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Page last updated at 12:27 GMT, Monday, 5 May 2008 13:27 UK

Is stress a health and safety hazard?

By Innes Bowen
BBC Radio 4, More or Less

Under the watchful eye of the boss in BBC series The Thick of It
What makes for a stressful day?

It's widely thought that employees on lower grades suffer if they have little control over their jobs. Is this true?

A group of middle managers gathers in central London for a half-day workshop on stress. Merren Barber, an occupational health physiotherapist, delivers a stark warning: managers who put too much pressure on their workers can cause serious health problems.

"Stress isn't an illness but there's quite a bit of evidence that it increases the risk of high blood pressure, heart disease and mental health problems. So people potentially can become ill because of chronic stress," Barber tells the group.

Is this really true?

Stress management courses are now a staple of corporate life and the claim often made that there is a link between stress and ill health has become the received wisdom.

The Health and Safety Executive (HSE), the government body in charge of protecting people's health at work, has even made giving workers more control over their workload a legal obligation.

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According to employment lawyer Gordon Turner, the HSE standards on stress are so rigorous that many employers fear details of their working practices becoming public. "It's so easy to slip up. If an employee takes a grievance as far as an employment tribunal, companies often settle rather than risk a public hearing that might attract the attention of the HSE."

Both the HSE and stress management trainers are influenced by a famous survey of the health of British civil servants known as the Whitehall II study. Led by Prof Sir Michael Marmot, an epidemiologist at University College London, Whitehall II has tracked the lives of thousands of civil servants for more than 20 years in an attempt to assess the effect of job status on health.

According to Professor Marmot, it is not stress per se that has an adverse effect on health and life expectancy. Rather it is working in a job where there are high demands accompanied by a lack of control. "People of high status tend to have high demand and that doesn't seem to cause any illness problems at all."

David Cameron and Boris Johnson campaigning ahead of the mayoral election
Is it working closely with the boss...

Some academics in this field have their doubts. Dr John MacLeod is one of a team of researchers at Bristol University who are sceptical about Professor Marmot's findings.

"We looked at these issues in a study of 6,000 working men in South West Scotland. Unusually, when these men were recruited in the early 1970s, it was the middle classes and the more advantaged who were experiencing high levels of stress. In those circumstances stress was not associated with poorer health."

Professor Marmot's response is that the Scottish study does not use good measures of stress.

Sick of work

As far as heart disease is concerned, it is not only Dr MacLeod and colleagues at Bristol University who are unconvinced there is a proven link with stress. The American Heart Association website states that "current data don't yet support specific recommendations about stress reduction as a proven therapy for cardiovascular disease".

Man at desk expressing frustration in BBC series The Thick of It
... or not closely enough?

Dr MacLeod believes that so-called psychosocial explanations of ill health are a distraction from what he believes are more likely causes of a growing health divide between richer and poorer people.

"We don't really know the causes but material disadvantage in childhood is one of the strongest predictors of health in adulthood. So the best bet would be to target and reduce childhood deprivation if we want to see reductions in health inequalities."

So are companies wasting money by sending managers on courses that might make them feel guilty about placing high demands on their workers?

Dr MacLeod doesn't go that far. "It may not reduce the risk of heart disease but creating fairer workplaces is a humane and just thing to do."

Here is a selection of your comments.

I was diagnosed as having work-related stress a few months ago and have had to cut down my hours. I am a senior manager who had thrived on pressure and deadlines for years, but suddenly it all took its toll on me. It has very clear physical symptoms - an irregular heart rhythm for one thing, loss of sleep or sleeping too much, and hyper-ventilating so much that the diaphragm muscle is sore. My employers have been very good about it, but I am now looking at leaving a job that I have loved for years. I will never now underestimate what stress can do to you.
Elizabeth, Worcester

Stress is a health and saftey issue. Six months ago I was told my job was under threat. I have a contract that specifies there are no maximum working hours and that partial performance is zero performance, ie if you fail to do one part of your job you get zero pay. I can't get paid compensation for missed holiday and I can't carry holiday forward. I work at least one 12 hour day a week and my contract expressly does not allow overtime pay.

During this year I have already attended meetings on a Friday where I have been given work to do with a deadline of Monday 10.30am when I have already worked five days in a row including a scheduled 12 hour day. I got so tired a few weeks ago I could no longer speak correctly and after trying to say the same sentence three or four times I just started to headbutt a filing cabinet out of frustration. All this because of an *additional* 12 hours of meetings per week plus additional 12 hours of work ALL unpaid ALL in addition to what I was doing before. The contract is something out of Charles Dickens and the management errors are unbelievable.
James, London

I left my graduate job in a medical position because I, like Emma, had absolutely no control over my tasks. I had an Excel spreadsheet in form of a schedule and each line represented an hour. Some tests would take three or more hours but would be crammed in this little line. My managers had absolutely no idea how the work was done but only gave us grief for complaining or not finishing the tasks assigned. Because of this, I'm having to start again from the bottom of the pile.
Lisa, Glasgow

"It's widely thought that employees on lower grades suffer if they have little control over their jobs. Is this true?" Yes, it is. I have no control over my job. I have a timetable worked out weekly by the supervisors that tells me what I have to do every hour on the hour and if something changes I have to go and ask my supervisor for something to do even though I am an adult and I can work out for myself that needs doing. It causes me no end of stress and frustration.
Emma, Egham

Incompetent management is quite easy to find in today's Britain - Terminal 5 being a recent example - but is this caused by too much stress or too little? Of course the Dr Macleods of this world will bleat about "creating fairer workplaces" but will this get the job done or will the job go to India?
Michael Clarke, Kensington, London

Most people use the word "stress" inappropriately when in fact they are discussing or experiencing a degree of pressure. "Stress" occurs when the actual or perceived ability to cope has been breached: when it has in fact become "distress". Managers need to understand the complexities involved in managing the six key areas identified in the HSE's Management Standards in order to provide a mentally healthy and safe working environment - this is what stress training should be about.
Roger Edwards, Droitwich Spa, Worcestershire, England

As a civil servant I can appreciate this article. For me, one of the biggest motivators is seeing your boss put in a good day's work. If this isn't the case, then resentment builds.
Mr Rank 'n' File, California


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