Introduction
This article focuses on measures that can be taken to manage psychosocial risk factors faced by cleaners. More details of the work of cleaners and the psychosocial risk factors that they are exposed to are given in this OSHwiki article and EU-OSHA E-facts 51[1]. Factors not covered in these articles, such as digitalisation and the implications of COVID-19, are briefly mentioned below.
When workers do not have the right resources to deal with the demands of their work successfully, this can cause stress and affect their mental and physical health[2],[3]. Psychosocial risk factors faced by workers in the cleaning sector include poor work organisation, violence and harassment (including sexual harassment)[4] as well as exposure to other hazards such as chemicals[5] or poor ergonomics.[6],[7] Cleaning workers generally have limited influence on how they do their work so cannot control many of the psychosocial hazards that affect them, such as the organisation, pace and scheduling of work and the work can be very monotonous. They have few opportunities for career advancement, and they enjoy few professional benefits. They often lack support from their immediate supervisors. They usually have few opportunities to take part in planning and developing their work to reduce psychosocial risks and associated health problems[8],[9]. Other issues identified include stigma, lack of acknowledgment of their work, disrespect and discrimination, low job security and social protection, unsocial hours, working in isolation[10]. The sector also has a high prevalence of female, migrant and ageing workers[11],[12]. Addressing the issues is beneficial for employers. Apart from the benefits for worker health and wellbeing, effective cleaning management systems need suitable cleaning methods, equipment, trained cleaners and reliable communication and consultation[13].
Digitalisation and cleaning work
AI software is available in the market for managing remote teams of cleaners. However, the use of AI software to monitor cleaning workers can lead to work intensification, time-pressure, loss of job control and autonomy, risky and unsafe worker behaviours, increased job stress, and workplace accidents[14],[15].
While the use of digital platforms in cleaning services can open job opportunities for cleaners, they can also increase pressure on cleaners if they find themselves obliged to compete with others on the platform by reducing the pay rate they offer (in addition, the platform will deduct its service fee from the cleaner). Platform cleaning workers have also reported instances of unsanitary work conditions, discrimination, and excessive requests in exchange for a good rating, and abuse [16],[17],[18].
COVID-19
During the COVID-19 pandemic, cleaners reported that worsening of work conditions (e.g. work overload, feelings of job insecurity) and concerns of health risks of health risks (e.g. ‘fear of contagion’ effect for their families, firstly, and for themselves, secondly) were the factors contributing the most to an increase in mental health issues during the first acute period of the pandemic[19]. Essential workers such as cleaners must be included in emergency planning.
Prevent musculoskeletal disorders and psychosocial risks together
Cleaning work is manual and can involve repetitive work, awkward movements and manual handling of loads. There is increasing evidence linking exposure to psychosocial risk factors, such as demanding work, and lack of control over work to musculoskeletal disorders. Exposure to musculoskeletal risk factors, such as fast-paced work, can contribute to psychosocial risks. Prevention therefore requires a holistic, participatory approach to workplace risk assessment that considers both physical and psychosocial factors together[20],[21],[22].
Importance of a positive work environment
Depending on how it is managed, the work environment can either boast workers’ wellbeing or lead to stress[23]. Positive, supportive employment relations with clients and employers, where cleaners’ work is acknowledged, can contribute to a more positive sense of self for cleaners and improve their mental wellbeing, motivation and work performance.
Prevention hierarchy
Psychosocial factors relate to organisational, physical or social characteristics of the work and the work environment. Actions against psychosocial risk factors should follow the usual hierarchy of control measures:
Examples of interventions for specific risk factors
The implementation of measures must be based on a risk assessment with the participation of cleaners. As cleaners are also highly exposed to risk factors for musculoskeletal disorders, it is preferable to address musculoskeletal disorders and psychosocial risks together during risk assessment. Table 1 provides examples of measures that can be taken to address psychosocial risk factors in cleaning work.
Table 1: Prevention and intervention strategies for dealing with occupational psychosocial risk factors in the cleaning profession (adapted from EU-OSHA[24]. See also[25],[26])
| Risk factors | | |
|---|
| Measures | |
|---|
| Time pressure and cleaning schedules | - Ensure realistic time planning – systematic and well planned, with enough time for each task and for unpredictable factors
- Have routine daily cleaning conducted during quiet/slow periods. Map out cleaning tasks to examine issues, plan and prioritise. There are now smart tools that can help with calculating the needed time for a given task and planning cleaning on a needs basis
- Take an overview of the workload for all workers. This will help to divide work fairly between workers.
