Workplace Stress

Posted on by Steven Sauter, PhD

This is the time of year when we all may feel a little more stress due to the demands of the holidays. Unfortunately, stress at work can be a year-round issue further exacerbated during these months.

Work organization and job stress are topics of growing concern in the occupational safety and health field and at NIOSH. The expressions “work organization” or “organization of work” refer to the nature of the work process (the way jobs are designed and performed) and to the organizational practices (e.g., management and production methods and accompanying human resource policies) that influence the design of jobs.

Job stress results when there is a poor match between job demands and the capabilities, resources, or needs of workers. Stress-related disorders encompass a broad array of conditions, including psychological disorders (e.g., depression, anxiety, post-traumatic stress disorder) and other types of emotional strain (e.g., dissatisfaction, fatigue, tension), maladaptive behaviors (e.g., aggression, substance abuse), and cognitive impairment (e.g., concentration and memory problems). In turn, these conditions may lead to poor work performance or even injury. Job stress is also associated with various biological reactions that may lead ultimately to compromised health, such as cardiovascular disease.

Stress is a prevalent and costly problem in today’s workplace. About one-third of workers report high levels of stress, and high levels of stress are associated with substantial increases in health service utilization. Additionally, periods of disability due to job stress tend to be much longer than disability periods for other occupational injuries and illnesses. Evidence also suggests that stress is the major cause of turnover in organizations.

Attention to stress at work has intensified in the wake of sweeping changes in the organization of work. Organizational downsizing and restructuring, dependence on temporary and contractor-supplied labor, and adoption of lean production practices are examples of recent trends that may adversely influence aspects of job design (e.g., work schedules, work load demands, job security) that are associated with the risk of job stress.

There is also growing appreciation that work organization can have broader implications for the safety and health of workers—not just for stress-related outcomes. For example, long hours of work may increase exposures to chemical and physical hazards in the workplace, or night shifts may expose workers to heightened risk of violence.

The good news is that there are steps organizations can take to reduce job stress. As a general rule, actions to reduce job stress should give top priority to organizational change to improve working conditions. But even the most conscientious efforts to improve working conditions are unlikely to eliminate stress completely for all workers. For this reason, a combination of organizational change and stress management is often the most useful approach for preventing stress at work. The best design for a stress prevention program will be influenced by several factors—the size and complexity of the organization, available resources, and especially the unique types of stress problems faced by the organization. Details on preventing stress at work can be found on the NIOSH Stress at Work topic page—specifically in the Stress at Work booklet and in the Working with Stress video. The content of the video is also available on YouTube:

Researchers in the field of work organization and health continue to tackle workplace stress issues. In March 2008, NIOSH will cosponsor the Seventh International Conference on Occupational Stress and Health (External link: The conference will feature more than 500 new studies from all points of the globe, on the causes and effects of job stress including information and tools needed to create more healthy and stress-free workplaces.

In good health,

Steven Sauter, Ph.D.

Dr. Sauter is a Senior Scientist in the NIOSH Division of Applied Research and Technology and serves as Coordinator of the NIOSH research program on Work Organization and Stress-related Disorders. In 2007, he was awarded the NIOSH James P. Keogh Award for his significant contributions in the areas of organization of work and musculoskeletal disorders.

Posted on by Steven Sauter, PhDTags ,

56 comments on “Workplace Stress”

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    English Translation (provided by Thais Morata):
    Congratulations! Success to everyone that conducted this work.

    This is a very common problem in every working enviromnet. People create stress to each other hic!

    It is a very good if I have a trustful person who could be very patient to listen and share idea to solve stress from work.

    Stress for EHS personnel comes from constant new federal regulations, particularly DHS, with no capability for organizations to keep up with them in funding and staffing. We are obligated to comply and have no realistic way to do so. The federal government is creating regulations demanding mountains of paperwork that are supplanting our physical ability to install the safety and security measures the regulations are intended to address. I have three 3″ binders full of paperwork for one tiny aliquot of a select agent! Bureaucracy at it’s finest!

    As an OSHA regulatory specialist and consultant for the veterinary, medical and dental industries I find your article to be extremely useful and especialy timely. Thanks so much for bringing this issue to us in a succinct and informative manner and helping lead us to resources for our clients and employees~

    May your holidays be stress free~
    Doc Chery

    Congratulation for your excelent work, what I concern about this stress topic is that the causes of stress is deep known, and the recomendations related with have a limited impact, as they are followed just for short periods of time in the workplaces.

