The forgotten realm of the new and emerging psychosocial risk factors

Abstract

In Europe, employers of all private and public enterprises have a legal obligation to protect their employers by all the different types of workplace hazards to the safety and health of workers. The most important methods developed for the work-related stress risk assessment are based on the Cox's research commissioned by European Agency for Safety and Health at Work (EU-OSHA) and are the Management Standard HSE for work-related stress in United Kingdom, the START method in Germany, the Screening, Observation, Analysis, Expertise (SOBANE) in Belgium, and the National Institute for Prevention and Safety at Work (INAIL-ISPESL) model in Italy, the latter based on the British Management Standard. Unfortunately, the definition of "work-related stress" elaborated by EU-OSHA was criticized, because it is not completely equal to the broader "psychosocial risk," which includes new and emerging psychosocial risk factors, such as the combined exposure to physical and psychosocial risks, job insecurity, work intensification and high demands at work, high emotional load related to burnout, work-life balance problems, and violence and harassment at work. All these new emerging psychosocial hazards could require different and additional methodologies to save workers' health and safety. For this reason, the concept that stakeholders and policy makers should keep in mind in order to develop better national regulations and strategies is that work-related stress risk and psychosocial risk factors are not the same.

The Forgotten Realm of the New and Emerging Psychosocial Risk Factors

In Europe, the principles of health and safety prevention are based on the "Framework Directive" 89/391/EEC-OSH and a series of subsequent individual directives¹⁾. Therefore, employers of all European private and public enterprises have a legal obligation to protect their employers by all the different types of workplace hazards to the safety and health of workers. In 2004, the European social partners signed the framework agreement on work-related stress in order to increase the awareness and the understanding of this occupational risk factor²⁾. The Agreement provided the description of stress and work-related stress, the identification of problems of work-related stress, the responsibilities of employers and workers as well as the reduction and prevention of problems of work-related stress. The work-related stress risk factor, rooted on the new WHO's health definition (1986), which is not "merely the absence of disease or infirmity but a positive state of complete physical, mental and social well-being" ³⁾, was also highlighted because of its very high burden disease. Indeed, the 2014 European Risk Observatory report, based on the literature review, has recently calculated the huge economic costs of work-related stress and psychosocial risks due to absenteeism and presenteeism, loss of productivity, health care costs, and social welfare costs in the form of disability benefit payments across the world, from Europe to non-European countries⁴⁾. As a result, European stakeholders have produced important documents, such as government regulations, and different methods were adopted by European countries in the attempt to assess theoretically and manage work-related stress. These methods were based on the Cox's research commissioned by European Agency for Safety and Health at Work (EU-OSHA), where Cox identified 10 types of stressful work characteristics (psychosocial hazards), which are divided into two groups: "content of work" and "context of work" ⁵⁾. Accordingly, the most important methods developed for the work-related stress risk assessment were the Management Standard HSE for work-related stress in United Kingdom, the START method in Germany, the Screening, Observation, Analysis, Expertise (SOBANE) in Belgium, and the National Institute for Prevention and Safety at Work (INAIL-ISPESL) model in Italy, the latter based on the British Management Standard⁶⁾. Unfortunately, the definition of "work-related stress" elaborated by EU-OSHA was criticized, because it is not completely equal to the broader "psychosocial risk", which differently includes other and emerging psychosocial risk factors, such as the combined exposure to physical and psychosocial risks, job insecurity, work intensification and high demands at work, high emotional load related to burnout, work-life balance problems, and violence and harassment at work^7-9). Indeed, the work-related stress agreement (2004) did not deal with violence, harassment, and post-traumatic stress, which were concerned in a next and specific European agreement, in 2007. Indeed, violence and harassment at workplace are generating high costs associated with absenteeism, turnover, and productivity loss, as well as¹⁰⁾. Furthermore, in a recent review about job stress models for predicting burnout syndrome⁹⁾, Chirico showed that occupational burnout syndrome owns specific antecedents and consequences, which are different from those associated with the work-related stress risk factor, and consequently, occupational burnout should be considered as a specific psychosocial risk, which it could be defined, for instance, "work-related burnout" and requiring specifically new and more specific tools to be assessed; they could include the Organizational Check up System (OCS) by Leiter and Maslach¹¹⁾ or new models, such as the Job Demand Resources model by Demerouti and Bakker¹²⁾ or the Demand-induced strain compensation (DISC) model by de Jonge and Dormann¹³⁾. The other issue concerns the fact that the work-related stress risk assessment is only the first phase of a more complex strategy including the risk management, which consists of corrective measures for improving those organizational aspects that are weak and leading to work-related stress-strain. This comprehensive strategy should be primarily aimed at improving the organization's health and not at individual level. However, this strategy could be expensive. For instance, the corrective measures used to address a high workload could require new employments. These years, according to the International Labour Office (ILO)¹⁴⁾, the current economic recessions are increasingly experiencing precarious work, reduced work opportunities, fear of losing their jobs, massive layoffs, unemployment, and decreased financial stability, with serious consequences for employers' mental health and well-being. Indeed, most of the studies documented that a rise in unemployment, increased workload, staff reduction, and wages reduction were linked to an increased rate of mood disorders, anxiety, and depression¹⁵⁾. For this reason, the current European methodologies for assessing and managing the work-related stress risk factor could be ineffective and useless, if they do not consider the economic recession, including all the new and emerging risk factors. The ILO defined psychosocial factors (hazards) in 1984, in terms of "interactions between and among work environment, job content, organizational conditions and workers' capacities, needs, culture, personal extra-job considerations that may, through perceptions and experience, influence health, work performance and job satisfaction." Today, there is a reasonable consensus in the scientific community regarding the nature of psychosocial hazards; however, it should be noted that new forms of work and the changing working environment give rise to new hazards; therefore, the definition of psychosocial hazards can still evolve¹⁴⁾. As Europe experiences great economic, social, and technological change, workplaces are also changing. Occupational safety and health (OSH) research is essential to address the gaps in knowledge of known, new, or emerging risk factors to ensure safety, health, and well-being in workplaces. The 2013 EU-OSHA report¹⁶⁾ highlighted the "Priorities for occupational safety and health research in Europe," in 2013-2020, focusing on demographic change, globalization and the changing world of work, and safe new technologies. All these factors and new emerging psychosocial hazards could require additional and different tools and methodologies to save workers' health and safety. To date, the work-related stress risk assessment is mandatory in almost all national laws¹⁴⁾; on the contrary, the assessment of new and emerging psychosocial risk factors seems to be forgotten. This lackness is a key challenging issue for all the stakeholders in the next future. For this reason, the most important concept that stakeholders and policy makers should keep in mind to develop better national regulations and strategies in order to improve health and safety at work is that work-related stress risk and psychosocial risk factors are not the same. This should be the starting point for every strategy aimed at psychosocial risk assessment and management.

Conflicts of interest: The authors declare that there are no conflicts of interest.