Hungary: EWCO comparative analytical report on Work-related Stress

  • Observatory: EurWORK
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  • Published on: 22 November 2010



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The Hungarian Act on Health and Safety has prescribed since 2008 that containing psychosocial risk factors at the workplace shall be the responsibility of the employer. It has also determined that employee representatives may take part in fulfilling this duty. Although the legal regulations have included the assessment of psychosocial factors among the risk assessment responsibilities, the nature of the question does not allow the introduction of measurable standards. Health promotion and stress management at work have received attention at multinational companies mostly, while smaller enterprises face difficulties with respect to stress-related risk assessment and stress management due to the shortage of capital and free practical guidelines.

Q1 Monitoring work-related stress at the national level

1. Are there any instruments in place to monitor work-related stress at the national level, for example, national surveys, sectoral studies, epidemiological studies, action research, or other research programmes? Please describe the main sources of information available on work-related stress in your country (coverage, methodology, definitions used, etc.).

The concept of stress has become widely used in the wake of the work of János Selye, a Hungarian-born scientist. Although used previously as well, the term was given a new interpretation and physiological content by Selye. He was proud that, given that other scientists failed to come up with a better expression for the phenomenon, the phrase had gained recognition in every language, which proves his linguistic aspirations.

Selye’s original definition of the term reads as follows, “Stress is condition, manifested in a cluster of specific symptoms, which comprises all, non-specific transformations incurred in the biological system. The organism’s adaptive reactions are understood in the framework of stress.”

Surveys on stress at the workplace

Stress in the agriculture

GfK Hungária - a member of GfK Group, one of the largest market research companies in the world, whose main activity is divided into Custom Research, Retail and Technology and Media - carried out a survey comprising 1,000 employees in April 2008. The survey focused on several sectors, thus the results allow an analysis of the working conditions of agricultural employees with respect to workplace stress. The Agriculture Sectoral Social Dialogue Committee published the results concerning agriculture only in its publication titled ’Workplace Stress and the related tasks of social partners” (see HU0902019I). Of the entire sample, 236 respondents were working in agriculture. Respondents were asked to assess statements using a 1-5 scale (1 - fully disagree, 2 - agree in a very small degree, 3 – moderately agree, 4 – more or less agree, 5 – fully agree; 0 - no opinion).

Relations of work-related stress and health based upon Hungarostudy Health Panel 2006

The purpose of the Hungarostudy Epidemiological Panel 2006 (Hungarostudy Egészségpanel Felmérés 2006) was to map the attitude of the Hungarian population to mental and physical health, health care and personal health maintenance, as well as to monitor the evolution and trends of psychosocial risk factors. The Hungarostudy surveys have been carried out every year since 1998. The one conducted in 2006, involving 3690 respondents, was a follow-up to, or the second wave of, the survey carried out in 2002.

In the Hungarostudy 2006 survey the short version of the Siegrist effort-reward imbalance questionnaire was used. The effort dimension of the questionnaire consists of four topics, which analyse pressure of time, interruption, distraction and increasing efforts during work.

The effort-scale of the shortened questionnaire contains six items. Questions relate to rewards of work, promotion possibilities, workplace security and unfavourable changes at the workplace. E.g.: Are you rewarded in accordance with your efforts? Respondents are asked to assess statements using a 1-5 scale. The quotient of the values in the effort and reward scales provides the index for measuring workplace stress. Should the value of the index be 1 or more, it indicates high workplace stress.

2. Provide, if available, data on the overall level of work-related stress based on the identified sources. If possible, identify the main trends in this matter presenting data (e.g. for the last five years).

Q2 Risk factors for work-related stress

Based on the main or most used monitoring instruments available (identified in Q1), please provide information on the following risk factors for stress.

Note: If available, please provide information on the main changes or trends in text. Any tables with figures illustrating those trends should be included in annex (if possible, breakdown the data by gender and/or other relevant variables).

Quantitative demands: workload, working hours, quantity and intensity of work.

Qualitative demands: these refer to emotional and cognitive demands at work and may include work-life balance issues, complexity of work, dealing with angry clients and suffering patients, feeling afraid, having to hide emotions, etc.

