Regulations, policies and practices concerning work ...

Work & Stress

ISSN: 0267-8373 (Print) 1464-5335 (Online) Journal homepage: http://www.tandfonline.com/loi/twst20

Regulations, policies and practices concerning work stress in five European countries Michiel Kompier , Erik De Gier , Peter Smulders & Dirk Draaisma To cite this article: Michiel Kompier , Erik De Gier , Peter Smulders & Dirk Draaisma (1994) Regulations, policies and practices concerning work stress in five European countries, Work & Stress, 8:4, 296-318, DOI: 10.1080/02678379408256538 To link to this article: http://dx.doi.org/10.1080/02678379408256538

Published online: 25 Sep 2007.

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Date: 06 June 2016, At: 02:15

WORK

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STRESS, 1994, VOL.

8, NO. 4, 296-318

Regulations, policies and practices concerning work stress in five European countries MICHIEL KOMPIER, ERIK DE GIER, PETER SMULDERS and DIRK DRAAISMA Downloaded by [Radboud Universiteit Nijmegen] at 02:15 06 June 2016

TNO-Prevention and Health, PO Box 2215,2301 CE Leiden, The Netherlands Keywords:

Work stress; Policy; European comparison.

A comparative inventory of regulations, policies and practices in The Netherlands, Sweden, UK, Germany and France with regard to the prevention of work stress was carried out. In each country

data were collected by means of interviews with key informants and through exploring relevant documents and literature. It was found that Sweden, The Netherlands and the UK-those countries with framework legislation in the field of health and safety-recognize stress as an important health and safety topic, whereas Germany and France do not yet recognize stress as an important policy issue. However, even in the first group ofcountries less attention is being paid towards psychosocial work characteristics when compared with traditional health and safety issues, such as noise, machine safety and toxic agents. There is a clear lack of well-documented (national) 'examples of good preventive practice', even in Sweden and The Netherlands. Recommendations are being formulated concerning type of legislation, guidance and information, monitoring and risk assessment, costs and benefits, examples of good practice and European networking.

1. Introduction and purpose of the study At the request o f the Dutch Ministry of Social Affairs and Employment, a comparative inventory of regulations, policies and practices in T h e Netherlands, Sweden, UK, Germany and France with regard t o the prevention o f w o r k stress and the improvement of well-being at w o r k was carried out. T h e study was brought about by: (a) the European framework directive on health and safety at w o r k (89/391/EEC) that came into force o n 1January 1993. Although stress and well-being at work are not as such, elements that are central t o the framework directive, a certain amount of attention is given t o the aspects in article 6 of the above-mentioned directive.' (b) the need for effective national and international policies on stress prevention and healthy working conditions. To illustrate this need, the International Labour Office (ILO) recently published a Conditions of W o r k Digest entitled Preventing Stress at Work (ILO 1992) and several projects are being pursued by the European Foundation for the Improvement o f Living and Working Conditions (Paoli 1992, Wynne 1990). Well-being at w o r k was one o f the priorities of the 1992 European Year of Safety, Hygiene and Health Protection at Work.2 (c) the fourth new Action Programme (1993-1998) o f the European Commission, which makes special reference t o rules and practices concerning people's well-being and stress at work. T h e main purpose of the study was to form an impression of the ways in which a number of European Union (EU) member states and Sweden (at the time of the study still a nonE U member) actually pay attention t o the prevention o f w o r k stress and the improvement of well-being at work. Table 1 summarizes the main issues o f the study. 0267-8373/94 S10.00 Q 1994 Taylor & Francis Ltd

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2. Methods The method used was primarily explorative. In each country data were collected by means of interviews with key informants. In these interviews a list of topics was used which covered the issues set out in table 1 (see also de Gier et al. 1994). For each country a list was drawn up of a restricted number of key informants. These informants were drawn from ministries (mostly Ministries of Labour), labour inspectorates, central organizations of employers and employees and stress research groups. Data were also collected by exploring relevant documents and literature: government publications, research reports, brochures, books and journals. The interviews took place from April through September 1993.

3. Results First, the main results are summarized for each country. Next, a comparison between the countries under scrutiny is given. 3.1. M a i n results f o r each country 3.1.1. The Netherlands: In The Netherlands, the industrial relations system is strongly centralized and there is much emphasis placed upon creating a consensus between the social partners and national government. Central organization of employers and employees form a rather powerful force. Labour relations can generally be characterized as harmonious. Table 1.

Main issues o f the study

(1) Type of industrial relations The role of government and social partners

(2) Legalframework The presence of general framework legislation The importance o f self-regulation as a principle The existence of specific regulations on stress or well-being at work The phase of the implementation of the framework directive The nature of enforcement The special attention paid by labour inspectors to the prevention of work stress The existence of a well-developed health and safety infrastructure

(3) Work stress prevention in general The preparation of work stress as a separate and relevant health and safety issue by the relevant parties The existence of special governmental stress prevention policies o r programmes The general involvement of the social partners in policy-making and research programmes The possible existence of separate stress prevention activities amongst the social partners alongside governmental or tripartite initiatives Connection between health and safety policies and other related governmental policy fields such as social security, industrial and technological policies (4) Diyerenr aspects of work stress prevention activities Active transfer of knowledge by the various parties involved in the prevention of work stress (leaflets, seminars, books, etc.) The existence of a national monitoring system for describing the prevalence and causes of stress at work Formal research networks in the field of stress at work Separate stress research groups within and outside universities The existence/popularity of job redesigning prevention programmes (public/private) in separate firms and sectors The existence/popularity of employee assistance programnies in private and public enterprises National examples of good ways of dealing with stress prevention at work

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The legal framework pertaining to working conditions is broad. The Dutch Work Environment Act (WEA) has implications for both the physical and psychosocial working environments. The WEA defines the roles of the minister, the labour inspectorate, employer, employees, work councils and safety and health specialists. Self-regulation is an important concept: concern for safety, health and well-being at work is the clear responsibility of the employer. The employer has to cooperate with the employee, who also has his obligations, for example to work carefully and to cooperate in training and education. The phrase ‘stressat work’ does not have a literal translation in the WEA and the facet of well-being is comparatively new in Dutch legislation on working conditions. As to thc psychosocial aspects of work, the WEA (article 3) states: Employees should have the possibility of organizing their own work in accordance with their own professional qualifications. Employees should have sufficient opportupity to determine their own work pace. Each employee has the right to be informed about the purpose and the results of his or her work. Employees should have sufficient opportunity to keep in contact with their colleagues. The workplace should be laid out in accordance with modern ergonomic principles. Monotonous and repetitive jobs should be avoided. Differences between the workers’ personal characteristics, such as age, gender, physical and mental constitution, work experience, skills and knowledge of the working language, should be taken into account. Safety and health hazards must, as far as is practicable, be prevented at the sourcc. According to the acting Minister for Social Affairs and Employment, ‘these ground rules are the essence of systematically preventing stress at work; (de Vries 1990). Apart from the psychosocial (or well-being) section of the WEA, there are no special legal regulations relating to stress in the workplace. As of 1 January 1994, the Working Environment Act changed in light of the implenientation of the European framework directive on health and safety, new legislation on the prevention of absenteeism due to mental and physical ill health and on the grounds of the special desire t o create a legal basis for certifying Occupational Health and Safety Services. The WEA is administered by the labour inspectorate which falls under the jurisdiction of the Ministry of Social Atfairs and Employment. Its inspection policies are based o n a system approach. Nowadays, in contrast to the recent past, labour inspectors focus upon checking the organizational set-ups chosen by employers to ensure that working conditions are good. The organizational set-up includes the ways in which responsibilities drc distributed; the ways in which self-inspection is carried out and risk assessments arc compiled by the company; how action plans are drawn up; and how cooperation bctwccn employer and employees is organized. At the same time, labour inspectors check to sce whether the employer satisfies the minimum working conditions requirements. Regarding the inspection of the psychosocial aspects of the work environment (WEA, articlc 3), the outcome of the systems approach emerges from the six ‘system questions’ posed by labour inspectors. The six system questions are as follows: -