- Try to vary busy periods with more calm periods, and incorporate this in the planning
- Include periodic deep/comprehensive cleaning
- If workers cannot carry activities within a set time, examine the reasons for this
- Instruct supervisors and workers who are involved with the planning, on how they can contribute to the reduction of work overload
- Check planning regularly and involve cleaners, adapting when necessary
- Provide a rapid/urgent response to spills; require all workers to assist in spot cleaning/spills management
- Accommodate periods of bad weather
| |
| High workload | - Assess how to reduce workload. Look at how the job is done, ergonomic equipment to make the work easier and more efficient, training in good ergonomic methods
- Improve workflow,
- Introduce time buffers,
- Calculate with work breaks and rest time.
- Take account of individual work ability. Would teamwork help?
| |
| Unrealistic work demands - mismatch between employer expectations and worker performance | - Communicate expected results clearly. Agree with cleaners what is realistic.
- Ensure sufficient workers for the workload
- Provide good initial training and refresher training
- Consult workers on how efficiency could be improved, e.g. through work organisation, equipment and training. Have an open channel for cleaners to report problems and take prompt action
| |
Conflicting demands | - Set and communicate priorities,
- Establish a realistic balance between quality and quantity
- Transparent decisions.
- Provide some autonomy to workers to prioritise their workload
- Encourage cleaners to report and discuss conflicts so a realistic solution can be found
- For contract cleaning, make it clear that workers take instructions from the employer, the client cannot add extra tasks and any requests from the client must be discussed with the employer
| |
| Unclear role | - Give all workers an induction into the organisation and their role at a specific site – if possible, in writing. Provide job descriptions in writing
- Ensure workers know who they are reporting to and that the management structure is clear
- Use team meetings to discuss and clarify roles
| |
Monotonous work | - Create diversity in job demands, e.g. creating more meaningful tasks; allowing control, supervision, or preparation of tasks; creating (autonomous) teams, or rotating tasks
- Consider combi-jobs (e.g. jobs that combine caretaking and cleaning)
- Train workers so they can take on new roles
| |
| Lack of control or influence over tasks/work | - Allow cleaners some flexibility in how to do the work.
- Introduce team-based cleaning with different levels of autonomy for the workers. This reduces time spent working alone; it increases responsibility at work to develop personal skills
- Listen to workers about their suggestions for improvements
| |
| Lack of control – AI monitoring | - Question whether such tacking methods are necessary and whether they will result in efficiency gains
- Ensure workers still have control over how to work, and take breaks when they need to (rest breaks, toilet breaks), including toilet breaks AI based on human-centred approach in the design and usage.
- Ensure the use of AI monitoring does not encourage a dangerously high pace of work or result in more monotonous work
- Ensure worker participation and dialogue if they are introduced
- Ensure workers have the skills and training to understand and safely use AI systems.
- Ensure adequate internal communication and flow of information
- Ensure that any performance evaluation is not only based on the AI monitoring. If used, it should be a support tool, not the decision-maker
| |
| Inadequate skills | - Ensure cleaners are trained, equipped and supervised to do routine cleaning. Include training on ergonomic solutions and the use of cleaning substances and provide cleaning workers with appropriate PPE
- Take and active learning approach, and use training to obtain feedback from cleaners on problems in the work and how to solve them
- Organise training so they can develop skills
- Ensure supervisors are trained and able to oversee work practices
| |
| Language difficulties | - Offer language courses.
- Improve recruiting and staff development.