Relations at work which may include social support from colleagues or supervisor, management style and relationships with colleagues/managers/the organisation; violence and harassment at work.

Autonomy, decision latitude and room for manoeuvre: control over work, including control over pace of work and over job content and decision-making power; predictability of work, use and possibility to develop skills.

Individual and collective mechanisms for employees’ involvement, particularly in relation to organisational change and change management, including communication of change.

The perception of the role that the employee holds in the organisation and whether the employee is clear about what is expected of them in terms of their job; clarity of the management changes, i.e., how organisations manage and communicate change; motivation; over commitment and reward.

Conflicts of value and organisational justice.

Precariousness of work (i.e. nature of the employment contract).

If there are no surveys or large scale research programmes available, please provide information on how stress is measured/assessed in other sources: qualitative research data on stress risk assessment at company level or sectoral level, studies with a focus on specific occupations, etc.

Survey results

a) According to the survey Stress in agriculture as much as 42% of agricultural employees found that stress (directly) posed a medium level problem at their work. Monotony seems to affect these workers to a lesser degree (28%). Fifty-six per cent of the sample indicated that they were concerned about the stability of their position at least to a medium degree. The difficulty of reconciling work and family life may be a considerable source of stress in the case of female workers with children. However, 66% of the respondents did not see it as a problem, while the rest are free to organise their working hours.

Employees in agriculture do not believe that working in the sector jeopardizes their health. As much as 55% of the respondents fully disagreed with the statement that the workplace was harmful to their health. It is less typical in the sector that someone is forced to perform a task instead of a co-worker; 33% of the sample indicated the opposite.

Physical fatigue is one of the most characteristic traits of agricultural work: 72% of the employees agreed fully, more or less, or to a medium degree, with the statement “I go home tired”. This also means that respecting breaks and rest times is of particular importance in agriculture.

Mental fatigue was mentioned as a problem by fewer respondents (56%). The absence of lunch-breaks may cause physical and/or mental tiredness or an overstrained condition. Close to one third of the respondents related that taking a lunch break posed medium challenge (3 and 4 in a five scale) for them.

Overtime greatly or moderately affects 34% of employees, while fast working pace meant a problem for 51% of them. 60% of the respondents had problems with tight deadlines. The lack of adequate work may be considered as a source of stress but a much as 91% of respondents in the survey stated that it had never affected them.

b) According to Hungarostudy 2006, 18.3% of employees feel that their workplace efforts are not sufficiently rewarded. The proportion of those who feel that they have absolutely no influence over what is happening in their workgroup makes up 24.4% of the sample, which means that one-fourth of Hungarian employees have little control at their workplace. 13.5% of the respondents are concerned about losing their jobs and thus have experienced stress and insecurity. 8.5% of the employees assessed they could expect no help from their colleagues when facing a difficult situation in life.

Table 1. Rate of workplace stress among respondents % (N=2,262)
Effort-reward imbalance Low level of control Workplace insecurity Low level of support from colleagues
18.3 24.4 13.5 8.5

Source: Hungarian State of Mind (Magyar lelkiállapot) (Kopp M., 2008)

The Institute of Behavioural Sciences at the Semmelweis University (Semmelweis Egyetem Magatartástudományi Intézet) conducts research, among others, on the relationship between stress and the quality of life. According to the report titled ‘The Hungarian State of Mind 2008’ (Magyar lelkiállapot 2008), the main reason of premature death (only 64% of men live to 65 years of age, while the corresponding proportion is 84% in the neighbouring Austria) among the Hungarian population – especially of people over 65 years – is chronic stress.

Data from the Fourth European Working Conditions Survey indicate that 44.6% of Hungarian employees believe that their health is affected by their work. This rate is below the rate characteristic to the new EU member states, but considerably higher (by 14 percentage points than those found in the EU15. The most frequent health problems were identified as back pain and muscle problems, followed by stress (25.7% of the respondents).