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Iloes the company pay enough attention to psychosocial factors when asscssing and evaluating the risks? Does the company pay enough attention to psychosocial factors when it comes to cducating and training on working conditions?


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- Is (middle) management able to provide the support to employees to help them cope

adequately with work stress? Are personal characteristics taken into account when tasks are composed and distributed? - Does the company pay enough attention to the aspect of stress when changing its processes o r organization? - Does the company pay enough attention to stress when it implements its policies on prevention of absenteeism through illness?


-

In The Netherlands, just as in many other countries, it has been customary for years to devote most attention to the traditional areas of ergonomics, physical health, (technical) safety and toxic substances. Increasingly a balance is being created between these traditional aspects and ‘modern’ psychosocial problems. Since much absenteeism through mental and physical ill health has been causally related to stress (Grundemann et a!. 1991). developments in this area have gained renewed impetus. Other stimuli have derived from theories relating to human resource management, total quality management and the maintenance of healthy organizations. In the view o f t h e government, work stress clearly constitutes a major health hazard, and this is why a special programme has been set up to reduce such stress. This stress programme comprises, amongst other things, the development of methods for inspecting psychosocial aspects of work (see above), the development of instruments for monitoring work stress (checklists and questionnaires) for specialists and managers and employees, and the dissemination of knowledge. Some exaniplcs of thc latter are: the sponsoring of a handbook on work stress (Kompicr and Marcelissen 1990) and o f a booklet aimed at employees and trade unions: Stress at the Workplace? Do Somethirig About I t ! (Kompier et a / . 1990); the co-sponsoring of and participation in various national conferences and workshops and of several television programmes and videos on the identification and prcvention of stress in the work situation. The Ministry also gavc the go-ahead for four large national prevention projects (‘examples of good practice’). These stress-prevention projects arc being carried out in a hospital, a construction firm, a metal factory and a regional institution for ambulatory mental health care. They are also linked to preventing musculoskeletal problems and adopting a healthy life-style (‘the integral approach’). Moreover, the Ministry sponsors research to identify risk factors and risk groups. Trade unions are becoming increasingly intercstcd in stress and well-being at work. Traditionally they have not had stress-prevention policies. Employers’ organizations d o not seem to be greatly interested in stress and people’s well-being at work. They are inclined to emphasize the fact that employees usually cope with stress in their own individual ways, and often where such problems arc related to work-where health and safety are concerned-this is ignored. The Dutch working conditions policy is linked to social security policy regulations: stress prevention is closely related to the desire to reduce absenteeism through mental or physical illness. The industrial policy relations are limited and there is great bureaucratic segregation between social and industrial policies. Until recently there has been no national monitoring system for identifying risk factors and risk groups within the working population. Thc Ministry of Social Affairs and Employment has recently introduced a national monitoring instrument known as ‘Work stress and physical work load’, which will be implemented periodically, starting in 1994. There is no central rcscarch fund to cover the whole quality o f working life field o r subsidize research on stress and well-being a t work. However, the government does


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support research into stress problems. No official contacts exist between policy-makers, employer and employee representatives and company experts on work stress and wellbeing. Whenever necessary, ad hoc work or advice groups are formed. Since 1993 an informal network has existed between the main research groups. There are many active research groups on work stress in both research institutions and universities. There are some examples of good stress prevention policies, but they are not very well documented. As far as companies are active in this area, they often focus on individual employees and their coping ability instead of on stressful work characteristics. Rothmans Manufacturing is an example of a company that manifests good work policies in this respect (Niljenhuis 1993). At the moment the government is stimulating several examples of good practice, the results of which will be published in 1995. 3.1.2. Sweden: S..ueden, a country with many unions, has long been famous for the Swedish model that was recently abolished (Theorell 1993). This model was characterized by centralized, natimwide, collective bargaining, steadily growing union influence, an active government labour market policy and very few labour disputes. Sweden possesses a comprehensive legal framework with respect to the working conditions. Its Work Environment Act applies to both the physical and psychosocial work environment. According to the act it is the employer who bears the main responsibility for the work environment. The act also regulates the organizational set-up for healthy work: a system of self-regulation and internal control. Internal control is a key facet of the WEA. The purpose of the provisions for internal control is to create good opportunities for the employer to be able to take actions that will guarantee the health and safety of employees. There is a special Ordinance Internal Control of the Working Environment, which contains binding provisions and general recommendations. The act also includes rules relating to the cooperation of employer and employees on work environment matters. Apart from the actual work environment legislation, there are a number of other laws and regulations that are important to occupational health and safety. Work stress is perceived as an important health and safety issue. Chapter 2, 0 1 of the amended Work Environment Act is of special relevance to stress and well-being at work (see also Levi 1992). Section 1 states: - Working conditions shall be adapted to people’s differing physical and mental

aptitudes. The employee shall be given the opportunity to participate in designing his own working situation and in processes of change and development affecting his work. - Technology, work organization and job content shall be designed in such a way that the employee is not subjected to physical or mental strains which can lead to illness or accidents. Forms of remuneration and the distribution of working hours shall also be taken into account in this connection. Closely controlled or restricted work shall be avoided or limited. - Efforts shall be made to ensure that work provides opportunities for variety, social contact and cooperation, as well as coherence between different working operations. - Furthermore, efforts shall be made to ensure that working conditions provide opportunities for personal and vocational development, as well as for selfdetermination and professional responsibility. -

Furthermore, there are several other legal regulations (ordinances, etc.) relating to stress in the workplace. As long ago as 1980 the ‘Psychological and social aspects of the working environment ordinance’ was published. Two hundred thousand copies of this ordinance


