6.2 Stress and Fatigue

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We all experience stress at some point in our lives. Stress is a change in our physical and mental state in response to situations we perceive as challenging or threatening. Situations causing stress are known as stressors. Stress can have a positive effect, making us more alert or more prepared to take on an important challenge. Stress can also have a negative effect, causing a range of physical and mental ailments. There are four types of stressors:

  • Acute stressors are time-specific events of high intensity and short duration that occur infrequently, such as a performance review, a car accident, or unexpected encounter.
  • Episodic (or daily) stressors may be similar to acute stressors but occur more frequently, have a longer duration, and may be of lower intensity. Making repeated requests of a worker to work overtime is an example of an episodic stressor.
  • Chronic stressors are stressors that persist over a sustained period of time, and include job insecurity, work overload, or lack of control.
  • Catastrophic stressors are a subset of acute stressors but differ in their intensity, threatening life, safety, or property. Robbery and physical assault are examples of catastrophic stressors.

Stress can arise from all aspects of our lives, including our work. Workplace stress is stress that is brought on by work-related stressors. Canadians report work to be the biggest source of life stress. Almost three quarters of Canadian workers report that their work entails some stress, with 27% reporting that work is “quite a bit” or “extremely” stressful.[1] The most frequently identified workplace stressors are heavy workloads, low salaries, lack of opportunity, unrealistic or uncertain job expectations, and lack of control over work.[2]

Researchers typically identify five factors contributing to workplace stress:

  1. characteristics of the job being performed, such as workload, pace, autonomy, and physical working conditions,
  2. a worker’s level of responsibility in the workplace, including the clarity of their role,
  3. job (in)security, promotion, and career development opportunities,
  4. problematic interpersonal work relationships with supervisors, co-workers, or subordinates, including harassment and discrimination, and
  5. overall organizational structure and climate, including organizational communication patterns, management style, and participation in decision making (job control).

These five factors demonstrate that workplace stress arises out of situations and events within the employer’s control. This, in turn, makes the occurrence of workplace stress an occupational health and safety issue.

Workplace stress produces a range of physical and mental health effects. Early physical signs of negative stress include increased heart rate, sweating, and nausea, reddening of the skin, muscle tension, and headaches. Early emotional and mental effects of negative stress include anxiety, depression, apathy, sleep disturbance, and irritability. Long-lasting or intensifying stress results in a worsening of these symptoms as well as the appearance of new symptoms, such as lasting depression, heart disease, chronic digestive issues, reduced sex drive, uneven metabolism, and increased susceptibility to infectious diseases.

Research led by Robert Karasek has revealed that job control is a key factor in determining how work-related stress affects us. His job demands-control model is explained in Box 6.1. It is also possible for negative effects of stress to manifest themselves in groups of workers and not just individuals, due to workplace dynamics and environment. Group manifestation can arise from so-called toxic workplaces. Toxic workplaces  are characterized by “relentless demands, extreme pressure, and brutal ruthlessness,” and represent the extreme of stressful workplace environments.[3]

Karasek’s job demands-control model

Before Robert Karasek’s groundbreaking work, most research into work-related stress focused on the effects of job demands, such as overload. Karasek discovered that the degree of control a worker has in her job plays a significant role in whether job-related stress will be positive or negative and whether ill health results.[4]

Karasek developed a model that analyzed the interaction of job demands with job control. He created a matrix that included four types of work, as illustrated below (adapted from Karasek, 1979).

Matrix that looks at the level of psychological demands and job control

Low-strain and passive jobs are associated with low stress, although passive jobs can lead to low motivation and dissatisfaction. The important boxes are active jobs, associated with high job demands but where workers possess a high degree of decision latitude (i.e., control) in the work, and high-strain jobs, which contain high demand but little job control. The cumulative effect of working in an active job is that workers builds their ability to cope with stress. Conversely, sustained exposure to high-strain work leads to psychological and physical illness.

Karasek and his research partner later added the concept of “social support” to the model. Social support is the degree of isolation or support provided by both supervisors and co-workers. They found that high levels of social support can mitigate some of the negative effects of high-strain work. They also note that the most hazardous form of work is work combining high demand, low control, and low social support.[5] Karasek found the effects most acute for workers in blue-collar occupations, which typically give workers little job control.

