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Monitoring work-related stress at national level: high heterogeneity between Member States
Various instruments are in place in EU Member States aimed at monitoring work-related stress at national level. These usually take the form of surveys. Some Member States have more than one survey and are able to provide trend information on stress, though the majority does not have national representative surveys.
Cohort surveys are run in some countries, such as Belgium. Here the Belstress study, a large epidemiological cohort study on stress at work and related health problems, ran from 1996 to 2006. In Sweden, the Swedish Longitudinal Occupational Survey of Health (SLOSH) is a longitudinal cohort study that aims to examine the relationship between work organisations, work environment and health among the same participants over a period of time. These types of surveys are very important as they allow for a deeper understanding of work-related stress. For example, recent analysis of the SLOSH cohort has shown how leadership style can play a role in relation to the development of work-related stress.
Repeated cross sectional surveys over time
A few European countries conduct national representative surveys to measure stress. This type of methodology is used to identify prevalence and trends, as well as the profile of risk groups.
Only a few of these used ‘validated questionnaires’, where complex epidemiological studies combining self-reporting, third party data and physiological measurement demonstrate a relationship between stress and some health outcomes. For example, the French SUMER survey in 2003 (repeated in 2009) includes the ‘Karasek’ questionnaire. This is rather unique in European surveys as it introduces a ‘validated questionnaire’ into a general survey. Results have highlighted that women are more exposed than men to ‘job strain’ work situations, with risks for health (cardiovascular diseases, musculoskeletal disorders (MSDs) and mental health problems). Also, clerks are more exposed than legislators or professionals; demands on them are higher and their room for manoeuvre is likely to be less.
Most other surveys would use proxy data for these validated questionnaires. In large-scale longitudinal, epidemiological research, they may also be used to understand causal relationships.
These types of surveys can provide valuable data concerning changes and trends relating to work-related stress and can help us understand the relationship between work/employment changes and stress-related issues. Such studies exist for example in Austria (Arbeitsklimaindex and Arbeitsgesundheitsmonitor), in which data are collected quarterly. In Finland, the Work and Health surveys carried out by the Finnish Institute of Occupational Health (FIOH) have been carried out every three years since 1997.
The Netherlands Working Conditions Survey (NEA) is the largest periodic survey on working conditions in the Netherlands and has been conducted six times. This survey includes work-related stress, although the way of measuring some work-related stress factors was changed in 2007.
In Norway, the Level of Living Survey: Working Conditions (Levekårsundersøkelsen: Arbeidsmiljø) is conducted every three years and includes questions that measure the subjective evaluation of control and demands of work.
The Survey on Quality of Life in the Workplace in Spain (Encuesta de Calidad de Vida en el Trabajo) is carried out each year by the Spanish Ministry of Labour and Social Affairs, giving a detailed picture of trends concerning stress since 1999. The most recent survey in this series relates to 2008.
The French Working Conditions Survey (Enquêtes Conditions de Travail), carried out every seven years, enables researchers to monitor work situations over time.
Labour force surveys are carried out on a regular basis in many countries, but do not normally include much data relevant to the issue of work-related stress. Nevertheless, one ad hoc module on work-related issues allows some mapping over time of one dimension of stress. In Malta, for example, a labour force survey in 2007 included work-related stress.
There are a range of one-off surveys available around the EU, some of which are relatively broad in scope, while others focus more narrowly on psychosocial risks at work. These surveys can provide an interesting snapshot of stress-related issues at a particular point in time. Some one-off surveys focus on specific sectors or occupations that are considered to be at particular risk of work-related stress. For example, in Cyprus, a 2008 study by Kyriacou and Constanti was carried out on call centre operators, focusing on issues such as individual personality, working conditions and workplace environmental conditions. In Hungary a series of sectoral studies have been carried out by GfK Hungária, including in the agricultural sector.
