Topic 4

Occupational Stress and Human Error

LEARNING OUTCOMES

1. Define occupational stress and human error;

2. Describe the three groups of stressors at the workplace;
3. Explain the relationship between stress level and job performance;
4. Elaborate the health effects of acute and chronic stress;
5. Explain the approaches to stress management; and
6. Discuss the possible causes of human errors.
OCCUPATIONAL STRESS

Definitions and Legislation of Occupational Stress

(a) European Commission

The European Commission (1999) defined work-related stress as a pattern of emotional, cognitive, behavioural
and physiological reactions to adverse and noxious aspects of work content, work organisation and work
environment.

(b) National Institute of Occupational Safety and Health (NIOSH)

Job stress is the harmful physical and emotional responses that occur when the requirements of the job do not
match the capabilities, resources, or needs of the worker.

(c) Health and Safety Executive (HSE) United Kingdom

Work-related stress is the adverse reaction people have to excessive pressures or other types of demand placed
on them at work.
Legislation of Occupational Stress

The Occupational Safety and Health Act 1994, Part I, Section 4(c)

• The provision of law that requires the workplace environment to be adapted to the
physiological and psychological needs of workers.

It means that if the workplace environment is not suitable for the mental health of
workers, they will suffer discomfort and stress.
 Definition of Stress

• Stress means pressure faced by an individual and the reactions as a

result of the stress.

• The increase in a person’s stress is more than his/her ability to

overcome it.

• Stress can be described as ‘ a feeling of doubt about being able to

cope, and stress management is aimed as much at modifying the
perception of stress as at removing external stressors.
Definition of Mental Stress

The experience of a perceived threat ( real or imagined) to one’s mental,

physical, emotional or spiritual well-being, resulting from a series of
physiological responses , and adaptations.
Stressors

Occupational stressors are divided into three groups:

(a) Individual Stressors - refers to any event, experience or environmental stimulus

that causes stress to an individual.
(b) Group Stressors - is poor interpersonal relationships or conflicts. These conflicts
can be among the members of the group or between the superiors and
subordinates. Groups have a lot of influence on the employees behaviour,
performance and job satisfaction.
(c) Organisational Stressors - In organisations, there is no shortage of factors which
can cause stress. Almost every aspect of work can be a stressor for someone.
Common individual stressors
Stressor Description
Career changes When an employee has to relocate geographically because of a transfer or promotion, it disrupts
the routine of his daily life, causing concern and stress.
Role conflict or The person is unclear about his actual tasks, responsibilities and expectations. It takes place
ambiguity when contradictory demands are placed upon an employee simultaneously.
Below expectations The job is not as per the expectations of the person.
Career concerns Unfulfilled career expectations and no opportunities for self-growth.
Work overload Those individuals work different shifts which are associated with problems of shift timing, personal
and family life.
Job dissatisfaction The person is unable to achieve his goal.
Personality The extent of stress is also determined by the personality of a person. A person with Type A
personality is highly susceptible to stressors, whereas a person with Type B personality is less
stress-prone. Traits of Type A personality include:
• Competitive;
• Aggressive and hostile;
• Fast talking;
• Impatient and dislikes waiting behaviour;
• Easily gets irritated by minor errors; and
• Likes to do several tasks at one time.
Group Stressors

Stressor Description
Managerial Managers create stress for employees through inconsistent behaviour, lack of
necessary support, inadequate advice or training, by forcing high productivity,
lackStressor
of concern for employeesÊ job and welfare.
Description
Managerial Managers create stress for employees through inconsistent
behaviour, lack of necessary support, inadequate advice or
training, by forcing high productivity, lack of concern for
employeesÊ job and welfare.
Group unity No unity among the members of the work group. In addition, this is associated
withunity
Group mistrust, No
jealously,
unity amongquarrels
the membersetc.
of the work group. In
addition, this is associated with mistrust, jealously, quarrels
etc.

Superior consultation Lack of participation

Interpersonal or intergroup
conflict
Lack of social support
Superior
consultation and consultation from the superiors before making a
Lack of participation and consultation from the superiors
before making a decision. The employees feel neglected.
decision. The employees
Interpersonal or
feel neglected.
Differences in perceptions, attitude, values and beliefs
intergroup conflict between individuals or groups.
Differences in Lack
Lack of social
perceptions, attitude, values and beliefs between individuals or
of friendship and support among teammates decrease
groups.
support coping ability.
Workplace violence or People who experience violence or sexual harassment suffer
Lack of friendship
sexual harassment and support
severe distress among after
and poor job performance teammates
the event. decrease coping ability.