- Provide translated information
- Provide short, simple leaflets
- Use pictograms and colour coding
- Use body mapping and hazard mapping tools for consultation during risk assessment
| |
| Poor communication and lack of information | - Enhance internal communication and flow of information, have regular team talks where the conversations are two-way and everyone is listened to. Act on the outcome
- Make sure information is easily available
- Let workers participate in the decision-making process. Involve workers and their representatives
- Make decisions transparent.
| |
Lack of participation | - Worker oriented management style; ask workers for their opinion, involve workers and their representatives in decision-making
- Vocational training for the management,
- Make decisions transparent.
| |
| Repetitive work, high physical workload | - Manage psychosocial risks and musculoskeletal risks together – these risks are linked
- Job rotation,
- Purchase ergonomic equipment that is suitable for the work environment
- Reduce manual handling
- Instruct workers how to use equipment correctly, and train them in correct cleaning methods
- Plan adequate work breaks
- Assess musculoskeletal risk factors and psychosocial risk factors together
- Enable workers to report problems early and address them
- Train workers to recognise ergonomic risk factors and solutions
| |
| Unsocial hours / shift work | - Improve shift plans / schedules, in consultation with cleaners
- Question whether all cleaning has to be done outside of normal working hours -e.g. make daytime cleaning possible through practical changes (e.g. vacuum cleaning early in the morning or using low-decibel vacuum cleaners to avoid disturbing clients).
- Involve all stakeholders when changing the working hours of the cleaners.
- Communicate schedules with workers,
- Allow changing shifts to help workers manage their work-life balanace
| |
| Lack of recognition/feelings of low status | - Enhance image of cleaning workers, give them the feeling of being important and provide feedback.
- Create a culture where other staff acknowledge the work of cleaners and treat them with respect.
- Ensure cleaner’ work is seen to be valued by the organisation.
- Include cleaners in workplace activities for other staff
- Train older workers to use their skills and experience to mentor young workers and newcomers
| |
| Isolated work | - Better organisation e.g. a team-based cleaning procedure where individual workers can exercise varying levels of job autonomy to reduce isolated work
- Try to create a good working atmosphere
- Ensure the cleaners can easily and quickly contact a superior to request reinforcements or advice
- Make sure assistance is available if a situation threatens to get out of hand
- Ensure cleaners can leave their post for a short (e.g. toilet) break
- Provide mobile phones, telephones, or intercommunication systems if needed
- Ensure cleaners a trained and know what to do in unforeseen circumstances
| |
| Financial insecurity | - Offer competitive wage rates
- Organise or provide the commute to the work location,
- Offer reimbursement of commuting expenses
| |
| Lack of learning opportunities and career development | - Organise vocational training
Support workers who ask for it. - Create diversity in job demands, e.g. by allowing control, supervision, or preparation tasks
- Organise frequent team meetings.
- Organise mentoring systems, where experienced workers mentor newcomers. Train them in this role
| |
| Lack of supervisor support | - Ensure supervisors are trained and able to oversee work practices, manage workers and trained in issues such as bullying and harassment
- Involve workers / ask them for their opinion, e.g through regular team talks with the supervisor where everyone can provide raise issues and make suggestions
- select appropriate personnel for management positions.
- Ensure that supervisors are treated with respect and able to raise issues with their manager and are problems raised are acted upon
| |
| Inadequate, broken/missing work equipment | - Keep a log and carry out a regular inventory to check work equipment and implement routine maintenance of all cleaning supplies and tools
- Have a system for reporting faulty equipment and promptly maintaining or replacing it. Check problems are resolved
- Ensure supplies are ordered regularly and in time. Have a system for cleaners to report when stocks are low
- Plan for equipment breakdowns by allowing time buffer
- Purchase reliable equipment that is suitable for professional cleaning and the work environment it is to be used in
- Don’t purchase cheaper cleaning products that require more time and effort to clean effectively
- Train cleaners to adjust and use equipment
| |
| Lack of resources such as technical resources and sufficient, trained workers | - Enhance work organisation and technical equipment – chose time-saving ergonomic equipment. Involve cleaners in selecting and testing new equipment
- Planning with time buffers,
- Plan a sufficient number of workers for the workload. Have contingency planning for staff sickness, holidays etc.
| |
| Harassment and violence from the public | - Establish a policy of how to deal with violence, communicate criteria for violence, include them into the risk assessment, train your employees, establish a reporting system, analyse incidents and provide post-incident support for victims. Agree measures with the client.
- Security measures could include coded doors, bolting entries, cameras etc. Include risks related to traveling to and from work in the evening or early morning
- Ensure quick communication is possible, telephone, radio, alarm buttons...
- Include issues that could arise from travelling home late.