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have been sold. In 1982 another ordinance on ‘Solitary work’ was published. The 1980 ordinance is currently being updated and will be superseded by the ordinance ‘Psychological and social aspects of work organization’. It will probably be several years before this new ordinance is implemented because the parties involved, such as employers and employees, have differing points of view. The National Board of Occupational Safety and Health issued an ordinance that came into effect on 1 July, 1993 on ways of dealing with violence and threatening behaviour in the working environment. In this ordinance, which applies to all work in which there may be a risk of violence or threats of violence, the following measures of prevention and aftercare are stipulated: - The employer shall investigate any risks of violence or threats which the work may

involve and shall take such measures as are needed. Work shall be organized in such a way that these risks are as far as possible prevented. There shall be special security routines that must be kept up to date and continually followed up. Employees shall be familiar with the routines. - Employees shall also receive sufficient training, information and instruction for them to be able to perform their work safely and securely. - Employees who are currently exposed to violence o r threats a t work shall be given special support and guidance. In addition, workplaces shall be positioned, designed and equipped so as to avert the risk of violence and threats as far as possible. It must be possible to summon immediate assistance in an emergency. The employer shall ensure that: in the interests of security, alarm equipment is provided where necessary; there are definite agreements on who is to receive alarm calls and what measures are to be taken when an alarm is given; safety routines and alarm contingency measures are practised regularly; alarm equipment is maintained and checked; other technical aids are available if necessary. - Tasks involving palpable risks of violence or threats may not be performed as solitary work. In addition, bullion and cash transport operations are to be organized and performed in such a way as to provide adequate security for the employees. - All events involving violence or threats are to be documented and investigated by the employer. It is important that there should be routines indicating what reporting procedure should be observed. - Employees who are threatened or exposed to violence shall be given prompt assistance and support so as to avert or alleviate both physical and mental injury. It is the employer’s duty to establish special routines for this purpose. Since Sweden is not as yet a member of the EU it was not obliged to change its legislation in accordance with European directives. As to enforcement practices, the labour inspectorate gives priority to supervising and inspecting the systems of internal control. This supervision is labelled ‘systems supervision’. The concept was introduced in the early 1980s by a National Commission that had been given the task to review the working methods of the labour inspectorate and municipal inspectors. The Commission wanted to introduce a new supervisory model based on checking the general handling of work environment questions in companies and on encouraging self-inspection of the working environment. The idea was that, in this way, the labour inspectorate’s input would produce more enduring results, so that resources could be utilized for the supervisation of workplaces that required additional attention, for example certain small businesses.


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The labour inspectorate defines systems supervision thus: ‘Systems supervision mcans the labour inspectorate scrutinizing the employer’s routines, resources, action plans and organization in so far as they have a bearing on the handling of work environment questions. Systems supervision also includes random checks of the actual working environment, to ensure that the above-mentioned conditions add up to a satisfactory environment’. The inspection results in a report addressed to the employer that contains stipulations or recommendations. These may include, for example, demands for: training various categories, establishing better information routines, elucidating the distribution of work environment responsibilities within the line organization, improving purchasing and planning routines, inspecting and testing routines and action programme stipulations and practical measures. The National Board of Occupational Safety and Health and the labour inspectorate havc also, in a manual, set out supervisory methods for organizational and social questions. Briefly, the subjects to which the questions in the manual refer are: (1) Problem signals (occupational injuries, incidents, absence through illness, personnel tumovcr, production hitches). (2) Local safety work. (3) Personnel information. (4) Changes or reorganization plans. (5) Hectic work pace, fragmented work (accompanied by hazards, piece-work, physical wear and tear, overtime, intermissions, possible job rotation). (6) Monotony (combined with sudden emergencies, solitary work, unsociable working hours). (7) Opportunities for stimulus and personal development (information, education, scope for reorganization). (8) Men tally strenuous customer/client contacts (poor goal description and information). (9) High level of mental strain (signalling systems, information, education, relict). (10) Control of technology or other people (scope for influencing the design of methods). (11) Social support, participation. (12) Work entailing special mental stress (violence, harassment, hazardous aspects, high responsibility). (13) Support for groups at risk (immigrants, cases of rehabilitation, young persons, new employees). The labour inspectorate can stipulate improvements in an inspection report addressed to the employer. Notice of measures taken and planned is requested within a certain period of time, for example within two or three months. If n o acceptable measures havc been presented by then, the labour inspectorate can order the employer. under pain of a fine, to make the improvements and can even prohibit certain kinds of activity, conditionally or otherwise. These penalties are, however, seldom imposed. As far as policy, funding and research goes, the infrastructure in Sweden is largc and rather unique and the financial resources for the working environment are considcrablc. However, these funds-for example the Swedish Work Environmcnt Fund, with programmes such as ‘workplace innovation’ and ‘learning and skills development’, and thc Swedish Working Life Fund-were not earmarked for the purpose of improving psychosocial working conditions. T w o institutions that are very important are the National Board of Occupational Safety and Health and the labour inspectorate. The National Board



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is the government’s central authority for matters concerning occupational safety and health. The labour inspectorate comes under the jurisdiction of the Board. Swedish government carries out an active policy of encouraging stress prevention and the improvement of well-being at work. Knowledge about stress prevention may be transferred in many ways: to companies, work and health specialists and t o the general public. First, there are important contributions based on thc various funds. Companies have to meet certain demands and can apply for projects that will be granted by thesc funds. Secondly, there is a tradition of specialist training and education of personnel in occupational health services. These training programmes are carried out by the National Institute of Occupational Health. The labour inspectorate also provides various training programmes for labour inspectors. Third, the general public has been addressed on several occasions. An early and very successful effort was the publication Strerr and Health by Lennart Levi (in Swedish). Due to the specific characteristics (the legal framework, the Swedish history of tripartite cooperation, the large institutional infrastructurc with respect to working conditions), trade unions and organizations of employers hardly manifest themselves at all with ’their own’ stress policy. The efforts of these organizations have been mainly directed towards (a) creating good (funding) conditions for improving working conditions in companies, (b) rcsearch accompanying thesc improvements and (c) cooperation with the other partners. In Sweden, the connections of stress prcvention with other fields of policy arc scarce. Several important statistics arc publishcd on work and health. There is not, however, a national monitoring system identifying (psychosocial) risk factors and risk groups in the working population. The National Institutc for Psychosocial Factors and Health (IPM), the Department of Stress Research (Karolinska Institutet) and the W H O Psychosocial Centre together form a network and have contacts all over thc world (research groups, policy-makers, social partners). Othcr research groups may join this network as many have done already. Other important rescarch institutes and groups are the National Institute of Occupational Health (Arbctsmiljoinstitutet), the Swedish Centre for Working Life (Arbetslivccntrum) and thc Dcpartrnent of Psychology a t thc Univcrsity of Stockholm. More than in most other countries, thc emphasis is on primary prevention of stress, through changing or rcdesigning work organization. Various large funds have been formed to promote a healthy work cnvironmcnt and work (re)organization, along the lines of the Work Environment Act. Also, the concept of learning (by individual employees and by organizations as a whole) has received morc attention in Sweden when compared to other countries. Somewhat in contradiction to thc large funding history and the large number of projects in Sweden, the number of well-documented casc studies in Swedish companies, as is the case world-wide, is limited. It is likely that the Working Life Centre evaluation of thc projects from the Swcdish Working Life Fund will yield several well-documented project descriptions. It will, however, be scvcral years before the evaluation report is published. Nevcrthelcss, sonic casc studies have recently been reported by the I L O (ILO 1992). In fact, five out of 19 studies (from ninc countries) in this book are of Swcdish origin. ‘Good practicc projects’, for cxamplc, arc those carried out by Asca Brown Bovery (Kvarnstrom 1992).

