Work Organization and Stress

Office and sales work are traditionally thought of as clean, easy, safe work. While life-threatening, acute injuries are rare in these fields, occupational hazards exist that diminish the quality of life and in some cases, cause serious injury and death.

Stress can be defined as a physical or psychological stimulus that produces strain or disruption of the individual’s normal physiological equilibrium. Stress reactions include headaches, gastro-intestinal and sleep disturbances, high blood pressure and other cardiovascular disease, anxiety, depression and increased use of alcohol and drugs. Work in offices and retail trades is stressful both because of the structure of the industries and because of the organization of work.

The Structure of Work

Employers are increasingly using part-time and temporary workers (“temps” or contract workers). Often, this arrangement provides the desired flexibility in working hours. But there are costs. Government labour statistics show that the average part-time worker in the United States, for example, earns only 60% as much as a full-time worker on an hourly basis. Not only are they paid less, but their benefits, like health insurance, pensions, paid sick leave and vacation, are substantially less than those received by full-time workers. Fewer than 25% of part-time workers have employer-paid health insurance, compared to nearly 80% of full-time workers. Sixty per cent of full-time workers have pensions, while only 25% of part-time workers have this coverage. In 1990 in the US, there were nearly 5 million part-time workers who would have preferred to be employed full time. Other countries are also undergoing similar transformations of work. For example, in the European Union, 15% of the workforce and roughly 20% of clerical and sales worked had part-time jobs in 1991, and 8.4% of clerical workers were temps (De Grip, Hovenberg and Willems 1997).

In addition to lower pay and few benefits, there are other negative aspects of this restructuring of work. Temps often live with the stress of not knowing when they will be working. They also tend to work more overtime because they are often hired for “crunch” periods. Neither part-time workers nor temps receive equal protection under many government laws, including occupational safety and health regulations, unemployment insurance and pension regulations. Few are represented by labour unions. A case study commissioned by the US Occupational Safety and Health Administration of contract labour in the petrochemical industry shows that contract workers get less health and safety training and have higher injury rates than non-contract workers (Murphy and Hurrell 1995). The health consequences of an increasingly non-unionized, temporary workforce should not be underestimated.

Work organization

When the well-known long-term study of heart disease, the US Framingham Heart Study, examined the relationship between employment status and the incidence of coronary heart disease, it found that 21% of women clerical workers develop coronary heart disease, a rate almost twice that of non-clerical workers or housewives. According to Karasek’s demand control model of job stress, work that is characterized by high demands and low control, or decision-making latitude, is the most stressful, because of the imbalance between responsibility and ability to respond (Karasek 1979, 1990). Occupations such as clerical work, electronics manufacturing, garment work and poultry processing are characterized by tedium, ergonomic hazards and low job control. Clerical work ranked among the most stressful in this regard.

Recognizing the social, economic and physical determinants of health effects related to occupational stressors instead of focusing solely on personal pathology is a first step in the complete and long-term management of stress-related problems. While many people may benefit from programmes that provide individual coping and relaxation exercises, workplace stress management programmes should also acknowledge the broader social and economic constraints that provide the context for the daily lives of working people.

Air Quality

Many buildings have serious indoor air pollution problems. In offices, the combination of poor ventilation design, sealed buildings and the build-up of chemicals from building materials, office machines and cigarette smoke has resulted in an office smog in many buildings. Micro-organisms (e.g., moulds, bacteria) can flourish in the air-conditioning and humidifying systems, evaporative condensers and cooling towers in many office buildings. The result may be “tight building syndrome”, which can involve a wide range of symptoms depending on the situation, including allergies and respiratory infections, such as legionnaires’ disease, that sometimes can reach epidemic proportions. Perhaps the most common office air pollutant is cigarette smoke, which can increase the level of respirable particles in the air to 5 times that of a non-smoking office. Since research has linked the cigarette smoking of a spouse with the increased lung cancer risk of a non-smoking spouse, non-smoking office workers may also be at risk.

Ergonomic Hazards

Ergonomic hazards in the retail trade have risen in recent years as new technologies and organizational structures have been introduced. The trend in retail has been towards self-service operations and towards larger retail outlets. The introduction of the electronic scanner has created shorter cycle times and increased repetitiveness. In addition, the work space is often not adapted to the new technology, and many work practices can lead to musculoskeletal stress.

