European Agency for

Safety and Health at Work

Stress and psychosocial risks: some practical solutions

Dr Eusebio Rial-Gonzalez

Project Manager

Overview

• Introduction to the Agency

• Psychosocial risks: current situation

• Agency activities and publications– Research review– Identifying ‘good practice’

• Some practical solutions– Tools and methods– Success factors

European Agency for Safety and Health at Work

Agency Network Structure

22ndnd Generation Agency Network StructureGeneration Agency Network Structure

DeliveryDelivery

FOCALPOINTS

BOARD

AGENCY

ConsultantsEuropean

Topic Centres

AssistanceAssistanceManagementManagement

NationalFocal Point

Network

EuropeanExpert Groups

BUREAU

EU Focal PointsCC Focal PointsEEA EFTA Focal Points

The Agency’s aims and role

• Aims to make Europe’s workplaces safer, healthier and more productive

• Acts as a catalyst for developing, collecting, analysing and disseminating information that improves the state of occupational safety and health in Europe

• http://agency.osha.eu.int

Psychosocial work environment: stress

• Second biggest OSH problem in the EU– Plus: interaction with second-biggest problem: back

ache and MSDs in general

• Approximately 28% of workers affected (40M)• Can be related to up to 50% of all absence• Number of people affected has doubled in the

last decade (HSC, GB). High in the public sector

• Estimated cost per year: – EU: €20,000 million (EC, 2000)– UK: £3.7 billion (HSE 1995/96)

Current situation

Workers reporting stress (by country)

Stress in Spain

•IV Encuesta Nacional de Condiciones de Trabajo (data from late 1999)

•Short-term ‘symptoms of stress’

Spain: conditions by sector

> 3 ‘stress symptoms’Accident at work in previous 2 years

Current situation: intimidation [1]

Workers reporting intimidation (by sector)

14

12

12

12

9

7

6

5

5

3

3

9

Public administration and defence

Education and health

Hotels and restaurants

Transport and communications

Wholesale and retail trade

Real estate

Manufacturing and mining

Construction

Financial intermediation

Agriculture and fishing

Electricity, gas and water supply

All EU

%

Current situation: intimidation [2]

15

14 14

12

11

10 10

8

7 7

6

5 5

4 4

9

FIN NL UK S B F IRL DK D L A E EL I P EU

%

Workers reporting intimidation (by country)

Current situation: EU15 / CC12

Health outcomes (CC12 vs EU15)

43 36 3019

4240 34 2441

27 28 33 23 2329

Health at risk Stress Backache Muscularpains in neckand shoulder

Overallfatigue

%

Romania CC 12 EU 15

Current situation: trends

Working ...

48 5054 56 6056

at very high speed to tight deadlines

%

1990 1995 2000

Current situation: trends by country

High-speed work (by country) (1995/2000)

8075 75

6763

58 58 57 56 53 52 52 50 48 48 46

69 70

6166 63 61

54 55 54

4650

37

59

5043

48

S NL FIN EL A DK D I EU F B L P UK IRL E

%

2000 1995

Needs identified by Member States

Exposure Indicator/OSHOutcome

Number of Focal Points Reportingthe Development of AdditionalPreventive Action is necessary

Stress 10

Vibration 9

Lifting/moving heavy loads 9

Handling Chemicals 8

Musculoskeletal Disorders 8

• Stress as top priority for action• Psychosocial risks: issues of definition and

reporting, but clearly a problem• Need to identify and disseminate ‘practical

solutions’

Stress research review (2000) – key findings

• Limitations in contemporary research but enough scientific evidence to support:

• Stress can be dealt with in the same way as other OSH issues:

• Adapting the ‘control cycle’ (already well-established for the assessment and management of physical risks) to the management of psychosocial risks.

• Practical examples of this approach applied already exist in the EU.

• Future research should concentrate on stress management interventions at the organisational level.

Actions to prevent or reduce stress at work

• Treat like other workplace hazards• Risk assessment and management:

– Identify hazards

– Decide who might be harmed and how

– Evaluate the risk by:

• Identifying what action is already being taken

• Deciding whether it is enough

• If it is not, deciding what more should be done

– Record the findings

– Review the assessment and check the impact of measures taken

Stress prevention: instruments and tools

• Psychosocial risks: different in nature from physical risks (not tangible, interactions, etc.)

• More difficult to develop standardised, ‘off the shelf’ solutions

• EU legislation: focus should be on risk assessment and primary prevention

• Long research tradition, but few practical tools• Need to develop user-friendly tools, especially

for SMEs

Identifying solutions

• Need to use tools that:– are valid and reliable – fit the organisational climate/culture– are sensitive to the context of the specific

workplace – risk assessment

• Some examples:

Work Positive: prioritising organisational stress

• Health Education Board for Scotland & Heath and Safety Authority (Ireland)

• ‘Commended entry’ at the Agency’s Good Practice Awards 2002

• Developed a user-friendly pack to guide organisations through a 5-step process1. Raising awareness, gaining and

demonstrating commitment2. Benchmarking: assessing the current

situation3. Identifying the causes and assessing the

risks4. Avoiding and reducing any risks

identified5. Reviewing the situationwww.hebs.com/workpositive

Work Positive: benchmarking tool

Completed by coordinator before questionnaire sent out

Work Positive: risk assessment questionnaire

3 pages: 54 questions + ‘open response’

CoPsoQ (2000)

• Copenhagen Psychosocial Questionnaire

• Developed by AMI (DK), after studying 16 other questionnaires

• 3 versions:– Long [141 questions]: for research purposes

– Medium [95]: to be used by work environment professionals (incl. software)

– Short [44]: to be used ‘by the workplace’

CoPsoQ

CoPsoQ

• Questions about working conditions, mental and general health, and coping

• Thorough psychometric development

• Already used in many studies: allows for comparisons to be made with national average (MS), and with age groups, job types, pay systems, etc.

