Help for the Holidays: Preventing Fatigue, Violence, and Stress in Retail

The holidays can be the most stressful time of the year—especially for retail workers who often work long hours and irregular shifts. These workers might also deal with crowds, violence, and robberies. This blog highlights the risk of fatigue, violence, and stress for workers in retail stores and provides strategies for making retail work environments and workers safer and healthier.

Preventing Fatigue

Fatigue is the body’s first response to insufficient sleep, a disturbed sleep cycle, an overly demanding physical or mental workload, or an insufficient period of recovery (such as time off) from work.[1]

Characteristics of retail work such as irregular and long shifts, long periods of standing, and reduced staffing have been shown to lead to fatigue and stress.[2] [3] More than half of retail workers have nonstandard shifts or workweeks longer than 48 hours and this may increase during the busy holiday season.[4]

Fatigue may affect cognitive ability, how we think, feel, and function, leading to slower reaction time and lessen workers’ ability to work safely. Fatigue may also cause retail workers to feel more irritable and make them more vulnerable to stress.[5] [6]

Comprehensive Total Worker Health® policies and programs may reduce worker fatigue. As a starting point, employers can take the following steps to prevent fatigue in retail.

• Consider allowing at least 10 hours between shifts, so workers can get 7 or more hours of sleep.
• Give as much advanced notice as possible for schedule changes.
• Ensure that 12-hour shifts do not include excessive workloads.
• Consider allowing rest breaks of 10 to 15 minutes regularly, such as every 1–2 hours during demanding work.
• Consider allowing for variation in workers’ tasks, duties, and positions to avoid monotony and muscle fatigue.
• Consider providing anti-fatigue mats, shoe inserts, and sit/stand stations for cashiers and others who stand for long periods.
• Record and review injuries, near misses, and other information to help determine whether fatigue is an issue.

Retail workers can also take actions to help improve sleep quality and quantity: [6] [7]

• Recognize that sleep impacts safety and health, including mental health and overall wellbeing.
• Get the 7 or more hours of sleep that you need each day to feel refreshed and alert.
• If possible, sleep in a dark, comfortable, quiet, and cool location to help you fall and stay asleep.
• Avoid heavy foods and alcohol right before bedtime.
• Drink enough water during the day.
• Assess priorities and consider if activities that involve missing sleep are worth the side effects associated with sleep deprivation.
• If your work schedule is causing you to lose sleep, discuss this with your supervisor.
• Seek assistance from a healthcare provider if you have difficulties sleeping.

The NIOSH Workplace Solutions: Using Total Worker Health® Concepts to Reduce Fatigue among Retail Workers and the Work and Fatigue website provide more recommendations and information.

Preventing Verbal Abuse and Physical Assaults

Workplace violence refers to any act or threat of physical violence, abuse, harassment, or intimidation that occurs in the work setting. It can range from threats and verbal abuse to physical assaults and even homicide. Retail workers are at a higher risk for many forms of workplace violence than workers in other U.S. industries.[8] Workers in gas stations and small retail establishments, such as convenience stores, face the highest risk of workplace violence of all retail workers. Retail workers also faced increasing instances of workplace violence during the COVID-19 pandemic. More recently, a survey of 400 retail employees found that nearly one in five workers had been a victim of workplace violence in the past year, 23% were verbally assaulted, 14% were physically assaulted, and 10% were bullied or emotionally assaulted.[9] Approximately three in five of the retail workers reported witnessing an incident of workplace violence in the past year. Workplace violence has been found to be associated with poor mental and physical health such as depression, anxiety, post-traumatic disorder, poor sleep, increased fatigue, burnout, and psychological distress.[10] [11]

There are many different types of workplace violence, categorized by the perpetrator of the violence. Workplace violence perpetrated by customers is the most common in the retail industry. This violence may occur in the form of threats or verbal abuse from disgruntled customers or as physical attacks during a robbery or shoplifting attempt. The prevention of workplace violence differs across the characteristics of the violent event. For robbery-related workplace violence, NIOSH published research-based solutions used to prevent violence in gas stations and convenience stores which may also help in other retail settings. Another resource the Occupational Safety and Health Administration (OSHA) offers is the OSHA Recommendations for Workplace Violence Prevention Programs in Late-Night Retail Establishments. Employers can incorporate the guidance document’s sample workplace violence checklists and incident report forms into their safety and security policies and procedures. Finally, crime prevention through environmental design deters criminal behavior by changing how physical environments are laid out. This can include ensuring highly visible work areas, controlling access to commonly stolen items, controlling entry of customers, and keeping a workplace well maintained.[12]

When referring to workplace violence perpetrated by customers, there are some basic dos and don’ts for workers to consider.[13]

Do

• Do attend all employer-provided training on how to recognize, avoid, and respond to potentially violent situations.
• Do report perceived threats or acts of violence to your manager or supervisor, following any existing policies that may be in place.
• Do remain aware of and support coworkers and customers if a threatening or violent situation occurs.
• Do report to your manager or supervisor persons who are perceived to be “casing” the store, loitering, or stalking.

