STRESS IN THE WORKPLACE

1. Introduction

Work-related stress is considered at national, European and international level a problem both by employers and employees. Having identified the need for a specific joint action in relation to this problem and in view of a consultation on stress by the European Commission, the European social partners included this theme in the European social dialogue work programme 2003-2005. Stress, potentially, can occur in any workplace and to any employee, regardless of the size of the company, the field of activity, the type of contract or employment relationship. In practice, not all workplaces and not all employees necessarily suffer from it. Taking the problem of stress in the workplace into account means substantially improving occupational health and safety and increasing efficiency, thus giving substantial economic benefits for the companies, the employees and the society as a whole. When considering work-related stress, it is essential to take into account the different traits of the employees.

2. Object

The purpose of this agreement is to improve the awareness and understanding of work stress by employers, employee and their representatives, by drawing their attention to the symptoms that can indicate the onset of work-related stress conditions. The goal of this agreement is to offer employers and workers a model to identify and prevent or manage work-related stress problems. Its purpose is not to blame (shame) the individuals because of their stress. Recognizing that oppression and violence at work are potential stressors but that the European social partners work programme 2003-2005 provides for the possibility of a specific negotiation on these issues, this Agreement does not affect violence at work, nor mobbing and physical overpowering, nor post-traumatic stress.

3.  Description of stress and work-related stress

Stress is a state that is accompanied by a general feeling of malaise, physical, psychological or social disorders and conditions and which results from the fact that people do not feel able to overcome the gaps between what is expected from them and what they can provide. The individual is capable of reacting to the pressures to which they are submitted in the short term, and which can be considered positive for the development of the individual, but in the face of prolonged exposure to strong pressure the individual feels it really difficult to react. Furthermore, different people may react differently to similar situations and the same person may react differently to similar situations at different times in his life. Stress is not a disease but a prolonged exposure to stress can reduce work efficiency and cause health problems. Stress induced by factors outside the working environment can lead to changes in behaviour and reduce working efficiency. Not all the manifestations of stress at work shall be considered to have been caused by the work itself. Work-related stress may be caused by various factors such as the object of the work or the organization thereof, the work environment, "poor" communication and so on.

4. Identification of work-related stress problems

Given the complexity of the stress phenomenon, the agreement does not aim at providing an exhaustive list of potential stress indicators. However, high absenteeism or a high staff turnover, interpersonal conflicts or frequent complaints from employees are some of the symptoms that can reveal the presence of work-related stress. Identification of a work-related stress problem can be performed through an analysis of factors such as work organisation and processes (work planning, working hours, the amount of autonomy, the distance between the needs imposed by the work itself and the employees' skills and knowledge, the workload and so on), the working environment and its conditions (exposure to illicit behaviour, noise, heat, hazardous substances, etc.), communication (uncertainty about job expectations, potential future employment opportunities, future changes and so on), and the subjective factors (emotional and social pressures, feeling that one is not able to cope with a situation, feeling the lack of help and so on): if the problem of work stress is identified, we must act to prevent it, eliminate it or reduce it. The responsibility of determining the appropriate measures to be taken is up to the employer. These measures will be implemented with the participation and cooperation of employees and/or their representatives.

5. Responsibilities of employers and employees

Under the Framework Directive 89/391 (the one from which the "626" occupational safety law originated), all employers are bound by law to protect employees' health and safety. This duty also covers work-related stress problems as they pose a health and safety risk. All employees have a general duty to comply with the protective measures decided by the employer. Problems associated with stress can be addressed within the risk assessment process, by planning a specific company policy on stress and/or through specific targeted measures for each identified stress factor.