    As a Physician we have to identify a model which maintain the corporation focus in this silent enemy.

    Excellent blog.

    We have the NIOSH Stress at Work booklet & Video, which staff & clients really enjoy. Thanks so much for making this into an easy to understand format for them.

    Stress at work is a perfect example of a hazard that exists at work but is affected by non-work issues as well. Of course, the workplace must be the principle focus of workplace authorities but the personal experience of stress at work is not greatly different from stress outside of work.

    There are personal techniques for coping with stress but I am also interested in how workplace authorities and corporations engage with the broader society in reducing stressors. I often think that companies should develop outreach programs where coping strategies can be shared more broadly.

    Also there is always the competition between productivity and workplace stress, in badly planned businesses or management strategies. These issues do not need to be in conflict but business needs to accommodate the fact that sometimes workplace safety may involve a reduction in profits.

    Thanks a lot,
    Great what you did send to me because we all need to know what are the root causes of stress, currently we are a team of HSE working in the onshore land rigs, we are stressed and we are under huge exposure to work pressure that make us disturbed, hope you understand our feelling .

    Good Job you’re doing mates.

    Good to see such a rounded approach to stress at work.

    A combined approach to organisational and individual interventions seems senible, though the evidence for the beneficial effects of organisation change tends to support only short term effects. Effects immitate those that occur when any work group is consulted about almost anything.

    The degree to which a mismatch between demands and resources/needs would be described as stressful is very uncertain. Tools which try to predict where mismatch could be significant are unspecific. Foreseeability is a very significant problem.

    So, if prevention can’t be assured and adverse effects can’t be predicted with any certainty in individuals, what is to be done?

    We seem to be left with focusing our attention on secondary prevention/mitigation. This is not a position that would please regulatory bodies; where the ethos is focussed on primary prevention.

    Congratulations therefore on thinking outside the box.

    I hope the validation research shows a real benefit of this initiative. Similar research in the UK has so far proved inconclusive. More reports are expected.

    This issue is very interesting. I realize that there are things I do not have control over in my workplace. So if I can not control the stressors I need the skills to control how I react to those stressors. For example: Provide Yoga classes for workers.

    I enjoyed the article and believe it has some relavance to my line of work however, I cannot get to the links you posted as my company had deemed that site (youtube) as a “sexual content” site and blocked it. Can you put them at another site that is accessable to “highly sensored” readers like me?? (I’m sure that my company is not the only one blocking that site.)

    This topic can really get a person thinking about work organization and its relationship with reducing stress at work. However, employers must not look beyond the fact that many employees come to the workplace in a state of stress because of the many factors going on in the world around us (rising costs of providing for their families well-being and education, gasoline at $3/gallon, the world’s political state, global warming, or whatever). Employers should maintain work organization and work practices that do not contribute any additional stress to the employee, but also look at programs to help the employee deal with stress outside of the workplace.

    Your topic is very timely, while both public and private business and academia work to streamline their operations; striving for efficiency and effective organizational administration intended to increase the economic bottom line of their organizations. They often times do not see the long-term effectives that short-term remedies have on their employees and their business.

    I will show my age with this comment, but it seems as if companies are now trying to fit a square peg in a round hole with their employees. There was a time when people could hire a friend,favorite college or service associate as ther executive managers because they wanted to have people around them that would agree with them or at least agreed with their management style. Now is not that time, there are no longer surplus employees that will do the work of the executive that was hired for who he or she knew or what previous organization they once worked to build.

    A considerable amount of managers seem to provide an envirnomnent in which people are required to work in constant chaos because that is how the executives of the company learned to manage and live. Workaholics are the norm not the exception and are rewarded for long hours of devotion to the company’s cause. The problem is the mind can only take that kind of stress for so long before people start to lose their edge and it effects their health. Poor managers think, “Well their used up, time to move on to the next fresh mind or body”, only to have burnt out some of their best trained, most experienced assets by forcing them to perform beyond human standards.

