Health for the Holidays: Risks and Recommendations for the Retail Industry

Posted on by Donna Pfirman; Jessica M.K. Streit, PhD, MS; Seleen Collins; and Vern P. Anderson, PhD, CPE

It’s finally here—the most wonderful time of the year… for shopping. People will visit retail stores to buy a variety of goods: the cleaning supplies they will use to prepare for holiday celebrations, the food and beverages they will serve at holiday gatherings, the holiday gifts they will give loved ones, and much more.

Economic projections suggest retailers should brace themselves for a heavy amount of seasonal shopping traffic this year. According to an October 2018 Gallup poll, 87% of Americans plan to shop and spend money on the 2018 holidays [Saad 2018]. The National Retail Federation (NRF) estimates retail sales for November and December 2018 will total as much as $720.89 billion, representing an increase of 4.8% over 2017 spending levels [NRF 2018].

It’s estimated that retailers will hire as many as 650,000 seasonal workers in order to accommodate the notable increase in consumer traffic [NRF 2018], joining the ranks of the 4.6 million U.S. workers currently employed in retail sales [BLS 2018].

As the industry works to meet the demands of holiday shoppers, it’s important for store owners, managers, and employees to remember that the hustle and bustle can take a toll on retail workers’ physical and psychological well-being.

“At this time of year, I’m constantly moving,” says Angela, a retail sales associate we spoke with. “I’m ringing up sales, bagging purchases, helping customers in the aisles. It’s physically draining, and when interactions become unpleasant—which is bound to happen—I get really stressed, discouraged, and even annoyed.”

Sources of Stress in Retail Work

Exposure to stressful working conditions, like those Angela describes, can negatively affect retail workers’ safety, health, and well-being [Tuckey et al. 2017, Cho 2018]. According to the NIOSH approach to job stress [NIOSH 1999], the following working conditions may influence employees’ job-related stress levels:

  • Job and task design. Heavy workloads, a hectic work pace, insufficient rest breaks, long work hours, and irregular work shifts can cause workers to feel out of control and place them at increased risk for stress.
  • Management style. Poor communication and a lack of family-friendly policies and practices can be significant stressors for retail workers.
  • Interpersonal relationships. When coworkers and supervisors are not supportive or helpful, retail employees’ stress levels can rise.
  • Work roles. Confusion about responsibilities or feeling like there’s too much to do can make work more stressful for retail employees.
  • Environmental conditions. Large crowds and noise from sources like store music, announcements, and shoppers can make the workplace feel unpleasant and raise employee stress levels.

Significance of Retail Worker Stress

When retail workers face stressful conditions day after day, they may experience headaches, stomach problems, increased blood pressure, sleep disturbances, and mental fatigue [NIOSH 1999; NIOSH 2016]. Workers in poor health are more likely to show up late to work or even miss a work shift altogether [Marzec, Scibelli, & Edington 2015; NIOSH 1999; NIOSH 2018; Cho, 2017]. When workers experiencing high stress levels do come to work, they may have difficulty concentrating on their assigned tasks [Stepan, Fenn, & Altmann 2018]. This lack of focus can have negative consequences for employee health, well-being, and job performance. The consequences can even be extremely serious for some retail workers, such as those who use heavy equipment (forklifts, for instance) or sharp tools (such as meat slicers or box cutters). Distracted operation of these types of industrial devices can lead to injuries ranging from minor contusions, surface cuts, and abrasions to severe or even fatal lacerations, bone fractures, nerve or spinal cord damage, and amputations.

Recommendations for Reducing Retail Worker Stress

While there is no “one size fits all” approach to preventing job-related stress, NIOSH recommends managers and employees work together to identify critical stress-related problems and design reasonable solutions to address them [NIOSH 1999]. A combined approach that improves working conditions and provides employees with information on stress management is often the most useful way to address stress in the workplace.

NIOSH has several online resources to help retail employers and workers who are facing stressful working conditions (to learn more, see the Resources box). Employers may find the NIOSH guide Fundamentals of Total Worker Health® Approaches: Essential Elements for Advancing Worker Safety, Health, and Wellbeing to be helpful when establishing healthy workplace programs and practices.

CDC-NIOSH Resources

We’d like to hear from you! In the comment box, tell us whether you are an employer or employee; which aspects of this post were most interesting or helpful to you; and what concerns and challenges you are facing during the 2018 holiday shopping season.

Donna Pfirman is the NIOSH Co-Assistant Coordinator for the Wholesale and Retail Trade Sector program.
Jessica M.K. Streit, PhD, MS,  is the Co-Assistant Coordinator for the Healthy Work Design and Well-being Cross-Sector program.
Seleen Collins is a Technical Writer-Editor in the NIOSH Education and Information Division.
Vern Putz Anderson, PhD, CPE, recently retired as NIOSH Coordinator for the Wholesale and Retail Trade Sector program.



BLS [2018]. Occupational outlook handbook: retail sales workers. Bureau of Labor Statistics,

Cho Y [2018]. The effects of nonstandard work schedules on workers’ health: a mediating role of work-to-family conflict. Intl J Social Welfare 27(1):74–87, DOI: 10.1111/ijsw.12269.

Marzec ML, Scibelli A, Edington D [2015]. Impact of changes in medical condition burden index and stress on absenteeism among employees of a US utility company. Intl J Workplace Health Mgmt 8(1):15–33, DOI: 10.1108/IJWHM-09-2013-0035.

NRF [2018]. NRF forecasts holiday sales will increase between 4.3 and 4.8 percent. National Retail Federation,

NIOSH [1999]. Stress…at work. Cincinnati, OH: Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 99-101,

NIOSH [2016]. NORA Sector Council Bulletin: Wholesale & Retail Trade, Issue 7. Cincinnati, OH: Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health,

NIOSH [2018]. Using Total Worker Health® concepts to reduce fatigue among retail workers. Cincinnati, OH: Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2019-102, DOI: 10.26616/NIOSHPUB2019102.

Saad L [2018]. Americans in the mood to spend this holiday season. Gallup,

Stepan ME, Fenn KM, Altmann EM [2018]. Effects of sleep deprivation on procedural errors. J Exper Psychol, advance online publication, DOI: 10.1037/xge0000495.

Tuckey MR, Boyd CM, Winefield HR, Bhom A, Winefield AH, Lindsay A, Black Q [2017]. Understanding stress in retail work: considering different types of job demands and diverse applications of job resources. Intl J Stress Mgmt 24(4):368–391, DOI: 10.1037/str0000032.

Posted on by Donna Pfirman; Jessica M.K. Streit, PhD, MS; Seleen Collins; and Vern P. Anderson, PhD, CPE

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Page last reviewed: September 26, 2019
Page last updated: September 26, 2019