on the

job might argue that it should not be considereda health and safety hazard because stress is notvisible, like more obvious hazards, such asexposure to chemicals, sharps, or confinedspace hazards.

But CUPE members know this is wrong. Likeviolence and overwork, stress is a significanthealth and safety hazard directly related to howwork is organized. Workplace stress comes from

how work is done. The effects of workplacestress on CUPE members are visible: illnessesand injuries negatively affecting membershealth and lives. Because workplace stressaffects workers health, it must be seen as aworkplace hazard and as a health and safetyissue.

Normal and toxic stressThe first definition used earlierdescribes normal circumstances forstress: stress is dealt with and then

it passes. Our instinctive reac-tion to stress is to combator flee the source of stress known as the fight or

flight reaction.

With normal stress we canfight or flee. The response occurs

fairly quickly and then the stressends. The three phases of normal

stress are:

Stress comes (facing an immediatethreat/demand).

Stress goes (dealing with the stress). Stress is over (the body relaxes, no longer

feeling stressed).



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An example of normal stress is short-term anxi-ety because you have lost something important(e.g., keys), or feeling temporarily stressedbecause your bus is stuck in traffic and you are

late for work. When the item is found, or thebus gets you to work on time, your stress dropsaway and is eliminated. There are many day-to-day occurrences like these that cause normalstress.

Toxic stress is another matter. As the namesuggests, toxic stress is like a poison. This formcauses the most damage, as the human body isnot equipped to deal with toxic stress. Unlikenormal stress that comes and goes, toxic stressstays with you, building up the harmful effects.The three phases of toxic stress are:

Stress comes (facing a demand or threatthat does not stop).

Stress stays with you (you have no way of

dealing with the stress). Stress builds up (you can never relax and

the stress is not eliminated).

Workers can experience toxic stress when theyare exposed to staff shortages, harassment, bul-lying, noise, and other hazards. This form of stress often leads to negative physical and psy-chosocial effects.

Physical reactions to stressBoth normal and toxic stress affect the bodyphysically, but toxic stress effects are moresevere.

The Generalized Stress Response is the phraseused to describe a variety of physical reactionsto stress, such as:

An increased metabolism, for example, fasterheartbeat and quicker breathing.

Increased blood pressure. Increased cholesterol and fatty acids in the

bloodstream.



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Decreased protein synthesis, impaireddigestion and immune and allergic responsesystems.

Faster blood clotting.

Increased production of stomach acids. Increased production of blood sugar for

energy. Localized inflammation (for example,

swelling and pain in joints, muscles, andskin).

Widened airways directing more oxygeninto the muscles.

Tensed up muscles. Increased sweating to cool muscles.

Stress can also cause workers to experiencesensations such as a dry mouth and difficultyswallowing, shortness of breath, a racing heart,butterflies or knots in the stomach, and tension,aching, shaking, or pain in the muscles.

These physical reactions are immediate, instinc-tive responses to stressors. Over time, as thesereactions occur too often as normal stressprogresses to toxic stress it can translate intomore severe physical and/or psychologicaleffects, such as:

Sleep disruption and disorders. Fatigue, apathy and lack of energy. Chronic aches and pains in the chest,

shoulders, back, neck and elsewhere inthe body.

Depression and a general decrease inenjoyment of life.

Changes in sexual activity. Conflict with family, friends, and co-workers. Weight gain or weight loss. Greater susceptibility to injury.

Immune system depression, greater vulnera-bility to illness and disease.

Other stress-related health problems, suchas, ulcers, heart disease, headaches, irritablebowel syndrome, diabetes, and menstrualdisorders.

Any combination of these effects can be veryharmful to a workers health and well-being.

Stress myths and clichsHere is a quick look at someof the misinformation aboutstress. Dont be misled byemployers and consultantswho use phrases and makeclaims such as these:

Stress is not a workplace health and safetyhazard.

A little bit of stress is healthy. Stress is good for you; it makes you more

productive at your job. Stress comes from your home life, not the job. All we need to do is learn to cope with our

stress. To deal with stress, all workers need to do is

take a stress management course. Stress can be solved with exercise, breathing

deeply and learning to relax more. Workplace wellness programs are the

answer to stress.



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Here are the realities key points to rememberabout stress:

Stress is a health and safety hazard. Stress can have serious health effects. On-the-job stressors cause workplace stress. Stress is largely caused by poor workplace

organization. Your joint health and safety committee

should deal with stress hazards. Workers need control over their jobs to

eliminate stress.

Be wary of employers who claim stress is nor-mal and unavoidable. Also be sceptical of employers who claim stress problems can besolved with stress management schemes, well-ness programs, team-building exercises, andanything else that sounds warm and fuzzy.

These are band-aid solutions that do nothing toeliminate stress hazards. Stress managementtechniques only deal with the symptoms of workplace stress. They do not get rid of stres-sors. These programs do not prevent injuries ordiseases. They are not a solution to workplacestress.

Relaxation techniques, counselling and copingmechanisms offer only temporary relief fromstress. Workplace stress hazards must be dealtwith at their source through primary prevention not after the fact. Preventing exposure to thecauses of stress is the only way to eliminate thehazard.

1.3 What causes stress?

Can you imagine the stress when youhear your five-year-old ask, Mommy, do

you have to go to work again? Manon Breton, CUPE member, 8th National Health and SafetyConference

Stressors cause stress. But what are thesestressors and how do we pinpoint them? Hereare a few causes of stress identified by CUPEmembers:

Lack of training and direction. Too many demands at one time. Deadline pressures. Uncertainty. Office politics and hostile management. Stale air, either too hot or too cold. Lack of windows and natural lighting. Violence, threats and bullying.

Too many bosses. Surveillance cameras. Working alone. Low morale among workers. Risk of injury and disease.

Work organization, lack of controland excessive demandsWork organization factors cause stress or makestress worse. How jobs are designed, carriedout, and the degree to which workers partici-pate in the decision-making process at theirworkplace can result in stress.



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The National Institute for Occupational Safetyand Health (NIOSH) in the United States defineswork organization as the work process and theorganizational practices that influence job

design. Work organization also includes broaderconsiderations, such as the economic, social,political and legal environment. These areimportant elements as they can affect newwork organizational practices. For example, if the country is going through tough economictimes, this can lead to layoffs, cutbacks anddownsizing.

The following are among the many workorganization factors that can cause stress, someof which build on what CUPE members haveidentified:

Lack of control and conflicting workdemands.

Lack of participation in decision-making andlack of autonomy (i.e., independence andability to self-direct) at work.

Lack of training and direction, and changesin work organization.

Lack of recognition of work done and lack of respect from supervisors.

Repetitive, boring and meaningless work. Unclear and conflicting work responsibilities. Low pay, lack of career development oppor-

tunities and job instability. Too much or too little work, overwork or

under-use of skills. Poor communication, new technologies and

time pressures. Privatization, outsourcing, downsizing,

mergers, staff cutbacks, restructuring, andother large-scale work reorganizationschemes.

Repressive management styles and tech-niques, such as Total Quality Management,constant improvement, teamworking, andquality circles.



