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Stress - the hazard of the nineties

Stress at work emerged as one of the leading elements in a recent survey of work-related illnesses carried out by the Health and Safety Executive as a "footnote" to the 1990 Labour Force Survey. While the growing phenomenon of repetitive strain injury (RSI) accounted for some 50,000 self-reported injuries, stress and depression accounted for a further 183,000 cases. A recent survey of absenteeism carried out by the Industrial Society pinpointed stress as the second highest cause of time off for sickness (Engineer 1993).

Of course, "stress" may be seen as a highly individual factor - "different people react to pressure in different ways", etc. However, a significant body of scientific opinion backs up the view that stress must be taken seriously as a health and safety issue. Professor Tom Cox, author of a recent report on occupational stress commissioned by the Health and Safety Executive has argued that a "control cycle", as required by existing legislation, should be developed as part of a more structured approach to the problem of stress at work (Cox 1993).

Along similar lines, Professor Cary Cooper, an expert on stress at the workplace, states that "It is now recognised that the way a job is designed or the way people are managed can affect their health and well-being as much as exposing them to a bit of machinery or a toxin."

In Part 2, we explore in detail the symptoms, effects and causes of workplace stress. In the next section we look at some of the changes in employment practice that have taken place over the past decade and that have contributed significantly to the creation of stress in the workplace.

Low control, long hours

While four million workers in Britain kick their heels on the dole, millions of others are forced into working weeks far exceeding any safe limit - because their basic pay rates are so low they have no choice but to put in long hours of overtime. Or because, like seafarers after the imposition by P&O of 24-hour shifts in 1986, they are given no choice. Or because "anti-social" shift patterns are integrated into the whole system of production.

The safety implications are well-known - though seldom well-publicised. Three major cases stand out - the Clapham rail disaster, the sinking of the "Herald of Free Enterprise" and the 1990 M42 pile-up in which six people died. In all these cases and many more, massive tragedies occurred because the workers involved were subjected to inhuman working schedules. The Clapham rail crash, in which 35 people were killed, was allegedly caused faulty work done by a technician who had taken only one day off in the previous 13 weeks. Signalling technicians in the department routinely worked seven day weeks and frequently went for 13 hours with only a five-minute break.

A number of studies have pointed out just how bad shiftworking is for health. A COHSE study carried out in the wake of a Health and Safety Executive report on shiftworking shows that nervous disorders such as anxiety and depression are more common amongst shiftworkers, that they suffer more digestive disorders and ulcers, due both to increased stress and irregular mealtimes, and are 40 per cent more likely to suffer heart disease than day workers (COHSE 1992). More recently, a British Psychological Society occupational conference held in January 1994 was told by researchers from Heriot-Watt that "only the hardiest of workers could easily tolerate shift work" (Financial Times 4 January 1994).

Terms and conditions for stress

Many factors surrounding the organisation of work, therefore - pace, pressure, the sheer amount of work in terms of hours and shifts - contribute both to work-related accidents and to a whole range of work-related illnesses, particularly stress. But finally, it has been shown that even the basic terms and conditions of work - issues like pay, sickness benefit, disciplinary procedures and so on - can affect workers' well-being. Restrictive trade union regulations, deregulation, casualisation, payment by results and fear of redundancy all seem to be adding to the levels of stress. The political and economic climate cannot be divorced from health effects.

All these problems are exacerbated by pay systems which act on a "work harder - earn more" basis. But in non-manual sectors, the trend towards systems like performance-related pay is taking a toll on workers' well-being, leading to growing problems like repetitive strain injury (RSI). Productivity schemes, performance-related pay, bonus systems and overtime incentives, all payment systems that are based on piece rates tend to increase the rate of RSI by encouraging the worker to work as long as possible as fast as possible.

Job insecurity and the related disciplinary systems growing up in many firms are a major contributory factor to stress at work. Apart from the obvious pressure in industries like construction that if you will not do an unsafe job someone out there will, fear of redundancy in itself is a potent force raising stress and anxiety levels.

Fear of losing the job may push workers not only into working long hours - itself bad for their health - but into coming into work even when sick, a tendency made worse by the recent government deregulation of sick-pay schemes. The introduction of Employers Statutory Sick Pay (ESSP) in 1983 placed the administrative burden of sick pay on the employers rather than, as previously, with the Department of Health and Social Security. Clearly, this has the effect of making employers exert stricter discipline on "absenteeism". A recent Hazards report shows that closer policing of absentees leads to lower levels of sickness absence - even when workers should be at home (Hazards 1993). A NALGO branch secretary quoted in the article gives an example: "One man in the building section had an industrial injury - he came back to work when he recovered and sustained another injury and took time off to recover. A sickness monitoring meeting decided to sack him despite the fact that the doctor had signed him off. He has now taken retirement on the grounds of ill-health."