3.1.3. United Kingdom: The British industrial relations systcm is characterized by voluntarism rather than by interventionism. Voluntarism provides interest groups (trade unions, employers) with a high degree of autonomy to build up their own relations. At the same time, compared with the Continent of Europe, the legal framcwork for industrial


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relations is limited. Bargaining takes place at sectorial, company and shop-floor level (multi-employer and single-employer bargaining). These are n o nationwide collective bargaining structures. Thus, the UK’s labour movement and employer organization structures are significantly different from those on the Continent and their structures are decentralized and fragmented. The British labour movement consists of a large number of individual unions under the umbrella organization of the TUC (Trade Union Congress). There is also considerable organizational fragmentation on the employer’s side. During the eighties and early nineties, Britain went through a period of economic recession. In the field of industrial relations union rights were restricted, without bringing about fundamental changes in British industrial relations. The principal law in the field of health and safety is the Health and Safety at Work Act (HSWA, 1974). It is an enabling act, meaning that it states matters in general terms (that is, defines general duties). The general principal obligation from this act is stated as follows: ‘It shall be the duty of every employer to ensure, so far as is reasonably practicable, the health, safety and welfare of all his employees’. This concept of self-regulation is intrinsic to framework legislation. Certain duties are specified in regulations stipulated in the HSWA. Apart from this, Approved Codes of Practice (ACOPs) are also important. The HSWA and the regulations under this act do not contain rules with respect to work stress. Because of the need to implement the framework directive on health and safety at work and the accompanying directives, the so-called ‘sixpack’ was introduced in the UK on 1 January 1993. This package of HSWA regulations contains the following six new sets of health and safety at work regulations: Management of Health and Safety at Work Regulations, Provision and Use of Work Equipment Regulations, Manual Handling Operation Regulations, Workplace (Health, Safety and Welfare) Regulations, Personal Protective Equipment at Work Regulations, and Health and Safety (Display Screen Equipment) Regulations. The accompanying guidelines of the last set of regulations require that employers evaluate the risks of mental stress problems associated with work: ‘The principal risks relate to physical (musculoskeletal) problems, bad job design and posture and from inappropriate working methods’. From the first set of regulations follows the key regulation of risk assessment (regulation 3): ‘Every employer (or self-employed person) shall make a suitable and suficient assessment of (a) the risks to the health and safety of his employees to which they are exposed at work, and (b) the risks to the health and safety of persons not in his employment arising out of or in connection with the conduct by him or his undertaking’. Furthermore the assessment should be revised to accommodate changes in work activities. If there are five or more employees it should be recorded. The guidelines ‘Five steps to successful health and safety management’ further clarify the concept of risk assessment for the benefit of directors and managers; they describe in detail the following steps: (1) set out your policy (in the form of a written statement and make explicit what the arrangements are for working with and monitoring hazards and risks); (2) organize your staff (involvement and commitment of staff as regards competence, control, cooperation and communication); (3) plan and set standards (define as measurable, achievable, realistic); (4) measure your performance (through active and passive monitoring); (5) learn from experience: audit and review (reliability and effectiveness of systems). It may be stated that assessing risk is central to regulating health and safety in the UK. Risk assessment is rooted in the (civil) common law as well as in the (criminal) HSWA. It is



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more or less the basic philosophy behind the HSWA and its underlying regulations. The implementation of the framework directive has reinforced this philosophy. The HSWA and the regulations laid down in this act do not contain rules that relate to work stress. Until now risk assessment has mainly been perceived as a means of assessing physical work hazards and risks. Introducing the new EU rules will probably also lead to psychosocial hazards and risks being assessed: that is to say, a less technical approach to risk assessment (see also Cox 1993). In the UK there is a well-developed health and safety infrastructure. ACOPs are made and approved by the tripartite Health and Safety Commission (HSC) with the consent of the appropriate Secretary of State. The HSC and its executive body, the Health and Safety Executive (HSE), are public bodies with independent status. Their formal position is regulated in the HSWA. The various inspectorates and laboratories fall under the HSC. The HSE is responsible for enforcing British health and safety legislation. Local authorities also have a duty to enforce such legislation. Enforcing has more to do with guiding and stimulating employers than with penalizing them. For reasons of bureaucracy the health and safety area does not have close connections with other social or industrial policy fields. For a number of years now British government has recognized that stress at work can constitute a serious threat to health. Its strategy is built on three pillars: (a) the publication of guidelines for employers on the general issue of mental ill health in the workplace, (b) research and (c) raising awareness about the importance of effective mental health policies. Very recently the HSE commissioned an important literature review to identify what are current areas of consensus on the causes, consequences and reduction of occupational stress (Cox 1993). Because of the difficulties of defining standards for preventing and addressing work stress, new supplementary legislation is not foreseen. The HSE considers the risk assessment concept the best framework for action. The CBI (Confederation of British Industry, the central employers’ organization) generally supports the HSC/HSE strategy, but its approach is mainly restricted to guiding and transferring relevant information to employers and workers. The TUC also supports the HSC/HSE stress-prevention strategy. It also tries to develop its own policy, for example by publishing several guidelines. The T U C sees work stress as primarily a collective rather than an individual problem. Recently, the TUC formed a Common Action Priority team on stress at work. The variety in terms used for work stress is remarkable. There is a general preference for using terms like mental health and mental illness when talking about work stress or occupational stress, though obviously this is now changing. O n the one hand, making the problem ‘medical’ has probably made it easier to draw attention to the matter. O n the other hand, this may have led to biases with respect to interpreting job design and other organizational measures intended to reduce stress in the work situation. In spite of the reference to organizational causes of work stress in nearly all official documents, brochures and reports on the subject issued by all the parties involved, this viewpoint has not become a commonly adopted one, either in practice or in research circles. A national monitoring system relating to work stress and related matters is lacking. There are no plans to organize such a system in the near future. In Britain several separate statistics are published which provide information on health and safety issues (Labour Force Survey, Riddor-statistics, Social Security Statistics). Public authorities do not systematically pay attention to building up joint networks of policy-makers, trade unionists, employers and researchers to examine the theme of work stress. However, in practice there have been, and continue to be, collaborative and publicled initiatives on mental health a t work. A separately developed research network is also