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Control is a central work organization factorlinked to stress. Lack of control at work canmake workers sick. A lot of workplace stressresearch has focused on control and demandfactors and how these lead to stress.Complicated models have been put forward topredict workers stress levels, using terms likedemand/control/support model, decision-makinglatitude and job strain hypothesis. But the idea

is fairly straightforward.

Lack of control is a cause of stress. It comesfrom not having the ability to decide how a jobis done. Examples include not being able todecide the pace of work, or what tasks getdone in what order. If a worker cannot controlthese elements, if they do not have the leewayof action to make decisions about their jobtasks, then they will have higher stress levels.

Control is different from power. Control con-cerns factors within the job how the job andits tasks are carried out. Power is broader thancontrol and concerns decisions such as when

work is scheduled, whether a worker willhave or retain a job, which workers will getadvancement within an organization, and otherlarger scale decisions. Uncertainty over thesebroader power factors can also cause stress.

The control/demand model adds another factor.If workers have excessive demands placed uponthem, they will suffer stress. For example, if

workers are given unreasonable deadlines, arebullied by their employer to work overtime, andare forced to work through breaks, then theyare facing excessive work demands that cancause stress.

When lack of control is combined with highdemands, a worker will almost certainly sufferhigh stress levels. These factors can create toxicworkplace stress, causing increased heart diseaseand possibly death, depression, exhaustion,low self-esteem, and increased upper extremitymusculoskeletal disorders. Job uncertainty cancompound lack of control and high demands,making stress an even greater hazard.



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Work organization schemes, such as TotalQuality Management (TQM) and quality circlesmight be introduced to workplaces and sold asa way for workers to gain more control over

their work. After years of these practices beingimposed on CUPE members and other workers,the opposite effect has emerged workers haveless control. A recent NIOSH study of work reor-ganization found that:

Various work participation or involvement strategies may often be more ceremonial than substantive, having little meaningful influence on worker empowerment or

perhaps even eroding workers means toinfluence job conditions through more tradi- tional labour-management mechanisms such as collective bargaining.

This means that rather than helping to combatstress, work reorganization strategies such as

TQM can take away our real control and leadto more stress.

In 2001, the Communications Workers Union(CWU) in the United Kingdom surveyed 2,729 of its members about stress. CWU members wereasked to rank causes of stress in order of impor-tance. These workers ranked bad management,excessive workloads, staff shortages, and otherpoor work organization factors as the leadingcauses of stress. Work organization factors arethe single biggest predictors of stress at work.

Overwork and work shift schedulesStress is among the many negative healtheffects caused by overwork and acceleratedpaces of work. Overwork like stress is a

work organization health and safe-ty issue. It is characterized by:

Long and difficult hours.

Unreasonable work demands. Multi-tasking. Pressure to work overtime (paid and

unpaid). Fewer rest breaks, days off, holidays and

vacation. Faster, more pressured work pace. Performance monitoring. Unrealistic management expectations. Additional, often inappropriate, tasks piled

on top of core duties (e.g., doing more thanone job).

No replacement during sick leave, holidaysand vacations.



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Overwork affects our quality of work. Whenworkers cant get the job done the way theywant it done, they will experience stress. Inoverwork conditions, the protective mechanism

of the stress response breaks down due tofatigue, overexertion and other factors. Thestress that results is not given enough time forrelease and instead builds up, leading to toxicstress. Stress and overwork go together. Thesetwo health and safety hazards are both conse-quences of poor work organization.

Long hours, shift work, and night work arestressors related to overwork. These stressorscan disrupt workers family and social life,increase fatigue, create sleep deficits, affectconcentration, increase exposure to chemicalhazards, and make workers more susceptible toworkplace injuries and illnesses. All of thesefactors can also contribute to higher stress levels.

Part-time, casual, reduced-hours, temporary andsplit shift work can also cause stress. Part-timeand reduced-hours workers suffer stress fromnot having enough hours to support themselvesand irregular work shifts. Short notice forfulfilling work commitments can create stressfor casual and temporary workers. Split shiftworkers experience job stress due to constantly

juggling work, family and social commitments,often times putting family and social livessecond to work demands.

Physical working conditionsPhysical work conditions can also be stressors,such as:

Noise and vibration. Poor and inadequate lighting. Temperature extremes too hot or too cold,

or too much variation in temperature. Overcrowding, poor spacing and work area

layout. Exposure to toxic substances. Ill-fitting and poorly designed work tools,

furniture and workspaces. Poorly maintained work environment. Poor indoor air quality. Bad building design. Working with hazardous equipment. Lack of outside amenities and bad site

planning such as no parking, no access topublic transit, no proximity to green spaceand recreational facilities.

Any of the above can cause or compound stress.Many of these stressors are also linked to workorganization. For example, studies have corre-lated high, ongoing noise disturbance and lowspeech privacy at work resulting from poorwork organization, with elevated stress andreduced job satisfaction. Other physical factors,such as the absence of windows and naturallight in a workplace, have likewise been linkedto higher stress levels for workers.



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Job insecurity, cutbacks andreorganizationCUPE workplaces have changed in recentyears. Cutbacks, privatization, reorgs,and downsizing have con-

tributed to a heightened senseof job insecurity. All of these fac-tors are causes of workplacestress.

In two decades, public sector jobs dropped from one-fifthof all employment inCanada, to less than one-sixth by 1996. The mostsevere cutbacks occurred between 1992-1996when 121,000 jobs across the country werelost. During those same years, 694,000 jobswere created in the private sector and 266,000more people opted for self-employment. Thesenumbers represent huge cutbacks and downsizingin the public sector, along with a massive shift

towards privatization.

At the same time, public needs and expecta-tions have not decreased. If anything, they havebecome greater. The Canadian public requiresand expects a very high standard of servicefor the work performed by CUPE members insectors such as health care, social services,municipal services, education and elsewhere.Cuts in staffing levels have imposed higherdemands on CUPE members and can be asignificant cause of stress.

Bullying, harassment and violenceThese three hazards can cause stress and areagain linked to work organization.

Bullying has become a more widely-recognized

hazard in Canadian workplaces. The Britishpublic sector trade union UNISON defines

bullying as:

Offensive, intimidating, malicious,insulting or humiliating behaviour,

abuse of power or authority whichattempts to undermine an individual or

group of employees and which may cause them to suffer stress.

Bullying can create a dangerous, debilitatingand negative workplace climate that elevatesworkers stress levels. As a result, workers maysuffer headaches, back pain, stomach ailments,insomnia, depression, fatigue, anxiety and evensuicidal thoughts.

Harassment verbal abuse; threats; slurs;insults; discrimination on the basis of age, race,ethnic origin, gender, sexual orientation or ability;and its other forms causes stress.

Progressive amendments to Quebecs Act Respecting Labour Standards and other Legislative Provisions in 2002 have added lan-guage on psychological harassment. It definespsychological harassment as:



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Any vexatious behaviour in the form of repeated and hostile or unwanted conduct, verbal com- ments, actions, or gestures, that affects anemployees dignity or psychological or physical

integrity and that results in a harmful work environment for the employee.

The amendment to the provinces legislationfurther states: every employee has a right to awork environment free from psychologicalharassment. Employers are obligated to preventpsychological harassment. It also says that thisprovision is implicit in every collective agreementin Quebec.