- Keep the number of lone working cleaners to a minimum
| |
| Harassment and bullying in the workplace | - Have a policy of no acceptance of bullying, a healthy corporate attitude (individuals are encouraged to report difficulties) risk assessment, take it seriously and handle it confidentially, establish a reporting system and procedure, train managers in conflict management, provide access to independent employee referral service.
- Inform your employees about their legal right of protection, investigate complaints concerning harassment at work and take appropriate measures.
- Train cleaners and supervisors
- Agree protocols and measures with the client
| |
| Discrimination of migrant and immigrant workers | - Encourage immigrant workers to talk to their manager about problems. Encourage and support workers in taking language classes if necessary or helpful. Communicate a no tolerance policy for discriminating comments or behaviour. Asses the risk of discrimination. Offer advice and support where possible with problems outside of work – e.g. ad hoc time off or change of shift to attend an official appointment
| |
| Risk and hazards for older workers | - Policy for the support of older employees. Support the health through preventative measures such as a good and reliable work organisation. Try to avoid repetitive work, different tasks have different demands. Changing the task reduces strain at work. Reliable working times and breaks help older employees to establish a healthy routine. Take into account the individual qualification and experience of your employees.
- Do they have preferences in their tasks and working times?
- A good and open corporate culture is a main asset for healthy employees – young and old.
- Train older workers to be able to mentor younger workers
- Introduce mixed generation cleaning teams. This can help with task rotation of heavier tasks and transfer of knowledge
| |
| Addressing specific risks for women workers | - Women and men can face different risks at work. It is important to include gender issues in the risk assessment such as unsocial working hours, the risk of violence and harassment if working at isolated work locations or at night,
- Involve all workers, women and men, at all stages of the risk assessment. Avoid making prior assumptions about what the risks and hazards are. Encourage women to report issues that they think may effect their safety and health at work, as well as health problems that may be related to work
| |
| Poor work-life balance | - Create benefits e.g. childcare benefits, meal benefits.
- Organise or provide commute to the work location.
- Offer reimbursement of commuting expenses.
| |
| Outsourced cleaning | - Ensure that proving for workers’ occupational safety and health and worker training is part of the contract requirements
- Ensure that training for cleaners is included
- Ensure that the bids are high enough to allow for realistic cleaning schedules
- Ensure cooperation and coordination with contractors on health and safety and contractors’ employees are included in your risk assessments and arrangements
| |
Examples of prevention practice
Reducing stress among hospital female cleaning workers – inclusion of service workers in a hospital-wide approach
An intervention in a hospital to implement an OSH management system into general management, covered medical services and support services. It was based on health circles in each hospital service to identify specific risks and target groups in the different workplaces, and to elaborate adequate measures. One key factor for success was the involvement of all stakeholders (representatives of different services, departments, and even from the municipality). In this trusted atmosphere it emerged that the main concern of cleaning staff was psychological pressure. Following the introduction of new measure, the hospital cleaners stated that they felt a lot more self-confident in their new uniforms, the risk of harassment decreased, and they felt more accepted by medical staff[27].
Protocols for cleaning services in a university[28]
Acting on an initiative by the trade union, the risk assessment method of Spain’s national OSH institute was used to make an assessment of psychosocial risks of the work of the workers of a private cleaning company in a Spanish university. Psychosocial issues identified included problems with work autonomy, workload, worker supervision and participation, and organisational interest in worker wellbeing and remuneration and action was taken based on the results. Detailed protocols were developed for work tasks to clarify and reinforce work autonomy and workload for the employees. Priority was given to night shift workers. Each job position was given specific details about required tasks during the shift. This distinguished high priority tasks and those to be performed daily from other tasks that could be either optional or be performed on a more extended basis. The use of the protocols resulted in workload reduction, improved workflow, clarity over break time. They provided workers with sufficient knowledge and freedom to decide certain aspects of task planning and distribution, for example the cleaning methods to be followed and how to properly distribute furniture and office equipment during cleaning tasks. Senior and intermediate managers in the company attended specialised training on social skills and team management.