Such considerations have not stopped the UK from eagerly competing in the international market as purveyors of the lowest-paid and most "flexible" workforce. Cases like the transfer of production from Hoover's Dijon plant to Cambuslang in Scotland through the undercutting of French pay and conditions provide shameful examples of this "bidding-down" strategy. In a reverse example of this trend, transfer of production by the Timex corporation in 1993 from Dundee to the far East, following on a courageous battle by its Scottish workforce against attacks on their pay and conditions, demonstrates the formidable power of multinational corporations to abandon traditionally well-organised labour markets for the super-exploitation of the Third World.

Ironically, the recent Rover sale to BMW on the basis of the much-trumpeted "turnaround" achieved in the company at its workers' expense was completed in the wake of union agreement to a Company Plan which promised, in return for massive increases in flexibility and pace of working, the prized goal of a "Job For Life".

Just how meaningless this is has been shown by the accounts of workers at Rover's Cowley plant, who describe how an increasing number of workers on temporary, fixed term contracts are in fact being hired by the company to cope with fluctuations in demand. In addition, the company's absenteeism, lateness and sickness provisions have now become so draconian that workers risk losing their jobs with only the most minor infringements of a total attendance pattern. For example, three separate sickness absences, or five episodes of lateness, in one year will slot a worker into the first stage of the disciplinary procedure, threatening them eventually with the sack. Yet repeated sickness and lateness are symptomatic of stress caused by this kind of system of employment.

The use of annualised or even "zero" hours programmes is an example of this approach. Under annualised hours, workers' contracts are changed so that they agree to work a certain number of hours a year, rather than any fixed pattern per day or week. This gives employers total flexibility to require, for example, workers to carry out a 14-hour shift if a crisis crops up in the plant, with their only compensation extra time off in lieu - a "privilege" often difficult for workers in low-wage, exhausting jobs to use constructively.

As the following story shows, even those working in the very organisations responsible for promoting improvements in the nation's health are not immune from the kind of work practices guaranteed to cause stress.

'We have contracts which require us to do a minimum of 36 hours a week. In practice, the workload is such that most of the workers in the department do up to 55 or 60 hours a week just to get through the most urgent jobs. Any 'overtime' we do is unpaid, and we can only take time off in lieu of extra hours done at the weekend, before 8.00 in the morning, or after 7.00pm at night. This shows that only work done on top of this eleven hour day is perceived as extra. Added to the pressure caused by the sheer volume of work, part of our holiday and pay entitlement is performance-related. The unrealistic workloads mean that you have to be achieving maximum productivity all the time to have any prospect of receiving performance related pay or holiday. The employers rely on the dedication and commitment of the staff to stop this whole system from falling apart at the seams. But I do not know how long this can last. I feel frustrated and angry - partly because of the pressure I'm under, and partly because the way the work is structured means that I rarely have the chance to do the job to the best of my ability. After several sleepless nights, often waking at one or two in the morning worrying about how to solve a problem at work, I'm unable to work in the most effective way. Lots of us in the Department come into work even when we're sick - partly because you run the risk of being called in for a 'counselling' interview if you're off for a couple of days, and partly because the work just piles up to an even more unmanageable level when you're away.' Health Promotion Adviser for a London Health Authority

In some TV companies this policy has been carried to extremes, with workers required to work shifts as long as 70 hours at short notice. While they may receive weeks of free time in return, the pattern is never predictable, making it impossible to plan leisure activities and totally ruling out workable childcare arrangements. Such developments show that even relatively skilled, professional employees are not immune to the demands of the "flexibility" drive. Contracts specifying "zero" hours, on the other hand, tend to affect much lower-skilled employees. In these agreements workers like supermarket shelf-fillers are employed on a basis of no specified hours, but are expected to be "on call" whenever extra demand requires. Recent job advertisements for building labourers, for example, specify that such workers should have their own phone at home so that they can be called to jobs at short notice.

Such increasingly privatised, individualised working arrangements - sometimes spelt out in the form of "individual" or "personal" employment contracts - are becoming a feature of what is described as new "high-tech" forms of homeworking. Computer-based work such as data inputting or word processing, and an increasing range of telecommunications jobs, can now be carried out directly from home or by an individual worker "on the move", linked to the employer through a computer modem. Some employers have been able to save up to £3,000 per worker by instituting these methods.

Such forms of work organisation allow for a high degree of monitoring and are a long way from the romantic "high-tech cottage" dreamt up by some "flexible specialisation" theorists in the more optimistic 1980s. A recent Guardian report gives a vivid, if depressing, picture of the everyday conditions of one such worker:

"For the forefront of technological revolution, Sharon Curtis' back bedroom looks a bit of a mess. Toys, books and the innumerable pieces of junk that a family accumulates just about crowd out the battered Amstrad and printer that are the tools of her trade. It is about as far from the image of the teleworker communicating electronically from a far-flung croft as can be imagined. Mrs Curtis works from a street in north London, collecting work and delivering typed letters and scripts in an old banger...with two children, she and her husband Ray, a postman, find her income essential." (Guardian 22 March 1994).

Job insecurity is bad for your health

First of all, a casualised job is unlikely to be an organised job. The sharp decline in trade unionism from 58 per cent of the workforce in unions in 1980 to 40 per cent today has almost entirely encompassed the "new" service sector employment areas where these jobs are concentrated. In an unorganised workplace, you do not have the chance to stand up for your rights or to have a say in how your place of work is run. Low-margin employers like sub-contractors are unlikely to be too conscientious when it comes to implementing every detail of even inadequate health and safety provision.