Don’t

• Don’t argue with a customer if they make threats or become violent. If needed, go to a safe area (ideally, a room that locks from the inside, has a second exit route, and has a phone or silent alarm).
• Don’t confront or chase a customer who is in the process of a ‘smash and grab’.

Reducing Work-Related Stress

Work-Related Stress

The holidays are a stressful time for most workers, but retail workers bear the brunt of the busy holiday season. Fatigue, exposure to physical violence and verbal abuse, long hours, lack of control over work tasks and schedules, and poor support from supervisors and colleagues can all contribute to work-related stress for retail workers. A 2021 survey found that 47% of retail workers say their stress level increases during the holidays.[14]

Work-related stress is a harmful physical and emotional response that people may have when work demands and pressures exceed their workplace knowledge or capabilities.[15] Not everyone responds to stress the same way. Some common reactions include feeling sad or overwhelmed, being anxious, not feeling motivated, or feeling tired. If workers are exposed to stress over long periods of time, harmful physical or emotional responses such as headaches, musculoskeletal disorders, poor cardiovascular health, anxiety disorders, chronic illnesses such as diabetes, suicidal thoughts, and harmful substance use may occur.[16] Research shows that work-related stress has been linked with a greater likelihood of missing work due to poor physical or mental health.[17]

Approaches to Improving Worker Mental Health

While there is no “one size fits all” approach to preventing work-related stress, NIOSH recommends managers and employees work together to identify critical stress-related problems and design reasonable solutions to address them. Research shows that a comprehensive approach to addressing work-related stress by emphasizing changes at both the organizational and individual level leads to more successful and long-term improvements in worker mental health.[18] Organizational approaches include giving workers greater control over their work tasks and conditions, and training managers in supportive supervision. Individual approaches may include educating employees on stress-reduction strategies and providing resources and referrals for assistance.

Workplaces can be a key place for resources, solutions, and activities designed to improve mental health and well-being. In 2022, OSHA produced the website Workplace Stress: Make work better – mental health matters. The webpage provides an overview of mental health challenges including emotions that are temporary and not part of a diagnosable condition, such as feeling sad and anxious, grief, and stress. The website includes related resources for the improvement of worker mental health and well-being. Resources on the webpage include guides for supervisors and managers on how to talk to workers about workplace stress. There are also related mental health checklists that identify ways for employers to alleviate workplace stressors and support employee’s mental health.

Also in 2022, the World Health Organization (WHO) published the WHO guidelines on mental health at work. These guidelines include evidence-based recommendations to promote mental health in the workplace. The recommendations cover organizational interventions, manager/worker training, individual interventions, return to work, and gaining employment. The guidelines were written to help workplaces and employers implement evidence-based interventions for worker mental health.

Employers and workers can work together to prevent fatigue, violence, and stress in retail during this busy holiday season and all year round. See the NIOSH Stress at Work topic page the Healthy Work Design and Well-being Program for more information. 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.

Cammie Chaumont Menéndez, PhD, MPH, MS, is a Research Epidemiologist in the NIOSH Division of Safety Research.

L. Casey Chosewood, MD, MPH, is Director of the NIOSH Office for Total Worker Health.

Adrienne Eastlake, MS, RS/REHS, MT(ASCP), is an Industrial Hygienist in the NIOSH Division of Science Integration and is a NIOSH Wholesale and Retail Trade Program Co-Coordinator.

Jennifer M. Lincoln, PhD, CSP, is Acting Director of the NIOSH Division of Safety Research.

Suzanne Marsh, MPA, is a Lead Research Statistician in the Surveillance and Field Investigations Branch in the Division of Safety Research of NIOSH.

Jeannie A.S. Nigam, MS, is a Research Psychologist in the NIOSH Division of Science Integration and Co-Coordinator of Healthy Work Design and Well-being.

