Psychosocial risks and work-related stress: risk assessment

Stress can be caused by multiple factors, which are work and non-work related. In 2005 nearly one in four workers in the European Union (EU)-27 reported to be affected by work-related stress and it has become the second most reported health-related problem at work ^[1]. This article will focus on how to conduct a psychosocial risk assessment in order to properly implement effective interventions to eliminate stress at source and/or to reduce its adverse effects on workers and organisational performance.

Stress is commonly defined as a perceived imbalance between the demands made on people and their resources or ability to cope with those demands ^[2]. Although the experience of stress might appear primarily psychological, stress also affects people’s physical health ^[3]. Stress is not a disease but prolonged exposure to it may reduce effectiveness at work and may cause ill-health ^[2], ranging from mild headache to severe depression. The symptoms of stress in organisations can result in increased absenteeism, high staff turnover, disciplinary problems, violence and psychological harassment, reduced productivity, as well as reduced attention, mistakes and accidents ^[2]. Factors, both inside and outside the workplace, can influence workers’ health. Work conditions can affect workers’ personal health and work-life balance but exposures and activities outside work such as financial problems, unhealthy lifestyles, can also affect workers’ health, and performance at work ^[4]. Therefore not all manifestations of stress at work can be considered as work-related stress and due to its multiple causes stress is thought to be a complex phenomenon ^[5]. Nevertheless, the accumulated scientific evidence over the last three decades on the study of stress clearly suggests that ill-managed work features, such as constant high job demands, tight deadlines, harassment, and unsupportive managerial style, are likely to provoke the feeling of stress in workers ^[6]. Legally, all employers have a general duty to ensure the safety and health of workers in every aspect of their work as highlighted in the Framework Directive 89/391 and other regulatory standards.

This includes risks related to psychosocial aspects of work, usually termed "psychosocial hazards" as opposed to physical hazards such as noise, chemicals, etc ^[7]. To take the measures necessary for protecting workers’ safety and health, employers are obliged to carry out a suitable and sufficient risk assessment (RA) of safety and health. This includes assessing the risk of work-related stress causing personal ill health arising from work activities, and taking measures to control that risk. Measures include the prevention of occupational risks; provision of information and training to workers, providing the means to implement the necessary measures ^[8]. Where elimination of risks is not possible, the risks should be reduced ^[8]. Work related stress is largely preventable by taking appropriate action through conducting a risk assessment which is a systematic examination of aspects of work that could cause injury or harm; whether hazards can be eliminated and, if not what preventive or protective measures need to be in place to control the risks ^[2].

It is the responsibility of employer to ensure a RA is carried out; however, in practice, this may be done by the employer; an employee or manager designated by the employer; or by an external assessor ^[2].

There are key elements to consider when conducting a psychosocial risk assessment. Senior management support for tackling stress in the organisation is crucial. They need to provide the necessary resources for conducting the risk assessment and budgetary provision for improvement actions following the RA ^[9]. Senior managers need to lead the way for healthy workplaces in the same way as they lead towards higher levels of productivity. Managers at the top, but also all line managers, have a role to play in reducing stress within their team by adopting a supportive style leadership style ^[10].

Another key aspect of the RA process is to consult employees and involve them in the process of identifying sources of stress as well as remedial actions. Optimally the workers’ subjective evaluation of their situation should be included. The individual situation obviously varies from one person to the other which makes it inevitable to consult employees instead of only assessing external circumstances that might cause stress ^[3]. Also employees are the ones who are more familiar with their own job and the ones who should be involved in implementing any changes to it; therefore, they are more likely to suggest the most relevant interventions to tackle specific stress issues ^[2].

There are many risk assessment tools and methodologies available to help employers assess the psychosocial risks. The choice of method always depends on the size of the organisation, the type of work activities, the particular features of the workplace and any specific risks ^[8]. A stress RA involves the same basic principles and processes as for other occupational risks. The stepwise approach commonly used includes five steps:

1. Identify the hazards and those at risk
2. Evaluate and prioritise the risks
3. Decide on preventive action
4. Take action
5. Monitor and review

Step 1: Identify hazards and those at risk

This first step involves understanding how the work is done and how harm could be caused. It is important to distinguish hazard from risk. A hazard can be anything, inclusive of work materials, equipment, work methods or practices that have the potential to cause harm. Because of the psychological nature of stress, the term psychosocial hazard or risk factor is often used. A risk is the chance, high or low, that somebody may be harmed by the hazard. A number of psychosocial hazards or factors are known to lead to stress. There may be hazards, which are sector specific, such as the hazards in the education sector. Across all sectors and company size there are psychosocial factors that have been identified in many studies and these include:

Source: Adapted from Cox (1993) and ESENER (2010) ^[7]

There are also factors that may help to determine who or which groups of workers are most at risk including absenteeism, high staff turnover, aggressive communication, accidents, psychosocial problems, health problems and complaints from workers, etc. Particular attention should be paid to groups of workers who may be at increased risk, e.g. workers with disabilities, migrant workers, young and older workers. Existing data collected within the organisation such as sickness absence, staff opinion surveys, staff turnover, occupational health referrals and return to work data may help detecting the ‘hot spots’ or problem areas.