Research into the model has found links between high-strain jobs and high incidence of heart disease, hypertension, mental health issues, and other negative health outcomes. While men and women experience job strain in similar ways, some recent research suggests that the presence of social support has a stronger effect in ameliorating negative stress effects for women than for men.[6] Also, the stress-buffering effects of job control have a greater impact on older workers than younger workers, suggesting older workers have developed coping techniques that younger workers have yet to discover. [7]

Karasek’s groundbreaking work reveals that job design, work environment, and worker autonomy are significant factors in determining whether work stressors will lead to negative health effects for workers. This finding suggests that HR tasks such as job design can profoundly affect the workplace hazards faced by workers.

There are two main challenges associated with recognizing workplace stress as a hazard. First, stress is often perceived as an individual’s response to a situation, and any two individuals can react differently to the same stressor. This perception can lead managers to identify the issue with the individual rather than the stressor itself. This response is an example of an employer blaming the worker for an injury and a variation on the careless worker myth that we read about in Chapter 1. Faced with an explanation that blames the worker, it is important to be cognizant of the difference between root and proximate cause. “Stress is not merely a physiological response to a stressful situation. Stress is an interaction between that individual and source of demand within their environment.”[8] In other words, while individuals may respond differently to stressors (which is the proximate cause of the health effect), the root cause of the reaction is the workplace dynamics that create the stressor.

Second, isolating workplace stressors can be difficult, especially chronic stressors. Non-work stressors do affect workers and can also be used by employers as an excuse to deny that stress-related health effects have workplace causes. Also, as with other types of ill health, individuals have different tolerances for stress, meaning the same stressors may affect one worker more than another. As a result, it can be difficult to have chronic stress recognized as a workplace hazard or the cause of a workplace injury or ill health. A workers’ compensation board, for example, is more likely to accept claims resulting in catastrophic or acute stress (e.g., post-traumatic stress disorder) than chronic stress.

Story: Workers’ compensation and chronic stress

In January 2007, Parks Canada employee Douglas Martin filed a claim with Alberta’s WCB for chronic stress. For the previous seven years, Martin had spearheaded an effort to have park wardens armed while they were performing their duties (an ongoing health and safety issue in Parks Canada). This effort was stressful and conflict-ridden, and Martin felt he had experienced reprisals by his employer in the form of lack of promotion, training, and work.

The previous month, Martin had received a letter threatening him with disciplinary action over an unrelated matter. Martin “already had a written reprimand on his file and feared that the next disciplinary action would be dismissal. He alleged the letter, following the stress of years of conflict over the health and safety issue, triggered a psychological condition. He took medical leave beginning December 23, 2006, consulted medical professionals for treatment, and initiated a claim for compensation for chronic onset stress the following month.”[9]

Martin’s workers’ compensation claim was refused and he lost his appeals of the decision. Alberta’s WCB policy stated that it accepts claims for chronic stress only if the worker meets each of four criteria:

  • there is a confirmed psychological or psychiatric diagnosis as described in the psychiatric manual of mental disorders (commonly called DSM),
  • the work-related events or stressors are the predominant cause of the injury; predominant cause means the prevailing, strongest, chief, or main cause of the chronic onset stress,
  • the work-related events are excessive or unusual in comparison to the normal pressures and tensions experienced by the average worker in a similar occupation, and
  • there is objective confirmation of the events.[10]

The WCB accepted that Martin was experiencing psychological effects and that the stressors were predominantly work-related. They denied the claim on the grounds that the events were not excessive or unusual in comparison to normal pressures and that there was not objective confirmation of the events.

As in all WCB cases, the decision revolves around the specifics of Martin’s situation. Nevertheless, it demonstrates how the bar to successfully establish a WCB claim for chronic stress can be set so high as to be unreachable by most workers. Further, the requirement that the events be “excessive or unusual in comparison to the normal pressures and tensions experienced by the average worker” marginalizes workers who may have a heightened sensitivity to stress. Finally, the decision, by arguing that fear of dismissal is not unusual in the workplace, downplays the role of management in creating an unusually stressful situation.

