Robert Pater, SSA/MoveSMART Director
Occupational Safety and Health News Digest (September 1987)

Those waiting for the fad to fade, like last year's trendy clothing, must already be blue in the face. Stress has continued to be a sign of the times. There's good news; really understand stress management and you can better promote safety, performance and morale.

Safety and health professionals concerned with having a healthy organizational bottom-line--hopefully all of us--already know some of the effects of negative stress. Stress costs industry $6-20 billion each year, about 1-3% of the GNP, according to researchers, McMurray and Conley. There are expenses other than the well-documented reductions in productivity, increased turnover, and greater health care usage. Softer costs include:

• Stressed employees tend to resist change, rejecting new systems or procedures.
• In a service industry, the "product" is delivered by people; staff who are disaffected and stressed will not provide as good service as those who have high morale and manage stress strongly.
• Nonproductive conflict can rise.
• Creativity, best promoted in an organizational climate where there is safe exploration of ideas, decreases when there is too much stress; instead, staff focus on protecting their image and their jobs.

These days, capable safety and health professionals know they must be stress management agents. Why? Studies show poorly managed stress results in increased accident incidence and severity. And hurts the organization overall.

Stress Affects

How does unmanaged stress affect people?

• Tunnel-vision. Perception becomes distorted, people blow things out of proportion. Have you ever seen someone frantically searching for a paper or tool that's sitting plainly in front of them? Another not able to find keys she is holding in her hand? Or misfiling something--putting the ice cream in the cupboard and the keys in the freezer? And sometimes people forget about vital tasks in favor of relatively unimportant ones.
• Mentally overwhelmed, can't focus. An example is reading the same report three times without knowing what you've just read. Or going through the motions, sleep-walking, in a fog, like a zombie.
• Loss of sense of humor. Morale plummets, the atmosphere becomes gloomy and overly intense.
• Coordination is reduced, people become clumsy.
• Balance becomes compromised, as people stop adjusting to the small propriocentric (internal) cues necessary to maintaining their equilibrium.
• Mental or physical exhaustion builds, contributing to all accidents.
• Increased susceptibility to illness. A recent American Medical Association survey indicated physicians believe 80% of their patients have psychosomatic (stress-related) illnesses.
• Daydreaming. Wishful or "save me" thinking ("Maybe I'll win the lottery or inherit a fortune or get offered the perfect job") drains time. Also, people may wistfully long for "the good old days," clearly in contrast with what is happening now.
• Increased alcohol and drug usage.

The Stress-Injury Connection

These stress reactions can lead to common injuries, especially when attention, judgment, and coordination are affected or too much tension persists.

• Overexertion (usually back injuries from lifting) can be caused by poor body mechanics. Mental distraction or excessive body tension can lead to workers' lifting, pushing or pulling the wrong way, even when they know better ("It's not so much knowing what to do, it's remembering to do what you know"). Also, being preoccupied with other concerns may overshadow the good judgment that an object is too heavy or bulky to move without help.
• Stress-induced inattention can lead to struck by/struck against accidents; distracted people can literally run into walls, desks, or machines.
• Slips and falls--the majority of which are on the same level--are often the result of tunnel-vision or poor balance; and distracted people can trip over "minor" hazards like tools, parts and open drawers.
• Finally, poor body mechanics or excessive tension can lead to the two main types of bodily reaction injuries--"straw that broke the camel's back" ones caused by repetitive motions (carpal tunnel syndrome is typical) or those resulting from a sudden movement (for example, throwing your back out in attempting to catch yourself from falling).

Stress Claims: Even When You Win, You Lose

Are these costs not direct enough for you? Consider the rise in stress claims, workers compensation cases where employees plead job-related stress has disabled them from working. These cases, which one anonymous observer called "the lower-back injury of the 80's," appear to be increasing, in number and in cost. Check your State's workers compensation statistics for the alarming facts--stress claims are on the rise.

The first page of any Sunday Los Angeles Times' classified section advertises several legal firms who encourage stress claim filings. And in Oregon, stress claims have been rising by a yearly rate of 60% since 1982, now comprising one-fifteenth of all State workers comp claims. And the costs are enormous. Mental stress cases cost Oregon employers an average of $12,246--almost double the average workers comp claim--in direct costs for each "closed" claim (each of which may be reopened when a condition becomes aggravated).

Add to this the costs of rehabilitation and replacement and the true costs really zoom. And watch out! These numbers may not have peaked. Many unions are staunchly defending stress claims as appropriate recourses for those white collar workers they represent.

Who puts in stress claims?

One loss control manager described these claimants as "very intelligent and articulate people" who have low self-esteem and are unhappy in their personal lives. This same manager contends less intellectual employees who are under stress tend to increased accident rates rather than filing stress claims. Attributing causes on stress claims range from harassment to job-transfer stress to being disciplined or dismissed to normal work stress.

The Cost of Winning a Stress Claim

If you decide to fight a stress claim and win, you still pay.

1. One safety director estimated the legal cost of successfully defending a stress claim at $15,000 in research and legal fees.
2. Stress claims can divide other employees into camps rooting for or against the claimant-employer combatants. The organization's approach to handling the claim will influence the future action of these employee "spectators." Heavy-handed attempts to discredit the claimant can leave some employees in fear for their own future treatment by the company and have others disillusioned by organizational insensitivity.
3. Time is lost--organizational representatives (Safety and Personnel staff, claimant's supervisor and coworkers) may be asked to speak to the defense attorney(s) or to testify at a hearing. Disruptions can sidetrack employee efforts away from their work.