    Companies need to truly analysis their operations, understand what will help them manage effectively and get the “right” people in the “right” place to do the job. Reward them fairly, and treat their employee’s like they want to be treated. Less does not always mean more, managers have lost the true meaning of the lean concept. In a perfect business world the mater should be Confidence, Competence, Safety and Discipline.

    If your employees are properly trained and skilled, they will be have the confidence to make the right decisions, they are competence at their job, which makes them effective, efficent and safer employees. When you provide a disciplined professional work environment that both reflects concern for your employees as well as allows people to feel part of a bigger picture than just the individual job they are doing, you have successed as a manager.

    I know what you are thinking, “but it costs to train,it takes people away from their jobs which leads to down time & costs overruns”. What you should be thinking is training, job safety and providing a disciplined caring work envirnoment that produces people that are knowledgable,skilled and supported as employees actually will save you money in the long run, and increase your employee’s effectiveness.

    Also, if a crisis does arrive you will not be standing in a boat with the people around you repeating, “Yes, Fred there is a hole in the boat and “you” are sinking”

    In my opinion, valuing your employees and your customers may be the only way in which we will bring our economy back into focus. “Never waste a good mind, wherever you find it.”

    REMEMBER CCDS, not chaos should be your management rules.

    If this is true…why doesn’t the government try to make mandates to protect the public from being overworked??? I feel the US government is as big an offender of overworking employees as the private sector is.

    Ironically the model organization to study workplace stress is CAL/OSHA here in California, and especially in San Diego where there is only one enforcement office serving two large highly industrialized counties. I left the compliance unit of CAL/OSHA back in the year 2001, but have maintained communication with my ex-colleagues in CAL/OSHA, and have found to my dismay that the workplace situation is steadily getting worse. The line inspectors are being overloaded with work that is impossible to accomplish within the legal time limits and statutes.

    1. The six compliance officers assigned to serving general complaints and investigating accidents have been recently reduced to six in the San Diego area. As a result each officer is juggling as many as twenty accident investigations and inspections.

    2. The CAL/OSHA officers must issue citations to irate employers in order to maintain acceptable job performance, yet then they personally must defend the citations in the numerous appeals before an administrative law judge. CAL/OSHA’s Legal Unit is no longer supplying the attorneys to defend all the citations that are issued. Furthermore, the State is short of judges so the appeal cases are scheduled two by two at simultaneous times before the same judge, a totally impossible situation that often leads to violent arguments as to how to proceed.

    3. The administrative paper work and bureaucratic procedures involved with each CAL/OSHA inspection and investigation has become onerous prolonging case closure.

    4. Managerial supervision is pronounced with the advent of the computerized office where employees are going to work on Saturdays just to catch up on the enormous load of e-mails that need to be answered. The computerized office has also promoted constant managerial monitoring of the inspectors’ work.

    5. The over all work that CAL/OSHA inspectors must perform is poorly distributed with many experienced and favored employees are placed in positions of little work load, while the basic line inspectors have an impossible workload, and are doing the work of multiple job positions.

    6. This high stress situation has increased the turnover of compliance inspectors with many leaving for other more comfortable jobs with the State or just leaving in total frustration. Many inspectors have developed high blood pressure and musculoskeletal disorders under the stress of of their workload, and some have been found dead in their homes from strokes decimating the inspector staff even further.

    Although I am not in a position to invite NIOSH to perform a study of the horrible, stress-filled plight of the line CAL/OSHA inspector here in San Diego or in other CAL/OSHA enforcement offices, in sympathy for my over-stressed ex-colleagues, I hereby challenge NIOSH to perform a workplace stress study of the San Diego Office of CAL/OSHA and possibly other CAL/OSHA enforcement offices, and I guarantee that NIOSH will find the worse case workplace of any that has ever been studied. Thank you for your attention.