Addressing psychosocial risks during an intervention to prevent MSDs among hospital cleaners[29]
The work of a hospital operational department (cleaners, porters, etc.) involved physically strenuous work and awkward movements. The key objective was to introduce equipment and other measures to reduce the physical workload, but they also wanted ensure they had competent staff that could share their valuable experience with new recruits. The intervention was based on worker participation. A survey was carried out on the ‘social capital’ among the staff to involve them in the decision-making process. Health circles and risk management workshops were created to obtain feedback from staff regarding their working conditions, to identify risk factors and to propose preventive measures. Based on this feedback courses and seminars were held. Seminar topics included stress management. Specially trained health advisors were introduced to provide peer to-peer advice, and staff are now involved in changes, such as the selection of new equipment and footwear. Mixed-generation cleaning teams were established so younger and older and new and experienced staff could work together and assist each other. Experienced staff provided training to new recruits, while younger colleagues assisted them in more strenuous tasks. Male staff may help with the most strenuous tasks. Older, experienced workers now mentor and train new recruits. As well as preventing MSDs, employees’ self-confidence increased as the intervention emphasised the importance of support staff in hospital operations. The mentoring role of older employees also increased their self-confidence. A team spirit was created through intergenerational cooperation, giving employees a sense of solidarity and ensuring they performed age-appropriate work.
Measures to reduce the demanding cleaning workload can also bring psychosocial benefits[30]
A contract cleaning company introduced various ergonomic and organisational measures to reduce the physical workload. Often such measures are also relevant to reducing psychosocial risk factors: smart technology allowed cleaning on a needs basis – cleaners can vary their tasks accordingly which also reduces their workload. Training coaches in ergonomics helped individual cleaners improve their cleaning techniques. Task rotation reduced MSD risk factors but also made tasks less monotonous. Working closely with occupational coaches and ergonomists, gave employees the opportunity to voice their complaints, ideas, initiatives and improvement proposals.
Psychosocial factors in the return-to-work of a hospital cleaner with an MSD[31]
Taking account of psychosocial risk factors is relevant to the prevention of work-related MSDs, but it is also relevant to supporting a successful return to work[32], as this example demonstrates. A cleaner developed low back pain resulting in sick leave. One of the contributing factors was working extra shifts because she had economic problems. The worker was supported within the structure of the hospital’s inclusive health and return-to-work policies and an external return-to-work programme. A trusted supervisor kept in touch while she was off sick and the cleaner was involved in devising her return-to-work plan. On return she was allowed to take short breaks to exercise and rest. This gave her a control over the situation. Based on risk assessment, various ergonomic changes were made to equipment and work tasks helped to make her work easier. She was integrated into a team for support from colleagues if needed, which also meant she no longer had to work alone. She was supported by her team leader checking with her about her work ability at the end of each shift and her colleagues were informed about her reincorporation and were very supportive. Her line manager organised a social worker to help her with her personal economic situation that had led to her working the extra shifts.
Good management of cleaning work – schedules and training
Software tools are available for helping to plan cleaning schedules. One example, suggested by the OiRA tool for cleaners developed by the European social partners, is CleanNet[33],[34]. Developed in Finland, it can be used to calculate the needed time for a given task. It covers both cleaning and property maintenance. It is available in various languages. This is just one example, and other software tools are also available.
An example of training resources
This video by the Janitor Store provides advice on how to motivate and engage cleaners. https://www.thejanitorialstore.com/public/Quick-Training-Ideas-for-Cleaning-Technicians-819.cfm
Health circles[35]
Lower graded groups such as cleaners may be less likely to be consulted and actively involved in hazard identification and solution implementation. Part from being important for effective risk management, lack of consultation can contribute to cleaners feeling that they are not valued, which in turn can affect job motivation. One case study used health circles to involve workers. Ergonomic risks were identified and addressed, but also factors such as time pressure.
OiRA risk assessment tools
EU-OSHA provides several OiRA – online risk assessment tools – for the cleaning sector, that cover the range of hazards and risks faced by cleaners, including work-related stress and violence[36]. The tools include some covering domestic cleaners.
Body and hazard mapping
Body mapping and hazard mapping are visual ways to involve workers in risk assessment, including psychosocial risk assessment. In body mapping workers mark health problems they relate to their work on a body chart. In hazard mapping, workers mark hazards on a plan of their workplace. Being visual, the tools are useful to use with migrant workers or others who may lack language skills. They are also useful for joint assessment of ergonomic and psychosocial risks.[37]