Along with this lack of union organisation - which, for example, prevents workers from taking advantage of legal provisions for electing health and safety representatives - goes the very lack of job security itself, which means workers are far less likely to protest against unsafe corner-cutting working practices for fear of losing their jobs. A supreme example of this is in the construction industry, where the carnage on the building sites continues on the basis of "If you won't do it, someone else will". But examples like the one given above on the Rover disciplinary procedure are evidence of a growing trend in which workers, even if they are injured or otherwise ill, are afraid to be sick for fear of losing their jobs. Ironically, this obsession with cranking up attendance patterns is now registering among the more "caring" professions of the public sector, with employees being offered "counselling" (a disguised form of disciplinary process) if their sickness absence exceeds certain levels.

So job insecurity is a potent force for weakening workers' organisation, confidence and ability to speak up for themselves at work. But more than that - and this is our second point - this kind of casual, peripheral employment has in itself been found to have a serious effect on the health of those involved.

A study published in March 1994 which brought together the work of a team of academics based on interviews with 6,000 employed and unemployed people, has established a close link between psychological well-being and individuals' sense of job security - or lack of it (Burchell 1994). The new tier of insecure labour created by the government's much-vaunted "flexibility", the study concludes, is damaging health, creating depression, causing marriage breakdown and leading to an increased sense of social isolation.

Unemployment is only the most acute form of this set of social problems, which is also linked to a increased degree of underemployment in which people find themselves shifting in and out of the labour market in unstable, part-time, poorly-paid jobs. Both unemployed men and those in low-paid insecure jobs were found to suffer roughly the same levels of depression, isolation and ill-health stemming from their situation. The stress stemming from job insecurity was also found to be a major factor in marriage breakdown.

So today's "peripheral" labour market does not only lower your pay, weaken your union organisation, intensify your labour and create the conditions for unsafe, unhealthy workplaces - it also attacks workers themselves, as people, at the heart of their physical and mental well-being.

Finally, workers are extensively - and increasingly - affected by violence in their working lives - an issue we examine in Part 2. The overall climate of recession and "underemployment" pushes workers into taking jobs as, for example, security guards which combine long hours and low pay with solitary working, thus inevitably raising the risk of serious violence - and the stress that accompanies that risk. The introduction of systems like One-Person Operation (OPO) on the buses leave drivers alone to face the common hazard of drunken and abusive passengers on 24 hour schedules. In general, the ever-tightening staffing levels imposed by cost-conscious employers leave workers increasingly vulnerable to attacks - for example by mental patients in under-resourced, poorly-staffed hospitals.

Europe to the rescue?

The picture we have painted of today's deteriorating working conditions, and their effects on workers' health and safety, is a grim one - though, we are afraid, only too accurate. This does not mean we lack ideas for strategies or solutions - we are saving those for Part 3! But many trade unionists, anxious about the increasing threat to health and safety provision - as well as general terms and conditions - have been looking to Europe for an answer.

There are good reasons for looking in this direction. The Social Charter (now Chapter) adopted by the European Council in December 1989, lays the basis for a comprehensive programme of workers' rights aimed at providing a level playing field of harmonised conditions across the whole European Community (EC - now known as EU or European Union). The Social Charter included:

• freedom of movement for labour including equal access to employment and social benefits
• improvement of living and working conditions, especially for part-time and temporary ("atypical") workers
• the right of equal treatment for men and women
• the right to freedom of association and free collective bargaining
• the right to workplace health protection and safety, including training, information, health and safety for employees.

The UK, already suspicious of the whole European project, adopted a systematic policy of "opt-out" which reached its culmination in late 1991 when Britain was the only one of the 12 EC states not to agree the Social Chapter of the Maastricht Treaty.

A major example of the British government's reluctance to co-operate in any European project to establish minimal worker rights is its attitude to hours of work, about which Sir John Cullen, Chair of the Health and Safety Commission has argued: "there is no good evidence to suggest that they have any effect on health and safety (Health and Safety at Work 1991).

Britain is the only EC member state to have almost no regulation of the hours of the working week, overtime, night work or holidays. As a result, UK employees work longer hours than any of their European counterparts - an average of 43.7 a week, compared with the European average of 40.4 hours. Almost 30 per cent of British workers work over 46 hours a week - more than in any other European country (Labour Research 1994).

What is to be done?

In his introduction to the GMB's anti-deregulation Freedom to Kill pamphlet, the General Secretary, John Edmonds, argues that "Work should enhance life; it should not endanger health." In Britain today, we are a very long way from that idea.

An appalling toll on workers' lives, a rising level of work-related illnesses, a government set on demolishing what legal defences workers still have, may make people feel powerless in the face of the onslaught. But there are strategies and resources available to workers to defend and extend their rights on health and safety and these are examined in this handbook which we hope will be useful to all those trying to combat workplace stress.