6. Prevent, eliminate or reduce work stress problems

Various different measures can be applied in order to prevent, eliminate or reduce these problems. These measures can be collective, individual or both together. Specific measures can be introduced for each identified stress factor or the above measures can be part of an integrated anti-stress policy that is both pre-emptive and assessable. Should the company be unable to provide, in-house, the required skills and competence it can make use of third-parties resources in compliance with European and national agreements, collective agreements and business practices. Once the anti-stress measures have been defined they should be reviewed regularly to evaluate their effectiveness and determine whether they use the available resources optimally and whether they are still appropriate or necessary.
These measures can include, for example:
• management and communication measures able to clarify the company's objectives and the role of each employee, to ensure adequate support from management to individuals and work teams, to bring about consistent accountability and control over work, improve the organization, processes, conditions and working environment;
• training managers and employees to improve their awareness and understanding of stress, its possible causes and how to deal with it and/or to adapt to change;
• provide information and consultancy service to employees and their representatives in compliance with European and national agreements, collective agreements and business practices.

7. Implementation and control over time

According to article 139 of the Treaty this voluntary European framework agreement commits the members of the UNICE/ UEAPME, CEEP and ETUC (and the EUROCADRES/CEC Liaison Committee) to implement it in accordance with their own procedures and practices and those of the social partners in the various Member States and in the countries of the European Economic Area. The signatories also invite their affiliated organizations in the candidate countries to implement this agreement. This agreement shall be implemented within three years from the date of its signature. Affiliated organizations will notify the application of the agreement to the Social Dialogue Committee. During the first three years following the signing of the agreement, the Social Dialogue Committee prepares an annual summary table of the situation relating to the implementation of the agreement. During the fourth year the Committee prepared a full report on the actions undertaken for the purposes of the implementation of the agreement. The signatories will evaluate and review the agreement at any time upon request of any one of them after five years from the date of signature have passed. If there are any questions about the content of the agreement, the affiliated organizations which are interested in it may jointly or separately apply to the signatories who will answer them jointly or separately. In the implementation of this agreement the members of signatory organizations shall avoid imposing unnecessary burdens on SMEs. The implementation of this agreement does not constitute a valid reason to reduce the general level of protection granted to employees within the scope of this agreement. This agreement has no affect on the right of the social partners to conclude, in the relevant scenarios, including the European level, any agreements that adapt and/or complete this agreement so as to take into account the specific needs of the social partners concerned.

INTER-ASSOCIATION AGREEMENT made on June 9, 2008 for the implementation of the European framework agreement on work-related stress concluded on 8 October 2004 between UNICE / UEAPME, CEEP and ETUC

Art. 1 - Introduction

1. Work-related stress is considered at national, European and international level a problem both for employers and employees. After having identified the need for a specific joint action in relation to this problem and in view of a consultation on stress by the European Commission, the European social partners included this theme in the European social dialogue work programme 2003-2005.
2. Stress, potentially, can occur in any workplace and to any employee, regardless of the size of the company, the field of activity, the type of contract or employment relationship. In practice, not all workplaces and not all employees necessarily suffer from it.
3. Addressing the question of work-related stress can lead to greater efficiency and improved health and safety of workers, with consequent economic and social benefits for companies, workers and society as a whole. When dealing with the problems of work-related stress it is essential to take into account the different characteristics of workers in the meaning specified by the second paragraph of art. 3.

Art. 2 - Purpose

1. The purpose of this agreement is to improve the awareness and understanding of work stress by employers, employees and their representatives, by drawing their attention to the symptoms that can indicate the onset of work-related stress conditions.
2. The goal of this agreement is to offer employers and employees a model to identify and prevent or manage work-related stress problems. This agreement does not have the goal of attributing the responsibility of the stress to the individual.
3. Since the social partners acknowledge that oppression and violence at work are potential stressors but that the European social partners work programme 2003-2005 provides for the possibility of a specific negotiation on these issues, this Agreement does not deal with violence at work, harassment or post-traumatic stress.