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lacking. Nevertheless, there is a small group of people involved and there are ample opportunities to meet each other and to exchange information. In the UK, where preventing stress at work is concerned there are no widely used ‘best practices’, with the exception of the Post Office project (Cooper et al. 1992). This project deals primarily with the individual and not with the organization. Partly because of the results of this project, some companies have introduced Employee Assistance Programmes (EAPs). EAPs are the instruments most commonly used to combat and research (action research and evaluate) work stress. This approach is rather individual-oriented and often diverts attention from organizational causes of work stress. EAPs might provide a rather easy way out for some employers. The programmes have led to a commercial circuit of suppliers of all kinds of in-company and outside services. 3.1.4. Germany: Viewed as a whole, German labour relations can be characterized as harmonious. There are remarkably few labour conflicts. The degree of organization amongst employers is high. Approximately one-third of the working population belongs to one of the DGB (Deutscher Gewerkschaftsbund) unions. The union movement is active not only at sector level but also at state level. There is also a clear union influence at company level, through the works council. The German administrative model is highly decentralized, and, as far as labour is concerned, also fairly fragmented. It is made up of a multitude of laws, ordinances and other regulations. In the area of work safety and health there are two types of public law, and they reflect the so-called ‘dual legal system’ in Germany. One set is based on the national labour law and the other is based on the social security law that was developed by the 75 Accident Insurance Funds (Berufsgenossenschaften).The impact of social security legislation on working conditions is of great importance. According to the industrial accident insurance body, their funds are allowed to develop and implement ‘Unfallsverhutungsvorschriften’. These accident-prevention regulations are prescripts which arc comparable with legal ordinances and are aimed at preventing industrial accidents and industrial diseases. The first-mentioned national legislation on occupational safety and health is divided into two fields: (1) technical measures (on equipment, places of work, hazardous installations, the organization of occupational safety and health, etc.) and (2) social measures (on working time and on special groups, such as young people, mothers, the handicapped and home workers). An important national law concerning the level of organization in individual companies is the Arbeitssicherheitsgesetz (ASIG: the Occupational Safcty Act). The ASIG is mainly intended to strengthen expert services within the company. It is an overall law on the basis of which companies are obliged to appoint occupational doctors and safety experts. In Germany, the so-called ‘innerbetriebliche Arbeitsschutzorganization’ (meaning cooperation at company level, in companies of more than 20 workers) is important between the employer, the occupational doctor, the safety expert and the ‘Sicherheitsbeauftragtc(n)’ (‘safety officers’). The German health and safcty system is relatively technically oriented. Official German government documents do not pay attention to stress a t work or to psychosocial job demands. A recent publication by the Ministry of Labour on Occupational Safety and Health in Germany(Pa1andandSchwedes 1991)describesin detail thelawsandregulationson working conditions pertaining to matters such as chemical hazards, safety, accident prevention, and working hours. The word ‘stress’ is not to be found in this overview of the German health and safety system. Nevertheless, the ASIG offers possibilities for influencing stress and well-being in the workplace through the intervention of occupational



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physicians and occupational safety officers. It is their responsibility to, amongst other things, advise the employer on ‘occupational psychological and ergonomical questions’ arising in the organization. According to the German Ministry o f Labour, it has also been possible since 1972 to influence employees where mess and well-being in the work situation is concerned o n the basis of the ‘Betriebsverfassungsgesetz’ (this law deals amongst other things with the information, consultation and participation in decisionmaking activities o f t h e work council with respect to the w o r k environment). There are n o special legal regulations related to stress at the workplace. Recently, the German parliament decided not to implement the European framework directive on safety and health. It was argued that new legislation would cause problems for small- and medium-sized enterprises and that several aspects of the framework directive had already been regulated in existing German regulations. T h e dualist system in Germany implies that t w o labour inspectorates are active. O n e o f the inspectorates (with 3400 industrial inspection officers in the original West German states) is a government service and administers government rules at the level of the individual states, thus making the states responsible for the implementation (monitoring and enforcement) o f the national occupational safety and health regulations. T h e other inspectorate is the Technical Inspection Service o f the ‘Berufsgenossenschaften’ (accident insurance funds, with about 1700 inspectors). This inspectorate is responsible for the implementation of the accident-prevention regulations. Although government documents d o not pay attention to stress at work, the Ministry of Labour is certainly interested in the matter. An important problem for thc German governrncnt in this rcspect is contained in the question, ‘How can stress and well-being be measured more o r less objectively?’ A special position, within the framework of w o r k and health, is taken b y the Bundesanstalt f u r Arbcitsschutz (BAU) in Dortmund. This institute supports the federal government in Bonn with its research and advice. It also supports German industry on questions relating to safety and health. B A U works closely together with another fcderal institute, BAFAM (Bundesanstalt f u r Arbcitsmedizin, Berlin). Recently, a joint working group on stress a t work was formed. T h e Federal Ministry o f Research and Technology, together with the Ministries for Labour and Social Affairs and for Education, is also interested in stress-related matters. I t issued a research and d c k l o p ment programmc on ‘work and techniquc’ in 1989. As in many countries, improving the health o f the workforcc does not seem to be a high priority issue for employers. Their principal concern relating to personnel is with salaries, new technologies, lean production and sickness absence rates. Many German employers like to think o f stress and well-being as a personal characteristic o f their cmployccs and not as a characteristic of a work situation. Trade unions rarely participate in discussions on stress and workplace health promotion. They often see workplace hcalth promotion approaches as being too idealistic and as having little to d o with the reality of the workplacc. Finally, occupational health scrviccs in Germany devote far more attention to chemical, physical and biological hazards than to psychosocial problems such as monotonous work, social climate and working hours. There is n o systematic dissemination programme on knowledge of work stress on thc part of the government towards companies, employers and employees. However, B A U and BAFAM are considering the possibility o f a kind of manual directed at companies. As to monitoring stress, surveys are carried out on representative samples o f employees in Germany to ascertain the level of their work and j o b satisfaction. Nevertheless, work and health monitoring systems are perceived as lacking in Germany. It is ‘politically undesirable’, it is said, ‘because monitoring studies could make situations too explicit’.

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The Ministry of Labour occasionally offers financial support to the companies that try to improve their working conditions. These model projects are often monitored by the ‘Bundesanstalt f u r Arbeitsschutz’ in Dortmund. They deal, for example, with health circles where employees are encouraged to participate actively in stating and discussing any health-related problem they may have and any work-related stressor they may perceive. Health circles create an atmosphere of trust. The model projects also deal with j o b redesign and stress prevention (Kuhn 1992a, b). 3.1.5. France: In France, with its centralized state model, government plays an important role in regulating industrial relations. Collective bargaining in France is characterized by a fundamental conflict of interest between employers and employees. Other hallmarks of the French system are a low degree of organization amongst employees (with rather weak and ideologically split trade union) and rather paternalistic employers. As far as health and safety at work is concerned, there is a ‘dual legal system’, as is the case in Germany. First, the French have an extensive and detailed set of laws and regulations on labour and occupational safety. It is part of the Labout Code (Code du Travail). Secondly, there is the Social Security Code (Code de la Stcuritt Sociale) which relates particularly to health and safety a t work only as far as compensatable occupational accidents and occupational somatic diseases are concerned (‘risque professionel’). In the Labour Code the emphasis is on the physical working environment. Psychosocial aspects are not explicitly discussed. The Labour Code comprises a set of General Provisions on: the principles of prevention, introducing health and safety regulations, consulting employees, training, emergency procedures, dangerous substances, and penalties linked to non-compliance with the law. There are also provisions for children and women, occupational medicine and the labour inspectorate. Furthermore, there are a great number of specific provisions on all sorts of physical working conditions, lifting, dangerous apparatus and machines, clothing and equipment, meals and breaks. This act also regulates the organizational set-up required for healthy work and includes rules on cooperation in work environment matters between employers and employees. In the organizational set-up an important role is taken by the Joint Committees (the new ‘Comitts d’Hygihe, de Stcuritt et des Conditions de Travail’). A Joint Committee is obligatory in companies employing more than 50 workers (in the building industry, more than 300). In addition to employee representatives, the employer or his representative and the works physician make up these commissions. The tasks of the commissions involve analysing working conditions and risks, making relevant suggestions for improvement, carrying out inspections, and investigating occupational accidents and occupational diseases. Moreover, all employers must establish or join an occupational health service. The structure of these services is controlled by law, with the number of occupational health physicians and nurses depending on the number of workers and on the existing health risks. The law strongly emphasizes the responsibility of the employer and employees in taking care to create a good working environment. However, the law comprises many very detailed requirements on the working conditions that have to be met by companies. This does not leave much room for self-regulation at company level. Moreover, labour inspectorate enforcements are strongly directed at the content of the problem and are less concerned with the process of policy-making in the company. The EU framework directive was incorporated into the Code du Travail by the law of 31 December 1991 and came into effect on 31 December 1992. It introduced several important principles stemming from article 6 of the EU framework directive:


