Prevalence of Occupational Stress and Associated Factors

Abstract

Background: occupational stress is a negative physical and emotional response for the mismatched between the demand of work and capacity and needs of individual employees. Occupational stress and its related co-morbid diseases like depression and anxiety are responsible for a large proportion of disability worldwide. However, there is no study on occupational stress among factory workers in Ethiopia. Occupational stress might be increase due to high workload, high psychological and physical work demand, low co-worker and supervisor support, substance use and lack of physical exercise among factory Workers.

Objective: To assess the prevalence of occupational stress and associated factors among Addis pharmaceutical factory in Adigrat, Tigray, Ethiopia, 2018.

Methods: An institution based cross-sectional study was conducted at Addis pharmaceutical factory from May 15 to 30, 2018. About 423 samples were included by using simple random sampling technique from the total of 952 study populations. Data was collected through self-administration structured questionnaire. The prevalence of occupational stress was assessed using short version of Siegrist’s scale Effort-reward imbalance questionnaires which had Cronbach's α 0.80 and in the pre-test of this study it had good reliability. The collected data was entered to Epi-data version 3.1 and exported to Statistical package for social science version 20.0 for analysis. Descriptive statistics was used to summarize and present the results in to paragraphs, tables and graphs. A logistic regression analysis was done to identify variables having an association with occupational stress and to control the confounder factors. Odds Ratios and 95% Confidence interval were reported with P < 0.05 and considered as significant.

Results: The response rate of this study was 94.1%. The prevalence of Occupational Stress in the study population was 30.2 % (confidence interval 25.6 -34.7). Female sex (adjusted odds ratio 3.68; 95% confidence interval, 1.61-8.42), low job control ability (adjusted odds ratio 3.10; 95% confidence interval, 1.29-7.46), over workload (adjusted odds ratio 3.60; (95% confidence interval, 1.59 - 8.18), alcohol current use (adjusted odds ratio 2.458; 95% confidence interval, 1.05-5.76) and Lack of physical exercise habit (adjusted odds ratio 3.12; 95% confidence interval, 1.28 - 7.57) were significantly associated with Occupational stress

Conclusion and recommendation: - the prevalence of Occupational stress was found to be high. Female sex, low job control ability, over workload and Lack of physical exercise habit were found to be independent predictors of Occupational stress. Therefore, it is recommended that Occupational stress needs due attention and remedial action from policy makers, Addis pharmaceutical factory’s manager, and other concerned bodies.

Statement of the problem

Stress can be defined in vague terms as human being feelings of pressures in everyday life. No one is free of stress: in a normal range, it helps us to motivate and to be productive, but too much stress or a strong response to the stressor (stimuli) has dangerous health consequences. Stress is “the nonspecific response of the body to any demand’’(1,2).

Occupational stress is the detrimental physical and emotional response that occurs when the demands of the job do not balance with the capabilities, needs, knowledge and resources of employees or negative responses due to extraordinary efforts spent with little rewards acknowledge, which leads to poor health(3,4).

It’s characterized by physiological problems such as headaches, loss of sexual drive, serious physical illness, increased heartbeat and blood pressure, palpitations and chest discomfort, breathlessness, muscle ache, sleeping problems, etc. Behavioral problems such as, impulsiveness, eating disorder, easily distractibility, speech problems, irritability or aggressiveness, grinding of teeth, increasing smoking and use of drugs and alcohol, increased errors, absenteeism, etc. and psychological symptoms such as anxiety, fear and tension, memory problems, depression, dissatisfactions, seeing only the negative, poor judgment, worries and catastrophic thoughts, overestimation of danger(5,6).

Occupational stress studied interchangeably by giving different names like work-related Stress, job stress, work-place stress, and work stress in many areas, but all represent for common sense which is stress induced due to work (7). Commonly, the Cause of occupational stress includes internal situations such as attitude, thinking, and lifestyle of the person and external situations such as harsh working environment, increasing demands of Work, relationships problem (with co-workers and supervisor) and communication problem(8).

According to WHO report, stress affects 25% workers worldwide and it is the second most commonly reported work-related problem, which affected 22% of employees in the European Union(9). The healthcare costs of occupational stress estimated about $5.4 billion each year throughout the globe(10) and it is the second highest cause of absenteeism for non-manual workers(11). 60% of absenteeism of factory workers as attributable to stress-related disorders(12).

In USA, stress considered as Health Epidemic of the 21st Century because $300 billion a year lost due to stress and increased by 10 to 30 percent among all demographic groups with over 50% of individuals perceived that it negatively impacted work productivity(13). One recent report of Great Britain also shows more than five hundred thousand different workers suffered and twelve million working days were lost due to work-related stress, depression, and anxiety in 2016/17(14). Work-related stress, depression or anxiety accounts for 40% of work-related ill health and 49% of working days lost, in 2016/17(15).

Occupation stress is highly affecting the education, agriculture, health institution, and industries(16). Occupational stress and its related co-morbid diseases like depression and anxiety are responsible for a large proportion of disability worldwide since it has an impact on individual persons psychological or physical wellbeing like increased medical and insurance costs with reduced income and on organizational like financial implication, deteriorate of productivity, increase employee absenteeism and turnover(8,17). Occupational stress is related to the low quality of life, job burnout, increasing the risk of accidents and work-related injuries and cause job change and early retirement of employees(18).