Art. 3 - Description of stress and work-related stress

1. Stress is a condition that is accompanied by a general feeling of malaise, physical, psychological or social disorders and conditions and which derives from the fact that people feel unable to overcome the gap between what is expected from them and what they can provide.
2. The individual is absolutely capable of sustaining a short-term exposure to stress, which can be considered positive, but he/she finds it more difficult to sustain a prolonged exposure to intense pressure. Furthermore, different individuals may react differently to similar situations and the same individual can react differently to similar situations at different times in his or her life.
3. Stress is not a disease but a prolonged exposure to stress can reduce work efficiency and cause health problems.
4. Stress induced by factors that are not part of the working environment can lead to changes in behaviour and reduce working efficiency. Not all the manifestations of stress on the workplace can be considered to have been caused by the work itself. Work-related stress may be caused by various factors such as the object of the work or the organization thereof, the work environment, "poor" communication and so on.

Art. 4 - Identification of work-related stress problems

1. Given the complexity of the stress phenomenon, this agreement does not aim at providing an exhaustive list of potential stress indicators. However, high absenteeism or a high staff turnover, interpersonal conflicts or frequent complaints from employees are some of the symptoms that can reveal the presence of work-related stress.
2. Identification of a work-related stress problem can be performed through an analysis of factors such as the inadequacy of work organisation and processes (working hours, amount of autonomy, distance between the needs imposed by the work itself and the employees' skills and knowledge, workload and so on), the working and environmental conditions (exposure to illicit behaviour, noise, heat, hazardous substances, etc.), communication (uncertainty about job expectations, potential future employment opportunities, future changes and so on). and the subjective factors (emotional and social tension, feeling that one is not able to cope with a situation, feeling the lack of help and so on.)
3. Once a problem of work stress is identified, it is necessary to act to prevent it, eliminate it or reduce it. The responsibility of determining the appropriate measures to be taken is up to the employer. These measures will be implemented with the participation and cooperation of employees and/or their representatives.

Art. 5 - Responsibilities of employers and employees

1. According to the framework directive n. 89/391, all employers have a legal obligation to protect workers' health and safety at work. This obligation also covers work-related stress problems as they pose a health and safety risk. All employees have the general duty to comply with the protective measures set by the employer.
2. The management of work-related stress problems may be carried out on the basis of the general risk assessment process, i.e. through the adoption of a separate stress policy and/or specific measures aimed at identifying stress.

Art. 6 - Prevent, eliminate or reduce work-related stress problems

1. Prevention, elimination or reduction of work-related stress problems may involve the adoption of various measures. These measures can be collective, individual or of both types. They can be introduced in the form of specific measures targeted at identified stressors or as part of an integrated stress policy that includes both pre-emptive and response measures.
2. Should the company lack the required professionals it will be authorised to call third party (external) professionals, according to European and national legislation, collective agreements and practice.
3. Once the anti-stress measures have been adopted they should be reviewed regularly to evaluate their effectiveness and determine whether they use the available resources optimally and whether they are still appropriate or necessary.
4. These measures for example may include:- management and communication measures able to clarify the company's objectives and the role of each employee, to ensure adequate support from management to individuals and work teams, to bring about consistent accountability and control over work, improve the organisation, processes, conditions and working environment; - training managers and employees to improve their awareness and understanding of stress, the possible causes of stress and how to deal with it and/or to adapt to change; - provide information and consultancy service to employees and their representatives in compliance with European and national agreements, collective agreements and business practices.