Hungarians are inclined to misjudge the balance of work and private life. To the question whether their workload and social and family commitments are reconcilable, almost 20% of respondents answered “Not really” while 8% answered “Not at all”. Nonetheless, it should be noted that the average weekly working hours are among the highest in Europe (42.4 hours per week) and the prevalence of part time employment is merely 4.7% among men and 6.4% among women.

Regarding job satisfaction, 75.9% of respondents are satisfied or very satisfied with the working conditions (the EU 27 average is 82.3%), however, more than one-fifth of them consider that there is a risk of losing their jobs within the following six months.

Q3 Work-related stress outcomes

Please provide information (including references to the sources or studies) on stress-related outcomes:

  • Individual outcomes (e.g. mental health illnesses, including depression and anxiety, and physical illnesses, such as cardiovascular diseases, musculoskeletal disorders (MSDs), disabilities, fatigue and sleeping problems);

  • The social construction of stress by group of workers: can you provide references and main findings of research discussing this issue; factors acknowledged as stressful by some group of workers; groups which refer to stress or not to describe unsatisfactory situations

  • Organisational outcomes (effects that individual stress outcomes have on organisations, e.g. absence from work, job satisfaction, morale, level of commitment, productivity, and the impact of these outcomes on organisations’ costs, performance, or innovation capacity);

  • Labour Market or Societal level outcomes (the ‘costs’ to society of stress). This could include issues such as higher levels of unemployment and of recipients of incapacity benefits, costs to health and welfare systems, loss of productivity.

How stress affects health

The three stages of the General Adaptation Syndrome (GAS) described by Selye are also applicable to the development of workplace stress. In the first stage of the syndrome, called ‘Alarm’, prompted by the stressor, the body’s adaptation capacity decreases below the normal level, the body prepares for the stress response is a state of alarm. ‘Resistance is the second stage, in which the body’s resistance and adaptation capacity increases. ‘Exhaustion is the third and final stage in the GAS model, which come if the stressor persists for and extended period of time or if it’s too strong, and the employee has no resources to cope with this. If such a situation persists, then the state of chronic stress may develop, the consequences of which may include depression, anxiety, burnout, various motor- and cardio-vascular diseases (Hungarian State of Mind 2008, Kopp M p. 289).

Q4 Interventions on work-related stress management

What relevant information is available about interventions on work-related stress management and their effectiveness?

Are any interventions in place to prevent or manage work-related stress? If so, what kind of interventions are they? Please describe them making reference to coverage, effectiveness, since when they are in place, etc.

Prevention and work-related stress management

The amendment of the Act on Health and Safety at Work, in effect as of 1 January 2008, stipulates that the management of psychosocial factors at the workplace falls within the employers’ responsibility. In order to facilitate the correct interpretation of the task by the employers and to promote the right practices, and with a view to the interest of the public, the Hungarian Labour Inspectorate (Országos Munkavédelmi és Munkaügyi Főfelügyelőség, OMMF) published some guidance, which is also available on the website of the authority.

Pursuant to the Act, all the factors (conflicts, work arrangement, work organisation, the insecurity of employment relationship, etc.) affecting employees at the workplace, may constitute psychosocial risks, which may affect workers’ psychological response to these factors and may lead to work accidents, stress or psychosomatic illnesses.

In the interest of occupational safety and health, according to the Act on Health and Safety at Work employers shall observe the following general requirements:

a) hazards shall be avoided;

b) unavoidable hazards shall be evaluated;

c) hazards shall be eliminated at the place of origin;

d) the human factor shall be taken into consideration when setting up the workplace, when selecting the work equipment and procedures, with particular regard to reducing the amount of working time spent on monotonous or frequently repeated procedures and the detrimental effects of such, and to the scheduling of the working time, and to avoid any psychosocial stress that may result from work;

e) the achievements of technical progress shall be applied;

f) sources of hazard shall be replaced with non-hazardous or less hazardous sources;

g) a uniform and comprehensive prevention strategy shall be developed for the work process, technological process, organization of operations, work conditions, social relations and the impact of work environment factors;

h) collective technical protection shall have priority over individual protection;

i) sufficient information shall be provided to employees.