Harassment reduces job satisfaction, can increaseturnover at workplaces, and, like bullying, createsa workplace climate hazardous to workershealth and safety. Harassment is also linked tophysical symptoms, such as stomach ailments,headaches, nausea, over and under eating,

sexual problems, and deteriorated interpersonalrelations.

Violence is still a significant hazard in CUPEworkplaces. The presence and/or threat of vio-lence at work can contribute to elevated stresslevels. Violent incidents at work make a deepimpression, leaving workers on edge andstressed for long periods.

1.4 Who is affected by stress?

Stress has been near the top of the health andsafety priorities list for several years for CUPE.

The public sector in Canada has been damagedby cutbacks, privatization schemes, and otherinitiatives. The result: high levels of stress forpublic sector workers.

A 2001 Canadian Policy Research Networks(CPRN) study found workplace stress had dou-bled. Twenty-seven per cent of workers in2001 compared to 13 per cent of workers tenyears earlier reported high job stress. The studyfurther reported a decrease in job satisfactionover the same time period, from 62 per cent of workers reporting high job satisfaction to a dropof 45 per cent. As stress levels increased inCanadian workplaces, job satisfaction declined the two seem to go hand-in-hand.

Women experience more stress than men,according to the CPRN study. Sixty-two per centof female non-professional workers and 59 percent of female professional workers reportedhigh-perceived stress levels, compared to 54per cent of male non-professional workers and43 per cent of male professional workers.Female workers also reported higher levels of role overload. Canadian non-professional femaleworkers experienced a 15 per cent increase inhigh job stress, an eight per cent increase inhigh role overload and a 13 per cent drop inhigh job satisfaction from 1991 to 2001.



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These numbers do not indicate a weakness onwomens part. Their stress levels are higherbecause women, more than men, generallyhave greater family responsibilities. Women still

handle more childcare, child-raising, elder careand other family duties than men. Canadianwomen in the paid labour force often do doubleduty working inside and outside the homeand working away from the home, which canworsen their stress hazards.

1.5 What are the stressoutcomes?

Im exhausted, on edge, distraught, cant

concentrate. I have no time for family,hobbies, and volunteer activities.

Headaches, tension, arthritis. Do youwant to hear more?Name withheld, CUPE member, 8th National Health and SafetyConference

Stress can cause many negative health out-comes. CUPE members listed these effects of workplace stress:

Headaches and tension. Chest and stomach pains. Joint and muscle pains; arthritis. Increased use of alcohol and drugs. Lower interest in sex. Feeling angry and aggressive more often.

Weight gain and weight loss. Feeling anti-social and idle.

Psychological disease and social andbehavioural changesStress is a known cause of many psychologicaldiseases and disorders, as well as many socialand behavioural changes, such as:

Depression, feelings of apathy and low self-worth, crying spells.

Anxiety, increased tension, fearfulness. Changes in eating habits. Sleep disorders, insomnia, fatigue and

exhaustion.



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Irritability, mood changes, constant negativity,over-reaction and irrational behaviour.

Inability to concentrate and see tasksthrough to their conclusion.

Burnout. Sexual dysfunction. Increased use of drugs, alcohol and tobacco. Paranoia and social isolation and withdrawal. Suicidal thoughts.

Many of these outcomes can severely affectworkers lives. Descent into acute depression,for example, can cause workers to be off the jobfor years and end careers prematurely.Likewise, the psychological effects of stress candevastate workers family and social lives.

Specific worker studies have connected stressand psychological diseases. For example, high

job demands among male power-plant workershave been associated with depressive disorders.

Depression has also been linked with specificworkplace stressors such as lack of job satisfac-tion, workplace role conflict and ambiguity (notknowing what your job is).

Heart disease and other physiologicaloutcomesExposure to job stress increases the risk of heartdisease and other physiological problems. Thephysiological reactions to stress described earlierwith the Generalized Stress Response can beearly triggers of more severe heart problems tocome.

Heart disease is the leading cause of death inCanada. It includes coronary heart disease,hypertensive disease, heart and circulatory sys-tem disorders, and other conditions. Stress in

the workplace has been directly linked to manyof these diseases. High stress can make theheart beat faster, which can lead to excessiveoxygen intake in the heart muscle. This canincrease the possibility of heart attack. Stresscan also upset the hearts cardiac rhythm. Anexcessively raised heartbeat can lead to life-threatening ventricular fibrillation. Numerousworker studies correlate stress and higher ratesof heart disease.

Stress can also make workers vulnerable toother diseases, including:

High blood pressure. Headaches and migraines. Impaired digestion due to a decrease in

intestinal movement. Menstrual disorders there is some evi-

dence of an association with stress. Ulcers from lowered blood flow. Irritable bowel syndrome there is some

evidence of a link with stress. Diabetes from excessive levels of fats and

glucose released into the bloodstream. Various illnesses from lowered immune

function due to stress.



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Personal and family-life conflictLike any workplace hazard, the effects of stresscan spill over from work and have an impact onworkers lives with their family and friends.

With stress especially with toxic stress workers continue to suffer outside their workinghours. Family and personal relationships suffer.The deterioration reveals itself in marital prob-lems, family breakdowns, domestic violence,increased use of drugs and alcohol, isolationand withdrawal from personal relationships,reduced interest in sex, and other psychologicaloutcomes. Stress can contribute to exhaustionand fatigue, causing workers to lose interest inor feel too tired for personal or family hobbiesand recreational activities. This can intensifythe negative effects of stress, creating a viciouscircle.

Striking a balance between work and life/familycan be an impossible task. Juggling childcare

arrangements, sick family members, elder care,and extended family responsibilities are difficulton their own. When stress is added to theseresponsibilities, workers ability to meet all of their commitments becomes harder. Somethinghas to give. Workers and their families well-being are typically what suffer most.

Workers dividedStress can create conflict in the workplace thatshows up as anger, frustration, envy and mis-trust. These can be destructive forces in a CUPE

workplace, especially if directed at other CUPEmembers someone to blame other than theemployer. Co-workers, stewards, staff represen-tatives, and other union workers might become

targets. Conflict can isolate workers from oneanother. Some may even blame themselves fortheir stress, compounding the problem.

These circumstances divide workers and harmunion solidarity. It is vital to understand thatworkplace stressors such as how work isorganized by your employer cause the stress,not co-workers or the union. Dont let employertechniques such as performance monitoring and

surveillance devices create competition andresentment. In a divided workplace, theemployer gains and workers lose. There isstrength in numbers. When confronted by stresshazards, members need to remember that solu-tions and strategies for change depend onworker solidarity.



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Work-related musculoskeletaldisordersStress can contribute to work-related muscu-loskeletal disorders (WRMDs), also known as

Repetitive Strain Injuries (RSI) andMusculoskeletal Injuries (MSI). WRMD is acatchall phrase for various injuries (e.g., carpaltunnel syndrome, epicondylitis). These injuriesusually involve repeated trauma to muscles,tendons, and peripheral nerves.

WRMDs have a work organization component.Ergonomic injuries do not only result from man-ual working techniques, for example, how aworker holds a mop when mopping, or how aworker lifts materials. The effects of stress dueto poor workplace organization can also con-tribute to an ergonomic injury.