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(1) The principle of prevention is extended from safety to health in general, together with the obligation to apply a health and safety risk assessment method (articles L. 230-2). (2) The principle of obligations for employees (articles L. 230-3). Before, the law only knew obligations for employers, as a result of which the law was sometimes ironically called the ‘penal law’ (‘code pCnal’) for employers. (3) The obligation for an enterprise with more than 50 employees to have a Joint Committee (articles R. 231) also came into force for the building industry where previously 300 employees was the lower limit. The terms ‘stress’ and ‘well-being’ are not to be found in French law, though since the EU framework directive has been incorporated, notions and short-cycled work have been considered (articles L. 230-2d). What also arises from the E U framework directive is that planning prevention technology, organizing work, working conditions, social relations at work and the influence of environmental factors should be integrated. Those notions relate to the concept of stress, though this concept was not a guiding principle in the making of the law. In addition to this, it is important to realize that the social security system does not recognize mental problems or illness caused by work as occupational diseases. Thus, as in most countries, in practice the emphasis is still on the physical working environment. The regulations on working conditions-incorporated in the Labour Code-are enforced by the labour inspectorate (Service ExtCrieur du Travail et de I’Emploi, SETE) which is part of the Labour Ministry. Besides its enforcement task, the labour inspectorate has three other main inspection tasks relating to regulations on (l),dismissal, (2) employee representation a t company level and collective agreements, and (3) wages and working hours. Health and safety accounts for about 30% of their activities. The SETE is organized on a regional basis, with 96 departmental offices, including 440 inspection sections led by an inspector and assisted by approximately 900 assistant inspectors. called labour controllers. In addition to this, each region has a medical labour inspector and an engineer to provide advice. In view of the extensive tasks they have, it is widely believed that there are too few inspectors. There is a formal relation between the labour inspectorate and the inspecting body of the social security organization as far as exchanging information is concerned. It applies to exchanging information on general subjects that are relevant to the district or the country as a whole. It does not apply to information regarding individual enterprises. Actual cooperation on that plane occurs at district level because of the personal relationship network between inspectors. Problems of work stress are not high on the Ministry of Labour’s priority list and there is no policy programme on the subject. Work stress is not seen as a major health and safety issue, except by some labour unions. Traditionally, as in many other countries, most of the attentioh in the field of occupational health and safety (in terms of policy-making, legal regulations, etc.) has been devoted to the ‘traditional topics’ such as ergonomics, somatic health, and (technical) safety and toxic agents. Employers maintain that in as far as stress problems arise they may be dealt with appropriately through the attention given to working conditions in general. In their view, stress is often a personal problem and this is where the occupational physician can often be of help. Labour unions are more inclined to think of work stress as a problem relating to time pressure and mental overload because of the strong drive towards efficiency in French companies. They also consider these problems to be important and on the increase in view of the rising numbers of occupational accidents occurring in recent years. They especially mention various economic sectors, such as nursing, banking and social work. However, unemployment is seen as a more


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important problem and, partly because of that, work stress problems receive little atten tion. U p until now a systematic and national monitoring system to identify risk factors and risk groups in the workinq population has been lacking, but there is a periodical survey on working conditions that also covers some aspects of stress problems. The data stemming from this system are receiving little attention. There is no central research fund covering the whole quality of working life field, or research on stress and well-being at work. Formal networks between policy-makers, employer and employee representatives and company specialists on work stress and well-being are lacking. There is, however, an important fund put aside for improving working conditions. This Fund for the Improvement of Working Conditions (Fonds pour I’ AmClioration des Conditions de Travail, FACT) was installed by the government. Companies that have plans of an innovative and exemplary nature can be given financial support. Several projects on job satisfaction, work organization, absenteeism and motivation have been carried out. Research on stress at work is less quantitatively oriented than in Sweden and The Netherlands, but it is developing. There is no formalized network between researchers. There are n o well-documented examples of good practice in stress prevention, though some action research is being done. In so far as companies are active, their orientation is often towards the individual employee rather than towards work-related stressors.

3.2. Comparison between the countries 3.2. I . Legalframework: Table 2 summarizes various aspects o f the law and its administration in the four EU member states and Sweden. Referring to the items in the table:

(1) A distinction can be made between the group of countries with framework legislation (Sweden, The Netherlands and the UK) and those without (Germany, France). This kind of legislation enables quick and efficacious adaptation. In principle, adapting or introducing regulations o r ordinances under the law is sufficient. Guidance is also of importance and can take different forms, such as codes of practice and simple guidelines. (2, 5, 8) Characteristics of framework legislation are: broad coverage of risks (health, safety and well-being at work), self-regulation as the guiding principle of the legislation (that is, the recognition of joint employer and employee responsibility for working conditions a t enterprise level) and system cnforccment instead of an approach of penalizing adopted by labour inspectorates. (3, 6) So far, Sweden is the only country which has separate work stress prevention ordinances under its working conditions act. (4) Thc obligatory implementation of the framework directive into national legislation has only been realized in three of the four EU countries: the UK, France and The Netherlands. Germany refused to implcment this directive. (7) Finally, little fundamental difference exists between the five countries as regards their organization of national infrastructure in the field of health and safety. All countries possess one o r more labour inspectorates. Moreover, all countries dispose of at least one private or public national institute which endorses health and safety policies a t firm level (training, documentation, research). 3.2.2. Work stress prevention in general: Table 3 summarizes the mail1 aspects for the fivc countries examined. Referring to the items in the table:

+

hsw

(8) Legal coverage: health, safety, well-being

+

-

+

+

Not applicable

hsw

hs(w)

WEA. Work Environment Act; HSWA. Health and Safety at Work Act; ASIG, Arbeitssicherheitsgesetz (the Occupational Safety Act). hs(w), Health, safety (and well-being). FWD, Framework directive on health and safety at work. + / -, Indicates whether country is with/without listed aspect.

Broad coverag-

hs

Legislation-labour inspectorates-advisory bodies and research efforts

+

(7) Health and safety infrastructure

+

intrinsic in framework legislation

+

hs

+

-

-

+ 1993

+

Not applicabl-

1993

-

-

-

France

+

WEA/policy rules

+

(6) Enforcement of work stress prevention

+

ASIG (1973)

-+

Germany

1994

-

WEA/ordinances/ policy rules

+

Not applicable

(5) System enforcement

(4) Implementation FWD ready

+

(3) Separate work stress regulations

+

+

UK HSWA (1974)

Intrinsic in framework legislation

Ordinances: (Psychological +social aspects 1980, 1982; solitary work; violence at work 1993)

+

+ WEA (1980/1994)

+

WEA (1978/1991)

(2) Self regulation

(1) Framework legislation

The Netherlands

Aspects of the law and its administration: comparison of the five countries Sweden

Table 2.