Employers shall evaluate the qualitative and, if necessary, the quantitative aspects of risks jeopardizing the health and safety of employees (Every employer (excluding self-employed) have to conduct risk assessment, this activity needs special expert knowledge in case of external or internal staff as well). Based on the given evaluation, the employer is obliged to implement preventive measurements which ensure improved working conditions and which are then incorporated into the employers’ activity at all control levels.

There are multiple stressors that influence people’s life in their working and social environment interpreted either in a broad or narrow sense.

Noise in the physical work environment in the case of jobs which require concentration, along with climatic effects (eg. air temperature, humidity, draught, radiant heat), have been known for long as stressors (stressor factors prompting stress) and are under regulations within employment health care. Protection for employees is provided adequately by the prevailing law and by the observance of workplace normative and limiting values against stress derived from the physical workplace environment. These regulations are known by the employers and are kept under strict supervision by the labour inspectorate.

Increased attention has been paid recently to factors by the Labour Inspectorate of the so-called psychic and social environment at workplaces; to the so-called psychosocial factors, and the process is ascribable to the recognition of the importance of stress and stress management. The amendment of the Act on Health and Safety at Work is related to the workplace aspects of the described phenomenon, and also draw the employers’ attention to the importance of prevention in such cases. It can be regarded as a new, hardly recognised problem in Hungary, which has not yet become common knowledge among employers or employees and is widely misconceived. Namely, that stress is not an illness and the challenges leading to stress are themselves required to physical, mental and emotional development.

According to the abovementioned guidance of the labour inspectorate mainly long term stress may lead to:

  • behaviour disorders, excessive smoking, irritability, alcoholism, low performance at work;

  • psychological effects: depression, aggression, confusion, inattention;

  • physical symptoms: headache, elevated blood pressure;

  • psychosomatic disorders: gastrointestinal disturbances, respiratory diseases and cardiovascular problems.

By definition, long term stress is the result of a traumatic event or a chain of events in which the person experiences extreme, disturbing or unexpected fear and stress due to (unreasonable) social, family, interpersonal and workplace expectations or conflicts, insecurity which exceed the person’s ability and capacity of managing problems. Other relevant factors are: how much control the employees have over working methods, if they understand their tasks properly, whether or not enough support is provided for them by the colleagues and by the management, and if they are well-qualified for the given task.

According to the labour inspectorate guidance list of symptoms which may bring the probable problems to employers’ notice: high rate of fluctuation among employees, repeated cases of absence from work mainly due to organic diseases, negligence of deadlines, lack of discipline, aggressive reactions, accidents, mistakes, low work performance, notices of doctors of employment health care who may detect early symptoms and accumulation of problems at periodical aptitude tests and examinations.

What can employers do?

According to the regulations in force employers shall assess the prevalence and the degree of problems, the arrangements have been done up to that point to remedy the problem, and if those were sufficient, and whether further steps are required. Employers can have recourse to services of employment health care, and experts authorised to carry out professional labour or health inspection activity for risk assessment.

However, it is less known even among employers that due to the nature of the problem the character and quality of the arrangements in order to reduce psychosomatic stress widely differs from the ones used previously in general regarding health and safety measurements.. It is vital for prevention to boost health care development activities, to provide conflict and stress management trainings and informational materials, proper control, management and education, and also to clarify roles and areas of responsibilities of employees besides providing (social) support and motivation for them.

Which organisations are promoting these interventions? E.g. at national level (health and safety authority, labour inspectorate, social partners, government), at sectoral or at company level?

Are the interventions devised to be implemented at the primary (action on causes) / secondary (action on individuals) or tertiary (action on the consequences of stress) stage?

Are any common instruments to measure stress at organisational level being used, developed, tested or assessed? Please describe them, indicating since when they are in place.

Lélekre Hangolva – Move Europe

The 8th initiative of the European Network for Workplace Health Promotion (ENWHP), which is being carried out under the supervision BKK Bundesverband (Germany) in Europe and being coordinated by the National Institute of Health Development in Hungary, aims the following targets:

  • to raise attention and awareness to the necessity and importance of health development at workplaces an within the society extensively;

  • to mobilize workplaces to get involved in the campaign, and to ensure them that the investments regarding the employees mental health and emotional well being will surely be remunerated;

  • to work out arrangements and good practices, also to encourage pooling of experience in the field of workplace health development.

