OCCUPATIONAL HEALTH

Workplace stress and wellness

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The World Health Organisation (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. In keeping with this broad definition, occupational health aims to maintain the highest level of physical, mental and social well-being of workers in all occupations. This is primarily done by ensuring that workplaces are healthy. This, in turn, means that workplace hazards (which pose significant risks) are promptly and accurately identified and controlled so as to protect the health of workers.

However, the sole purpose of occupational health is not only to ensure that people who come into the workplace do not develop illnesses, but also to safeguard the well-being of workers so that they maintain optimal health, and even to assist employees with non-occupational related illnesses to achieve higher levels of health and wellness. This could be in the form of programmes, policies and or services that ensure the creation of a “healthy workplace”.

There are many influences on a healthy workplace and these have been categorised into four main groupings by the WHO. Firstly, there is the physical environment, which has received the greatest emphasis over the years. However, the importance of the psychosocial environment, as a second grouping, is being increasingly recognised. The third and fourth groups that need to be factored into creating a healthy workplace are the personal health resources of the workplace, and the participation of the community in improving not only the health of workers but also that of their families and the communities at large. For these reasons, the definition of a healthy workplace has expanded to include a place where employees and employers collaborate to develop, implement and continuously improve health by promoting and sustaining policies, programmes and practises that are easily accessible.

Every person has a basic right to engage in productive work, the benefits of which are manifold to both the employee and employer. The physical benefits of increased regular activity and mobility, as well as the mental health benefits of increased social interaction, time structure and social identity are very well-documented. It is also mutually beneficial for the employer to ensure optimal health for workers as a healthy workplace is conducive to increased productivity. This improvement results from less staff absenteeism, a decrease in the need to recruit and retrain new staff, a lower incidence of workplace accidents and an increase in staff morale.

The importance of maintaining employee wellness through occupational health is far reaching. As stated earlier, a key aim of any effective wellness programme is addressing issues of mental health. In our South African context, mental illness is a substantial public health challenge, with occupational stress being a growing contributor to the mental health burden. Work-related stress has been described by the International Labour Organization (ILO) as a ‘global epidemic’. Furthermore, the cost burden within the South African context has been documented at R3-billion every year. For the above-mentioned reasons, work-related stress is a serious health problem that cannot be ignored and, indeed, needs to comprehensively tackled by both workers and employers in order to secure a healthy workplace.

Many of the risk factors of work related-stress relate to specific job characteristics. These include the actual job features, such as complexity of work and a wide variety of tasks. Other risk factors include working patterns, (for example, long working hours and shift work). Difficult organisational roles, such as playing multiple, conflicting and/or ambiguous roles with in the workplace, have also been recognised as important risk factors. Finally, job insecurity, poor work relationships, a lack of career development opportunities, a negative or hostile organisational climate and a home-work imbalance have all been identified as causes of work-related stress.

The management of work-related stress not only involves developing employee assistance programmes aimed at individual workers but also strategic approaches to identifying and mitigating risk factors at an organizational level, thereby creating healthy workplaces. The solutions, therefore, are usually multi-faceted, and require buy-in, at the outset, from employees and management alike. Ultimately, these occupational health interventions should benefit both workers currently affected by work-related stress as well as those not yet presenting with the symptoms of stress but also exposed to the risk factors.

The National Institute for Occupational Health (NIOH) has recognised this as an area that requires more study and service development. In light of this, it has established a Mental Health Unit in its Occupational Medicine & Epidemiology Division. This unit has started doing research into occupational stress in South Africa, and plans to support both employees and employers in their efforts to reduce this increasingly common, and serious, occupational health problem.

Further information can be obtained from the Head of the Occupational Medicine Section on +27 (0)11 712 6400 or by contacting Dr Spo Kgalamono at spo.kgalamono@nioh.nhls.ac.za.

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