Work-Related Stress: Its Implications for Public Health

Work-related stress has been a great concern to management, employees, and other stakeholders of organizations because it poses serious health problems to employees which often led to low productivity. This review article examined the effect of work-related stress on the health status and level of productivity of the employee, as well as the burden of huge healthcare expenditure on the employer. A systematic review and meta-analysis of relevant literature show that about forty percent of job turnover and fifty percent of work place absenteeism were caused by work-related stress with attendant job dissatisfaction among employees, and health problems including hypertension and cardiovascular complications. Furthermore, healthcare expenditure were nearly 50 percent greater for employees who reported high level of stress, and as a consequence about 44 percent of women and 36 percent of men quit their jobs. Work-related stress has been attributed mainly to burn-out, job insecurity, poor employee-employer and employee-employer communication and intrapersonal conflicts as well as inadequate human and material resources. Therefore, instituting primary, secondary and tertiary prevention measures has potential to mitigate the effects work-related stress when employees are empowered with the knowledge and skills required to identify triggers of work-related stress and learn to express their feelings is paramount.

Work-related stress is a challenge both to the employee and employer because it caused appropriately 40 percent of job turnover and 50 percent of workplace absenteeism which are consequences of the negative impact of work-related stress on an employee’s physical, emotional and behavioural aspects of health. Overstretched employees were prone to diseases including hypertension and cardiovascular problems. More so, an employee’s satisfaction with his or her job comes not only from conditions inherent in the job and social environment of the organization itself, but also from the broader environment which work takes place [1,2,3,4,5,].

Triggers of work-related stress

Work overload and under load, fear of a possible job loss, a workaholic tendency, advancement in technology and work place bullying are culpable for work related stress. Other causes of stress include unclear vision about carrier path and conflicting professional roles, lack of break time during the workweek, lack of vacation time, interpersonal conflicts, administrative or clerical tasks, adverse working conditions and management practices such as; unrealistic demands, lack of support, unfair treatment, low decision latitude, lack of appreciation, effort-reward imbalance, conflicting roles, lack of transparency and poor communication [6.7.8,9,10].

Manifestations of work- related stress

Manifestations of work-related stress are categorised as follows

(a) Physical symptoms: which include headache, grinding of teeth, high blood pressure, clenching of jaws, muscle ache, chest pain, constipation or diarrhoea, shortness of breath, cardiovascular disorders, indigestion, insomnia, perspiration, constant fatigue, skin rashes, ulcer, loss of appetite, overeating, marked decline in personal appearance, and quick fiery temper.

(b) Psychological symptoms: such as anxiety, tenseness or nervousness, irritability or unhappiness, worry, pessimism, sadness, defensiveness, frequent illness, anger,  mood swings, fatigue, hypersensitivity, frustration, apathy, indifference, depression, loss of motivation, slowed thinking or racing thoughts, feelings of hopelessness, inability to concentrate on the simplest routine tasks or duties, being overly emotional and aggressive in conflict situations, difficulty recollecting previous events, and inability to make decisions.

(c) Behavioural symptoms: including fidgeting, pacing, restlessness, overeating or loss of appetite, impatience, anger, quickness to argue, procrastination, alcohol and drug addiction, withdrawal from social activities, neglect of responsibilities, poor job performance and personal hygiene, shift in religious inclinations, changes in close relationships, sleeplessness,  high turnover rate, work-related accidents, nail biting or lip chewing, foot tapping, knee jiggling, blaming others at the slightest offense or weeping, absenteeism or lateness to work which reduces task performance and productivity.

Consequences associated with work- related stress

Work-related stress contributes to inefficiency, ineffectiveness, job dissatisfaction, intentions to quit or turnover, absenteeism, low productivity, huge health care expenditure either out of pocket or borne by the organization, Others include social vices such as alcoholism and drug addiction, and health problems such as hypertension, cardiovascular disorders and depression [2,11,12]. As a corollary to the above listed consequences associated with work-related stress, studies show that about 44 percent of women and 36 percent of men indicated the intention to quit their jobs due to work-related stress and the attendant huge health care expenditure which was approximated to cover 50 percent because a greater proportion of employees were found to have reported high level of stress. Furthermore, sixty percent of all lost work days each year was attributed to the effects of work-related stress and job loss among employees which further impacted negatively on financial and or family stability [13].

Prevention of work-related stress

Employees should be encouraged and empowered with the knowledge and skills required to prevent or at least reduce risks inherent in work-related stress in the following ways posited [2].  

(a) Primary prevention: seeks to address the ergonomics around the employee, work and environmental designs, and organizational and management development,

(b) Secondary prevention: involves educating and training the employee, and

(c) Tertiary prevention: which is characterised by the development of a more sensitive and responsive management systems that enhance occupational health.

Furthermore, employers are encouraged to adopt corporate policies that contain activities for the prevention of and the protection of the employee from work-related stress, both at the individual and organizational level to equip the employee with the knowledge and skills required for identifying situations which could trigger work-related stress by employee organising their time properly. Also, employees should learn to accept what they cannot change thus making lifestyle changes while promoting their own health by not hesitating to express their feelings or keeping a sense of humour as a way of coping with work-related stress [14,15,16].

Work-related stress according to a review of related literature is caused mainly by work overload, job insecurity, poor inter and intra-personal communication and conflict management strategies within the organization and the employee and inadequate resources. Stakeholders should institute primary, secondary and tertiary prevention strategies aimed at preventing or at least reducing the incidence of work-related stress as well as empowering employees with the knowledge and skills required for the identification of situations which could trigger work-related stress such as promptly expressing their feelings and having a sense of humour.

Conflict of interests

The authors declare that there was no conflict of interests in the up to and after the preparation of this manuscript, inputs were received from all the authors who also double as members of a research team.

Acknowledgements

The authors wish to thank the coordinator and other faculty members for allowing them make use of educational resources at the university of Calabar, department of public health’s centre of excellence and training resources for health manpower.