Facts of Life:
Issue Briefings for Health Reporters
Vol. 8, No. 9
September 2003

Working Yourself to Death:
Stress on the Job

The Issue

The Facts

An Unhealthy Economy

Expert Sources

References

Say the phrase “unhealthy job,” and toxic chemicals or non-ergonomic desk arrangements may spring to mind. But researchers have been steadily documenting a more insidious health threat: workplace stress. Job-related stress most often manifests itself as a cardiovascular problem like high blood pressure, but the pathways connecting stress to health are mostly unknown.

• Workplace stresses can double the rate of death from heart disease, according to a 2002 study of 812 healthy employees. High demands, low control, low job security and few career opportunities contributed to the overall stress measured in the study. (4)
  
• One study found that workers who had little control over their jobs were up to 50 percent more likely to die during a period of five to 10 years than workers who had high-stress jobs but more decision-making responsibilities. (5)
  
• Office workers who are exposed to low-level office noises, including quiet conversations, have higher levels of the stress hormone epinephrine than those working in silent offices. (7)
  
• Clerical workers show more signs of biological stress during the workday than those in executive or more senior positions, according to a British study. (8)
  
• Stress can thwart the heart-healthy aspects of a physically active job, according to a study of utility workers. Thicker arteries (a sign of atherosclerosis) were found among physically active but stressed workers. Those who were physically active but not stressed had thinner arteries. (9)
  
• Low-income workers who work long hours say that family nutrition is one of the first things sacrificed to the demands of their job. The workers say that they skip meals, eat on the run, eat too much junk food and have trouble preparing healthy meals for their children. (10)
  
• Work-related stress (including job insecurity) and fatigue may increase the risk of cold, flu and stomach inflammation. In one study, employees in demanding jobs developed colds 20 percent more often than those in less demanding positions. (11)
  
• Men who work in physically violent or dangerous occupations, as well as those who work in female-dominated professions, may commit more domestic violence than men in managerial positions. (12)
  
• Social support seems to help New York City traffic enforcement agents keep their blood pressure down: Female agents get the most benefit from supportive supervisors, while men tend to rely on co-worker support. (6)
  
• In some cases, work stress can be beneficial to health: A 2001 study found that the immune system got a boost when faced with the active stress of meeting a work deadline, while the passive stress of watching violent scenes on TV can weaken immunity. (13)
  

In an economic downturn, people worry about the robustness of stock portfolios and ask if the government is doing enough to revitalize the economy. It is more than a cliché, however, to say that hard times have physical as well financial consequences for a nation’s health.

Downsizing, long work hours, staff restructuring and job strain can be linked to chronic disease, injuries and accidents, says Paul Landsbergis, Ph.D., an assistant professor at Mt. Sinai School of Medicine and research associate at the Center for Social Epidemiology.

“Psychosocial job conditions do seem to be getting worse,” Landsbergis says, citing a series of European surveys and one U.S. survey suggesting “dramatic increases” in work pressures since 1977. And while employees in Japan and several European countries are working fewer hours than in the past three decades, the opposite has happened in the United States.

“United States workers’ average weekly work hours are now the longest in the developed world,” Landsbergis says. “Prime-age working couples are contributing nearly four additional months of annual work time since the 1970s.”

Landsbergis says that studies of chronic disorders like cardiovascular disease provide the strongest evidence that recent job trends may be having a negative impact on workers’ health. Researchers have identified job strain, or the combination of high demands and little control over one’s work, as a particular risk factor for high blood pressure and heart disease.

“Since chronic diseases such as cardiovascular disease and hypertension take years to develop, we may be observing only the initial stages,” Landsbergis says.

Other links between economic uncertainty and health can be unexpected. For instance, a study of food-processing plant employees suggests that layoff fears can increase the risk of work injuries and accidents. Employees who worried about job loss were less apt to work safely, causing more injuries, according to psychologist Tahira M. Probst, Ph.D. (14)

Can work-related health problems be reversed?

“I suspect that is the case,” Landsbergis says, although he notes that paucity of data about health impacts of interventions to reduce job stress. Some cardiovascular studies, however, suggest that blood pressure does improve as job strain decreases.

Landsbergis thinks many employers would like to improve work conditions and employee health, but acknowledges that they face their own workplace stresses.

“In the global economy, [employers] are under pressure to reduce costs and get people to work harder and faster,” he says. “Federal, state and local governments are under similar pressure ... because of budget cuts. So the issue goes beyond the wishes of individual employers.”