Working in a stressful environment can shorten your life — workplace wellness programs

Highlights:

• Work-related stress negatively impacts the lifespan due to exposure to continuous stress, increasing the likelihood of developing age-related physiological and psychological illnesses
• Occupational stress speeds the process of biological aging by promoting accelerated telomere shortening and methylation cycle alteration
• There are approaches that can be implemented by both the employer and the employee to reduce and avoid the effects of stress
• Wearable devices can be used to detect stress and help decide which intervention is a priority

Introduction

Adult late-life survival and lifespan are determined by many factors that individuals experience throughout their lives. One of these factors that play a role in the lifespan equation is work and related stress. This factor is important considering the amount of time adults spend working, leading to continuous exposure to stress for prolonged periods of time. Research has highlighted that work-related stress is associated with conditions like coronary heart diseases, strokes, depression, anxiety, and other disorders. All these conditions are associated with an increased risk of early death, therefore, reduced lifespan.

Why does occupational stress reduce lifespan?

Research explains that work-related stress contributes to reduced longevity by means of a concept called “allostatic load". This concept explains that prolonged, continuous exposure to stress (chronic stress) leads to activation of the stress response (1). The constant activation of the fight or flight response is suggested to cause endocrinal and biochemical changes that accelerate biological aging by inducing rapid telomere shortening (1, 2). With time, this continuous exposure leads to a diminished capacity to cope with stress, causing a more substantial reaction that translates into accelerated aging (3). In a study by Nilsen et al. that followed 221 participants, the impact of stress on mortality was measured (1). Results of their study revealed that high-stress jobs resulted in a three times higher death rate compared to low strain jobs, which had about 40% lower mortality rate. In addition, the investigators found that low job control translates into increased mortality. The authors concluded that modifying work-related stress may contribute to better health and longer lives (1). In another study, Ahola et al. found that individuals with work-related exhaustion had an accelerated biological aging process measured through telomere length compared to those without occupational fatigue (2).

Factors influencing work-related stress

Numerous elements have been found to influence work-related stress. These factors were categorized into those related to work context and those that pertain to work content (4). Factors related to work context include organizational culture and function, career development, decision control, home-work balance, and other factors. These factors focus on how poor pay, career stagnation, inadequate communication, little to no career development, job insecurity, lack of control over the workflow, and insufficient work-life balance stress individuals and their families, leading to increased mortality and reduced lifespan (4, 5). This has been validated by a systematic review that attributed work-related stress as a factor that increases the risk of and plays a role in the early development of age-related disorders, like coronary heart diseases (6).

Regarding factors related to work content, they include the work environment, equipment, workload, and schedule (4). Examples of stressors within this context include the lack of suitable facilities that accommodate staff, poor utilization of skills, high work volume in the form of multiple tasks at the same time, consistent deadline pressures, long, unsocial work hours, and others. Together, these factors and personal characteristics might augment the effect of work-related stress and result in increased mortality (4, 7).

Stressors at work lead people to develop stress reactions, including psychological, physiological, cognitive, and behavioral reactions (4, 8, 9). Examples of responses to these reactions include elevated pulse pressure, high blood pressure, poor concentration, anxiety and depression, smoking, coffee abuse, nervous laugh, poor dietary choices, drug abuse, hormonal disbalances and others (10).

What can be done to reduce occupational mental stress?

In addition to contributing to accelerated biological aging, work-related mental stress plays a role in work absenteeism and lost productivity (2, 11). It translates into negative economic implications for the employer and the overall economy. According to research, there are solutions that can be implemented by the employer and others by the employee to relieve occupational stress (11). For example, the employer can take a proactive approach to screen causes of work stress, initiate steps to prevent it from occurring, mitigate its effects if it happens, and provide stress management intervention at the workplace. Examples of interventions that could be provided to the employee include flexible work schedules and intermediaries and consultants that the person can refer to in case of feeling stressed (11). Regarding employee intervention, the American Psychological Association recommends that people manage stress by tracking it through using a journal and developing healthy responses to stressful situations instead of reverting to behaviors like stress-eating or alcohol (12). In addition, employees should incorporate activities like yoga, deep breathing techniques, or meditation in their daily routine. Also, having a goodnight's sleep, taking some time off when needed, managing time, and discussing negative situations help reduce stress (12).

Technological advances have allowed the development of wearable devices that help detect stress under different situations, one of which is work. Han et al. were able to detect work-related stress using such technology (13). They utilized the features of electrocardiogram and respiration to detect and classify stress. Results of their study highlighted that employing such a device yielded a 94% accuracy in detecting stress (13). This highlights how technology can be utilized to improve the well-being of employees and prevent work stress before it negatively affects the health and longevity of people. These results are supported by further studies, which showed that mental stress could also be monitored through detecting heart rate variability (HRV) because the latter parameter is affected by the mental status (14). The accuracy of HRV measurement by commercial devices, like the Oura ring, has been tested in trial settings (15). Results highlighted that HRV measurements obtained by the Oura ring were comparable to those of standard electrocardiogram measurement. In addition to the previous, other devices, like Apollo Neuro, help the wearer address stress by balancing the nervous system response. This highlights how technology can be utilized to improve the well-being of employees and prevent work stress before it negatively affects the health and longevity of people.