-

x

$

3

0

2

2.

B

-

+

-.

+-

-+

+ Research (instruments; risk groups; enforcement) and information transfer

+

Research and information transfer

-

Research and information

+ Research by unions, conferences both sides of industry

-+ Some studies by unions

No

Social security; industrial policy

+-

-+

Germany

+-+ Social security

+-

France

Industrial policy, science policy, social security

‘Arbeit und Technik’/ BAU

Partly

+-

Via advisory bodies; Research programme and own initiatives ‘Arbeit und Technik’, (training, research, collective agreements information, collective agreements)

+Via advisory body; and own initiatives (collective agreements)

+

Via research and funding institutions

+

UK

Emphasis more on individual than on organizational factors

+

The Netherlands

Emphasis more on organizational than on individual factors

+

Sweden

Comparing general characteristics of stress at work for the five countries

BAU, Bundnanstalt fur Arbeitsschutz. +/ Indicates whether country hasldoes not have listed characteristic.

(5) Connections with other policy fields

(4) Special governmental programmes

(3) Separate initiatives of social parmers

(2) Involvement of social parmers

(1) Perception of work stress

Table 3.


x



313

(1) Work stress and the need to prevent or combat it is not an issue that is of equal importance in all five countries. Again the countries with framework legislation are the most sensitive in this respect. (2) The same conclusion applies to the involvcment of the social partners and the organization of special government prevention programmes. (3) It is only in the UK that both sides of industry organize stress prevention activities either separately or in cooperation with HSC and HSE. In The Netherlands only some trade union organizations pay systematic attention to preventing work stress but not on a regular basis. (4) The funding of health and safety activities is very often a mixture of public and private funds and all countries except Sweden have experienced a structural shift towards privatization of funding. (5) A weak point of health and safety efforts in all five countries is the isolation of the worker protection field from other policy areas, such as industrial or economic policy. In three countries there is an explicit connection with the social security system: in The Netherlands, Germany and France. 3.2.3. Dgerent aspects of work stress prevention activities: aspects. Referring to the items in the table:

Table 4 summarizes various

(1,3) O n the whole it is the countries with framework legislation which have organized most preventive activities, ranging from well-developed research efforts to disseminating knowledge on stress prevention. (2) Although various monitoring systems on working conditions do exist in most countries, a national monitoring system on stress at work has only been developed in The Netherlands. (4) Specialized formal stress research networks o r research groups are present in Sweden and The Netherlands, and, to a lesser extent also in the UK, Germany and France. (5) From the angle of work stress prevention, the attention given to j o b redesigning because of work stress is only to be seen in Sweden and The Netherlands, though it is not completely missing in the other countries. (6) What is significant is the great popularity of employee assistance programmes in the UK. This kind of approach concentrates on the individual causes of work stress. (7) Regrettably, the number of examples of good preventice practice in the five countries is limited.

4.

Discussion

Two groups of countries When comparing the five countries one may distinguish two separate groups. Although there are some obvious differences within each group, there is a group of countries which already pays quite a lot of attention to preventing work stress: Sweden, The Netherlands and the UK. The second group, Germany and France, d o not yet recognize work stress as an important policy issue. However, this does not mean that stress prevention o r j o b redesign approaches are completely lacking. The difference between the two groups of countries can partly be explained by the actual differences between their models of industrial relations. What seems to be more important is the presence of national framework 4.1.

+

+

+

+ +

(4) Stress research groups

(5) Job redesigning

+

+-

-+

Separate sources

-+

Germany

Some available-

-+

-+

-+

+

-+ Well developed

-+

+-

-+

-+

Less important

-+

University and non-university groups, consultants

+

+-

-

N o emphasis

+I-. Indicates whether country is with/without listed aspect.

(7) Best practices

(6) Employee assistance programmes

Important

+

+

(3) Stress research networks Mostly informal

+ Separate sources and new national survey

-

(2) National monitoring system

+-

UK

Leaflets, research reports, books, conferences, training courses, video, TV-broadcasting

Separate sources

(1) Active transfer of knowledge

The Netherlands

Comparing various aspects of work stress prevention

Sweden

Table 4.


-

No emphasis

-+

+-

-

-

France

a c

2

9.

F

%

P

e

w


315


legislation. The three countries with developed work stress prevention progammes all are countries which possess framework legislation in the field of health and safety.

4.2. Attention towards stress when compared to traditional health and safety subjects Although stress is an important subject in some of the countries under study, most of the attention in the field of occupational health and safety is clearly still being devoted to ‘traditional topics’ such as ergonomics, somatic health, (technical) safety and toxic agents. Significantly more attention is being paid to chemical, physical and biological hazards than to psychosocial risks such as poor job content, monotonous work, lack of control, and poor social support. This conclusion supports the results obtained from a survey carried out in 1990-1991 amongst private and public companies in several European countries (Wynne and Clarkin 1992): this study showed that actions which are often related to problems in connection with stress at work, d o not have high priority when compared to chemical and physical hazards.

4.3. Lack of examples of good practice There clearly is a lack of well-documented (national) ‘examples of good practice’. This conclusion is in line with the conclusions of several key publications and reviews on stressprevention programmes (for example, Burke 1993, Cooper and Payne 1988, Cox 1993, Ivancevich et al. 1990, Kahn and Byosiere 1992, Karasek 1992, Murphy, 1984, 1986, Newman and Beehr 1979). Kahn and Byosiere characterize most stress-prevention programmes as follows: -

There is a great deal of activity directed at the management o f stress.

- This activity is concentrated disproportionally on reducing the effects rather than reducing the presence of stressors a t work. -

The main target is the individual rather than the organization.

- There is a lack of serious research into the effects of all this activity. -

However, progress is being made: there is a minority of programmes for which persuasive empirical data are available.

The crucial question for stress-prevention programmes, ‘How well-and why-do they work?’, cannot yet be answered because of this lack of ‘best cases’. As to this question, Kahn and Byosiere (1992) conclude: ‘The research evidence to answer this question is unfortunately meager and the methodological problems are serious’. Some of the basic methodological problems relate to: lack of longitudinal research, lack of control groups, difficulties in using laboratory research designs in quickly changing profit organizations, the nature of the stress concept itself (not one but many causal factors, inside and outside work), too much reliance on subjective data, only short-term (individual) outcomes, rather monodisciplinary approaches (for example, not cooperating with an economist). However, there are important other problems as well. To management, as was also demonstrated in the present study, stress is merely an individual problem caused by personality, life-style or family problems, requiring individual measures. To worker representatives, on the other hand, stress is merely a consequence of organizational factors, such as poor job design or poor style of leadership or management. The dominance of management views, particularly in the USA but also in the UK, has strongly contributed to the development of Employee Assistance Programmes and individually oriented stressmanagement techniques, such as relaxation, meditation and biofeedback (see also Cox

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1993). Also, at the moment the economic recession plays a role, being in favour of such statements as: ‘Be glad that you havc a job; there is no time for luxury’.