Specific stress risk factors that have been linkedto WRMDs include:

Job dissatisfaction. Intensified workload. Monotonous and repetitive work. Low job control. Role uncertainty. Inadequate work-rest cycles. Limited social support from supervisors.

Workers are more vulnerable to WRMDs whensuffering specific physiological reactions tostress. For example, stressors activate the cen-tral nervous system, which in turn increasesmuscle tone. This can lead to tendon biome-chanical loading, which adds to the risk of

WRMDs. Stressors stimulate the autonomicnervous system, triggering the release of adren-alin and noradrenalin. Muscles and tendonsthen tighten, reducing the flow of nutrients to

the tendons. These tendons will not self-heal if there are microlesions (small injuries) to thetendon fibres caused by ergonomic strain. Theresult: chronic muscle fatigue and muscle pain.An activated central nervous system (brought onby stress) can also cause corticosteroids to bereleased. This has been linked to tunnel syn-dromes. The central nervous system also releasescytokines that can cause tendon inflammation,contributing to or causing WRMDs.

BurnoutWorking under continuallystressful conditions can leadto burnout the end result of physical and mental exhaus-tion caused by exposure to

toxic stressors.Some symptomsof burnout are:

Emotionalexhaustion, feeling emotionally overextendedand nearly depleted of emotional resources.

Negative feelings, irritability, and a deterio-rated sense of self-image.

A decline in feelings of competence and adecrease in work performance, feeling help-less and hopeless.



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Specific workplace stressors that cause burnoutinclude role conflict at work, lack of control overones job, and lack of social support on the job.Sufferers of burnout can be ill and away from

work for long periods. They often withdrawfrom day-to-day life. Unlike depression, whichcan have many causes, burnout is directlylinked to stressors at work. And it usually affectspeople without prior psychological illness.Stress often results in increased absenteeismand extended leave to recover from burnout andother negative health outcomes.

Synergistic effects of stress and otherdiseasesThe effects of stress can work synergistically,combining with other illnesses and diseases tomake worse those illnesses and diseases.

An American study showed that workers whosuffered toxic stress levels at work were three

to five times more likely to catch a cold. Theirstress levels made them more vulnerable toviral infection. In Finland, researchers studiedthe synergistic effects of stress and heart dis-ease among manufacturing sector workers. Thestudy found that workers suffering high stresslevels had twice the risk of death from heartdisease than workers in the same jobs that hadlow stress levels. A study of telecommunicationsworkers looking at ergonomic injuries foundhigher rates of upper extremity musculoskeletaldisorders among those with high stress levels

caused by job pressures and low decision-mak-ing control at work. If workers suffer the effectsof stress, they are at greater risk of other ill-nesses and injuries.

Critical incident stressThis condition sometimes known as post-traumatic stress can occur when workers areexposed to a single, severely stressful circum-stance, such as a natural disaster, road accident,murder or assault.

Critical incident stress is a serious condition thatrequires professional treatment and care. It is aserious health and safety hazard that must beprevented. In workplaces where there is thechance of critical incident stress affecting workers,programs to respond to workers needs must bein place. All steps should be taken to preventcritical incident stress.

Critical incident stress is beyond the scope of this guideline, which focuses on normal andtoxic stress. CUPEs Health and Safety Branchhas a separate critical incident stress fact sheetavailable.



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Part 22.1 Is stress a health andsafety hazard for you?

Stress is sometimes not regarded as an obvi-ous health and safety hazard. The key is toidentify the causes and symptoms, discussedin Part 1 of this guideline, and be preparedto act.

On the surface, stress may not seem as direct

a threat as asbestos, infectious diseases, orneedlestick injuries. With those hazards, thethreat is more clearly identifiable and the nega-tive health outcomes are well documented anddirect. Stress is not as cut and dry. It is relatedto work organization issues and their outcomes.For example, job insecurity is a cause of stress,which in turn can lead to WRMDs, burnout, oranxiety. These outcomes might be attributed tosome cause other than job insecurity. Burnout oranxiety is often dismissed as being caused byan individuals lifestyle or their inability tocope. That incorrectly shifts blame to the workerinstead of their workplace a classic employermanoeuvre.

2.2 Identify the problem

We need more communication to break the isolation caused by stress.Jose Duarte, CUPE member, 8th National Health and SafetyConference

Many of us know that stress is whats causing

our health, job satisfaction, morale, family andpersonal relationships to deteriorate. CUPEmembers know it too. Its not the membershipthat needs to be convinced that stress hasbecome a significant health and safety hazard:its the employer.



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Surveys and questionnairesSurveys usually involve handing out a writtenquestionnaire. Its a great tool for gauging theextent of a health and safety issue. A sample

stress questionnaire is provided at the end of this guideline. It can be used in full or in part. If it is too long, just use the questions that are rel-evant to your local or workplace.

Often the employer claims that there is no evi-dence for a problem like stress. When memberscan show the results from a questionnaire, theytake a major step towards addressing stress bygaining recognition for the hazard.

Its a good idea to have either the union,through its health and safety committee, or the

joint (union/management) health and safetycommittee involved. Prior to distributing thesurvey, hold some type of membership informa-tion session. Ensure that members know the

questionnaire is confidential and explain itspurpose: to assess the stress problem in theirworkplace as a first step towards making nec-essary improvements to eliminate the hazard.

Any survey or questionnaire must be clear, con-cise and basic. It may be necessary for the localto have the questionnaire translated, taking intoaccount dominant first languages among mem-bers in their workplace.

To avoid any hassles later regarding the legiti-macy of the process and results, the joint healthand safety committee and/or the employershould approve the questionnaire.

Once the survey is ready, it should be distrib-uted throughout the workplace. The unionrepresentatives on the joint health and safetycommittee should be responsible for collectingcompleted questionnaires.

There needs to be a plan and process in placefor tabulating the questionnaires that areagreed to by those involved (e.g., union, unionhealth and safety committee representatives,etc.). Once the results are calculated, theyshould be presented and discussed at a unionmeeting, highlighting those issues that are cen-tral to stress in your workplace. Use the relevantsections of this guideline to help explain thestress hazards in your workplace. The question-

naire results should then be presented at a jointhealth and safety committee meeting, prefer-ably in a session or sessions dedicated only todealing with stress hazards.

The results of the questionnaire need to beacted upon. It is not enough to just take thepulse of the membership. The questionnairemust form the basis for action by the jointhealth and safety committee to find solutions toworkplace stress hazards.



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If the employer or management representativeson the joint committee do not want to co-operatewith conducting a survey, the union shouldsurvey the membership on its own. Similar

procedures to those already described shouldbe followed. However, the level of co-operationwithin the workplace may not be the same,especially when it comes time to discuss thematter at the joint health and safety committeelevel. Perseverance will be required. The jointcommittee should be the staging ground topresent the unions survey results; the first leverfor change on stress. The committee is a forumfor concretely addressing health and safetyhazards and union members must use it to pushfor change.

MappingMapping techniques can also be used in yourworkplace, both to identify the stress hazardsand the health effects. CUPE has used mapping

extensively in workshops, schools and researchprojects.

Mapping is based on the idea that a picture isworth a thousand words. It uses basic visualand participatory action research principles. Byrepresenting hazards and their effects visually,they can be more easily recognized and moreclearly expressed than by written explanations.

