The workplace, especially in industrialized countries, has become increasingly a world of white-collar workers. For example, in the United States in 1994, white-collar work was done by 57.9% of the workforce, and service occupations accounted for 13.7% of the workforce. The professional occupations have moved from the fourth to the third largest occupational group (AFL-CIO 1995). Table 1 lists standard professional jobs according to the International Standard Classification of Occupations (ISCO-88). White-collar membership in national unions and organizations has grown from 24% in 1973 to 45% in 1993 (AFL-CIO 1995). Professional, managerial and technical occupational employment is expected to grow faster than average.
Table 1. Standard professional jobs
Physicists, chemists and related professionals
Physicists and astronomers
Geologists and geophysicists
Mathematicians, statisticians and related professionals
Mathematicians and related professionals
Computer systems designers and analysts
Other computing professionals
Architects, engineers and related professionals
Architects, town and traffic planners
Electronics and telecommunications engineers
Mining engineers, metallurgists and related professionals
Cartographers and surveyors
Other architects and engineers
Life science and health professionals
Biologists, zoologists and related professionals
Pharmacologists, pathologists and related professionals
Agronomists and related professionals
Health professionals (except nursing)
Other health professionals
Nursing and midwifery professionals
College, university and higher education teaching professionals
Secondary education teaching professionals
Primary and pre-primary education teaching professionals
Special education teaching professionals
Other teaching professionals
Education methods specialists
Personnel and career professionals
Other business professionals
Other legal professionals
Archivists, librarians and related information professionals
Archivists and curators
Librarians and related professionals
Social science and related professionals
Sociologists, anthropologists and related professionals
Philosophers, historians and political scientists
Philologists, translators and interpreters
Social work professionals
Writers and creative or performing artists
Authors, journalists and other writers
Sculptors, painters and related artists
Composers, musicians and singers
Choreographers and dancers
Film, stage and related actors and directors
Source: ILO 1990a.
One characteristic of professional office staff and managers is that their work function may require decision-making and responsibility for the work of others. Some managers or professional staff (for example, engineers, nurse administrators or social workers) may be located in industry and experience industrial hazards shared with the line staff. Others with managerial and executive functions work in buildings and offices remote from the industry itself. Both groups of administrative workers have risk from the hazards of office work: occupational stress, poor indoor air quality, chemical and biological agents, repetitive strain injuries (RSIs), fire safety concerns, sexual harassment and violence or assault in the workplace. See also the article “Offices: A hazard summary” in this chapter.
In a study of executive “hardiness” in the 1970s, not enough women could be found in executive positions to be included in the study (Maddi and Kobasa 1984). In the 1990s, women and minorities have had increasing representation in positions of authority, professional jobs and non-traditional jobs. However, a “glass ceiling” clusters most women in the lower levels of the organizational hierarchy: only 2% of senior management positions are held by women in the United States, for example.
As women enter traditionally male occupations, the question arises as to whether their experience in the workplace will result in an increase in coronary heart disease similar to that of men. In the past, women have been less reactive than men in stress hormone secretions when faced with the pressure to achieve. However, in studies of women in non-traditional roles (female engineering students, bus drivers and lawyers) a laboratory experiment showed that women had almost as sharp an increase in epinephrine secretion as men exposed to a difficult task, considerably higher than female clerical workers in traditional roles. A study of male and female managers in 1989 showed that both sexes had a heavy workload, time pressure, deadlines and responsibility for others. Women managers reported lack of communication at work and conflict between work and family as sources of stress, whereas male managers did not. Male managers reported the highest work satisfaction. The female managers were not found to have the support of a strong work network. Studies of professional women and their spouses showed child care responsibilities to be more heavily borne by women, with men shouldering chores with less time-specific demands, such as lawn care (Frankenhaeuser, Lundberg and Chesney 1991).
Although studies do not indicate that working leads to smoking, workplace stress is associated with increased smoking rates and difficulties in smoking cessation. In 1988, a higher rate of smoking was observed among female professionals as compared to male professional workers (Biener 1988). Smoking is a behavioural style of coping with stress. For example, nurses who smoked cigarettes reported higher levels of job stress than non-smoking nurses. In the Women and Health study, salaried workers were more likely to report job strain (45%) than hourly wage workers (31%), and more difficulty unwinding after work (57%) than hourly workers (35%) (Tagliacozzo and Vaughn 1982).
International changes have caused political and social restructuring that lead to large numbers of people emigrating from their country of birth. Workplace adaptation to minority groups results in more diverse workers represented in managerial positions. Implications of these changes include human factor analyses, personnel policies and diversity education. Ergonomic changes may be needed to accommodate diverse body types and sizes. Cultures may clash; for example, values regarding high productivity or time management may vary among nations. Sensitivity to such cultural differences is taught more often today as a global economy is envisioned (Marsella 1994).
New Structures of Work Organization
An increase in the use of participative techniques for input and governance of organizations, such as joint labour-management committees and quality improvement programmes, have changed the typical hierarchical structures of some organizations. As a result, role ambiguity and new skill requirements are frequently mentioned as stressors for those in managerial positions.