Settling Can Lose in the Long Run

Frequently, insurance carriers recommend settling either "nuisance" or potentially costly cases. On a claim-by-claim basis, this strategy makes sense (remember the high cost of successfully defending a stress claim?). But when you look at the large organizational picture, this approach can backfire.

Settled claims also drive up insurance premiums. Standard "non-responsibility" clauses ("Payment of this sum does not imply admission of acceptance of claimant's charges," and so forth) notwithstanding, settlement can send three signals to other employees:

1. A "green light" to other potential claimants
2. A "hazardous conditions" sign to those concerned with their own health and safety ("Will I catch the same stress as her?")
3. A "flashing red light" to the manager or supervisor who was the "cause" of the claimant's personal problems

What You Can Do: Strategies

There are specific strategies you can implement to reduce stress-related accidents and claims. Methods that can make stress work for, not against, your organization and employees.

• Focus on developing a safety-conscious, high morale climate. Safety--like stress management--is ultimately a personal issue. You can help reduce organizational hazards, but everyone is responsible for their own safety and health. Remember the morale-safety tie.
• Develop a stress claims strategy. Prepare your line of defense against a possible claim (Will we fight them all? Settle those least costly?). Appraise management staff of the growing incidence of stress claims; discuss ways they can prevent claims or stem their spread.
• Help managers make clear what they expect of line supervisors; make sure supervisors communicate what they want their subordinates to be doing. Hazy or contradictory expectations are among the greatest sources of work stress.
• Listen. Pay attention to repeated employee complaints or problems. Tend to these before they blossom into accidents or stress claims (or lowered productivity, high turnover, low morale). Don't let complaints fall through the cracks. Many personnel experts report that stress claims can be headed off by empathically listening to the upset employee; there is no guarantee the employee's problems will be fixed, just a greater likelihood he won't file a claim (he may shrug it off, quit, transfer, get counseling, etc.).
• Promote support among staff. James House's studies ("Work Stress and Social Support") shows strong support substantially alleviates work stress. So team building, company leisure programs, recreational leagues, and other peer support activities can pay dividends.
• Encourage laughter. A relaxed atmosphere--not a silly one- can help staff get perspective on problems and better enjoy their jobs.
• Develop safe, stress-reducing exercise programs, available before or after work. Properly designed, these programs will also improve participants' balance, strength and coordination, helping reduce motion-related accidents.
• Reduce unnecessary control. "Stress" for most people is equated with a feeling of being out of control. As much as feasible, allow workers to determine their own pace, schedules ("flextime"), benefits ("cafeteria-style"), methods of celebration (managers really don't have to get involved in planning holiday parties), recreational teams, etc.
• Call attention to groups of accidents. Ask for discussion on the underlying causes, and conclusions on what can be done to prevent subsequent injuries.
• Provide solution-oriented training. Too often, stress management training merely identifies general problems; effective training focuses on realistic techniques that increase personal control.
• Acknowledge personal and work pressures but emphasize stress as ultimately an individual issue ("There may be many pressures, but each of us is responsible for our stress reactions--what's one person's meat is another's poison."). Let people know that stress is part of being alive. Caution supervisors to not say "this is a stressful place to work."
• Train management and supervisory staff in recognizing and adjusting organizational stress, and in harnessing it towards greater productivity.
• Help managers to control their own stress and not "pass it on" down the line.
• Be cautious of hiring training consultants who don't understand business in general or your specific organization's mission. Some well-meaning instructors have an individual-vs.-the-organization orientation that can throw fuel on the stress fire. Prime focus of all training must be on solutions, not blame.
• Employ strong change management. Change induces stress (IBM Medical Director, Dr. Alan McLean contends, "Change always involves loss of some kind."). Big changes are more stressful than smaller ones. Help your organization plan changes that are implemented one step at a time, thereby dissolving resistance. Give people time to digest the change before they have to do it. For example, in automating a manual process, provide employees to be affected lots of lead time, involve them in the changeover planning, and train them in the new skills required--all before the actual computerization.
• Improve the fit of workers with their tasks. Hire people who fit the job (hiring an ambitious person for a dead-end job can be a stress setup for her and her coworkers). Internally transfer those needing a change before they're desperate; redesign job duties for those with special skills.
• Other Human Resource Development strategies: provide career development programs, strongly orient new-hires to positively set their expectations, clarify grievance procedures, strongly recognize employees who promote safety on a grassroots level.
• Support employees in dealing with their individual problems. Contract with a confidential EAP (Employee Assistance Program) that can serve as a place of first resort for concerns of employees (and, optionally, their families). A good program accepts referrals from employees themselves or from their supervisors, trains managers in the referral process, and is well-advertised to all staff.
• When effective, EAP's help catch problems when small, prevent their bursting into accidents or stress claims.
• Work closely with other employee support professionals--Personnel, Occupational Health Nurses, Safety Coordinators, Safety committee members. Together, develop plans for monitoring morale and preventing stress flare-ups. Together, develop a list of practical stress management methods you can distribute to current and new staff.

Ultimately, good stress management is good safety management. Wisely supporting organizational staff to effectively and safisfyingly do their jobs will head many accidents, stress problems, and stress claims off at the pass.