Whitehall studies

It’s true, working too hard can kill you

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CNV00004_1It seems a life-time ago when stress management courses were de rigueur and people, including me, were making a living from them. (Now it’s either resilience training or mindfulness but that’s another story).

There was plenty of research about to back up what we were doing. The famous Whitehall studies which showed that the more senior you were the less likely you were to die early. In industry after industry it was the same story. Employees at the bottom of the hierarchy suffered more ill-health than more senior ones.

One of the factors contributing to this was the amount of control people had – over decision-making and the way they spent their working day. The more control or autonomy people felt they had, the less stressed they tended to be.

Now a recent study in the US has confirmed once again that people in stressful jobs with little control at work were more likely to die.

The research followed more than 2,000 Americans in their sixties over a seven-year period.

Those in low demand jobs reduced their death risk by 15% and those who were able to set their own goals and had flexibility at work were 34% less likely to die.

They also found that the people in the higher risk jobs were heavier. Comfort eating? Less time for exercise?

26% of those who dies were in front-line service jobs and 32% worked in manufacturing – both sectors with high demand and low autonomy.

55% of the deaths were from cancer (linked this week with high levels of anxiety and depression), and 22% from circulatory system diseases.

Erik Gonzales-Mulé at the Kelley School of Business at Indiana University said employers didn’t need to reduce demand on their workers but should allow them more flexibility in how jobs were done. “You can avoid the negative health consequences if you allow them to set their own goals. set their own schedules, prioritise their decision-making and the like”.

I’m having deja vu here.This is like re-inventing the wheel. We knew all this decades ago. Remember autonomous working groups? Have American businesses forgotten about US contributions to organisational psychology and research on motivation? In America most workers still don’t get sick pay or maternity pay and have minimal holidays.

Japan has its own problems with employees working too hard (see recent post)

And we aren’t much better in some respects in the UK with the worst sick pay in the EU!

Recently experts and members of parliament have expressed concern about working conditions in call centres and on-line distribution centres. Sports Direct and Asos have been criticised for having Victorian working conditions. Some of these places are like “warehouses” on the edge of towns with no windows for natural light, just like giant container units.

Perhaps I should brush off my old notes and get back on the road again. Why do businesses never learn how to get the best out of people?

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Three-day week perfect for over 40s

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ThumbsUp-maleIt helps them keep sharp. Well long weekends are something I’ve espoused for years so it’s nice to see some scientific evidence.

Economic researchers in Japan (where there is a culture of long hours and karoshi  – death by overwork) analysed the employment habits and cognitive test results of 3,000 men and 3,500 women above the age of 40 in Australia, including retired and unemployed people.

They found that a part-time job is the best balance between keeping the brain stimulated and becoming completely exhausted through stress.

People who worked about 25 hours a week tended to get the best scores. Those who didn’t work at all scored about 20% lower on the series of tests (reading, numbers and patterns).

Working 40 hours a week was linked to a slightly smaller cognitive deficit but working 55 hours or more was worse than being retired or unemployed.

Working over 50-55 hours is known to cause heart problems in men in particular and an increase in error rates and accidents. The Whitehall study of 10,000 civil servants also found that people who worked working 55 hours a week did worse on cognitive tests than those who kept to 40 hours. Despite this body of knowledge the UK government still opted out of the European Working Time Directive.

Many countries have extended or scrapped the state retirement age and many people face the prospect of working into their 70s. Finnish experts have already warned that people may not be physically or mentally capable of sustaining the effort required to continue in their jobs.

Some companies , like BMW, have invested in modifying the workplace to cater for older employees but they are probably an exception.

Marianna Virtanen, a Finnish Occupational Health expert (they are hot on OH in Finland) who led the Whitehall studies in the mid-80s said that the new research seemed to show tat “Middle-aged and older people should limit their working hours to keep their cognitive capacity fit“.

She did wonder whether a long working week caused a drop in cognitive ability or whether a drop in cognitive ability led to people working longer hours to compensate. She conceded however that “In certain jobs where there is a lot of intense focus and concentration is needed, working long hours may be more exhausting to cognition“.