Many studies and investigations have found a higher rate of cumulative trauma disorders in cashiers than in non-cashiers, and a dose-response relationship between the work and these disorders. These jobs usually require high levels of upper extremity activity, and, as a result, carpal tunnel syndrome, tendinitis and tenosynovitis are experienced by a large proportion of cashiers. General merchandise clerks have been shown to have moderate levels of wrist activity and high levels of ankle activity. The check stand design can greatly influence the cashier’s posture and movement patterns, causing awkward positions, long reaches and frequent lifts. As a result other common areas of discomfort are the neck, shoulder, elbow and back. Prolonged standing for cashiers and clerks can also lead to back pain from the compressive forces associated with the activity. Additionally, prolonged standing may cause discomfort in the legs, knees and feet, and varicose veins. Further risk to the back comes from moving stacks which can be too heavy and/or too large.

There are many other sectors within the retail trades that experience these disorders as well as many more. For example, retail floristry and hairdressing are frequently associated with skin problems such as rashes and chronic dermatitis. The most common injuries in eating and drinking establishments are lacerations and burns. Take these factors into account along with the high turnover rate of employees and the inadequate training that can occur as a consequence, and the result is a setting that is conducive to chronic pain, discomfort and eventual cumulative trauma disorders.

Office Trades

The image of white-collar work being safe and clean is often deceptive. The dramatic change in workforce characteristics where job specialization, the repetitiveness of tasks and physical demands have all increased and available work space has decreased has led to many ergonomic injuries and illnesses. The most obvious injuries are associated with safety, such as falls on slippery floors, trips over electrical cords, collisions with open file cabinet drawers and moving heavy objects such as boxes of paper and furniture. However, with the ubiquitous use of computers in offices today, a new pattern of health problems exists. The areas of the body most frequently affected by cumulative trauma disorders are the upper limbs and neck. However, prolonged visual disply unit (VDU) use can lead to inflammation in the muscles, joints and tendons of the back and legs as well. Serious wrist disorders such as carpal tunnel syndrome, tendinitis and tenosynovitis are often associated with VDU use. These conditions can result from continuous wrist extension during keyboard use or from direct mechanical pressure on the wrist from such things as the sharp edge of the desk. Disorders of the fingers may result from the numerous, rapid fine finger movements that occur during typing. Shoulders being held in a static elevated position, resulting from too high a work surface, can possibly lead to tendinitis. As is often the case, prolonged sitting, which is characteristic of VDU use, can reduce the blood circulation and increase blood pooling in the legs and feet as the soft tissue in the legs is compressed. Lower-back pain is often a disorder associated with prolonged sitting, as the compressive forces in the spine can be elevated, especially if the chair is poorly designed. Other common health effects of VDU use are eye strain and headaches from improper lighting or VDU flicker. The computer is rarely the only piece of equipment in large offices. The noise level generated by the combination of copiers, typewriters, printers, phones and the ventilation system is often higher than the 45 to 55 dBA recommended for easy office and phone conservation and can interfere with concentration and elevate annoyance and stress levels, which have been associated with heart disease.

Environmental Hazards

The leading environmental hazards related to office and retail trades are primarily concerned with the consumer society: mall development and groundwater problems related to “green fields” development. In many suburban communities in advanced industrial nations, retail trade and office development in malls threatens the viability of both downtown urban areas and open space in the suburbs. In Asia and Africa the problems are different: along with the vast, unplanned growth of urban areas has come even sharper geographic division of social classes. But in the North and in the South, some cities have become dumping grounds for the poor and disenfranchised, as shopping centres and office complexes—and the more privileged classes—have abandoned urban areas. Neither the work of the future nor the consumption possibilities associated with it are available, and the urban environment has deteriorated accordingly. The new efforts of environmental justice organizations have sharpened the discussion of urban development, living, shopping and work.

The development of offices also presents the problem of wasteful uses of paper. Paper presents a problem of resource depletion (the cutting of forests for paper pulp) and the problem of solid waste. An international campaign against chlorine has also pointed out the chemical hazards associated with paper production. The recycling of paper, however, has captured the imagination of the environmentally conscious, and the paper and pulp industry has been induced to increase production of recycled paper products, as well as to find alternatives to the use of chlorine compounds. Electronic communication and record keeping may very well pose a long-term solution to this problem.

The enormous problem of excess packaging materials is a critical environmental concern. For example, Fresh Kills landfill, New York City’s dump for residential garbage, the largest landfill in the United States, covers about 3,000 acres and receives approximately 14,000 tons of trash a day. At present, in some places, the landfill reaches 150 feet (about 50 m) deep, but is projected to go to 450 feet (about 140 m) in 10 years. This does not include commercial or industrial non-toxic waste. Much of this waste is paper and plastic, which could be recycled. In Germany, producers of goods are required to take back packaging materials. Thus, companies are strongly encouraged to reduce their own wasteful retail marketing practices.

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