Work-related mental stress focus of research and policy debate

Flexible working may be contributing to levels of stress according to a study among German employees. The research was carried out at a time when there was continuing policy debate on amendments to the Occupational Health and Safety Act to address work-related stress. An annual Absenteeism Report by health insurer AOK has provided new evidence which suggests the ‘flexibilisation’ of working times and locations is associated with higher levels of mental strain.


An annual Absenteeism Report (in German) has looked at the impact of flexible working on employees’ levels of stress and related health risks. The 2012 research was jointly compiled by WidO, the research institute of public health insurer AOK, and Bielefeld University. The study was published at a time when there was an on-going policy debate about the Occupational Health and Safety Act (Arbeitsschutzgesetz). An initiative by four federal German states suggested the amendment of the act so that it addressed work-related mental strains.

Survey on health impact of flexible work

New survey results by Klaus Zok and Heiko Dammasch from WidO indicate a high prevalence of work-related mental strain relating to flexible forms of work. The survey looked at such issues as flexible working times and locations and the resulting work–life imbalances. The findings were based on a representative cross-sectoral telephone survey carried out during autumn 2011 in which 2,002 workers were contacted and the following responses were collated:

  • 26.4% reported they were affected by musculoskeletal pains;
  • 20.8% said they felt fatigue;
  • 20.1% were not able to rest their minds in leisure time;
  • 16.1% felt uninspired and somewhat burned out;
  • 15.3% experienced insomnia;
  • 15.1% revealed they had suffered from work-related anger.

The authors defined ‘traditional’ forms of flexible work as work at night, shift work or ‘standard’ overtime, and made a distinction between these and ‘new’ forms such as flexitime and on-call duty.

The survey results for ‘new’ forms are shown in the table.

Table: Extent of ‘new’ forms of flexible work

Flexible forms of work

% of respondents (n=1,994)



Working time accounts


In the previous four weeks…

Working time determined by employee


Taking work home


Work at more than one site


Phone or e-mail contact outside of working time


On-call duty


Company provides the opportunity to take leave for:

Child care


Care of family members




The table gives the % share of respondents working in new forms of flexible work

To investigate the impact of flexible work on well-being, a factor analysis was carried out. All responses indicating health strains, including such problems as musculoskeletal pains, were summarised under the heading of ‘mental strain’. Responses referring to work-related stress, time pressure, work overload, working time or managerial issues were grouped under the title of ‘job strain’. Responses referring to satisfaction with work, employment security, health, leisure and family life made up the category ‘overall satisfaction’.

Bivariate and multivariate analyses revealed that forms of flexible work impacted differently on mental strain, job strain and satisfaction. But all three factors were negatively affected by:

  • any form of overtime work;
  • having little say in determining working time;
  • the duration and distance of commuting.

Mental strain was most likely to be caused by work–life imbalances. Not having the chance to take care leave had the most detrimental effect on mental well-being, followed by having to work during leisure time, commuting time and (normal) overtime.

Overall, all traditional forms of flexible work were seen as causes of mental strain, as well as lack of flexitime, having little say in determining working time, taking work home and work-related contacts by e-mail or phone during leisure time.

The authors suggest that in order to reduce health risks, employers should avoid requesting overtime work and should promote work from home or telework to cut down on long commutes. Also, giving workers more say in determining their working time was seen as necessary for preventing health problems.

Debate on Occupational Health and Safety Act

The WidO Absenteeism-Report raised particular interest because it was published at a time when there was widespread public debate about Germany’s Occupational Health and Safety Act (OHS).

According to the Evaluation Report (529Kb PDF) on the European social partners’ Framework Agreement on Work-related Stress (78Kb PDF), legislation in 13 Member States plus Norway and Iceland addressed psychosocial risks.

Germany’s 1996 OHS Act, however, does not make any explicit reference to mental hazards. Instead, the issue has been addressed through concepts and trainings for labour inspectors and occupational doctors, by a quality guideline for conducting risk assessments and by training for management, staff and employees.

In 2011, the information sheet Protection and strengthening of health in the case of work-related mental load was integrated onto the 2013–2018 programmes of the Joint German Occupational Health and Safety Strategy (GDA). Activities in the future will be geared to qualification measures, to improving health risk assessments, to the dissemination of good practice cases and to the implementation of company design solutions.

Criticism of the initiatives

However, the programme has been seen as insufficient by critics from the trade unions and the governmental opposition.

In June 2012, a letter (in German, 71Kb PDF) from the Green Party to the Bundestag, Germany’s Federal Cabinet, revealed that only about 20% of all companies carried out a health risk assessment on mental strain. The figure came from a representative survey of 6,500 companies conducted on behalf of the current GDA evaluation, though the report has yet to be published.

In July, the German Metalworkers’ Union (IG Metall) in its report, Anti-stress regulation (in German, 3.16Mb PDF), called for a statutory order enforcing the implementation of risk assessments of work-related stress. In the autumn of 2012, four federal states jointly proposed to the Bundesrat, the German Federal Council, the launch of an initiative for amending the OHS Act (in German). They said the Act should include specific regulations for health risk analyses of mental strains and should also address work organisation, participation of employees and sanction mechanisms. In December 2012 the process was still on-going.


Against the background of the current public debate, WidO’s research highlights the need for a broadening of the scope of investigation on work-related stress factors to times and spaces beyond working time and company premises. It remains to be seen whether this will be addressed by GDA, and whether the agency will respond with any concrete proposals. Meanwhile, the initiative for amending the OHS Act can be expected to continue.


Zok, K. and Dammasch, H. (2012), ‘Flexible Arbeitswelt: Ergebnisse einer Beschäftigtenbefragung’, in Badura, B. et al. (eds.), Fehlzeiten-Report 2012, Springer, Berlin, pp. 39–52.

Birgit Kraemer, Institute of Social and Economic Research, WSI

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