Some one-off surveys focus on a particular issue. For example, in Slovenia in 2008, the Clinical Institute of Occupational, Traffic and Sports Medicine (Čili za delo) carried out a survey on mobbing, based on interviews carried out in respondents’ homes.
There are also a range of large health surveys, in which a limited number of questions are devoted to stress. This is the case with the Danish National Health and Morbidity Survey 2005 (in Danish, 4.63Mb PDF), in which stress was measured by the question ‘do you feel stressed in your everyday life?’.
Many of the surveys that examine stress are carried out by national governments. This is the case in Germany, for example, where the Federal Ministry of Labour and Social Affairs (BMAS) produces an annual report on health and safety at work, and other occasional studies on health at work that include work-related stress. Similarly, the Latvian Ministry of Welfare (LM) has issued a study on working conditions and risks. In Portugal, the Labour Ministry (MTSS) carried out a national survey on working conditions in 1999–2000, but it has not been repeated since.
Germany’s health insurance organisations also carry out surveys that on occasion include psychosocial risks such as stress. For example, the so-called Absenteeism Report conducted by WIdO, the scientific research institute of statutory health insurer AOK and the University of Bielefeld, focuses in its 2009 edition on work and psychosocial risks. The report analyses the data on absence rates available from the 9.7 million employed people insured by AOK in 2008.
Social partners also play a role in producing surveys, either conducting them themselves, or commissioning surveys from external bodies. In Greece, the Greek General Confederation of Labour (GSEE) commissioned a survey on working conditions in 2008 carried out by a private research and consulting organisation. Trade unions in other countries have also sponsored research into stress. For example in Luxembourg, the Confederation of Independent Trade Unions (OGB-L) commissioned a study into work-related stress in 2006, which was carried out by the organisation Stimulus.
Other survey sponsors include research bodies, such as the Economic and Social Research Institute (ESRI) in Ireland, which conducted a national survey of the work experiences of over 5,000 employees, together with the National Centre for Partnership and Performance (NCPP). The labour inspectorates in some countries also sponsor research into stress. This is the case in the Netherlands, for example, where an annual survey is carried out by the country’s labour inspectorate, based on a standard questionnaire.
Central statistics offices run surveys in some countries such as Norway, Poland and Romania.
Survey infrastructures to measure work-related stress
A number of European countries make use of a sophisticated range of surveys, which allow for the monitoring and better understanding of work-related stress.
For example, work-related stress and health has been investigated for a long time in Sweden, so there are several sources that investigate stress and health issues in the Swedish labour market. In particular there are three surveys with national coverage which provide information on work-related stress. The first is the Swedish Work Environment Survey (SWES), which has been carried out by Statistics Sweden (SCB) every other year since 1989. Secondly, SLOSH (Swedish Longitudinal Occupational Survey of Health) is a longitudinal cohort study which followed up on SWES 2003. The aim of the study is to examine the relationship between work organisations, work environment and health. The study includes more questions than SWES, and has the advantage that it studies the same participants over a longer period of time. The survey was commissioned by the Stress Research Institute (Stressforskningsinstitutet) and was carried out by SCB from March to May 2006. Thirdly, Work Related Disorders is a survey commissioned by the Swedish Work Environment Authority (AV), which measures new and old work-related disorders as reported by the respondents during one year. Studies on work-related disorders have been conducted since 1991 on the whole population and from 2003 on those in work.
France is another example and can use a range of data coming from surveys carried out by the Ministry of Employment (research and statistical unit: DARES). These include:
- French Working Conditions Survey (Conditions de Travail, CT);
- Medical Monitoring of Risks Survey (Surveillance Médicale des Risques, SUMER);
- Health and Career Path Survey (Santé et Itinéraire Professionnel, SIP);
- Organisational Change and Information Survey (Changement Organisationnel et Information, COI);
- the Samotrace programme, a monitoring system for mental health at work launched in 2006 by the French Institute for Health Surveillance (InVS).