    The majority of the articles that I have read relating to work place stress emphasis steps to take to relieve the inner stress we feel and how to breathe correctly; stress good posture etc. The problems are external and those that the employee has no controll over. When management tells you that they are unable to fill job opening due to budget cuts and we all have to do the best that we can….and this goes on year afer year and is effecting all businesses…what do you do? Quit? It is the same every where. The work piles up and stress builds even if the employer/manager says it is is not OK because we all know that you are being rated based on your performance against your fellow worker. The carrot gets dangled! If you work for a government agency like I do, the budget cuts are getting worse and the volumes are reaching stagering levels. I won’t cut corners like my fellow workers (moral dilema) and I suffer on the inside. I need the benefits; I have a cronicaly ill husband who depends on my health insurance through my government employer. When Washington says no funds and then increases the workload or allows faulty services etc…..we can not argue with Washington. I am a hard worker…but I feel like a slacker when I can’t reach my goals that I set weekly and monthly. I have ended this year, as my fellow workers have, with a room of unresolved cases and nowhere to put them and 2008 processing year is on the horizon! Merry Christmas! Ho! Ho! Ho!…I think not! Not this year!

    Thank you to NIOSH leadership for continuing to look outside the box to deliver on the Nation’s promise.

    The article is right on the money. Recently at my place of employment, we have just gone through a “job reduction” through job redundancy. Supposedly to make the operation more viable. However, the Company is spending money like drunken sailors, with increased overtime, when prior to the layoffs O/T was all but eliminated. Special projects costing in the hundreds of thousands of dollars and apparently no end in sight. All of this at a time when the life of mine, is in the 3 or 4 year range. So the new catch phrase being used by management is, “we must all do more with less in orer to ensure that we remain financially successful and retain the jobs that are remaining”. To this end, many more of my co-workers have since left voluntarily adding more stress to an already tense work environment. Moral is at an all time low, most if not all have lost the desire to work positively and the work site has become a place to bring home a pay cheque and that’s it, no more. My fear is my co-workers are starting to show the signs mentioned in the article, their health and well being is now at risk. What has happened to the old addage, a happy work force is a productive work force?

    I like the blog! However because DOD blocks all access to You-tube, I and those I want to have watching the videos cannot access them. Would you consider a 2nd avenue to view them that is acceptable to DOD?

    Thank you admin

    Stress for EHS personnel comes from constant new federal regulations, particularly DHS, with no capability for organizations to keep up with them in funding and staffing. We are obligated to

    I have treated many employees at major corporations and and have been designated an EAP rep for salaried employees. My experience with highly educated employees experiencing stress is often due to dysfunctional organizations and HR practices. NIOSH states “Certain problems, such as a hostile work environment, may be pervasive in the organization and require company-wide interventions”; I have seen “pockets” of these dysfunctional units within large organizations and the impact on employee health.

    Organizations that do not follow their own stated values and circumvent the written corporate policies. Employees assume these work rules are consistent for all employees but in reality find they are not practice leading to insecurity because they cannot depend on the policies being implemented.

    I wonder if NIOSH has looked at the research done by Pamela Lutgen-Sandvik at Arizona State University. She published an article “Communicative Cycle of Employee Abuse”; in short she identifies what amounts to ‘Bulling’ in the work place. Her studies indicate this is quite prevalent in the US.

    Bulling in schools is an already recognized problems but it needs to be addressed in the workplace since this is a common cause of stress as I have witnessed through my interface with white collar, highly educated and professional employees. The EU OSHA equivalent has a detailed publication on this prevalent problem in Europe and in fact several countries have adopted laws against this form of organizational behavior. In addition several States in the US have also introduced legislation to outlaw bulling in the workplace. I believe this is a ripe area for research in Occupational Psychology and shouldn’t be overlooked.

    I believe Pamela Lutgen-Sandvik is currently on faculty at the University of New Mexico in the Communication Dept.

    I am very interested to know if NIOSH and Occupational Psychology researchers have delved into this subject. I am most interested for any enlightment on the subject.

    Workplace bullying is a major occupational health concern world-wide. The Seventh International Conference on Occupational Stress and Health—”Work, Stress, and Health 2008: Healthy and Safe Work Through Research, Practice, and Partnerships”—held March 6–8, 2008, featured many papers on this topic that received international press coverage. NIOSH also has research underway on bullying at work. You may also want to search for research on the topic from Dr. Gary Namie.

    Beautiful article!. Claps for Steve and all his efforts in this issue. I would like to stand out two things:

    1) What about developing countries?. The systems of work are so diverse that you can find communities with antique agriculuture systems, taylorism, and new lean production technology. The worst: lack of good will from stakeholders to do something. Then the challenge is bigger for all us.