Mapping is a participant-driven form of collectinginformation that recognizes workers as a sourceof valuable information and producers of knowl-edge. Health and safety improvements are morelikely in workplaces where workers, with theirunion, are involved in identifying problems and

developing solutions.



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Three types of mapping are typically used toassess a health and safety hazard: body map-ping, hazard mapping and your world mapping.Body mapping shows the physical and psycho-

logical effects of stress hazards. Hazard mappinglooks at the layout of a workplace, chartingwhere hazards exist. Your world mapping paintsa wider picture by looking at how workplacehazards affect workers beyond the workplace,for example, how stress hazards affect familylife. These three forms of mapping provide acomplete picture of health and safety hazards.

CUPE has developed extensive mapping materi-als. These materials are available to any inter-ested CUPE local by contacting the NationalHealth and Safety Branch orvisiting the cupe.caweb site.

2.3 Taking action

If weve got stress in the workplace, we should fill out the accident/incident reports, like we do

with any other problem.Cyril Wilson, CUPE member, 8th National Health and SafetyConference

This section covers specific actions for addressingstress in your workplace. Together with the solu-tions and strategies section that follows, it is aplan for dealing with workplace stress.

Right to refuseEmployers have a legal responsibility to providea safe and healthy workplace under both

Canadian federal and provincial health andsafety legislation. This principle is commonlyknown as the general duty clause. It appliesto stress. The employer is responsible forproviding a working environment where

stressors like any other hazards areeliminated, controlled or minimized.

CUPE members in most workplaces havethe right or the obligation to refuseunsafe work, as stated in the federal

and provincial health and safety legislation.Usually, the right to refuse involves the workerrecognizing a hazardous or unsafe working con-dition that might affect her/his health or thehealth of someone else. The worker then clearlynotifies the employer or supervisor that she/he isrefusing unsafe work in accordance with thehealth and safety legislation.



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The employer and/or the joint health and safetycommittee must then investigate the workrefusal. If the matter is not resolved, a govern-ment occupational health and safety officer must

intervene to facilitate a resolution.

Traditionally, the right to refuse has been used inother areas, such as with possible exposure totoxic chemicals or cases where work-ers are required to work in con-fined spaces without proper engi-neering controls. CUPEs positionis that the right to refuse is alegitimate way to address ahealth and safety hazard. Thesame procedure for refusingunsafe work should be used withstress. But the grounds for refusingunsafe work should be directlystated as being due to stress haz-ards, specifying some direct sign of

stress (e.g., time pressures, rushingunsafely through tasks to completework, violence, harassment and bullying, etc.).

Stress is a health and safety hazard that cancreate unsafe working conditions. A work refusalis therefore a valid and direct way to combat theproblem. Refusing unsafe work on the groundsthat stress is a hazard forces the employer andthe joint health and safety committee to dealwith stress.

Take your breaksIts always a good idea to take your breaks.Slowing down and stopping your work on yourbreak will help to relieve stress. It will also help

you avoid the cumulative effects of toxic stress.

If your collective agreement states that you areentitled to coffee and lunch breaks, make sureyou are taking these breaks. Similarly, if yourcollective agreement states that you have specifichours of work, then stick to those hours of work.

Provisions that define breaks and the length of work days ensure that workers get a proper restfrom work and that they are paid for all of thetime they spend working.



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The body and mind need to rest. A fifteen-minute break can really help. Taking a breakreminds members that they have some controlover their job. Asserting control is central to elim-

inating workplace stress.

Taking a break also signals to employers andsupervisors that CUPE members know theirrights at work and that they are able to exercisecontrol where they have it. This is a vital point. If a supervisor sees a worker working throughher/his break on a regular basis to completetasks, that supervisor will assume that the work-er does not need the break and will likely assignat least the equivalent of fifteen minutes morework. Taking breaks is a sign of solidarity amongworkers, as workers in the same job should beworking the same hours, at the same pace.

Report stress health and safety hazardsCUPE has developed a Health and Safety

Complaint Form and a Violent IncidentReport Form. These two forms are good tools fordrawing attention to a health and safety hazard.The forms are colour coded, with copies that goto the employer, the joint health and safetycommittee, the local union, and the worker.

The Health and Safety Complaint Form can andshould be used to report stress health and safetycomplaints. One way to ensure the form is usedto report stress and other hazards in CUPE work-

places is to negotiate the forms into the healthand safety committee Terms of Reference. Byusing the complaint form, a paper trail is createdensuring all parties that should know about ahealth and safety hazard do know about thathazard. Because the joint health and safety com-mittee receives a copy, it should be fully aware of the stress hazard and act upon members con-cerns. CUPE members must report stress hazards,as we do with any other workplace health andsafety hazard.

Joint health and safety committeesWorkplace stress cannot be tackled withoutdirect involvement from joint occupational healthand safety committees. CUPEs National Healthand Safety Branch has focused a lot of attention

on revitalizing health and safety committees. Inrecent years, committees have become too warmand fuzzy with little action on health and safetyissues. CUPEs position is that members not buyinto management co-operative schemes andinstead realize that health and safety committeesare mechanisms for change. Joint committeesmust be a place where solutions to health andsafety issues are created and acted upon.



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2.4 Solutions andstrategies for change

We need to create, adapt and maintain

jobs that suit our physical, mental and social conditions that will help eliminate stress hazards.Ross Ferlenda, CUPE member, 8th National Health andSafety Conference

The solutions and strategies outlined belowcomplement the actions described in theprevious section. Where the actions areimmediate ways to confront stress, solu-tions and strategies are broader policyand structural changes that aim to preventor eliminate stress in CUPE workplaces.

Workplace reorganizationCUPE workplaces need to be reorganized toeliminate stress hazards. Proactive prevention at

the source is the most effective way of solving ahealth and safety problem. The following organi-zational changes will help prevent and eliminatestress:

Measures should be put in place to increaseworkers real control. Examples includegiving workers more autonomy, more partici-pation in decision-making, more opportunityfor self-directed work, and more opportunityto use and develop their work skills.

Workers should have the right to refuse over-time and overtime should be capped.

Workloads must be decreased and mademore manageable for workers and sufficientstaff levels must be set.

Sufficient rest times and breaks must beprovided.

Job designs must be reviewed to lower stresshazards, for example, working alone shouldbe eliminated, and work tasks should beassigned in an appropriate manner accordingto experience and competence. Any jobredesign must have meaningful worker input.

Monotonous work should be avoided oreliminated where possible and more varietyof work tasks should be incorporated intoworkers jobs.



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The physical features and arrangement of workspaces must be redesigned to lowerstress hazards (e.g., minimize noise, introducenatural lighting, ensure proper ventilation is

in place, etc.). Flexible work arrangements should be put in

place to accommodate workers responsibilities(e.g., between family and work).

Communication needs to be improved toavoid workers suffering from stress in silenceor isolation. Improved two-way communica-tion will facilitate worker input on job designand other factors.

Workplaces need to foster a supportive work-place climate to help eliminate stress, forexample, by not tolerating bullying, harass-ment and violence in any form.

Supervisors need to be supportive of workers,for example, by listening to workers ideasand concerns and acknowledging workerscontributions to the workplace.

Leave days should be provided to permitworkers time for childcare, elder careand personal reasons.