The Netherlands is also an example of a country that carries out numerous surveys on work-related stress. The NEA is the largest periodic survey on working conditions. Six surveys have been performed to date in 2003, 2005, 2006, 2007, 2008 and 2009. The Employers Working Conditions Survey (WEA) is another national survey, with a sample of at least 5,000 employers, and is conducted every other year. It concentrates on working conditions and employment-related issues regarding policies as well as ‘ad hoc’ activities regarding working conditions and working relations. The Dutch Labour Inspectorate carries out another survey (Werk in Bedrijf) every year in which labour inspectors query a national sample of more than 2,000 Dutch employers with a standard questionnaire on working conditions and the way they manage these. They also visit the shop floor and ask for relevant reports. Every year a specific set of working conditions is questioned in detail, and in 2007, work-related stress factors were investigated.
It is obvious that this is a complex topic, so it is necessary to increase our knowledge and understanding by analysing information provided by various sources and types of respondents.
From a comparative point of view, it is important to be able to draw and learn from the knowledge and expertise available to develop other survey instruments that can contribute to a better understanding of work-related issues and how to address them.
The Annex gives details of the main national surveys and other monitoring instruments for stress that are in place in individual European countries.
Overall level of work-related stress
Work-related stress is often difficult to evaluate, as it can be quite difficult to define and depends very much on the definitions and methodologies used in research. It also has some subjective elements that depend on the nature of individuals and their own responses to stress factors. In some countries, stress is widely recognised as a work-related issue; elsewhere well-being in the workplace is promoted, while in other countries it does not have such a high profile. According to different surveys, the incidence and trends of stress also tend to vary within countries, as these may use varying methodologies and definitions.
Some parties have argued for the production of one single indicator to measure and monitor stress. However, a group of experts appointed by the French Ministry of Labour, with the task of assessing psychosocial risk in the workplace, argued that given the differences in theoretical models, all indicators cannot be combined. It would be necessary to develop a coherent set of indicators in order to monitor work-related stress in an efficient way.
Trends vary from country to country, with some reporting an increase in stress levels, some reporting a decline and some stating that the trend has been broadly stable over the past five years. But it can be difficult to monitor trends across many countries due to a lack of directly comparable data.
Countries reporting an increase in stress levels over the past five years include Germany, where the WSI Works Council carried out a survey between September 2008 and January 2009, interviewing 1,700 works council members about their establishment’s innovative capabilities, working conditions and occupational health. Results showed that 79% of all works council members interviewed stated that the psychological strain for employees at the workplace had risen between 2006 and 2008.
In Denmark, although it is difficult to pinpoint trends, data from the SUSY survey shows that from 1987 to 2005 the share of individuals experiencing stress to a severe degree rose from 5.8% to 8.8%.
In Estonia, data from European Working Condition Surveys show that the share of respondents who associate their work with stress increased from 26% in 2001 to 32% in 2005. However, it is thought that some of this increase could be explained by the increased focus and attention on the issue of stress in recent years.
In Ireland, although there is no definitive survey evidence, lawyers are seeing an increase in bullying and stress claims, according to Aisling Butler, who chairs the Health and Safety Lawyers Association of Ireland ( HSLAI). The trend is manifesting itself in more cases for unfair dismissal coming before the Irish Employment Appeals Tribunal, in which issues of bullying and stress are raised.
In Belgium, the Flemish Workability Monitor found that around 29% of employees have work-related stress problems (of which 10% have acute problems) and that this has remained broadly stable since 2004. Levels of stress have also been broadly stable in the UK over the past five years. In Sweden, the number of workers indicating that work has caused stress has fallen following a peak in 2003, although it has risen over the 10 years from 1998.
In Norway, surveys have pointed to a decline in work-related stress, although researchers note that the trend should be interpreted with care, as factors that are not related to work could influence the employee’s tolerance and subjective experience of work-related stress.