    2) How stress should be understand?. For some experts stress is “life” itself. According to this principle we need a “moderate” stress to feel enthisiastic and be productive. Therefore we should keep the stress in good levels not to eliminate it at whole.

    While there are special concerns in developing countries, a good deal of the NIOSH stress research can be applied to all workers. Stress in developing countries is a an important concern at the World Health Organization (WHO). Evelyn Kortum in WHO’s Department of Public Health and Environment is overseeing this initiative.

    Additionally, the next Work, Stress and Health Conference will be held in Puerto Rico in November, 2009, and will focus on this topic. The title of the conference will be “Work, Stress and Health 2009: Global Concerns and Approaches.”

    I am currently undertaking an Employment Law Course in the UK. I am preparing an assignment in relation to stress management in the workplace.

    I am comparing the differences between UK and US law surrounding this topic and have found this site to be very useful.

    Many thanks

    Great information to reduce or eliminate the work stress. Thanks for sharing it.

    I have some additional steps that can help on reducing or eliminating the work stress…

    ◦develop your time management and organizational skill
    ◦Take breaks as often as you need
    ◦Try to keep yourself happy, enjoy on what you are doing and smile…
    ◦Relax time to time during your work hours…

    stress also comes about when your trust in security to help you with hostile family members are shattered .security needs to be trained properly and held accountable for any harm mental or physical that comes to the employee when they are told to escort a hostile and aggressive family member off the property they should not dismiss the nurse fear of potential(perceived/implied)impending harm to self.

    At posting #24, Dr. M. Bradshaw, MD, MPH, wrote about workplace bullying and asked whether NIOSH had “delved into this subject.” (Posted 2/5/08) NIOSH responded that workplace bullying is a major occupational health concern world-wide, and pointed to its research underway on bullying at work, with a link to a press release of 7/28/04. (Posted 4/12/08)

    That press release, states:
    “Most incidents of bullying in the workplace appear to be perpetuated by employees against one another, early findings from a study by the National Institute for Occupational Safety and Health (NIOSH) suggest.” It states: “Data reported from the survey indicate the following: In the most recent incident that had occurred, 39.2 percent involved an employee as the aggressor, 24.5 percent involved a customer, and 14.7 percent involved a supervisor.”

    As an AFGE Local 12 Union Steward focused on workplace bullying, I found these figures inconsistent with my personal experience and the results of a survey of supervisory behavior at the US Department of Labor which I presented at the Labor and Employee Relations Association Annual Conference in 2007. The NIOSH report seriously understates the extent of supervisory bullying.

    The problem lies in the choice of the “key respondents at 516 private and public organizations” who are “human resources professionals or other individuals who were knowledgeable about their organization.” The sample size is good enough, but a survey of HR staff is not the way to find out how managers are treating employees. HR staff and “other individuals who were knowledgeable about their organization” are likely to be biased toward putting the company management in a good light.

    Unfortunately, the press release for this flawed study is getting attention. NIOSH should conduct a proper study by surveying a random sample of employees. (If a few HR and public affairs folks fall into the sample, there is no harm done.) And don’t ask people whether they have been bullied. Rather, ask whether they were subjected to specific negative acts and failures to act.

    Oh, AFGE Local 12 took a step to address this problem in its “Proposal to Secretary of Labor Elaine Chao on Workplace Bullying and Psychological Harassment” at

    We had multiple goals when including workplace bullying questions on the National Organizations Survey (NOS) referenced above. It is likely that the survey underestimates the workplace bullying problem because the survey was sent to decision makers (including human resource professionals). However, other goals of the research were to learn about policies and training related to workplace bullying and managers are most likely to be involved in such programs.

    We are also including questions on workplace aggression and bullying on the General Social Survey (GSS), which is a representative sample of adults 18 years and older in the U.S. These results will help to quantify workplace bullying experiences of individual workers. The findings of this survey are expected next year.

    Your are right jobstress arises due to lack of job. Another main cause lacking of interest in job. We should love our job rather than the company we work for.

    This is an excellent training resource for anyone involved in learning about stress at work.

    I encourage all OHS students specially those specialising in the area of occupational psychology.

    I am a graduate student at Old Dominion University completing a Risk Assessment course. I was reviewing you submission in regards to the topic “Stress at Work”. I found the article interesting and justifiable in many aspects, such as turnover rate, cardiovascular disease and homicide.