Employers should provideEmployee Assistance Programs(EAPs) as a way to counter theeffects of stress, keeping in mindthat these programs do notreplace the need for employers toprevent and eliminate workplace stressors.

Governments need to increase public sectorfunding to counter staff shortages, overwork,and other stressors.

Employers should reduce sudden changes(e.g., new technologies, abrupt work shiftrearrangements) in the workplace.

Split shifts should be eliminated.

Training to identify stress hazards should beinstituted, preferably union-provided training.

Work that is reorganized following these recom-mendations will be less stressful. The changesand supports will help prevent stress by reorgan-izing work to eliminate stress hazards.

Worker controlWorkers need control for their jobs to be fulfilling.Work must be a meaningful part of our lives.Many of the recommendations in the previoussection will provide greater worker control. Amore democratic workplace is a safer andhealthier workplace.



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Workers also need to fully utilize existing controlsto combat stress. For example, stress health andsafety hazards must always be reported andbrought to joint health and safety committee

meetings. Likewise, workers must insist thatstress hazards be inspected and investigated by

joint health and safety committees or health andsafety representatives at their workplaces.Actions such as these are good examples where-by workers can exercise their existing control tohelp prevent stress.

Stress policyA policy is a good starting point forchange on a health and safety issue.The health and safety committee in yourworkplace should be instrumental intabling and pushing for the adoption of a workplace stress prevention policy. Apolicy would start from the premise thatstress is an occupational health and

safety hazard, and that all steps possi-ble should be taken to prevent the haz-ard. The policy should contain a defini-tion of workplace stress.

Further specifics could be added to the policy. Forexample, it could have anti-bullying and anti-harassment statements that aim to get rid of workplace stress. A policy could also include astatement about the pace of work, whereby anypace of work that creates stress, and therebyposes a health and safety hazard, should beprohibited.

The exact range of a stress policy in a givenworkplace may vary. What should be central isthe universal principle of health and safety lawin this country: the employer is obligated to pro-

tect workers health. The policy should reflectthis, including a statement from managementthat stress is an organizational problem that it iscommitted to solve. The policy should also outlinea reporting procedure for workers experiencingstress.

A good policy paves the way forfurther solutions andstrategies, for example,collective bargaining lan-guage on stress, the roleof the joint health andsafety committee, andeven changes to legisla-tion. Any policy should bereviewed from time to

time to assess its effec-tiveness. Policies can beupdated and revised if necessary.

Stress health and safety contractlanguageStress can be addressed through collective bar-gaining. Collective agreements should alwaysaim to improve workers health and safety.Because stress is largely caused by how work isorganized, collective agreements can be used toreorganize work to eliminate stress hazards.



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Any collective agreement language on stressshould have prevention of the hazard at its core.A definition of workplace stress should be spelledout in the collective agreement to frame stress

hazards. The concept of normal versus toxicstress could be mentioned in the definition.

Language should set some limits on workers jobdescriptions to avoid toxic stress working condi-tions. Collective bargaining should consider provi-sions that aim to reduce and eliminate stress,such as:

Set minimum staffing levels. Establish flex-time and job sharing initiatives. Create more favourable shift arrangements

and permit workers to swap shifts with eachother to accommodate family and otherresponsibilities.

Set limits to overtime. Create shorter or compressed work

weeks. Allow for voluntary reduced hours at

work to accommodate personal orfamily needs. While working reducedhours, workers keep their full-timestatus, seniority and full benefits.

Establish sufficient rest breaks. Create childcare provisions and

parental leaves to address work-familyimbalances.

Provide time and resources for members toreceive union health and safety training onstress and other health and safety issues.

Language should include provisions for the jointhealth and safety committee to investigate stresshazards and to make recommendations forimprovements.

Any local entering into collective bargainingshould look at their stress situation and push tointegrate stress language into their collectiveagreement. But be wary when you are negotiat-ing stress language if your employer only wantsto talk about wellness programs, exerciseschemes, and other health promotion, band-aidsolutions that do not prevent stress. Research hasshown that any benefits that come from stressmanagement programs are merely temporaryand are lost if workers return to a work environ-ment where stressors remain unchanged. Do not

negotiate for wellness programs andother suchschemes asthese will not

prevent stress hazards.

Stress legislation andregulationsWhile Canada has no explicit stress

legislation or regulations, theresponsibility for providing a

healthy and safe workplace still restswith employers. This responsibility is known asthe general duty clause. But it does not go farenough to prevent stress hazards. Legislation isneeded that explicitly covers stress as a healthand safety hazard.



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There are legislative examples from other parts of the world that address workplace stress. InDenmark, the Order on the Performance of Workis a regulation of the Work Environment Act . That

order states that workers mental or physicalhealth must not be harmed due to work organi-zation factors, such as the rhythm of work, repet-itive work and isolated work.

In Sweden, the Working Environment Act sayswork content, technology and organization mustbe: designed in such a way that they do notexpose the workers to undesirable physical andmental damage due to excessive strain that leadsthem to suffer sickness and accidents. TheSwedish law further states that work should aimto: involve a compensation in the form of diver-sity in work, satisfaction, social participation andpersonal development. This basically means that according to Swedish health and safety law work must be meaningful and fulfilling to the

worker in order to prevent physical and mentalstrain. The Swedish Work Authority has alsostarted a program to recruit new health and safe-ty inspectors with psychosocial and work organi-zation qualifications. These inspectors are beingsent out to workplaces to inspect stress, work-load, and other work organization hazards.

Similar legislation could be beneficial in Canadafor eliminating stress. Also, the language from theScandinavian examples could be integrated intostress collective agreement clauses and policiesin Canadian workplaces.

Of course, legislation on the books is only part of the battle. As with other health and safety haz-ards, enforcement of the law is fundamental toensure workers health and safety is protected.

CUPE members can call in government healthand safety inspectors to investigate and issueorders where workers refuse unsafe work due tostress hazards or where workers make com-plaints when stress hazards are not dealt withby employers and/or joint health and safetycommittees.

Workers compensationCUPE members can get compensation for stress-related injuries and illnesses in some parts of thecountry. Compensation boards in Quebec andSaskatchewan have recognized chronic (i.e.,toxic) stress claims. Other jurisdictions usuallyonly recognize critical incident stress claims thatresult from a single, highly stressful or traumaticevent.

Compensation boards are reluctant to open whatthey perceive to be the floodgates on stressclaims by rewarding compensation for stress-related illnesses and accidents. But this doesnot mean that CUPE members should not file forcompensation in cases of toxic stress. Only bypressuring compensation boards by filing stressclaims, as well as arguing the stress componentof other claims (e.g., ergonomic injuries) is thereany hope to reverse the current practice to denystress claims.



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With the work organization conditions faced bymany CUPE members, it can be argued thatstress plays a role in almost any illness or acci-dent. This argument should be made to help

hasten the process so that compensation boardsrecognize their duty to fairly compensate workersdue to the harmful effects of stress.

We need to remember that the focus should beon prevention first and foremost in order to avoidthe need for compensation.

Union involvementCUPE is committed to eliminating workplacestress by recognizing that stress is a health andsafety issue. Ending stress in CUPE workplacesrequires the same diligence and dedication asother health and safety issues demand.