Workplace violence or sexual People who experience violence or sexual harassment suffer severe distress and
harassment poor job performance after the event.
Organisational Stressors
Stressor Description

Organisational factors Some of the common organisational factors are:

 High pressure environment;
 Excessive rules and lack of participation from the
superior;
 Lack of leadership; and
 Major changes like transfer or adaptation of new
technology.
Work overload Excessive workload places tremendous pressure on a person.

Work underload Very little work of a routine and simple nature would lead to
monotony and boredom.
Working conditions Workplace is adapted to human not physiological needs.
Four categories of stress for jobs:

(a) High Strain Job (Distress)

It refers to low capability to cope with the high job demand. People exposed to this category of
jobs would be most likely to suffer high strain.

(b) Active Job (Eustress)

It refers to a job with high demands and an employee with high competency in coping skills.

(c) Low Strain (Neustress)

It refers to a job with low demands and workers with high job control.

(d) Passive Job (Neustress)

It refers to low job demands and workers with low job control.
Stress and Disease

• Solid link between lifestyle and disease

• 70 – 85% of all diseases and illness is stress-related, from common cold
to cancer, from herpes to haemorrhoids (piles)
• Stress – a complicated and complex phenomenon affecting one’s
personality and life experiences
• Many means and strategies available to cope with stress.
Occupational stress and injury and accidents

• Mechanism not well documented

• Psychological job demand
• Frequency of job problem
• Job dissatisfaction
• Interpersonal conflict
• Work and non work stress factors
Occupational Stress

• Definition of Occupational Stress

• Who is at risk of getting stress
• Stress reactions
• Effects of stress on the organization
• Sources of stress at the workplace
• Methods to reduce stress
• Action plan to reduce stress
Complexity of Occupational Stress

• Requires different explanation models than the biomedical and toxicological

approaches used elsewhere in occupational medicine

• Important areas of considerations and research– multi-casualty, intervening

variables, time sequencing and healthy worker effects

• Subject usually dealt in Social Science or Psychology

• Prevention may be accomplished by creating a healthy work environment based on

recognized organizational principles – also workers’ coping mechanisms.
Occupational stresses

Factors of occupational stresses

• Factors intrinsic to the job
• Role in the organization
• Career development
• Relationship at work
• Organizational structure and climate
Common Workplace Stressors

• Organizational
• Change
• Inadequate communication
• Interpersonal conflict
• Conflict with organizational goals
• Career development
• Lack of promotional opportunity
• New responsibilities beyond level of training
• Unemployment
Occupational Stress of shiftwork

• Fatigue with work shift assignment

• Diminished performance
• Sleep alternations
• Aggravation of other diseases
• Changes in behaviour
• Increase drug use.
Situation warranting Psychiatric Consultation

• Erratic behaviour
• Mood instability
• Exposure to life-threatening trauma
• Potential for violence
• Recent history of closed head trauma
• Established pattern of interpersonal conflict
• Unexplained changes in productivitity
Factors intrinsic to the job

• Poor physical working conditions

• Shift work
• Work overload
• Work under-load
• Physical danger
• Person-environment fit
• Job satisfaction
Workplace violence

• -a major health and safety issue over the recent decades

• Violence; threat of violence and harassment -affects the mental health stress and
productivity of workers
4 categories of workplace violence

Distinguish by the type of perpetrator

1) Strangers e.g. – robberies, criminal acts,
2) Patients or customers – act on caretakers or service staff
3) Co-worker ( current or former) - in response to a grievance or perceived
injustice
4) Family member or non –workplace acquaintances on employee at work
Violence warning behaviours

• Leakage of intentions to a third party

• Acts of preparing for an attack
• Identifying with violence offenders
• Fixation on a person or cause
• Desire for retaliation for perceived grievance
• Certain psychopaths, antisocial , paranoia, and psychosis
Violence prevention

• Gathering information – a culture of communication and awareness

• Employers should have clear policies regarding , harassment, intimidation, violent
threat, and violence
• Report no matter how small
• Assess situation
• Threat assessment team
• Early intervention after trauma – to mitigate acute stress disorders
Health Effects of Stress

The exposure to stress can be on two different levels, acute and chronic:

(a) Exposure to Acute Stress - Exposure to acute stress can be seen in individuals and groups:
(i) Individual Effects - The early stage of individual stress effects involves psychological, behaviour and
physical symptoms.