    One of the many questions I wanted to inquire about is NIOSH’s research in relation to the program regarding psychosocial matters. As we know in today’s society there are many variations in age, race and gender in the workplace; therefore, what is NIOSH’s advice on how to implement tools needed to evaluate and analyze data in relation to psychosocial factors when examining workplace stress? How do you plan to individualize studies for certain groups? For instance, the number one killer of women is homicide in the workplace, and driving is the number killer for men; therefore, how does NIOSH plan studies to reduce these rates? Reviewing the program revealed no supporting concrete evidence illustrating the results of the study in researching psychosocial attributes. Categorizing the determination of specific groups is essential in your successful program because every person exudes certain personalities and traits. One person may easily become stressed by a minor situation or altercation; whereas, another individual may be easy-going and able to tolerate high stress levels accordingly. Therefore, how would NIOSH respond to examining these various types of individuals, how would NIOSH measure the stress level tolerances, would NIOSH utilize certain tools to analyze the results, would NIOSH focus on any pre-disposing factors; i.e. results of physical or mental state of the individual prior to becoming employed, have the psychosocial symptoms always been existent, are there any primary, secondary and tertiary treatments, and finally how would NIOSH maintain continuity throughout the workplace to ensure a stress free environment? Overall, the program is right on point because stress can create havoc and even death at times depending on the magnitude of the situation and as professionals we can all relate to certain levels of stress, which can become integrated into our lives. All aspects of implementation in NIOSH’s research in regards to the workplace environment are accurate; however, my question is what about your focus on the individuals themselves and not only relying on the workplace environment for your outcome. Again, we truly appreciate NIOSH’s dedication and hard work in revolutionizing new techniques and research to assist in different aspects of health. Thank you for your time and I look forward to your response.

    These are interesting comments pointing out the complexity of the stress process and the challenges of intervening in a way that is responsive to this complexity. The scientific community has long recognized that individual and extra-organizational sources play a role in the stress process (see, for example, There has been less attention, however, to strategic approaches to address these sources in a coordinated way. A recent book chapter (see below) by NIOSH scientists discusses recent efforts toward more comprehensive approaches to the prevention of job stress. Also, you may be interested in the new NIOSH “WorkLife” program which focuses on coordinated or integrated approaches to diminishing health threats in general (not just stress) to workers in and out of the workplace. A growing body of evidence indicates that these approaches are more effective in protecting and improving worker health and well-being than traditional isolated programs. You can learn more about this approach and growing body of research by going to the NIOSH WorkLife program web page

    Sauter, S. L. & Murphy, L. R. (2006). Approaches to the management of job stress in the US. In P. Perrewe, A. M. Rossi, & S. L. Sauter (Eds.), Stress & quality of working life: Current perspectives in occupational health (pp. 168-183), Greenwich, CT: Information Age Publishing, Inc.

    Hello, I am a graduate student at Old Dominion University in Norfolk, Virginia taking a risk assessment course. One definition of risk is “the probability of a future loss”. Stress can be considered a workplace risk. The risks include negative health impacts on employees and monetary losses for employers. Stress in the workplace can be predicted and quantified for most occupations where stress is a factor, i.e. Air Traffic Controllers. Has NIOSH been made aware of any workplace stress-related risk management processes that prepare employees for the demands the position may require? Are employers required to provide stress management strategies and/or outlets for employees to communicate when stress has become overwhelming?

    Stress can be a factor in any workplace. Job stress results when there is a poor match between job demands and the capabilities, resources, or needs of workers. NIOSH recommends a combination of organizational change and stress management for preventing stress at work. More information can be found on the NIOSH Stress at Work topic page—specifically in the Stress at Work booklet and in the Working with Stress video.
    While employers are not required to provide stress management resources, many of them do. For an update on what employers are doing, take a look a the publication on the results of the 2004 National Worksite Health Promotion Survey in the American Journal of Public Health.

    Linnan, L. et al. (2008). Results of the 2004 National Worksite Health Promotion Survey. American Journal of Public Health, vol.98 no.8, 1503-1509.