Occupational stress is associated with middle age, working for long period, high workload, poor organizational social support, being female gender, separated or divorced marital status, low income, and alcohol consumption or cigarette smoking (7,19–23).

There are some studies done on occupational stress in sectors of human activity and socio-professional categories in Europe, but there is a paucity of studies in Africa including in factories those are owned by these European countries(24).

There are also some studies on occupation stress in Africa, but there are no studies about occupational stress among factories workers Ethiopia. So this research aims to assess the prevalence of occupational stress and associated factors among Addis pharmaceutical factory in Adigrat.

Literature Review

Occupational stress occurs when employees perceive as the work environment is harsh to his or her reaction that involves feelings of an inability to cope with real pressures or deadlines within the working environment(25).

As WHO reported, 25% of the entire population experience symptoms of stress at least once in their life(17).

A research conducted in Thailand among factory workers in rubber-glove factory showed 27.5% of them were job strain. That study was done among 200 workers by using job content questionnaire(26)

As a cross-sectional study conducted among palm oil mill workers in Malaysia shows that 21% of the employees had occupational stress based on O'Donnell Personal Stress Inventory(27). Another cross-sectional study conducted in Malaysia among polymer manufacturing workers experienced that occupational stress was 25.3%(28). Moreover, another cross sectional study done in male automotive assembly factory workers occupational stress had among 31.1% of them(29).

A study was done among the Ready-made Garment (RMG) industry female workers in Bangladesh which showed 22.9% of them had high stress according ERI –Q scale(30).

As many studies done in Iran emphasized in different factories like industries and companies, the prevalence of occupational stress were varied. For instance, in a case-control study conducted among car manufacturing workers showed that occupational stress assessed was 21.3% among the control group and 35.1% among case group workers with injuries had occupational stress(31). A cross-sectional study done among the employees of spinning industry showed that 29.2 % of them were found in high stress(32). Another study conducted in similar area which was cross-sectional study among 400 male employees of steel company shows that 53% of them had occupational stress(33). The scholars were also extended another cross– sectional survey among white-collar workers of Esfahan Steel Company conducted in Iran using validated standardized questionnaire on occupational stress was 50%(34).

In the assessment of occupational stress among garment factory workers in India which were a cross-sectional study reported that the prevalence was 26%(23). Another descriptive cross-sectional study conducted among thermal power workers in India to assess the occupational and non- occupational stress reported that the prevalence of occupational stress was 9.5%(35).

As INRS(Institute National research scientific) occupational health research conference in 2012 revealed that workplace stress in South Africa mineworkers had 23 % of them were found in a high-stress job(36).

A cross-sectional survey among textile workers in the Democratic Republic of Congo showed that 28% of workers suffered from occupational stress according to Karasek’s job demand control model and 22% according Siegrist’s scale effort reward imbalance model(22).

In Ethiopia, there is no study about occupational stress among any factory workers. So, this research can be filled the gap by indicating the prevalence and associated factors of occupational stress among Addis pharmaceutical factory workers as an input and as a gateway for other researchers.

Determinants of Occupational Stress among Factory Workers

Occupational stress have multifactorial causes(1). But, the most common were assessed in previous different literatures as socio-demographic factors, work-related factors, and psychosocial factors, clinical and behavioral factors.

Socio-demographic factors

From socio-demographic factors being single, divorce and separated marital status were significantly associated with occupational stress among managers of different pharmaceutical industries and mine factory workers in Pakistan and Indian (37,38). Another socio-demographic factors low monthly income was significantly associated with occupational stress among Garment Industry and steel company workers in India and Iran respectively(23,33).

Middle age groups which is from 25 to 30 years also were highly associated with occupational stress among Garment Industry workers, among steel company workers and among mine factory workers in India(23,33,38).

A study done in democratic Congo shows that occupational stress was associated with low educational level and few work experience in among textile workers(22).

Psychosocial factors

Stressors arising in the work environments are psychosocial stressors like time pressure and/or physical noise(12).

A study done in Sweden revealed that occupational stress was highly associated with demand and commitment conflicts and low influence at work (39). occupational stress is high among factory workers who were lack of supervisor support as research conducted among China Offshore Oil Worker showed(40). Another result from Malaysia come up that there were significant associations between occupational stress and organisational factors such as low decision latitude or job control, high psychological job demand and job insecurity (26,28)

Family-related problems among steel company employees in Iran was significantly associated with occupational stress(33).

The studies done on occupational stress in different factory workers of Indian reveals that job role conflict, lack of growth & development opportunities and unable control work and conflicting demands between work & home were strongly associated with occupational stress(41,42).

Occupational stress in Nigeria among Mat Factory Workers were associated with working under heavy stress with toxic work environment, negative workload, role conflict, lack of autonomy, career development barriers, difficult relationships with administrators and/ or co-workers(43).

Having a second job among male steel company employees also were significantly associated with occupational stress(33). A long working hour had associated with occupational stress as study done among garment factory workers in Turkey showed(44).

Another study done in Pakistan managers of different pharmaceutical industries showed that excessive work overload was more likely to associated with job stress(37).

A study done in Turkey revealed that mental illness and having chronic medical diseases had associated with occupational stress(44).

Behavioral factories also highly associated with occupational stress such as current use of smoking or alcohol and lack of physical exercise in their leisure time(35,38,45,46).