Art. 7 - Implementation and control over time

1. In compliance with the provisions of the article 139 of the Treaty this voluntary European framework agreement commits the members of the UNICE/ UEAPME, CEEP and ETUC (and the EUROCADRES/CEC Liaison Committee) to implement it in accordance with their own procedures and practices and those of the social partners in the various Member States and in the countries of the European Economic Area.
2. The signatories also invite their affiliated organizations in the candidate countries to implement this agreement.
3. Affiliated organisations will provide a report on the application of this agreement to the Social Dialogue Committee. During the first three years following the signing of the agreement, the Social Dialogue Committee shall prepare an annual summary table of the progress made in the implementation of the agreement. A complete report on the implementation measures taken will be prepared by the Social Dialogue Committee during the fourth year.
4. The signatory parties shall evaluate and revise the agreement at any time from the fifth year from the date of signature, if requested by any of the parties.
5. If there are any questions about the content of the agreement, the affiliated organizations which are interested in it may jointly or separately apply to the signatories who will answer them jointly or separately.
6. In the application of this agreement, associations belonging to the signatories shall avoid laying unnecessary burdens on the small and medium-sized enterprises.
7. The implementation of this agreement does not constitute a valid reason to reduce the general level of protection granted to employees within the scope of this agreement.
8. This agreement has no effect on the right of the social partners to conclude, in the relevant scenarios including the European one, any agreements that adapt and/or complete this agreement to take into account the specific needs of the social partners concerned.

Indications of the Advisory Commission for the assessment of work-related stress (articles 6, paragraph 8, letter m-quater, and 28, paragraph 1 bis, Legislative Decree no. 81/2008 as further amended)

Reference regulatory framework, purpose and structure of the document

Article 28, paragraph 1, of Legislative Decree no. 81 of April 2008, hereinafter referred to as Legislative Decree no. 81/2008, provides that risk assessment should be carried out taking into account, among the other, work-related stress risks, according to the contents of the European Agreement of October 8, 2004. In view of the well known and reported difficulties in the identification of the correct procedures for implementing this legislative provision, when adopting the supplementary and corrective provisions of the aforementioned Legislative Decree no. 81/2008, an additional paragraph (1-bis) was added to article 28; this paragraph entrusts the Advisory Commission with the task of drafting methodological indications about the correct fulfilment of the aforesaid obligations, aimed at directing the activities of the employers, their consultants and the supervisory bodies. In order to respect, within the deadline of December 31, 2010, the provisions referred to in Article 28, paragraphs 1 and 1-bis, of the legislative decree no. 81/2008, as amended, the permanent Advisory Commission for health and safety at work has set up its own committee (with three members) which, following a thorough debate between its members, has drafted this document, released from the Advisory Committee at its meeting of November 17, 2010.

The methodological indications have been developed within the limits and for the purposes identified by the Law taking into account the scientific production available on the subject and the proposals received by the Advisory Committee and are they have been drawn up according to criteria of simplicity, brevity and ease of understanding.

The document draws up a methodological path that represents the minimum level of implementation of the obligation to assess work-related stress risks for all public and private employers.

Definitions and general indications

Work-related stress is described in article 3 of the European Agreement of October 8, 2004 - as implemented by the Inter-association Agreement of June 9, 2008 - as"a condition that is accompanied by a general feeling of malaise, physical, psychological or social disorders and conditions and which derives from the fact that people feel unable to overcome the gap between what is expected from them and what they can provide." (Art. 3, paragraph 1). In everyday working activities this imbalance can occur when the employee feels unable to meet the demands of the job. Not all occurrences of stress on the workplace can be considered to have been caused by the work itself. Work-related stress may be caused by various factors in the working context and in the content of the work itself.

The assessment of work-related stress risk is an integral part of the risk assessment and is performed (as for all other risk factors) by the employer using the Prevention and Protection Service Manager (PPSM) with the help of the Company Physician, if any is appointed, and after hearing the with Occupational Safety Employee Representative (OSER).

Because of this it is necessary to indicate, prior to starting any work, the methodological path that allows a correct identification of work-related stress risk factors, as this identification will lay the foundations for planning and implementation of risk elimination (or risk mitigation if the former is not possible) measures. To this end, it is necessary to clarify that the necessary activities shall be implemented with the aim to include all employees, including managers and supervisors. The evaluation examines not just single employees but homogeneous groups (for example divided by tasks or other organisational subdivisions) that are exposed to risks of the same type according to an identification process that every employer can independently carry out according to the effective business organization (could be, for example, shift workers, employees in a specific sector or those carrying out the same job, etc).