(ii) Group Effects - The effects of stress on a group of workers can also be recognised in the following:
• Disputes and disaffection within the group;
• Increase in staff turnover;
• Increase in complaints and grievances;
• Increase in sickness absence;
• Increase in reports of work pressure;
• Difficulty in attracting new staff;
• Poor performance; and
• Customer dissatisfaction or complaints.
Signs and Symptoms of Acute Stress Disorder

Cognitive Symptoms Emotional Symptoms Physical Symptoms Behavioural Symptoms

 Memory  Moodiness  Aches and pains  Eating more or less

problems  Irritability or short  Indigestion:  Sleeping too much or
 Inability to temper diarrhoea or too little
concentrate  Agitation, inability constipation  Isolating oneself from
 Poor judgement to relax  Nausea, dizziness others
 Seeing only the  Feeling overwhelmed  Chest pain, rapid  Procrastinating or
negative  Sense of loneliness heartbeat neglecting
 Anxious or racing and isolation  Loss of sex drive responsibilities
thoughts  Depression or  Frequent colds  Using alcohol,
 Constant general unhappiness  Headaches cigarettes or drugs to
worrying relax
Health Effects of Stress

(b) Chronic Stress - If exposure to stressors continues for a long period of time, the
complications are not limited to individual psychological and physical health problems
but also affect the organisation.

(i) Effect of Chronic Stress on Individual

Psychological Diseases Physical Diseases
 Insomnia  Hypertension
 Anxiety  Ischemic heart disease
 Adjustment disorder  Stroke
 Prone to making mistakes  Digestive problems
 Burnout  Peptic ulcers
 Depression  Cancer
 Smoking, alcohol and drug addiction  Obesity
 Suicide  Accident or injury-prone
 Poor quality of life
Health Effects of Stress

(ii) Effects of Chronic Stress on the Organisation

The effects of chronic stress on an organisation are:
• Non-harmonious working relationship;
• Low morale;
• Reduced quality;
• Reduced productivity;
• Increased absenteeism;
• Lateness for work;
• Increased rate of injuries or diseases; and
• Increased turnover.
Levels of prevention

Primary prevention – This is a preventive and proactive measure that requires action on the part of the organisation to
modify or eliminate the existing stressors in the workplace. Design method for primary prevention is risk management.

(i) Work Demands – People’s skills are matched to the work demands. The organisation provides employees with adequate and
achievable demands.

(ii) Control or Coping Capability -Organisation assists in improving employees competency to do their work.

(iii) Support - Organisation provides policies, procedures and resources to adequately support employees. Furthermore, support the
employees in the form of competent colleagues, coaches and mentors, and professional networks.

(iv) Relationship - Organisation promotes positive behaviours and share information at work.

(v) Role and Responsibility - The organisation provides information to ensure the employees understand their role and
responsibilities.

(vi) Management Change - Employees are fully informed with adequate consultation of the plans and progress at each stage of
changes. The purpose is to enable them to understand the reasons for proposed changes.
Levels of prevention

Secondary prevention – This measure is confined to the individual workers. The purpose is to enhance the workers
ability to manage stressful conditions by increasing their awareness, knowledge, skills and coping resources.

(i) Prioritising and Organising - When job and workplace stress prevail, it is difficult to ignore it. The recommended
method is by prioritising and organising the responsibilities. These include time and task management:
• Time management: Creates a balanced schedule by analysing work schedule, responsibilities, and daily tasks.
• Task management tips for reducing job stress: Prioritises tasks and delegate responsibility.

(ii) Improving Emotional Intelligence - Emotional intelligence is the ability to manage and use personal emotions in
positive and constructive ways. The advantage is you can retain a large measure of self-control and self-confidence
even if you are in a job where the environment has grown increasingly stressful.

(iii) Work-life Balance - When stress on the job is interfering with your ability to work, manage your personal life. Pay
attention to your physical and emotional health. Try to find a balance between work and healthy living. Life balance
can promote harmony and happiness.
Examples of Healthy Living

Physical Mental Social Spiritual

 Relaxation  Philanthropy  Family  Prayer

 Exercise or  Volunteerism  Friends  Meditation
games  Samaritanism  Entertainment  Yoga
 Healthy diet  Tai chi
 Adequate sleep  Chi gong
 Avoid drugs,  Other martial
alcohol and arts
smoking
Levels of prevention

Tertiary prevention
• This measure refers to reactive strategies for individuals suffering from illness as a result of
stress.
• The purpose is to treat the medical illnesses, provide compensation and rehabilitate the
workers.
• Examples of methods of tertiary intervention are return to work programme (RTW), employee
assistant programme (EPA), occupational therapy and medical stress treatment.
HUMAN ERROR

• Human error is commonly defined as a failure of a planned action to achieve a

desired outcome.
• It is an unintentional action or decision and it is related to planning or execution of an
activity or a process.
• Human error is defined as an inappropriate or undesirable human decision or
behaviour that reduces or has the potential for reducing effectiveness, safety or
system performance.
Classifications of Human Errors

• Human error is a type of human failure.