CUPEs Health and Safety Branch has put stress and other work organization health and safety

issues, like overwork, violence and ergonomics front and centre on the unions health and safetyagenda. The union recognizes the changingnature of work has resulted in new health andsafety hazards for CUPE members. Whats more,issues like stress, overwork and violence can besignificant contributing factors to other healthproblems, such as WRMDs, depression and psy-chological illnesses. Members can reach out totheir union for support and assistance for dealingwith workplace stress.



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2.5 Summary: stress dos and donts

Do: Regard stress as a health and safety hazard. Evaluate the stress hazards in your workplace using the survey and/

or mapping techniques described in this guideline. Take your breaks and full meal break allotments to give your body and mind time to recover

from the rigours of work. Start work on time and leave work on time. Refuse unsafe stressful work situations. Report stress hazards.

Put stress on the agenda at joint health and safety committee meetings in your workplace. Recommend work organization changes at joint health and safety committee meetings to

eliminate stress hazards. Recommend workplace stress policies be put in place through joint health and safety

committee meetings. Bargain contract language that aims to eliminate workplace stress. File compensation claims for stress-related injuries and illnesses. Participate within CUPE to share knowledge, experience and solutions to eliminate stress.

Dont: Suffer in silence. Become isolated from your union Sisters and Brothers.

Tolerate stress hazards in any form. Work beyond your means. Work through your breaks. Work at an accelerated pace. Work unpaid overtime. Ignore the health and safety effects of stress. Leave solutions to stress up to your employer. Let stress issues fall off the table at joint health and safety committee meetings.



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ConclusionWorkplace stress is hazardous to CUPE mem-bers health. Stress is a workplace health andsafety hazard that must be prevented and elimi-nated, like any other workplace hazard. After-the-fact solutions, such as wellness programs,do not eliminate workplace stressors.

Stress is caused by many different sources, sev-eral of which centre on work organizationissues. Stress can cause numerous negative

health outcomes, such as increased incidence of WRMDs, elevated rates of heart disease,burnout, depression, and other conditions.

CUPE members, through solidarity actions, mustcombat stress. To start, we must take stressissues to joint health and safety committeemeetings and bargain provisions in collectiveagreements to defend against harmful stresseffects.

More and more we are realizing that the wayour work is organized can be harmful to our

health and safety. Stress is the perfect exampleof a negative health outcome that results frompoor work organization. When workers do nothave control and lack decision-making freedomat work, they will suffer from stress. Workersmust have input into how their jobs are per-formed to give meaning, value and purpose totheir work and to prevent and eliminate stress

hazards.

MF/cr/opeiu 491


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StressWhat is stress?Workplace stress is a serious health and safe-ty hazard that can have devastating effects.Stress occurs when there is a poor matchbetween workplace demands and a workers

degree of control. We feel stress as a result of demands that are placed upon mind andbody. Like violence and overwork, stress is asignificant health and safety hazard directlyrelated to how work is organized.

There are two forms of stress. Normal stressis characterized by:

Stress comes (facing an immediatethreat/demand). Stress goes (dealing with the stress). Stress is over (the body relaxes, no longer

feeling stressed).

An example of normal stress is short-term anxietybecause you have lost something important. Toxicstress is different, characterized by:

Stress comes (facing a demand or threatthat does not stop).

Stress stays with you (you have no way of dealing with the stress).

Stress builds up (you can never relax andthe stress is not eliminated).

Workers can experience toxic stress whenthey are exposed to staff shortages, harass-ment, bullying, noise, and other hazards. Thisform of stress often leads to negative physicaland psychosocial effects.

The Generalized Stress Response is thephrase used to describe a variety of physical

reactions to stress: increased metabolism,blood pressure, cholesterol and fatty acids inthe bloodstream; decreased protein synthesis;faster blood clotting; increased production of stomach acids, blood sugar for energy; local-ized inflammation; tensed up muscles; andsweating to cool muscles.

Stress can be associated with severe physicaland/or psychological effects, such as sleepdisorders; fatigue; chronic aches and pains;depression; changes in sexual activity; con-flict with family, friends, and co-workers;weight gain or weight loss; greater suscepti-bility to injury; immune system depression;and greater vulnerability to illness and disease.

What causes stress?Stress is largely caused by poor work organiza-tion factors such as: lack of control and conflict-ing work demands; lack of decision-making par-ticipation; lack of training and direction; unclearwork responsibilities; privatization, outsourcing,


HEALTH AND SAFE

FACT SHEET


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downsizing, mergers, staff cutbacks, and restruc-turing; overwork and poor work shift schedules.Cutbacks, privatization, reorgs, and downsizinghave contributed to a heightened sense of job

insecurity. All of these factors cause or compoundworkplace stress.

Control is a central work organization factorlinked to stress. Lack of control at work, nothaving the ability to decide how a job isdone, can make workers sick. Excessivedemands also cause stress. When lack of control is combined with high demands, aworker will almost certainly suffer high stresslevels. These factors can create toxic work-place stress, causing increased heart diseaseand possibly death, depression, exhaustion,low self-esteem, and increased upperextremity musculoskeletal disorders.

Physical working conditions such as noise

and vibration, temperature extremes, over-crowding, exposure to toxic substances, andpoor air quality also cause stress. Bullying,harassment and violence can cause stressand are linked to work organization.

What are the hazards?Stress affects the physical and psychologicalhealth of CUPE members. But it also spills outof the workplace, negatively affecting mem-bers family lives. The cumulative effects of stress can be devastating.

Major outcomes of stress are: Psychological disease and social and

behavioural changes (e.g., depression,anxiety, sexual dysfunction and suicidal

thoughts). Heart disease. Various physiological outcomes (e.g.,

headaches and migraines, impaired diges-tion, ulcers and diabetes).

Personal and family life conflict. Workers divided. Work-related musculoskeletal disorders. Burnout. Synergistic (combined) effects of stress

and other diseases (i.e., stress can makeworse other diseases and disorders).

Critical incident stress.

Identify the problemA first step is to recognize that stress is ahealth and safety hazard in your workplace.

If the negative health outcomes mentionedabove are affecting your members, stress islikely a significant contributor. Surveys andmapping techniques are excellent tools toidentify hazards in your workplace. A surveycan be done in co-operation with theemployer, in which case the union approvesthe survey and is involved in collecting andassessing the information generated. Theunion should conduct its own stress survey if the employer resists the idea or denies thatthere is a problem. Body mapping, hazardmapping and your world mapping techniquescan be used instead of or in addition tosurveys to identify stress hazards.



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ActionsStress hazards largely centre on issues of control and work organization. Taking actionon stress involves members exercising their

own control at work.

The following actions can help combat stress: Refuse unsafe stressful working conditions. Take your breaks. Report stress health and safety hazards. Take stress issues to the joint health and

safety committee.

Strategies for changeThe strategies outlined below complementthe actions already described. CUPE work-places need to be reorganized to eliminatestress by: Giving workers real control (e.g., more

autonomy, more participation in decision-making and more opportunity for self-

directed work). Workers should have the right to refuse

overtime. Workloads must be decreased and suffi-

cient staff levels must be set. Monotonous work should be eliminated. Physical work features should be

redesigned to lower stress hazards (e.g.,minimize noise, introduce natural lighting,and ensure proper ventilation is in place).