Step 2: Evaluate and prioritise risks

This step is about deciding who might be harmed and it may be necessary to gather supplementary data if existing data mentioned in step 1 is not deemed sufficient to evaluate the risks and take action. This can be done either through valid questionnaires (especially if the risks concern all employees of a large organisation), or interviews (small organisations or one service in a large organisation). In evaluating the risks arising from the hazards, questions to consider are:

• How likely it is that a hazard will cause harm (e.g. number of people reporting high workload, lack of training to do the job, etc.)
• How serious that harm is likely to be (e.g. is there a link between high workload and sickness absence, or health complaints)
• How often (and how many) workers are exposed to the risk
• List the risks in order of importance
• Use the list to draw up an action plan.

Step 3: Decide on preventive actions

Risk assessment is the first step to successful risk management. After completing the risk assessment, preventive measures need to be taken in order of priority, involving the workers and their representatives in the process. Employees will be able to bring their knowledge, experience and understanding of the activity. They will have an understanding of exactly how the work is carried out and will look at it from a different perspective from their manager or supervisor ^[11]. To decide on which actions to take, organisations may conduct focus groups with a sample of workers or require line managers to discuss best solutions during meetings with employees. The key to preventing stress lies with the organisation and management of work and effective measures in preventing work-related stress include the following ^[2], Interventions to prevent and manage psychosocial risks and work-related stress, Social Support at Work, job design.

• Allowing enough time for workers to perform their tasks
• Providing clear job descriptions
• Rewarding workers for good performance
• Enabling workers to make complaints and have them taken seriously
• Giving workers control over their work.
• Minimising physical risks
• Allowing workers to take part in decisions that affect them
• Matching workloads to the capabilities and resources of each worker
• Designing tasks to be stimulating
• Defining work roles and responsibilities clearly
• Providing opportunities for social interaction, and
• Avoiding ambiguity in matters of job security and career development.

In addition, line managers have a pivotal role in influencing employees’ behaviours and motivation through their managerial actions. In relation to stress management, they need to develop managerial competencies (See for example the HSE stress management competency indicator tool) to enable them to understand how their own style of management could cause or alleviate stress within their teams ^[10].

Step 4: Take action

Preventive and protective measures (e.g. redefining workload and timelines to do the work) should be preferred to reactive and individual measures treating stress symptoms (e.g. counselling services). Effective implementation involves the development of a plan specifying: i) who does what; ii) when a task is to be completed; and iii) the means allocated to implement the measures ^[2].

Communication of the findings to all employees is required to ensure that everyone involved in the activity, or exposed to the risk is made aware of the findings of the risk assessment and the actions taken to solve issues ^[11].

Step 5: Monitor and review

The effectiveness of the measures taken to prevent or reduce stress should be monitored. It is necessary to evaluate any action taken to establish what works best, and to assess the effectiveness of all solutions put in place to counter stress; when a significant change occurs, because new hazards may emerge and the work organisation and management need to be re-assessed; and when the preventive measures in place are insufficient or no longer adequate ^[2]. A psychosocial risk assessment may differ from other forms of risk assessments, e.g. assessing physical or chemical risks. As psychosocial hazards are subjective in nature and subject to fluctuations, the review should be done on a periodic basis to ensure that the findings of the risk assessment are still relevant. In addition, line managers have a role to play on a day-to-day basis in monitoring stress within their team. They are best placed to identify early signs of stress within employees and can act swiftly by discussing with the individual the challenges they encounter and how to tackle it before it becomes problematic ^[10].

Documentation of the assessment

The risk assessment for psychosocial risks must be recorded as any other risk assessment. Such a record can be used to: pass information to the persons concerned (workers, safety representatives, managers etc.); assess whether necessary measures have been introduced; produce evidence for supervisory authorities; and revise measures if circumstances change ^[2].

Stress is a multi-faceted phenomenon with multiple causes and requires a systematic approach to its identification and management. It is a growing issue in the workplace especially due to the current economic downturn but it is also an issue that can be prevented and reduced so it does not become detrimental to workers’ health. Employers will gain in performance improvements if employees are able to give their best and do not feel under constant unbearable pressure. Ample guidance and stress risk assessment tools are freely available to employers to support them in managing stress effectively.