• Human error can be classified into two main categories.
Causes of Human Errors

There are two main factors causing errors in the workplace:

(a) Organisational Factors

(i) Inadequate or inappropriate work layout;
(ii) Poor physical environment, such as noise, heat, humidity, poor lighting;
(iii) Poor ergonomics designs; and
(iv) Poor supervision.

(b) Individual Factors

(i) Low competency, such as inadequate skills, knowledge (training) and attitude;
(ii) Low motivation;
(iii) Poor emotional state;
(iv) High stress levels; and
(v) Poor physical condition
Occupational Health Doctor

• Occupational Medicine – preventive medicine

• Prevention of stress-induced illness is a complex process –
irrespective whether physical or mental stresses
• OHD – well placed – precluded from promotion in line management
a) know the management structure of the company
b) b) some understanding of the internal politics of the business
c) c) able to share the problems whilst remaining on the sidelines of
the organization
ABC STRATEGY

A = AWARENESS

What causes you stress?

How do you react?
ABC STRATEGY

B = BALANCE

There is a fine line between positive / negative stress

How much can you cope with before it becomes negative ?

ABC STRATEGY

C = CONTROL

What can you do to help yourself combat the negative effects of

stress ?
Stress Management Techniques

• Change your thinking

• Change your behaviour

• Change your lifestyle

Change your Thinking

• Re-framing

• Positive thinking
Re-framing

Re-framing is a technique to change the way you look at things in

order to feel better about them. There are many ways to interpret the
same situation so pick the one you like. Re-framing does not change
the external reality, but helps you view things in a different light and
less stressfully.
Positive Thinking

Forget powerlessness, dejection, despair, failure

Stress leaves us vulnerable to negative suggestion so focus on
positives;
• Focus on your strengths
• Learn from the stress you are under
• Look for opportunities
• Seek out the positive - make a change.
Change your Behaviour

• Be assertive
• Get organised
• Ventilation
• Humour
• Diversion and distraction
Be Assertive

Assertiveness helps to manage stressful situations, and will , in time,

help to reduce their frequency. Lack of assertiveness often shows low
self - esteem and low self - confidence. The key to assertiveness is
verbal and non - verbal communication. Extending our range of
communication skills will improve our assertiveness.
Equality and Basic Rights

1) The right to express my feelings

2) The right to express opinions / beliefs
3) The right to say ‘Yes/No’ for yourself
4) Right to change your mind
5) Right to say ‘I don’t understand’
6) Right to be yourself, not acting for the benefit of others
7) The right to decline responsibility for other people’s problems
8) The right to make reasonable requests of others
9) The right to set my own priorities
10) The right to be listened to, and taken seriously
Being Assertive

Being assertive involves standing up for your personal rights and

expressing your thoughts, feelings and beliefs directly, honestly and
spontaneously in ways that don’t infringe the rights of others.
Assertive People

• Respect themselves and others

• Take responsibility for actions and choices
• Ask openly for what they want
• Disappointed if ‘want’ denied
• Self - confidence remains intact
• Not reliant on the approval of others
Assertive Skills

• Establish good eye contact / don’t stare

• Stand or sit comfortably - don’t fidget
• Talk in a firm, steady voice
• Use body language
• ‘I think’ / ‘I feel’
• ‘What do you think?’ ‘How do you feel ?’
• Concise and to the point
Benefits

• Higher self-esteem
• Less self-conscious
• Less anxious
• Manage stress more successfully
• Appreciate yourself and others more easily
• Feeling of self-control
Get Organised

Poor organisation is one of the most common causes of stress.

Structured approaches offer security against ‘out of the blue’
problems. Prioritising objectives, duties and activities makes them
manageable and achievable. Don’t overload your mind. Organisation
will help avoid personal and professional chaos.
Time Management

• Make a list
What MUST be done
What SHOULD be done
What would you LIKE to do
• Cut out time wasting
• Learn to drop unimportant activities
• Say no or delegate
 • Plan your day
• Set achievable goals
• Don’t waste time making excuses for not doing
something
Ventilation

‘A problem shared is a problem halved’

Develop a support network through friends or colleagues to talk with.
It’s not always events that are stressful but how we perceive them.

Writing a diary or notes may help release feelings but do not re-read
what has been written.
Humour

• Good stress - reducer

• Applies at home and work
• Relieves muscular tension
• Improves breathing
• Pumps endorphins into the bloodstream - the body’s natural
painkillers
Diversion and Distraction

• Take time out

• Get away from things that bother you
• Doesn’t solve the problem
• Reduce stress level
• Calm down
• Think logically
Change Your Lifestyle

• Diet
• Smoking & Alcohol
• Exercise
• Sleep
• Leisure
• Relaxation
Diet

• Healthy eating habits

• Caffeine (Stimulant)
• Salt
Thank you….next topic