Donna Pfirman is Co-assistant Coordinator for the NIOSH Services and Construction sectors, and a Program Analyst in the NIOSH Division of Science Integration.

Hope M. Tiesman, PhD, is a Research Epidemiologist in the NIOSH Division of Safety Research.

For more information on retail work during the holidays see:

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

‘Tis the Season for Shopping and Safety

Reducing Fatigue and Stress in the Retail Industry: Workplace solutions

Driving Safety Tips to Keep Your Employees Safe this Holiday Season

Crowd Management Safety Guidelines for Retailers (osha.gov)

References

[1] Techera U, Hallowell M, Stambaugh N, Littlejohn R [2016]. Cases and consequences of occupational fatigue: meta-analysis and systems model. J Occup Environ Med August, https://www.ncbi.nlm.nih.gov/pubmed/27525527.

[2] Anderson V, Chun H [2014]. Workplace hazards and pre­vention options from a nonrandom sample of retail trade businesses. Int J Occup Safety Ergonomics 20(1):181–195, DOI:  10.1080/10803548.2014.11077036.

[3] NIOSH [2017]. Using Total Worker Health® concepts to reduce the health risks from sedentary work. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2017-131, https://www.cdc.gov/niosh/docs/wp-solutions/2017-131.

[4] National health interview survey: occu­pational health supplement. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, https://www.cdc.gov/niosh/topics/nhis.

[5] Caruso C [2014]. Negative impact of shift work and long work hours. Rehabil Nurs 39(1):16–25, DOI: 10.1002/rnj.107.

[6] Newsom R, Wright H. [2023]. The Link Between Sleep and Job Performance. Sleep Foundation https://www.sleepfoundation.org/sleep-hygiene/good-sleep-and-job-performance

[7] NIOSH [2018]. Using Total Worker Health® Concepts to Reduce Fatigue Among Retail Workers. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2019-102. DOI: https://doi.org/10.26616/NIOSHPUB2019102

[8] BLS [2022]. Workplace violence: homicides and nonfatal intentional injuries by another person in 2020. Washington, DC: Bureau of Labor Statistics. https://www.bls.gov/opub/ted/2022/workplace-violence-homicides-and-nonfatal-intentional-injuries-by-another-person-in-2020.htm

[9] Brittian J. [2023]. Diving into LPM’s Violence in the Retail Workplace Survey. Loss Prevention Magazine, May,  https://losspreventionmedia.com/survey-on-retail-violence/

[10] Andersen LP, Hogh A, Elklit A, Andersen J H,  Biering K. (2019). Work-related threats and violence and post-traumatic symptoms in four high-risk occupations: short-and long-term symptoms. International archives of occupational and environmental health, 92, 195-208. doi: 10.1007/s00420-018-1369-5

[11] Rudkjoebing, L.A., Bunghum, A.B., Flachs, E.M., et al. (2020). Work-related exposure to violence or threats and risk of mental disorders and symptoms: a systematic review and meta-analysis. Scandinavian Journal of Work, Environment & Health. 46(4), 339–349. https://doi.org/10.5271/sjweh.3877

[12] NIOSH [2023]. Reducing workplace violence in gasoline stations and convenience stores. Workplace Solutions. By Hughes SE, Chaumont Menéndez CK, Afanuh SE. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2023–121. https://doi.org/10.26616/NIOSHPUB2023121

[13] Centers for Disease Control and Prevention [2020]. Interim Guidance to Limit Workplace Violence Associated with COVID-19 Prevention Policies in Retail and Services Businesses. https://stacks.cdc.gov/view/cdc/92426/cdc_92426_DS1.pdf

[14] American Psychiatric Association [2021]. Holiday Stress. https://www.psychiatry.org/File%20Library/Unassigned/APA_Holiday-Stress_PPT-REPORT_November-2021_update.pdf

[15] World Health Organization [2020]. Occupational health: Stress at the workplace. https://www.who.int/news-room/questions-and-answers/item/ccupational-health-stress-at-the-workplace

[16] NIOSH. [1999] Stress at Work. https://www.cdc.gov/niosh/docs/99-01/#Job%20Stress%20and%20Health

[17]  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.

[18] LaMontagne AD, Keegel T, Louie AM, Ostry A, Landsbergis PA. A systematic review of the of the job stress intervention evaluation literature, 1990-2005. Int J Occup Environ Health. 2007; 13(3):268-280. doi: 10.1179/oeh.2007.13.3.268