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[Tvoivozhd <tvoivozd AT infionline.net>]

It is hard to change the mindset of the past---loyalty to an employer 
and desire to do a good job.  But to keep your sanity and health you 
have to place your own welfare first.  That means viewing an employer as 
an easily-dispensed with commodity, as employers view you for at least 
the past couple decades---obscured of course by happyspeak.  So start 
looking for a better job the first day you show up in your new office.

And you've got to get away from your eight-to-five secretarial chair and 
staring at a monitor for all that time---the combination of continual 
stress and physical inactivity will put you in the hospital or the 
morgue at an early age.

If you can do it, a home business is your best option.  As your own boss 
you may demand an eighty hour week, but you won't fire you and you have 
control over the conditions of work.  You want a thousand customers as 
your other boss, not one that is totally indifferent to your welfare.


The New York Times
------------------------------------------------------------------------


         September 5, 2004

*SICK OF WORK*


   Always on the Job, Employees Pay With Health

*By JOHN SCHWARTZ*

American workers are stressed out, and in an unforgiving economy, they 
are becoming more so every day.

Sixty-two percent say their workload has increased over the last six 
months; 53 percent say work leaves them "overtired and overwhelmed."

Even at home, in the soccer bleachers or at the Labor Day picnic, 
workers are never really off the clock, bound to BlackBerries, 
cellphones and laptops. Add iffy job security, rising health care costs, 
ailing pension plans and the fear that a financial setback could put 
mortgage payments out of reach, and the office has become, for many, an 
echo chamber of angst.

It is enough to make workers sick - and it does.

Decades of research have linked stress to everything from heart attacks 
and stroke to diabetes and a weakened immune system. Now, however, 
researchers are connecting the dots, finding that the growing stress and 
uncertainty of the office have a measurable impact on workers' health 
and, by extension, on companies' bottom lines.

Workplace stress costs the nation more than $300 billion each year in 
health care, missed work and the stress-reduction industry that has 
grown up to soothe workers and keep production high, according to 
estimates by the American Institute of Stress in New York. And workers 
who report that they are stressed, said Steven L. Sauter, chief of the 
Organizational Science and Human Factors Branch of the National 
Institute for Occupational Safety and Health, incur health care costs 
that are 46 percent higher, or an average of $600 more per person, than 
other employees.

"The costs are significant," Dr. Sauter said, adding, "Those are just 
the costs to the organization, and not the burden to individuals and to 
society."

American workers are not the only ones grappling with escalating stress 
and ever greater job demands. European companies are changing 
once-generous vacation policies, and stress-related illnesses cost 
England 13 million working days each year, one British health official 
said.

"It's an issue everywhere you go in the world," said Dr. Guy Standing, 
the lead author of "Economic Security for a Better World," a new report 
from the International Labor Office, an agency of the United Nations.

White-collar workers are particularly at risk, Dr. Standing said, 
because "we tend to take our work home."

Most stress-related health problems are a far cry from the phenomenon 
known in Japan as karoshi, or "death from overwork." But downsizing, 
rapid business expansion, outsourcing - trends that some have credited 
with increasing the nation's economic health - translate into increases 
in sick days, hospitalization, the risk of heart attack and a host of 
other stress-related problems, researchers find.

The changing workplace, said Hugo Westerlund, a researcher at the 
National Institute for Psychosocial Medicine in Stockholm, "does pose a 
threat to people's health."

Growth of the Untraditional Job

The days when an employer said "if you do your job, you'll have a job" 
are long gone.

The traditional career, progressing step by step through the corridors 
of one or two institutions, "is finished," said Dr. Richard Sennett, a 
sociologist at New York University. He has calculated that a young 
American today with at least two years of college can expect to change 
jobs at least 11 times before retirement.

Business has moved away from traditional employment, now an almost 
quaint concept described in a recent RAND Corporation study as 
"full-time jobs of indefinite duration at a facility owned or rented by 
the employer."

Instead, that study found, one in every four workers in the United 
States is "in some nontraditional employment relationship," including 
part-time work and self-employment. Four out of 10 Americans now work 
"mostly at nonstandard time," according to figures cited by Harriet 
Presser of the University of Maryland. The odd hours include evenings, 
nights, rotating shifts and weekends to meet the demands of global 
supply chains and customers in every time zone.