Governments should increase public sec-tor spending to counter staff shortages,overwork and other stressors.

Employers should reduce sudden changesin the workplace (e.g., new technologies,abrupt work shift arrangements).

Training to identify stress hazards should

be instituted, preferably union-providedtraining.

Workers need control for their jobs to be ful-filling. Work must be a meaningful part of ourlives. Acted on, many of these recommenda-tions will provide greater worker control. Amore democratic workplace is a safer andhealthier workplace.

A stress policy is a good starting point forchange. The health and safety committee inyour workplace should be instrumental intabling and pushing for the adoption of a work-place stress prevention policy. Stress can beaddressed through collective bargaining, asagreements should always aim to improve

workers health and safety. Because stress islargely caused by how work is organized, col-lective agreements can be used to reorganize work to eliminate stress hazards.

While Canada has no explicit stress legisla-tion or regulations, the responsibility for pro-viding a healthy and safe workplace stillrests with employers. This responsibility isknown as the general duty clause. But it doesnot go far enough to prevent stress hazards.Legislation is needed that explicitly coversstress as a health and safety hazard. CUPEmembers can get compensation for stress-related injuries and illnesses in some parts of



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the country. Compensation boards are reluc-tant to open what they perceive to be thefloodgates on stress claims by compensatingfor stress-related illnesses and accidents.

But its vital that CUPE members file for com-pensation in cases of toxic stress. Only bypressuring compensation boards by filingstress claims, as well as arguing the stresscomponent of other claims (e.g., ergonomicinjuries), is there any hope to reverse the cur-rent practice. CUPE is committed to eliminatingworkplace stress by recognizing it is a healthand safety issue. Ending stress in CUPEworkplaces requires the same diligence anddedication as other health and safety issuesdemand.

This fact sheet provides some information toaddress the hazard. More detailed informationis presented in the CUPE health and safetyguideline Enough Workplace Stress: Organizing

for Change.

For more information contact:National Health and Safety BranchCUPE21 Florence StreetOTTAWA, OntarioK2P 0W6Tel. (613) 237-1590Fax (613) 233-3438Email: [email protected]



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This is a sample questionnaire. Please feelfree to use portions of the questionnaire thatare relevant to your workplace, adjustingquestions as needed.

Assessing how stress affects CUPE membershealth and safety is an important first step toprevent stress health and safety problems.We are interested in your experiences withstress as a health and safety hazard whileworking for your employer.

Please answer the following questions bychecking the appropriate box or writing youranswers in the space provided.

Work organization

1. In the past two years has your workplacestress increased?

YesNoDont know

2. In your opinion, has the quality of yourwork suffered because of workplacestress?

YesNoSometimes

3. In your opinion, has your job satisfactiondeclined because of workplace stress?

YesNoSometimes

4. Has your job description or list of official job changed in the past two years?

YesNoSometimes

5. If your job description has changed,how has it changed (please check asmany as apply to you)?

More duties have been addedNew duties not previously part of my

job have been added

Faster rate of workHigher demands/expectations fromemployer/public/other departments,etc.Less training has been providedInadequate training for newduties/new technologiesLess supervisionMore supervisionIve been given supervisory type duties

More paperworkMore meetingsOther (please specify)

6. In the past two years, has your level ofcontrol over your job:

IncreasedDecreasedRemained about the sameDont know/Cant say

7. In the past two years have the staffinglevels in your work area or workplace:

IncreasedDecreasedRemained about the sameDont know/Cant say

Health and safety stress questionnaire



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15. Are you provided sufficient tools/equipment/machinery/supplies to doyour job?

YesNo

Sometimes

Health effects

16. Is stress a health and safety hazard/problem in your workplace?

YesNoSometimes

17. In your opinion, has absenteeism due tostress increased at your work area orworkplace?

YesNoDont know

18. During the past two years, have you takensick days because of stress (even if youdidnt identify those days as stress-relatedon your leave forms)?

YesNo

19. If you have taken time off sick due tostress in the past two years, how manyworking days were you away from work?

1-3 days4-6 days7-9 days

10-14 days15+ days

20.During the past two years, have you takentime off using vacation days, holidays, orleave time due to the health effects of stress?

YesNo

21. If you have taken time off because ofstress using vacation days, holidays orleave time in the past two years, howmany working days were you away fromwork?

1-3 days4-6 days7-9 days10-14 days15+ days

22.In the past two years have you experi-enced any of the following health effectsbecause of workplace stress? (Pleasecheck as many as apply to you.)

FatigueDepression and anxietySick more oftenHeadachesNeck and back painsTrouble sleeping/insomniaJoint/muscle painStomach/digestive problemsHigh blood pressureFeelings of powerlessnessUnable to relaxTense more oftenIncreased use of alcohol and drugsImpact on family and personal lifeMemory loss/troubleconcentrating/confused more oftenOther (please specify)

23.In no specific order, what three healtheffects of stress from the list in question#22 affect you the most?



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24.Have you received Workers Compensationfor a stress-related problem in the pasttwo years?

YesNo

25.In the past two years, have you exercisedthe Right to Refuse unsafe work at yourworkplace because of stress hazards?

YesNo

26.Have you had difficulty taking yourvacation/holidays/time off because of yourstress levels?

YesNoSometimes

Policy issues

27. Does your workplace have a stress policy? YesNoDont know

28.Does your local have contract language inyour collective agreement concerningstress?

YesNoDont know

29.In the past two years have you everraised stress concerns with any of the

following (please check as many as applyto you)?Co-workersUnion representativeJoint health and safety committeeSupervisorEmployer

FamilyOther (please specify)

Health and safety committees

30.Does your local have a joint (union/management) health and safety committee?

YesNoDont know

31. Does your local have a union-only health

and safety committee? YesNoDont know

32. Do you sit on a joint health and safetycommittee?

YesNo

33. Does your committee meet regularly? YesNoDont know

34. Have stress health and safety problemsever been raised at your joint health andsafety committee meetings?

YesNoDont know

35. Have any recommendations ever beentabled at your joint health and safetycommittee meetings to deal with stress?

YesNoDont know


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36. If recommendations have been made, hasyour employer acted on them and madechanges in your workplace to solve stressproblems?

Yes

NoDont know

37. Do you think your joint health and safetycommittee should be doing more to solvestress health and safety hazards?

YesNoDont know

38. What suggestions do you have for solvingstress problems in your workplace?

General information

39. Are you?FemaleMale

40. What is your age?Less than 20 years20-29 years30-39 years40-49 years50 or more years

41. How long have you been working in yourcurrent position?

Less than one year1-2 years2-5 years5-10 years10-15 yearsMore than 15 years

42. What type of work do you do?Social service workerHospital workerNursing home workerHome for the aged (public)Home for the aged (private)Educational workerTransportation workerMunicipal workerLibrary workerRecreation workerOther (please specify)

43. Do you work?Full timePart timeTemporary/Casual/Auxiliary



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44. Please use the space below to write anyremarks you might have about stressthat you feel have not been addressed inthis questionnaire, or any other commentsthat you might have about stress as a

health and safety issue.

Thank you for completing the questionnaire.



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(Psychology, Self-help) Enough Workplace Stress - Organizing for Change

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