Stress can be a killer for women too

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Woman&officephoneWe are all aware of how stressful work can be at times. Contrary to popular belief not all of it is caused by the deliberate actions of others but usually because of the way we interpret events. Something that is stressful for one person may not be for someone else. Stress can be caused inadvertently by someone lacking social or management skills, and increasingly rudeness at work is being identified as a major cause.

Common sense tells us that rudeness can affect our mood but it also affects our performance, our problem solving ability, and our willingness to work in a collaborative way – and research shows that even witnessing rudeness can create these adverse outcomes and damage the working climate especially in teams that need to collaborate.

Bullying is another source of stress and it might be on the increase again, fuelled by insecurity since the recession. It also seems that whilst the majority of bullies are men women bullies can be more persistent. There also seem to be gender differences. I’ve found in my work and research that women are more likely to bully using personal attacks whereas men bully under the pretext of performance management.

Now new research has shown that women in high pressure jobs run twice the normal risk of developing heart problems as a direct result of work-related stress. Those reporting work pressure to an excessive degree are also at an increased risk of developing ischaemic heart disease.

The research, published in the Journal of Occupational Health and Environmental Medicine, was based on a 5-year study of over 12,000 Danish nurses aged between 45 and 64. Whilst the link between stress and heart disease is well-established this is one of the first studies on women.

Stressed workers often resort to unhealthy ways of coping such as smoking, eating comfort food, or drinking, which can lead to them becoming overweight and creates a vicious circle. In a study carried out by the author amongst NHS employees nurses had the highest sickness absence rates and also smoked the most. Managers on the other hand rarely took time off but drank more!

A research team at Ohio State University has been studying the effects of stress on health for the last 30 years (psycho-neuro-immunology) and have shown that chronic stress can lead to cardiovascular disease, cancer. stroke, osteoporosis and diabetes. The culprit is stress-induced chronic inflammation as a result of the immune system being in a constant state of high alert. This in turn wears you down and makes your body less able to fight infections and diseases, heal wounds, and develop antibodies. On a less dramatic level it explains why you can’t shake off that cold or persistent cold-sore when you are stressed.

And the latest research shows that children with difficult childhoods, eg through being abused, are especially susceptible to the physical effects of chronic stress and that their immune systems may learn a hyperactive response to stress which kicks in again when they are facing stressful events as an adult.

Some good news is that becoming adept at yoga does lower your stress response.

Updated 2 May 2011: Women with high job strain have a 40% increased risk of cardiovascular (CV) disease compared to those with low job strain, according to research presented at the American Heart Association’s Scientific Sessions 2010. They defined job strain, a form of psychological stress, as having a demanding job, little or no decision-making authority or opportunities to use you creative or individual skills. Their findings were based on a sample of over 17,000 healthy women who participated in the Women’s Health Study. Primarily white health professionals with an average age of 57, they were tracked for 10 years whilst they provided information about job strain and job insecurity.

Job insecurity was associated with risk factors for CV disease such as high blood pressure, increased cholesterol, and excess body weight but not directly associated with heart attacks, strokes and CV death.

The higher CV risks for those who reported high job strain included heart attacks, ischemic strokes, coronary bypass surgery, balloon angioplasty, or death.

The findings that women in jobs with high demand and low control are at risk echo UK research on Civil Servants (The Whitehall studies). The first Whitehall Study compared mortality of people in the highly stratified environment of the British Civil Service over a 10 year period starting in 1967.

It showed that among British civil servants, mortality was 3 times higher among those in the lower grades when compared to the higher grades. The more senior one was in the employment hierarchy, the longer one might expect to live compared to people in lower employment grades. It also found higher mortality rates due to all causes but specifically coronary heart disease for men in the lower employment grade when compared to men in higher grades.

Twenty years later, the Whitehall II study, a longitudinal, prospective cohort study of 10,308 women and men, all of whom were employed in the London offices of the British Civil Service at the time they were recruited to the study in 1985, documented a similar gradient in morbidity in women as well as men. The studies revealed this social gradient for a range of different diseases: heart disease, some cancers, chronic lung disease, gastrointestinal disease, depression, suicide, sickness absence, back pain and general feelings of ill-health.

Companies might not use the S word so much these days , preferring to talk about resilience instead, but the pressure is still there and a source of illness and distress for many employees.