If the condition of managerial and supervisory work remains challenging, then the high stress/low illness individual can be described as a “hardy executive”. Such executives have been characterized as being committed to various parts of their lives (e.g., family, work, interpersonal relationships), as feeling a greater sense of control over what occurs in their lives and as regarding challenge in a positive mode. If stressful life events (e.g., staff reductions) can debilitate a worker, the model of hardiness provides a buffering or protective effect. For example, during periods of organizational change, efforts to maintain a feeling of control among workers could include increased clarity in work activities and job descriptions, and perceptions of the change as having possibilities, rather than as a loss (Maddi and Kobasa 1984).
Change in Workplace Technology
Work has altered so that in addition to the mental skills required of the professional, technological expertise is expected. The use of the computer, fax, telephone and video-conferencing, electronic mail, audio-visual presentations and other new technology has both changed the function of many managers and created ergonomic and other hazards associated with the machines which assist these functions. The term techno-stress has been coined to describe the impact of the introduction of new information technologies. In 1991 for the first time in history, US companies spent more on computing and communications hardware than on industrial, mining, farm and construction machines.
Computers affect how professional work and work processes are organized today. Such effects can include eye strain, headaches, and other VDU effects. The World Health Organization (WHO) in 1989 reported that psychological and sociological factors are at least as important as physical ergonomics in working with computers. Unintended consequences of computer use include the isolation of the computer operator, and the increase in working with computers in remote locations using high-speed modems. (See also the article “Telework” in this chapter.)
A well-known hazard is that of occupational stress, now linked to physiological outcomes, especially cardiovascular diseases. Stress is discussed extensively in several chapters in this Encyclopaedia.
A Swedish study of professional telecommunication engineers suggests that most studies of stress, which have usually been based on low- and medium-skill jobs, are not applicable to skilled professionals. In this study, three stress-reduction interventions were applied to the professional workforce with the following beneficial results: a feeling of being in control of one’s own work (thought to protect against high mental strain work); a lessening of mental strain; a lasting effect on social interactions and support; an improvement in elevated prolactin levels; a lessening of circulating thrombocytes (which may be a factor in stroke); and an improvement in cardiovascular risk indicators (Arnetz 1996).
As the human and financial costs of occupational stress have become known, many organizations have introduced initiatives that reduce stress and improve employee health in the workplace. Such interventions can focus on the individual (relaxation techniques and employee assistance programmes); on the individual-organizational interface (person-environment fit, participation and autonomy); or on the organization (organizational structures, training, selection and placement).
Managerial and professional workers are at risk for violence and assault because of their visibility and the possibility of adverse reactions to their decisions. Most commonly, violence and assault occur where money changes hands in retail settings or where troubled clients are seen. Workplaces at greatest risk for homicide (in descending order) are taxicab establishments, liquor stores, gas stations, detective services, justice and public order establishments, grocery stores, jewellery stores, hotels/motels, and eating/drinking places. Homicide in the workplace was the leading cause of occupational death for women, and the third leading cause of death for all workers in the United States from the mid-1980s to the mid-1990s (NIOSH 1993; Stout, Jenkins and Pizatella 1989).
Approximately 30 million people travelled from industrialized countries to developing countries in 1991, many of these business travellers. One-half of the travellers were US and Canadian residents, most commonly travelling to Mexico. European travellers were 40% of the total, with the majority visiting Africa and Asia. Health risks to international travellers occur when travelling to developing countries with high endemic rates of disease for which the traveller may have low levels of protective antibodies. An example is the hepatitis A virus (HAV), which is transmitted to 3 in 1,000 for the average traveller to developing countries and which increases to 20 in 1,000 people for those who travel to rural areas and were not careful with food and hygiene. Hepatitis A is a food- and water-borne disease. A vaccine is available that was introduced in Switzerland in 1992 and is recommended by the Advisory Committee on Immunization Practices for individuals travelling to areas with a high incidence of HAV (Perry 1996). Background and references for such hazards are provided elsewhere in this Encyclopaedia.
Other travel hazards include motor vehicle accidents (the highest rated cause of workplace fatality in the United States), jet lag due to diurnal disturbances, extended family absences, gastrointestinal disturbances, public transport accidents, crime, terrorism or violence. Traveller advisories for specific hazards are available from disease control agencies and embassies.
Health and Safety Interventions
Measure for the improvement of professional and managerial workers’ working conditions include the following:
- All managerial, supervisory and professional workers should be included in health and safety training on the worksite.
- Worksite smoking cessation programmes are appropriate as they are convenient, allow practice of cessation behaviours during working hours (when they are often most needed to cope with stressful events) and provide incentive to quit smoking.
- Stress- and time-management programmes lead to improved worker satisfaction and productivity.
- Diversity in the workplace will be commonplace in the coming century. Diversity training improves cross-cultural understanding.
- Female professional and managerial staff need workplace support for their demanding roles at home and in the workplace: family leave, support groups and increased opportunities for advancement and control over their work.
- Employee assistance programmes that are non-judgemental and confidential should be provided to all workers.
- Computer work hazards require organizational, environmental, equipment and training emphasis, as well as engineering improvements in workstation, monitor and remote worksite designs.
- Travellers need time to reorient to other time zones and countries, updated health information to protect them, time off to provide for family needs and security protections.
- All workers need engineering, work practice and protective equipment controls to protect against violent acts and assaults by others. Training in personal and office protection should deal with prevention, personal protection, and post-assault help and counselling.