    I definitely can relate to the increase in work related stress during the onset of this season. As a city employee, I am aware of many of the city implemented programs to help employees cope with both job and personal related stress. The most recent event that I have observed with my organization is that elevated stress levels were caused by projected lay-offs and the elimination of open positions that were needed to help the organization function more efficiently and reduce the work load of current employees. Ironically, in the past city jobs were highly sought after because of job security and great benefits. Like you mentioned in the article, this type of stress especially during the holiday season can cause a number of both chronic and acute illnesses. What proposals if any would you suggest to help employees cope with the stress of being laid off during this holiday season? And more interestingly, are there any there any current studies that analyze the effects of job-stress on employee’s health (both the development of chronic and acute illnesses) and job performance?

    Thank you for your comment. NIOSH does not have specific information related to stress from layoffs. You may want to search the literature. General strategies for coping with stress are outlined in the Working with Stress DVD and Stress at Work document.

    You also asked about current studies on stress, health, and job performance. A summary of NIOSH research and other outputs can be found on the NIOSH Work Organization and Stress-Related Disorders Program Portfolio page. See “outputs” in the right navigation bar. In addition to evidence from NIOSH publications and research cited on the NIOSH website, there is an abundance of research on the effects of stress on the development of illness in the open literature; however, the relationship between stress and performance is a subject that has received relatively little research attention thus far.

    I am graduate student at Old Dominion University, currently enrolled in a Risk Assessment course. The article about Workplace Stress is very relevant, timely, and applicable.

    The Surgeon General estimated that “80% of people who die of non-traumatic causes actually die of stress disease”. Nurses are healthcare providers that may experience extreme job strain. Job demands, inadequate staffing, long work hours, are a just a few situations that intensify their work related stress. Prescription-type drug abuse is rising nationwide. Many nurses have access to prescription-type drugs as a part of their daily work routine. With under staffing and fairly easy access, there is a concern that some nurses are at work “dope up or down” on various prescription-type drugs. These effects can cascade to disturbed health and behavior disorders and can affect work performance.
    This situation creates very complex health and safety risks. Is NIOSH aware of any research evaluating work induced stress causing prescription-type drug abuse among nurses?

    Thank you for your comment. Substance abuse among nurses has been the subject of a recent review [Dunn D. Substance abuse among nurses—defining the issue. AORN J. 2005 Oct;82(4):573-82, 585-8, 592-96; quiz 599-602]. Stress may well be a risk factor, but there has not been much work specifically addressing the issue. Much general information about substance abuse can be found at

    Hello, my name is Pooja Rajani and I am currently pursuing my masters at Old Dominion University. Your article is extremely interesting. I was curious if there was any difference in work-related stress that residents and doctors faced? Since residents are expected to work (minimum) 80 hours a week, it is natural to think that their lifestyle, eating habits and family life might be affected. Moreover, since North American health services tend to be curative as opposed to preventative, are doctors abusing drugs? Also, are there specific stress related illness found in ER doctors as opposed to a general practitioner? Could it be that more doctors are feeling the need to have a stress free lifestyle, and are therefore opting for specialties like dermatology, radiology, etc. which require little or no on-call hours? If so, this could be a reason for the shortages in primary care physicians. In that case, is the American Medical Association doing anything to prevent the stress in these types of specialties or the medical profession in general? What about other countries? Are the causes of stress the same or different for physicians?

    In other words, do changes need to be made in the way the work is organized in health care, to reduce stress?

    NIOSH is actively concerned about the health and safety of health care workers in general and work organization and stress issues rank high among these concerns. This is a priority topic within the National Occupation Research Agenda. In this regard, a review document on these subjects is under development at NIOSH and we anticipate it will be available by first of the year. Unfortunately, we do not have the information to respond to your other questions.

    Dear NIOSH Workplace Blogger,
    Please try not to let this note add to your stress level 🙂 I am a student at Old Dominion University in the Environmental Health program. One of our assignments is to post a comment on a NIOSH blog related to our course on Risk Analysis. The workplace stress topic interested me because of my workplace experiences in places where high stress levels, burn out, and health problems seem abundant. The combination of Dr. Sauter’s writing and the videos on YouTube were helpful in identifying organizational issues that are likely contributing to our unhealthy workplace.