Methodology

The evaluation consists of two steps: a necessary one (preliminary assessment); an optional one, to be activated in case the preliminary assessment reveals elements of work-related stress risk and the correction measures adopted by the employer as a result of the preliminary assessment have proven ineffective.

The preliminary assessment consists in the identification of objective and verifiable indicators (preferring, if at all possible, those quantifiable with figures), belonging at least to three distinct families: 
• Sentinel events such as: accident indexes; sick leave; turnover; measures, sanctions and reports by the Company Physician; specific, frequent formalised complaints from employees. The aforementioned events shall be assessed on the basis of homogeneous parameters identified internally within the company (e.g. trends over time of the accident indexed detected in the company).
• Work content factors such as: work environment and equipment; workloads and rhythms; working hours and shifts; distance (or closeness) between the skills of the workers and the professional requisites required.
• Work context factors such as: role in the organization, decision-making autonomy and control; interpersonal conflicts at work; career development and evolution; communication (e.g. uncertainty regarding the services requested).

In this first stage it is also possible to use checklists that are also applicable by the company staff entrusted with prevention tasks and duties; the checklists allow an objective, overall and, when possible, parametric assessment of the factors referred to in points I, II and III above. In relation to the assessment of the context and content factors mentioned above (points II and III of the list) it is necessary to consult the employees and/or the OSER. In larger companies it is also possible to consult a sample of workers (picked in a way that makes it representative). The choice of the modalities through which workers can be listened to and consulted is up to the employer and it also depends on the evaluation methodology adopted.

Where the preliminary assessment does not reveal elements of work-related stress risk that require use to corrective actions, the employer will be exclusively required to report it in the Risk Assessment Document and provide a monitoring plan. Otherwise, should the preliminary assessment actually identify elements of work-related stress risk that require use to corrective actions of various natures (technical, procedural, organisational, communication-based, training-related and so on). If the corrective actions are not effective then the Company shall move to the next step, the so-called in-depth assessment. The time and modalities of said step shall be set by the company when planning the corrective actions.

The in-depth assessment involves evaluating the subjective perception of employees, for example through different tools such as questionnaires, focus groups, semi-structured interviews focussing on the families of factors/indicators referred to in the above list. This stage obviously is aimed at the homogeneous groups of employees which have proven to be affected by the problems. In larger companies it is possible that this investigation stage be carried out through an adequately representative sample of employees. In companies with no more than 5 employees, in place of the aforementioned in-depth assessment tools, the employer may choose to use methods of assessment (e.g. meetings) that ensure the direct involvement of employees in finding solutions and verifying their effectiveness.

Transitional and final provisions

The date of December 31, 2010 from which the obligation established by article 28, paragraph 1-bis, of the legislative decree n. 81/2008 comes in force must be understood as the starting date of the evaluation activities according to the current methodological indications. The temporal planning of the aforementioned evaluation activities and the indication of the final deadline for the completion of said evaluations must be reported in the risk assessment document. The supervisory bodies, for the purposes of the adoption of the provisions for which they are responsible, shall take into account the effective date and time schedule referred to in the previous paragraph.

In order to verify the effectiveness of the methodology indicated herein, and also to evaluate the need for any integration thereto, the Advisory Commission will draw up a report within 24 months from the publishing of these methodological indications, following the monitoring of the activities on the activities carried out. The procedures for implementing this monitoring will be defined by the Advisory Commission.

Employers who, at the date of approval of these indications have already evaluated the work-related stress risk consistently with the contents of the European Agreement of October 8 2004, in the version approved by the Inter-Association Agreement of June 9, 2008 - shall not repeat any assessment but shall only update it in the cases provided for by art. 29, paragraph 3, of the legislative decree no. 81/2008, according to the provisions in this document.


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