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Downsizing and layoffs affect health, safety of those who stay
Occ health manager knows firsthand effects of cutbacks
Tamara Blow knows firsthand the stressful effects downsizing can have on workers who escape the layoffs and keep their jobs. "I've seen it; it's happening to me right now," says Blow, MSA, RN, COHN-S/CM, CBN, occupational health manager at a manufacturing site in Virginia that employs more than 6,000 people. Blow, who requested that her company name not be used, recently learned that her site's former medical director will not be replaced, so she and her staff will be taking up the slack.
Research and experience have shown that the threat of layoffs, and the related long workdays, not only take a mental toll on those effected, but they also can lead to deteriorating health and increased safety risks. Blow has seen this impact in her own work group and in other departments where layoffs have occurred or were anticipated. "Especially in salaried employees, I see a high degree of depression" when downsizing threats arise, says Blow.
Since the downsizing trend emerged in the 1980s, she has seen employees increase their rate of occupational injury. "Whether it's because they're distracted or depressed, they get injured," Blow says. There are a significant number of lacerations, for example, when layoffs are occurring, she says. Also, employees take care of everything that's bothering them physically, but they don't address the mental stress, Blow says. "Those who are left behind are faced with doing more with less, and that creates mental stress," she says.
Data supports that observation, says researcher Mika Kivimaki, PhD, of the Epidemiology and Public Health Department at the University College London (UK). "Employees who remained in work after downsizing may be at increased risk of being prescribed psychotropic drugs," Kivimaki notes. "In other words, enforced [layoffs] may boost mental health problems among those who keep their jobs," he explains. Kivimaki and colleagues published a study on the effects of layoffs on the workers left behind in the January 2007 Journal of Epidemiology and Community Health.1
Stress over jobs leads to safety risks
Work psychologists at the Washington State University examined 237 employees in two food-processing plants, assessing attitudinal outcomes such as job satisfaction, employee knowledge regarding appropriate safety behaviors, and employee motivation to comply with organizational safety policies, in conjunction with self-reported safety violations, on-the-job accidents, and workplace injuries.
In one plant, an entire shift had been laid off, and focus-group interviews showed employees expected the plant to be entirely phased out. In the other, the swing shift was being eliminated in favor of a night shift, and employees who could not make the change were expected to lose their jobs. Overall plant production was expected to remain the same in both facilities, however.
The workers first responded to survey instruments immediately after the shift changes and layoffs were announced, and then again six months later. The results were disconcerting for professionals concerned with employee safety. "This study produced important initial evidence that job security is related to meaningful safety outcome measures, such as safety knowledge, safety motivation, and to reported compliance with safety policy," noted lead author Tahira M. Probst, PhD.2 "The thing that really struck me the most was the relationship between being dissatisfied with your job security and how that affected your levels of safety policy knowledge — and your motivation to comply," says Probst, assistant professor of psychology at Washington State University in Vancouver. "That was the biggest contribution of this study: showing the direct relationship." This study, she notes, was the first to link together perceptions of security and these outcomes.
Blow says layoff-related anxiety affects different employees in different ways, and the occupational health manager should be as prepared as possible for the various outcomes. "You have that 20% who seem that they will always be high performers, no matter what, and can do more with less," she says. "But the other 70-80% of the worker population gets a lot of stress-related illnesses, depression."
Gender and ethnic background also seem to be factors in how employees respond to layoffs and how much of a safety impact they have, Blow says. "Women will admit to depression more readily than men will," she says. Being a woman also seems to contribute to how much the layoffs will affect them, Blow says. "Women feel that they are at a disadvantage in corporate America and believe that when layoffs come up, they will either be the first to go in a downsizing or that if they stay, they will have more work put on them and won't be compensated equally for it," she says. "And I can speak to that personally."
An employee at Blow's worksite who was not downsized but was feeling the stress of staff reductions around her did not acknowledge the symptoms until they became physical and very serious, she says. The woman, who is African American, began feeling depression, recalls Blow, who is African American. Among African Americans, mental illness is a stigma, she says. "So her productivity was declining, but she didn't say anything until finally she had physical manifestations," Blow says. "Her kidneys were shot, and she had cardiac symptoms, and then she felt that she could say something because it was physical, not mental, by that time."
Blow has seen her own department shrink over the years as the result of mergers and downsizing, and she points out that even among employee health professionals who are trained to spot and help remedy job-related stress in others, the effect was noticeable. "You begin to feel isolated and divided, and the stages of change and stress can show up visually — people walk differently, almost like zombies, and there's a lot of anger, and errors start being made that weren't there before," she says.
A swift, proactive response is crucial, she points out. "I sat down with them and told them that they are valued, that their decisions and input matter, and that I would do whatever I could to make sure changes were communicated to them as soon as I knew of them," Blow recounts. "There is a strong correlation between feeling valued and part of a team, and job performance and safety." Blow says that morale improved after she communicated to her staff that she would keep them in the communications loop, but that any department manager needs to be attuned to the effects job insecurity can have on production and in safety and error rates. (See "Use business skills to help management focus on employees," below.)
Use business skills to help management focus on workers
Good business skills, as well as good clinical skills, are valuable for occupational health leaders when a company is in flux, says Tamara Blow, MSA, RN, COHN-S/CM, CBN, occupational health manager at a manufacturing site in Virginia that employs more than 6,000 people.