During the campaign, informational materials based on specialized literature and good practice are distributed among workplaces. These materials support and motivate both employers and employees to introduce health development arrangements at workplaces as well as to persuade the interested parties that it is advisable to invest in programmes, which are beneficial to the development of employees’ mental health. The starting conference of the campaign was held in January, 2010.

The questionnaire of mental health development is available at https://www.workintunewithlife.eu/Default.aspx.

After the completion of the questionnaire the respondents can evaluate the quality of health care development arrangements within one’s organisation, and can also receive a feedback via e-mail about the results. The feedbacks contain several suggestions, ideas, proposals and practical pieces of advice concerning the possible ways of extending the health care development activities at the given workplace.

Please identify and describe up to three examples of good practice and their effectiveness in terms of stress management, with a special focus on the lessons learned. These can be at national, sectoral or organisational level.

The STEP – Take one step for your health project was launched by one of the biggest Hungarian companies (MOL Group (Middle-East Europe Oil Company)) in 2008-2009. This project consists of medical check-ups smoking cessation programmes, nutrition and health programmes as well as training and exercise programmes. The programme of the assessment and handling of workplace stress is part of the company’s Occupational Health Management, and it targets the involvement of 75% of the employees in the programme by 2010-11.

Other prominent mental hygiene programme was carried out – based on the results of the pilot studies – by the experts of the affiliated organisations of the Association for Healthy Workplaces in 2004 among the employees of MOL Group.The goal of the assessment was to explore the atmosphere of mental hygiene through random representative samples of the employees involved with the help of a series of trainings – partly subsidized through tendering.

Based on the Leymann-LIPT questionnaire, it also explored the question of burnout and healthy way of life. With the help of the results the factors requiring not only management intervention (risk management) but also individual care were identified. The main findings in the case of the examined company were as follows:

  • Even though the working atmosphere was found to be positive, the burnout rates were extremely high, which may result from the fact that most of the employees have had more than one workplace by then, and the effects of stress have accumulated.

  • Health care and health development were hardly present at the workplace, and efforts aiming at health promotion were also inadequate outside the workplace.

  • The process of alienation from the problems was also observable.

  • Employees reported numerous and frequent symptoms burdening their daily life. These can not easily be separated from the workplace and their private life as private aspects had not been the subject of the questionnaire, however, it still can be observed that most of their day is spent at the workplace. Most typical anomalies in the collegial relationships were found to be in conformity with other Hungarian researches.

  • Burnout rates not only deteriorate work performance but also damage the mental and physical health of the individuals, which is confirmed by the high number of admission of symptoms. It shall not be stated that all the problems are rooted in the workplace, but their existence and effect within the workplace hardly needs a proof.

  • The survey also proved the existence of stereotypes in employees regarding nutrition, life coaching, recreation and sports. Experiences shows that the majority of workplaces do not carry out researches of this kind, where the specific identification of hindering and negative factors would be in the focus. Even though willingness and cooperation from the management of these workplaces, the employees found the initiative of the management to be surprising. Constructive proposals or suggestions were not introduced by employees, however, their full cooperation testifies the real desire and aspiration for a change – in the face of the sensitive nature of the matter.

Considering the survey results and the different levels (primary, secondary and tertiary prevention) of handling workplace stress the following methods are regarded to be effective in reference to the exploration and solution of the problem.

Prevention

It aims to reduce workplace-stress, to transform workplace conditions and organisational relations as well as to create a positive psychosocial climate.

Possible forms:

  • Organization Development in order to create positive psychosocial climate;

  • Leadership and vocational training;

  • Adaptation of methods targeting integration and conformity;

  • Continuous monitoring of employees’ mental and health status, rehabilitation, recreation;

  • Familiarization of work models.

Intervention

It aims the earliest possible intervention, even with confrontation if necessary, to recognize and identify cases in time, to terminate the process and to decrease and minimize damage.