Examples of companies setting plans to mitigate the effects of work-related stress

It is no surprise that the COVID-19 pandemic has changed the way business is conducted. Due to quarantine measures, many employees found themselves working remotely (16). This work setting seemed to be promising at first, but as lockdowns extended, many employees found themselves suffering from mental burnout. The latter is perhaps attributed to dissolved boundaries between when the work starts and when it should end, leading to an unbalanced work-life outcome.

Google is a global provider of internet-based services that has taken notice of employee burnout and placed solutions to help tackle the issue. For example, the company promotes mindfulness practices and has set up classes for employees, like mediation sessions (17). In addition, the company has created virtual and in-person communities that encourage meditation practice. With regard to remote settings, they have implemented measures like “reset” days, in which employees get extra days off of work (18).

Similarly, companies like Microsoft have also noticed the rise in work-related stress, as the company polls showed a drop of 13% in employee satisfaction with work-life balance (19). In addition, the company noticed that during the pandemic, employees spent twice as much time in meetings and that work continued after the business day had ended. Their analysis revealed that employees who had more focus time and fewer distractions during work hours were less stressed and had better work-life balance. Additionally, the company analysts pointed out simple solutions that improved productivity and reduced burnout. For example, utilizing allotted vacations to rest and recharge, taking breaks in between meetings and collaboration sessions, and defining work schedules and hours.  

Why is it important to mitigate the impact of work-related stress?

Workplace stress poses a significant burden to the economy. A recent systematic review has found that the cost of work-related stress is estimated to be as high as $187 billion (20). The majority of the aforementioned costs were attributed to reduced productivity (70-90%), while the rest constituted the medical expenses.

Small investments in employee wellness could offset such a financial burden. For example, a study by Wijnen et al. found that investing as little as €50 in employee wellness led to net benefits mounted to €2981 on average for the employer (11). This equates to almost 60-fold benefit for the company. These results were further substantiated by evidence from a meta-analysis that found investing in workplace disease prevention and wellness programs reduced the medical costs by about $3.27 for every dollar spent on wellness programs (21).

Tips

• Recommend your patients/clients maintain physical exercise during the day to help them reduce stress. In addition, help them find when/how to do physical activity in the long run.
• Mention to your patient/client the importance of setting realistic productivity goals with their employer.
• Highlight the importance of avoiding unhealthy diets (time and ingredients), as they contribute to worsening the effect of stress.
• Advise your patients/clients to incorporate approaches like meditation to help them cope with stress. Highlight to them that starting simple is the best way to ensure success. As little as 5 minutes daily is a great start.
• Highlight the importance of pointing out stressful incidents or factors in their daily work and encourage them to discuss them with their employers to find a suitable solution.
• Tell your patients/clients about the importance of maintaining a restful night's sleep (usually decreases when stressed) because the reduced sleep quality can affect their work and negatively influence their lifespan. In addition, evaluate the usefulness of nutraceutical aids like melatonin, L-theanine, bioactive milk peptides, and others.
• Ensure that your patients/clients understand the job roles they apply to and encourage them to ask questions related to personal and professional development and work-life balance.
• Encourage people to use wearable devices with HRV and stress-detecting features to help them address the situation before it negatively affects their health and lifespan.
• Advise your patients/clients to take proactive steps to plan their day upon waking up in the morning. Tell them to avoid picking up the phone (set it to silent) and responding to emails or other life demands. This will help them manage their stress because they will be in control of their life instead of reacting.
• Help your patients/clients identify sources of undiagnosed stress, like dysbiosis and neurotransmitter imbalances.

Conclusions

Work-related stress is an important contributor to lifespan and mortality. Research has highlighted that mental stress and long work hours increase mortality by about 20% (7, 22). In this context, evidence from multiple studies revealed that occupational stress accelerates epigenetic aging and telomere shortening, all of which contribute to reduced longevity (2, 23). To mitigate the effect of work-related stress on people's lifespan, the employer can put certain procedures in place. Examples like the ones mentioned in the article can be implemented by various employers, as their cost of implementation is low, and the benefits exceed the costs (11). Additionally, people can reduce the negative influence of stress by applying certain physical and dietary modifications. Technology can also be utilized in this area and help identify and address the stress factors before they translate into a physiological or mental issue.

References:

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2.            Ahola K, Sirén I, Kivimäki M, Ripatti S, Aromaa A, Lönnqvist J, et al. Work-related exhaustion and telomere length: a population-based study. PLoS One. 2012;7(7):e40186.

3.            Ford MT, Matthews RA, Wooldridge JD, Mishra V, Kakar UM, Strahan SR. How do occupational stressor-strain effects vary with time? A review and meta-analysis of the relevance of time lags in longitudinal studies. Work & Stress. 2014;28(1):9-30.

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