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Thursday, 2 September, 1999, 12:47 GMT 13:47 UK
Stress at work: the pros and cons
Many people associate stress at work with ill health, but in fact stress can be good for you as well as bad.
Some people thrive on stress and this can help them get to high positions in business.
But, for others, particularly those at the bottom of the job scale, stress at work may have harmful effects.
The British Heart Foundation (BHF) says there is no evidence that stress actually causes conditions such as heart failure, but it may be a contributory factor.
"The problem is that it is difficult to measure stress.
"There is good stress and bad stress and people respond differently to stress," said a spokesman.
"Broadly speaking, if you ask someone what is behind a heart attack, they will say stress.
"But it is not clear cut. There is evidence that certain types of stress set off angina, but they do not cause it. It is the final straw."
He said the real cause is likely to be clogging of the arteries and other factors, such as smoking and lack of exercise.
The lack of consensus on stress' effect on health also means it is difficult to legislate against stress in the workplace.
The Health and Safety Commission is currently seeking opinions on the issue.
Stress causes the release of adrenalin, the so-called fight or flight hormone.
This causes the heart to pump blood faster to deal with the cause of stress.
But if the heart has a restricted blood supply because of clogged arteries, it may be unable to cope with the demands placed on it by the stressful situation.
Although stress is not believed to be a direct cause of heart disease, the BHF says it may lead people to adopt unhealthy lifestyles which affect the heart.
A recent BHF survey showed that work pressures were forcing people to take shorter lunch breaks, to eat pre-prepared, unhealthy food and indulge in other unhealthy behaviour.
"It has a knock-on effect," said the spokesman.
Alison Shaw, a cardiac nurse adviser at the BHF, said stress could trigger some forms of arrhythmia or irregular heart rhythms.
Most of these, such as palpitations or a skipped heart beat, do not require treatment.
"Many people ring the foundation about palpitations. The main message is to get them checked out, particularly if they make you feel dizzy. Most do not require treatment.
"The GP can check them out with electrocardiograms (ECGs) and sometimes with a 24-hour tape, which is like a portable ECG," she said.
Research also shows that people in less responsible jobs are more likely to suffer damaging stress than those in top jobs.
Professor Michael Marmot of University College in London has been studying the effects of stress on civil servants for many years.
He believes people who lack control in their jobs are much more likely to have health problems related to stress than those in senior management.
He said: "The lower you are in the hierarchy the higher the risk of disease.
"People who are in the middle range have more disease than people at the top. People in the lower part of the middle range have more disease than those who are in the upper part of the middle range, and people at the bottom have more disease than those in the middle range.
"So we're dealing with a social gradient which isn't only related to poverty, it's related to where you are in the hierarchy."
Long hours and heavy workloads
British people are working the longest hours in the European Union.
Recent surveys show that workers associate long hours and heavy workloads with illness and relationship breakdown.
An ICM poll, published in September, showed that 26% of workers said they had fallen ill as a result of workplace stress.
Some admitted it had led to them to screaming matches with their colleagues.
The Trades Union Congress says Britain's policy of allowing companies to opt-out of the European Union Working Time Directive, meaning people to work over the 48-hour a week limit on a "voluntary" basis, meant the protection it offered could be circumvented.
It says it allows managers to pressure staff to work longer hours under threat of losing their job or being overlooked for promotion.
A BBC poll shows one in five staff feel forced into signing opt-outs.
The Health and Safety Executive, which is conducting a huge survey into workplace stress to be published in early 2000, says preliminary results show one in five workers say they are "very" or "extremely" stressed at work.
Reasons for this include long hours and lack of support at work.
The survey is also investigating the health implications of workplace stress.
The Health and Safety Commission has begun a consultation exercise, seeking views on whether employers should be prosecuted over stress at work.
It estimates that up to half a million people a year develop stress at work.
One of the problems concerning legislation on the issue is that stress is a difficult condition to diagnose and correct.
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