Possible forms:

  • Regular information (can also be applied at prevention) on revealed cases, their treatment and possible risks;

  • Education: disclosure and implementation of new phenomena into education;

  • Conflict management: to develop proper culture of debate;

  • Measurements, researches;

  • Making necessary management decisions (e.g.: legal redress, re-organisation, management changes);

  • Psychological methods (trainings, workshops, team building, etc.).

Post-rehabilitation and after care

In many cases, victims may only be treated adequately at professional clinics and facilities.

Possible forms:

  • Mediation;

  • Occupational rehabilitation;

  • Psychological rehabilitation;

  • Legal rehabilitation.

The above mentioned suggests that the handling and treatment of workplace stress are mainly the subjects of organisational culture thus the identification of workplace stress factors is strongly advised not only at organisational but also at individual level if possible. In order to improve the success of individual efforts it is advisable to have a comprehensive view of the organisation in the following aspects:

  • Education, coaching (team training, self-concept, conflict management, educational packages)

  • Specification of positions and areas of responsibility

  • Researches of e.g.: workplace psychoterror and workplace stress; implementation of results into the extension of decision preparation and support of the management

  • Separate psychological methods (consulting hours, aptitude tests, screening etc.)

  • Legal assurance (strong interest protection, correct labour contracts)

  • Travel incentives

  • Programmes on nutrition and proper health care.

Are there any public discussions and/or interventions that address specifically the identification, prevention and management of stress due to organisational change and restructuring? If yes, please summarise them.

The main issue of the workshop organised by the Hungarian Focal Point of the European Agency for Health and Safety at Work was workplace stress. Practising psychologists, doctors of employment health care and labour protection inspectors were invited to discuss the national situation and the compulsory risk management tasks due to the modification of the law. The workshop was held in September 2009 and the number of those wishing to participate was higher than those able to register. The most important conclusion was that during the preparation of the company’s risk assessment there are still problems in terms of practical achievement, especially smaller enterprises need more practical directions.

Commentary

Please provide your own/your institution/centre view on work-related stress, referring to, for example, national debates about the topic or any other issue considered important from your national perspective which was not covered by this questionnaire.

According to the 4th European Working Conditions Survey stress prevalence in the new Member States EU10 is markedly higher (30%, in Hungary 26%) than in the old Member States (20% in the EU15); stress-related outcomes (overall fatigue, headache, irritability, sleeping problems, anxiety, heart disease) are higher as well.

The question of health care and stress management has been dealt emphatically within multinational and/or large companies in the recent years. Programs of the private sector offering complex workplace stress management and manager health screening have also been launched; however, the involvement of such companies is not yet to be considered as common practice.

Even though the evaluation of psychosocial factors within the scope of risk assessment was made compulsory by the new legislative enactment considering the nature of the given question, no measurable normative or definitive requirements shall be set up as far as individual and grouped differences are concerned.

References

  • Kopp, M. (ed.) Magyar lelkiállapot [The Hungarian State of Mind ] 2008.

  • Kopp, M. and Réthelyi, J., Where psychology meets physiology: chronic stress and premature mortality—the Central-Eastern European health paradox, Brain Research Bulletin 62, 351–367, 2004. Available at: http://www.behsci.sote.hu/download/psych_meets_phys.pdf

  • Virág, L. Stressz a munkahelyeken? [Stress at the workplace?], In: Munkavédelem és Biztonságtechnika. 38-43, 2009.

  • Online sources:

http://www.behsci.sote.hu/kopp-selye-magyar-tudomany.htm

http://www.ommf.gov.hu/index.php?akt_menu=172&hir_reszlet=163

www.oefi.hu/lelekrehangolva

http://www.oefi.hu/lelekrehangolva/eloadas/mi.pdf

http://www.berbarometer.hu/main/kutatasaink-kiadvanyok/apb-mezogazd-beszamolok-2008I-mell1.pdf

http://www.behsci.sote.hu/.

OSH in figures: stress at work- facts and figures EU-OSHA p. 20-21.

Katalin Balogh, Institute for Political Science, Hungarian Academy of Sciences

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