Workplace stress is the result of workplace factors. Consequently, preventing the negative effects of workplace stress requires changes to job design, workload, organizational culture, and interpersonal dynamics. These factors are both broadly known to employers and within their control. What the persistence of stressful workplaces reveals is that employers in such workplaces prioritize maintaining profitability, productivity, and control of the work process over workers’ health.

Related to stress is the experience of fatigue. Fatigue is the state of feeling tired, weary, or sleepy caused by insufficient sleep, prolonged mental or physical work, or extended periods of stress or anxiety. Acute, or short-term, fatigue can be caused by failure to get adequate sleep in the period before a work shift and is resolved quickly through appropriate sleep. Chronic fatigue can be the result of a prolonged period of sleep deficit and may require more involved treatment. Chronic fatigue syndrome is an ongoing, severe feeling of tiredness not relieved by sleep. The causes of chronic fatigue syndrome are unknown.

While lack of sleep is the primary cause of fatigue, it can be enhanced by other factors, including drug or alcohol use, high temperatures, boring or monotonous work, loud noise, dim lighting, extended shifts, or rotating shifts. As with other conditions, workers have differing sensitivity to fatigue. Fatigue can also make workers more susceptible to stress and illness.

Fatigue is a legitimate health and safety concern because workers who are experiencing fatigue are more likely to be involved in workplace incidents. Lack of alertness and reduced decision-making capacity can have negative effects on safety. Research has shown that fatigue can impair judgment in a manner similar to alcohol. WorkSafeBC reports the following effects:

  • 17 hours awake is equivalent to a blood alcohol content of 0.05 (the legal limit in B.C. and Alberta)
  • 21 hours awake is equivalent to a blood alcohol content of 0.08 (the legal limit in Canada)
  • 24–25 hours awake is equivalent to a blood alcohol content of 0.10.[11]

Most cases of fatigue are resolved through adequate sleep. The average person requires 7.5 to 8.5 hours of sleep a night (remember, this is an average—some require more, some less). While an employer cannot control how well a worker sleeps, they can adjust the workplace to mitigate fatigue. Shift scheduling is one of the most important administrative controls of fatigue: employers can ensure shifts are not too long or too close together as well as avoiding dramatic shift rotations (we discuss shift work in more detail in Chapter 7). Employers can also ensure that workplace temperatures are not too high, work is interesting and engaging without being too strenuous, and adequate opportunities for resting, eating, and sleeping (if necessary) are provided.

  1. Crompton, S. (2011, October). What’s stressing the stressed? Main sources of stress among workers. Canadian Social Trends, 44–51. ↵
  2. American Psychological Association (2015). 2015 Work and Well-Being Survey. Washington: APA. ↵
  3. Macklem, K. (2005). The toxic workplace. Maclean’s, 118(5), 34. ↵
  4. Karasek, R. (1979). Job Demands, job decision latitude, and mental strain: Implications for job redesign. Administrative Science Quarterly, 24(2), 285–308. ↵
  5. Karasek, R., & Theorell, T. (1992). Healthy work: Stress, productivity, and the reconstruction of working life. New York: Basic Books. ↵
  6. Rivera-Torres, P., Araque-Padilla, R., & Montero-Simó, M. (2013). Job stress across gender: The importance of emotional and intellectual demands and social support in women. International Journal of Environmental Research and Public Health, 10(1), 375–389. ↵
  7. Shultz, K., Wang, M., Crimmins, E., & Fisher, G. (2010). Age differences in the demand–control model of work stress: An examination of data from 15 European countries. Journal of Applied Gerontology, 29(1), 21–47. ↵
  8. Colligan, T., & Higgins, E. (2006). Workplace stress. Journal of Workplace Behavioral Health, 21(2), 89–97, p. 92. ↵
  9. Martin v. Alberta (Workers’ Compensation Board), [2014] 1 SCR 546, 2014 SCC 25, para. 6. ↵
  10. Alberta WCB. (2014). Policies and Information Manual, Policy 03-01, Part II: 6. ↵
  11. WorkSafeBC. (2014). Fatigue can also make workers more susceptible to stress and illness. WorkSafe Bulletin WS2014-14: 1. ↵
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Canadian Health and Safety Workplace Fundamentals Copyright © 2022 by Connie Palmer is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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