In Finland also, according to a FIOH study in 2003, 12% of wage and salary earners experienced very much or quite a lot stress, with the proportion falling slightly to 10% by 2006. In Romania, the Living Conditions Surveys (ACOVI), carried out annually by the National Institute of Statistics (INS), showed that the proportion of employees who find their jobs stressful fell from 20.9% in 2002 to 19.2% in 2003 and 2005.
Some studies show that there are differences in stress levels between different age groups. For example in Cyprus, a survey conducted by the Department of Labour Inspection in 2006 showed that:
- those who have worked for over 25 years report the greatest proportion of stress-related problems;
- 5.4% those aged between 40 and 63 reported problems related to stress, compared with just 1% of those aged between 18 and 24.
This is backed up by data from the Czech Republic (from ‘The price of health’ initiative sponsored by the Czech Ministry of Labour and Social Affairs (MPSV) in 2007), which show that levels of stress at work tend to increase with age. In Germany, surveys show that people aged between 30 and 39 were most affected by stress, listing work-related stress as the main source. Data from Greece show that stress levels fall away sharply after the age of 54 (8% of people up to age 54 said that they suffered from work-related stress, compared with 1.8% of those aged 55 and over). In Spain, individuals in the 45–54 age bracket are shown to suffer from the highest levels of stress, and those aged 16–24 from the lowest.
In Luxembourg, survey data have found that nationality and age correlated statistically with perceptions of stress. Portuguese nationals report higher levels of stress than those from Luxembourg, while the 25–29 age group perceives stress to be slightly higher than those in other age groups.
Stress levels are also reported to vary according to occupation, with a number of occupations classified as comparatively high risk for stress. These occupations include teacher, nurse, doctor, bus driver, traffic warden and police officer. It is interesting to note that some occupations include stressors (for example, doctors and nurses who are likely to be in contact with sick people). These stressors, combined with organisational factors (for instance, whether they have time to deal properly with their patients, whether they have support to help them deal with the emotional impact of working with people who are suffering, ) can result in different work situations leading to more or less stress.
In light of the high health costs linked to stress (increase in cardiovascular diseases, mental health problems and MSDs), some occupations should be monitored carefully with a view to assessing developments. For example, in Slovenia, 84% of teachers surveyed in 2008 said that their profession was very or exceedingly stressful. In Bulgaria, an empirical psychological survey of judges conducted in 2008 by the union of psychologists aimed to define the level of stress faced by judges. Using face-to-face structured interviews, its target population was 474 respondents, representing 8.65% of all judges in the country. This survey found that around half of respondents reported stress, including 24.4% at a low level and 22.0% at a medium level.
Surveys in Denmark have found that among employed workers, senior managers have the highest stress levels. In Italy, surveys have been carried out in the banking sector, showing high levels of stress for workers in this sector, both for those handling money and those not handling money. In the UK, the 2007–2008 Labour Force Survey found that the industry sectors of health and social work, electricity, gas and water supply and public administration and defence had a prevalence of work-related illness that was statistically significantly higher than average.
In terms of type of employment, in Denmark, surveys find that self-employed workers with employees have the highest stress levels (17.3%), whereas unemployed people have the lowest (7.7%).
Regarding skills and competence levels, surveys from Denmark show that employees whose work requires basic level skills have lower stress levels than those in more highly skilled jobs. The Price of Health 2007 survey from the Czech Republic also shows that stress levels rise in accordance with the level of education, ranging from 13% of respondents with basic or no education stating that they suffered frequently from enormous stress, to over 38% for those with a university education.
Educational levels appeared to have an influence on stress in Luxembourg, where surveys found that the higher the educational level, the lower the stress level. By contrast, surveys in Poland and Spain have found that the higher the level of education, the higher the level of stress.
Gender also seems to play a role is some countries. In Luxembourg, for example, 29.4% of women were reported to be under very high levels of stress, compared with 15.2% of men. In Romania, a slightly higher proportion of women than men reported stress at work. In Portugal, study data appear to show that women are more likely to suffer from stress overall than men.
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