    Three questions:

    1.Our text book, Introduction to Risk Analysis by Byrd and Cothern, has two chapters that I am wondering how they may relate best to workplace stress; one is on dosimetry and the other on epidemiology. I imagine the epidemiology side of workplace stress might be studied by looking at the various ailments affecting the population in a particular industry. Is there a way to measure the “effect of dose levels of stress” on workers? For instance, how much (dose of stress) getting yelled at by the boss causes a biological effect on the worker.
    2.Do you have advice for a worker to bring up potential improvements in organizational structure with management with a goal of improving the health of our workplace without offending management?
    3.Has NIOSH done any research on the potential for siestas (afternoon naps) to reduce workplace stress?

    1. Is there a way to measure the “effect of dose levels of stress” on workers?
    There is substantial literature on the effects of stressful job exposures on health-related outcomes and within this literature associations between levels of exposure to response levels are evident. For examples of this work, take a look at the Journal of Occupational Health Psychology or Work and Stress.

    2. Do you have advice for a worker to bring up potential improvements in organizational structure with management with a goal of improving the health of our workplace without offending management?
    The NIOSH booklet Stress…At Work provides guidelines for dealing with stress in the workplace. The document notes that “bringing workers or workers and managers together in a committee or problem-solving group may be an especially useful approach for developing a stress prevention program.”

    3. Has NIOSH done any research on the potential for siestas (afternoon naps) to reduce workplace stress?
    There is a growing literature on the salutary effects of napping on work-related outcomes, although NIOSH is not presently engaged in studies of this nature. Here’s a reference to a recent study of this nature: (Takahashi M, et al: Brief naps during post-lunch rest: effects on alertness, performance, and autonomic balance. Eur J Appl Physiol Occup Physiol 78: 93-98, 1998.) You might want to Google Dr. Masaya Takahashi or contact him directly for more information on this topic—he’s a leading expert in this area.

    I recently experience bullying in my workplace. Unfortunately, my employer would not defuse the situation and I left the office to avoid any further confrontation. I called my employer and asked him to please call me back when the situation enabled me to do my job. I waited in the parking lot for several hours, and after no call I went home. I called several times that evening to discuss the matter with my employer. He did not take my calls. The next am he called and felt I had deserted my position and told me not to come back. I was also texted by an employee “don’t come back”. Do I have any legal recourse in this situation? I really liked my job and felt my employer should have prevented the situation from excaluating to this point. I would not have left if I felt safe.

    PLEASE HELP!!!!!!!!!!!!

    As a research Institute, NIOSH does not advise on legal issues. You may want to consult a private attorney. If the workplace bullying was due to discrimination on the basis of race, color, religion, sex, national origin, disability, or age, then the U.S. Equal Employment Opportunity Commission (EEOC) may be able to provide guidance. Additionally, you can review your company’s policy on Alternative Dispute Resolution—sometimes referred to as the Employee Assistance Program (EAP). You may also want to look up the work of Gary Namie, a leading expert in the field of workplace bullying.

    Wonderful article. Our Manager is nice for the most part, however he doesn’t seem to have control over his actions at times. He threatens staff in front of other workers and even in front of customers.

    He also said to another employee in front of me that, “you know, I really like her, but I’m going to have to let her go…she is too slow”. Also he said, “You wait, at the beginning of the year blood will fly”. Not sure what he meant by that except that my job was at stake? (They may downsize at the beginning of the year). This was all said within one week.

    I have epilepsy and an abundant stress does effect me. It doesn’t need help from others whom don’t know how to handle themselves. I hope NIOSH, WV, sends information to post at worksites about bullying and its effects. Something that would speak to the “out of control” managers and owners, so they would take their actions more seriously.

    I read this very interesting document and even I had the chance to listen to Dr. Sauter’s presentation in Rome on November the 5th this year with reference to this subject. I would like to receive an electronic copy of his presentation in Rome.

    Dear Dr. Montagnani,
    Listed below are links to several NIOSH websites that contain information of the type I presented during my recent trip to Rome:

    Overview of the NIOSH stress program
    NIOSH report on hazards of shift work and long work hours
    NIOSH booket on preventing job stress
    Downloadable NIOSH video on prevention job stress

    There is more information of this nature that is accessible from the NIOSH topic page on job stress, but in the links listed above, I have tried to direct you to information that would have the most practical value for you.

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Page last updated: November 23, 2016