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Education And Debate

ABC of Work Related Disorders: STRESS AT WORK

BMJ 1996; 313 doi: (Published 21 September 1996) Cite this as: BMJ 1996;313:745
  1. Julia von Onciul

    Adaptation to the workplace and general adaptation syndrome

    Changes in the work environment have led to a change in the balance between physical and mental activity. Technological developments have reduced the amount of heavy physical work. Mental and emotional strain have increased in new working environments that are characterised by lack of time, more uncontrollable factors, background distractions, lack of space, general uncertainty, and more administrative work. The general adaptation syndrome, described by the physiologist Selye in 1975, characterises the process of prolonged exposure to stress and is a useful staged concept.

    General adaptation syndrome

    1. Alarm reaction

    2. Resistance stage

    3. Exhaustion stage

    What triggers work stress?

    Stressors are the agents which trigger the various stress reactions. Today's environment provides physical, emotional, and mental stressors that set off the initial alarm reaction. Physical stressors in factories are usually linked to noise and physical and chemical hazards. Emotional or mental stressors can be unpleasant or pleasant. A promotion can be just as stressful as the loss of a position.

    Stressors are additive and can build up. The way in which people are affected depends on their values, experience, and adaptability. A single stressor can become compounded if elements of the established support system fail—for example, if a car breaks down on the way to an important meeting.

    Work related stressors

    Physical stressors

    • Noise

    • Chemical hazards

    • Temperature extremes

    • Physical trauma

    • Radiation

    • Poor posture

    • Vibration

    • Handling of heavy goods

    • Monotonous tasks

    • Night shifts

    • Overtime

    Emotional and mental stressors

    • Fear (of sanctions)

    • Joy (about promotion)

    • Anger (over injustice)

    • Challenge (of a new position)

    • Shock (after sexual harassment or racial taunt)

    • Competition (with colleague)

    • Conflicts (with subordinates or managers)

    • Contradictory instructions

    • Negative thoughts

    • Time pressure

    • Structural changes

    • Monotonous tasks

    • Night shifts

    • Overtime

    1 Alarm reaction

    This is the immediate response to a challenge or threat. Mobilisation of the autonomic nervous system triggers the stress response (“fight or flight” response). The various body systems involved coordinate the readiness for …

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