4.4. Recommendations 4.4.1. Legislation: Legislation should take into account differences between countries in long-established constitutional and legal thinking and practice (Cox 1993). Nevertheless,

clear policy statements on the nature of desirable working conditions are a necessary start for successful national stress strategies. Moreover, it is suggested from this study that framework legislation, providing general rules on desirable psychosocial working conditions and on the responsibilities of employers and employees, is an important policy instrument to focus attention on stress at work.

Guidance and information: In order to put ‘stress’ on the agenda of both employers and employees, providing guidance on stress, its causes, consequences and prevention (through handbooks, manuals, videos) might be a better strategy than mere legislation. Several international agencies (European Foundation, ILO, European Commission) have recently been taking steps in providing this guidance, as have national ministries (for example, in The Netherlands). This guidance helps in raising awareness of stress as a health and safety subject, just like other traditional subjects such as noise, physical load o r toxic agents. This implies, for example, that stress prevention ought to be based on a proper risk assessment and take into account normal principles of prevention: reducing risks instead of influencing individual behaviours. Guidance could also help in such areas as educating managers and employees, and the training of inspection agencies.

4.4.2.

Monitoring and risk assessment: The development of comprehensive European, national and sectorial monitoring systems into health and safety and stress and well-beinr at work should be stimulated. Also at the level of companies, especially small- and medium-sized firms, simple instruments for risk assessment should be developed and distributed (see Kompier and Levi 1994).

4.4.3.

4.4.4. Costs and benefits: In order to relate psychosocial work characteristics-and health and safety in general-to other policy areas (for example, productivity, labour market facets, company image, human resources management, total quality management) it is important that more information is collected on various costs and benefits of stress prevention programmes. Does it pay, and when and to whom? 4.4.5. Examples ofgood practice as a ‘role model’: The development of national examples of good practice concerning the prevention of stress a t work is a condition sine qua non for effective stress-prevention procedures and for the involvement of both social partners in this field. 4.4.6.

European networking: The formation of national and European-wide networks of competent stress researchers and practitioners relating theory to practice seems necessary to develop this area further. Notes The framework directive states, amongst other things, that the employer has ‘a duty to ensure the safety and health of workers in every aspect related to the work, following


317


general principles of prevention: avoiding risks, evaluating the risks which cannot be avoided, combating the risks at source, adapting the work to the individual, especially as regards the design of work places, the choice of work equipment and the choice of work and production methods, with a view, in particular, to alleviating monotonous work and work at a predetermined work-rate and to reducing their effects on health’ (article 6). *To illustrate further this need, the Ministry of Social Affairs of Belgium (at that time (1993) the presidency of the European Union) in cooperation with the European Foundation, organizcd the Congress ‘Stress at work: a call for action’.

Acknowledgement This research was granted by the Dutch Ministry of Social Affairs and Employment.

References* BURKE,R.J. 1993, Organizational-level interventions to reduce occupational stressors. Work and Stress, 7 , 77-87. COOPER, C. L. and PAYNE, R. 1988, Causes, Coping and Consequences of Stress at Work (Wiley, Chichester). COOPER, C. L., ALLISON, T., REYNOLDS, P. and SADRI,G. 1992, An individual-based counselling approach for combating stress in British Post Ofice employees. In Conditions of Work Digest, Preventing Stress at Work (ILO, Geneva) 11(2), 246-256. COX,T. 1993, Stress Research and Stress Management: Putting Theory to Work (HSE Contract Research report, no. 61/1993). GIER,E., DE KOMPIER, M, DRAAISMA, D. and SMULDERS, P. 1994, Regulations, Policies and Practices Concerning Work Stress Prevention and Improving Well-being at Work in Sweden, Great Britain, Germany, France and The Netherlands (TNO-Prevention and Health, Leiden). GRUNDEMANN, R . W. M., NIJBOER, 1. D. and SCHELLART, A. J. M. 1991. The Work Related Character of Work Disablement [in Dutch] (Ministry of Social Affairs and Employment, The Hague), S-127. INTERNATIONAL LABOUR OFFICE (ILO) (ed. V. Di Martino) 1992, Conditions of Work Digest, Preventing Stress at Work (ILO, Geneva) ll(2). IVANCEVICH, J. M., MATTESON, M. T., FREEDMAN, S. M. and PHILLIPS, J. S. 1990, Worksite Stress Management Interventions. American Psychologist, 45,252-261. P. 1992, Stress in Organizations. In R. A. Dunnette and M. B. Hough KAHN,R. L. and BYOSIERE, (eds) Handbook of Industrial and Organizational Psychology, 2nd edn (Consulting Psychologists Press, Palo Alto). KARASEK, R.A. 1992, Stress prevention through work reorganization: a summary of 19 international case studies. In Conditions of Work Digest, Preventing Stress at Work, 11(2), 23-41. KOMPIER, M. A. J. and LEVI,L., Stress at Work: Causes, E#ects and Prevention; Guidefor Small and Medium-Sized Enterprises (European Foundation for the Improvement of Living and Working Conditions, Dublin). KOMPIER, M. A. J. and MARCELISSEN, F. H. G. 1990, Handbook Work Stress [in Dutch] (NIA, Amsterdam). KOMPIER, M. A. J., MARCELISSEN, F. H. G. and VAAS,S. 1990, Stress at the Workplace? D o Something About Ir! [in Dutch] (FNV/CNV/MHP, Amsterdam). KUHN,K. 1992a. Health circles for foremen at Volkswagen. In Conditions of Work Digest, Preventing Stress at Work (ILO, Geneva), 11(2), 220-222. KUHN,K. 1992b.Job redesign and stress prevention for crane operators. In Conditions of Work Digest, Preventing Stress at Work ([LO, Geneva), 11(2), 223-226. KVARNSTROM, S. 1992, Organizational approaches to reducing stress and health problems in an industrial setting in Sweden. In Conditions .f Work Digest, Preventing Stress at Work (ILO, Geneva) 11(2),227-232.

* An ‘extensive’ list is included in de Gier et al. 1994.

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LEVI,L. 1992, Case study no. 1: managing Stress in work settings a t the national level in Sweden. I n Condirions .f Work Digesf, Prevenfing Sfress af Work (ILO, Geneva) 11(2), 139-143. MURPHY, L. R. 1984, Orrupational Stress and IJreventive Managernetif (McCraw Hill, New York). L. K., 1986, A review of organizational stress management research. Jourtial ojOrptiixaMUHPHY, riorial Behavior Management, 8, 215-227. NEWMAN, J. I). and BEEHR, T, 1979, Personal and organizational strategies for handling job stress: a review of research and opinion. Persoririel Psyrholiigy. 32, 1-43. NIJENHUIS, C. H. 1993, Case study: the cigarettes factory. In A. W. K. Gaillard and M. A . J. Kompicr (cds) Work Stress mid Work Disabiliry [in Dutch] (MAKLU, Antwerpcn/Apeldooni), pp. I61 - 168. PAIANI), N. and SCHWEDES, I