"If you have a good relationship with management, and you have data and statistics that you can use to articulate the hidden costs that downsizing has on employees, that is a wonderful thing to be able to use to work with management before downsizing takes place," Blow says. A lot of employers may find that they have downsized departments and not saved money, she says. The reason? "Because of the severance they pay to the laid off employees, the cost of overtime and outsourcing to continue the production at the levels before the layoffs, and because a lot of times they have to maintain the same amount of infrastructure to keep production going," Blow says.
Occupational health managers who are involved in management decisions can act ahead of time to bring in employee assistance providers before downsizing takes place, rather than afterward for crisis management, which not only gives employees time to prepare and adjust, but sends the message to all employees that the company cares about what happens to them and that their welfare is not being overlooked.
"What occupational health managers have to do is to partner with management and show them why they need to trust us with this information ahead of time, and communicate with us for better outcomes," Blow explains. "It encourages morale and pays off for the employer if the company shows they acknowledge the stress involved and the value of the work/life balance." (See steps to lessen stress on employee hearts, below.)
Small, significant changes can cut layoff stress to heart
If layoffs are looming at your workplace, there are steps you can take to help reduce the affect the stressful atmosphere has on employees' hearts, according to a year-long study of workers at DuPont Corp.1
Stress management programs offered at companies where workers faced layoffs achieved "small but significant" changes in heart rate variability as well as decreases in arterial blood pressure, according to a report in the February 2007 Hypertension: Journal of the American Heart Association.
After participating in the year-long stress management program, office workers at a DuPont Corp. subsidiary in Milan, Italy, that was downsizing its workforce by 10% achieved lower stress scores than they had before beginning the stress management program. "And we were able to achieve these results in a working environment, without impinging on productivity, and with zero cost to the company," according to Massimo Pagani, MD, a senior author of the study and professor of medicine at the University of Milan. "By addressing stress at work, where stress occurs, rather than in a clinic, we may be able to prevent these workers from becoming patients."
Workers facing layoffs were compared to a control group of 79 healthy volunteers who worked outside of the company and reported no work-related stress. Electrocardiograms and tests of nervous responses demonstrated that, as expected, workers facing layoffs were feeling more stress and their heart rhythm was showing signs of that stress.
After baseline assessment, workers were offered the chance to take part in weekly, one-hour stress management sessions or to be part of a less aggressive education program that included articles and e-mails about stress management, along with services from the company's medical department. The weekly stress management sessions focused on mental relaxation techniques as well as cognitive restructuring exercises and coping skills to face life stressors, including work-related stress.
After a year, Pagani reported, "the stress management program induced a significant, small reduction in arterial pressure, and clear changes in ECG derived stress indices. Our study provides a potential model for the assessment of work-related stress at an individual level and suggests that stress management programs can be implemented at the worksite."
1. Lucini D, Riva S, Pizzinelli P, et al. Stress manageat the worksite: Reversal of symptoms profile and cardiovascular dysregulation. Hypertension 2007; 49:291-297.
Kivimaki says his previous research on municipal organizations showed that in downsized groups, cuts resulted in greater levels of job demands and job insecurity, along with declines in perceived job control, in those workers remaining.3 "We have previously also shown organizational downsizing to be a strong predictor of stress-related physical health outcomes, including cardiovascular mortality," he adds.4
Besides increased risks of illness, Probst says her surveys demonstrated that the added pressure to perform can lead to safety compromises. It is possible, Probst wrote, that employees who have to juggle competing job demands of production, quality, and safety may feel pressured to cut safety corners to keep their production numbers up, especially if they fear losing their job and are not actively rewarded for safe behavior. "These results suggest that organizations not only need to consider the effects that employee job insecurity has on the job satisfaction, health, and turnover intentions of employees, but also need to consider the possibility that job insecurity can have potentially dangerous implications for employee safety attitudes and behaviors," she noted.2
Keep an eye on increased sick time
If your workplace is anticipating layoffs — or cutbacks have already taken place — monitor sick time and leaves taken under the Family and Medical Leave Act (FMLA) as a marker of worker health, Blow suggests.
Especially in her hourly employees, Blow sees a marked increase in FMLA usage. "Also look for, especially, increased complaints related to cardiac and back pain, migraines, and re-emergence of chronic diseases that might have been in remission, such as lupus," she says. "I have seen a strong correlation between job stress and chronic illnesses coming back."
1. Kivimaki M, Honkonen T, Wahlbeck K, et al. Organisational downsizing and increased use of psychotropic drugs among employees who remain in employment. J Epidemiol Community Health 2007; 61:154-158.
2. Probst TM, Brubaker TL. The effects of job insecurity on employee safety outcomes: Cross-sectional and longitudinal explorations. J Occupational Health Psych 2001; 6:139-159.
3. Kivimaki M, Vahtera J, Elovainio M, et al. Human costs of organizational downsizing: Comparing health trends between leavers and stayers. Am J Community Psychol 2003; 32:57-67.
4. Kivimaki M, Virtanen M, Elovainio M, et al. Work stress in the etiology of coronary heart disease — A meta-analysis. Scand J Work Environ Health 2006; 32:431-442.
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