• Spanish and other versions

ISTAS-21: adapted from CoPsoQ

• Measuring only ‘dimensions’ for which there is good scientific evidence of impact on health

• Adapted by:– Arbejdsmiljpinstitittet – ISTAS– Instituto Nacional de Seguridad e Higiene en el Trabajo– Centre de Seguretat i Condicions de Salut en el Treball de

Barcelona– Universitat Pompeu Fabra– Universitat Autònoma de Barcelona– Mutua Fraternidad Muprespa– Gabinet Higia Salut i Treball– Departament de Salut Laboral de Comissions Obreres de

Catalunya (CONC).

www.istas.net/istas21

Other examples: WOCCQ

• WOrking Conditions and Control

Questionnaire (Package)

• Developed at the University of Liège

• Validated in French and Dutch, also

available in English

• Basic tool + optional questionnaires to

‘refine the diagnosis’

www.woccq.be

Other examples: QPSNordic

• General Nordic Questionnaire, Lindstrom et al.• Analysis at 3 levels:

– Task

– Individual

– Social and organisational

• Two versions:– QPSNordic: research, in-depth, 123 questions

– QPSNordic 34+: practical tool, 34 questions

• Available in English, Swedish, Danish, Norwegian and Finnish

QPSNordic 34+

QPSNordic

SUVA checklists

• Simple, attractive ‘checklists’ (4pp.)

• Self-assessment and space for ‘control measures’

• Also published support/reference documents

• Available in Italian, German and French

SUVA checklists

SUVA checklists

SUVA checklists

More than just tools: process issues [1]

• Example: ‘soft guidelines’ developed at AMI for the COPSOQ:

1. Never start a survey unless there is a clear intention to take action

2. All results are anonymous and participation is completely voluntary

3. Workers should have the right to see and discuss all results

More than just tools: process issues [2]

4. The results should be considered as a common tool for dialogue and future development – not as a judgment or a school report!

5. All parties – workers, middle management and management – should participate in, and be committed to, the whole process

Identifying practical solutions

• Agency’s European Week 2002: Stress, bullying, violence

• Raising awareness and disseminating practical solutions

• Factsheets• Case studies report• Good Practice awards

Agency publications – factsheets

• Factsheets available on:

– Work-related stress

– Bullying at work

– Violence at work

– Information from the Agency on stress at work

– Practical advice for workers on tackling stress at work

– Strategies to tackle psychosocial issues

– Research on work-related stress

Agency publications - magazine

Agency publications - reports

Case studies report: examples include:

• Regulatory approaches• Non-regulatory interventions• Campaigns• Guidance• Sector approaches• National and regional

authority initiatives• Workplace examples• Collective agreements

Good Practice Awards: European Week 2002 psychosocial risks

Examples:• 11 stress prevention• 4 violence• 5 bullying

Criteria:• Tackling risks at source• Real improvements• Sustainability• Consultation• > just legal compliance• Transferability

Stress prevention in an old people’s home – Spain – (1) how:

• Cooperation: management, trade unions & local insurance company

• Risk assessment of the work and a staff questionnaire

• Problems found included:– High work load

– Lack of information

– Lack of decision-making responsibility

– Little possibility of promotion

– Unforeseen events/changes of plan

– Physical work conditions and physical effort

Stress prevention in an old people’s home – Spain – (2) solutions:

• Providing lifting aids, hoists

• Staff training to deal with emotional stress

• Clear definitions of content of tasks and responsibilities, in an agreement

• Specifying functions and competencies of nursing assistants –e.g drug dispensing

• Increase staffing levels during peak hours

• Communication protocol for risks

• Increasing worker autonomy, discretion

• Promoting worker participation

Often low or zero cost solutions!

Good practice award winners I

Call centre in Germany: including stress prevention measures at the design stage

Preventive measures

• Staff participation, job rotation, task completion, scope, short breaks, training, improvements in work environment

Good practice award winners II

• Petrochemicals company in Scotland– During a plant commissioning project– Effective employee involvement: multi-

disciplinary project team formed, including an external expert

– ‘top five’ stressors identified and controls identified

Success factors [1]

What we can learn from experience:• Risk assessment is the key & the first step• Context-specific solutions• Thorough planning and a stepwise approach• Staff involved in identifying problems and

developing solutions• Combination of measures covering

anticipation, prevention, intervention, support and evaluation, with main focus on collective prevention measures

Success factors [2]

• Involvement & commitment from staff, their representatives and management: essential for long-term sustainability

• Solutions do not have to be expensive (sometimes low or zero cost), but there must be management commitment to take action

• Any outside expertise must be competent: experienced practitioners and evidence-based solutions

• May require liaison with external bodies – police, judiciary, local community (violence)

Summary

• Psychosocial risks: less tangible, not so straight-forward

• Tools for risk assessment already available and tested

• Variety of tools: from complex, research-led instruments to simple checklists

• No ‘easy fix’ or recipe for interventions: Context-specific solutions

• Collaborative process for identifying and tackling risks

Further information

• European Agency’s web feature on European Week 2002: http://osha.eu.int/ew2002

• European Agency’s Research on Work-related Stress (EN and IT) http://agency.osha.eu.int/publications/reports/203/en

Thank youThank you

http://agency.osha.eu.int

Eusebio Rial-Gonzalez

rial@osha.eu.int