These jobs require an increasing amount of time as well. Workers in the 
United States already put in more than 1,800 hours on the job a year: 
350 hours more than the Germans and slightly more than the Japanese, 
according to the International Labor Office.

Nonwork hours have also been increasingly invaded by technologies that 
act like a virtual leash.

"The distinction between work and nonwork time is getting fuzzier all 
the time," said Donald I. Tepas, professor emeritus of industrial 
psychology at the University of Connecticut, who has studied the health 
and safety effects of overwork and sleeplessness.

One result is an office culture where too much work is not enough.

And while some workers thrive in the changing workplace, others find 
their workplaces ruled by what one expert, Joanne B. Ciulla of the 
University of Richmond, calls "the work ethic of fear."

More than 30 percent of workers say they are "always" or "often" under 
stress at work, according to the National Opinion Research Center at the 
University of Chicago, and a quarter of those surveyed in 2002 said 
there often were not enough co-workers to get the job done.

Other surveys show no end in sight. In a new report, Kronos Inc., a 
human resources firm, found that 62 percent of American workers said 
that their job activities and responsibilities had increased over the 
past six months and that they had not used all of their allotted 
vacation time in the past year. And 60 percent of those surveyed said 
they did not expect any respite from increased working hours in the next 
six months.

Little wonder, then, that Dr. Richard A. Chaifetz, chief executive of 
ComPsych, the largest provider of employee assistance programs, said 
"the stress levels today are clearly higher than they were a few years 
ago."

The strain of working in an uncertain economic world weighed heavily on 
Sergey Shevchuk, a former programmer for financial services companies. 
He said he was caught in an emotional vise while the companies tried to 
weather the post-2000 stock slump by purging the ranks and looking 
toward cheaper labor through outsourcing.

"I was depressed and getting easily sick very often," he recalled. "I 
was coming home empty."

Mr. Shevchuk has since left the world of programming, where his work 
could bring $135,000 a year, and started Distinct Construction Service, 
a home contracting business in Fairlawn, N.J.

Diane Knorr, a former dot-com executive, said she believed that the 
stress of her job contributed to persistent stomach pain and 
sleeplessness. At first, she said, the feeling of being on call at all 
hours was exciting.

"The first time I got a call way after hours from a senior manager, I 
remember being really flattered" and thinking, "Wow! I'm really getting 
up there now."

But gradually, her work and family life became a blur with hours that 
were hard to scale back.

"If I leave at 5 and everyone else leaves at 6:30, I might look like the 
one who is not pulling his weight," she said.

In college, Ms. Knorr set a goal of making a six-figure salary by the 
time she was 49. She reached it at 35, and "nothing happened; no 
balloons dropped," she said. "That's when I really became aware of that 
hollow feeling."

A doctor suggested that she begin taking an antidepressant for the 
stomach pain, "which struck me as bizarre," she said.

The doctor described it as a treatment to increase the amount of 
serotonin in the digestive tract, but Ms. Knorr said she now realized he 
might have been giving her a subtle message about her own level of 
anxiety and depression. She eventually quit her job, and used her 
savings to start a nonprofit group, Wonder Inc., which provides mentors 
and activities for foster children.

Work can be seductive, said Dr. Arlie Hochschild, a sociologist at the 
University of California, Berkeley. One in five of the people she 
interviewed in the course of research for her book "The Time Bind" said 
the rewards of work could actually become stronger than the comforts of 
home, so "home became work, and work became home."

Dr. Hochschild warns of "the splintered self," a state of constant 
distraction, doing one thing and expecting another.

"It's not just time" that is lost, she said, "it's basically attention: 
what we give to one another."

Stress Equals Illness

Researchers are beginning to document the toll that the changing nature 
of work takes on health. The National Institute for Occupational Safety 
and Health, which has studied the links for decades, began a major 
initiative two years ago to study "the changing organization of work" 
and has worked with the American Psychological Association to build up 
the field of occupational health psychology at a dozen academic 
institutions nationwide.

Downsizing, studies find, is associated with poorer health, whether 
workers are fired or survive the downsizing and continue in their jobs.

Pioneering studies in Scandinavia, where centralized health care allows 
researchers access to vast databases of medical conditions and 
treatment, also have shown a strong link between downsizing and illness. 
A study by Finnish researchers published in February in the British 
Medical Journal, for example, found the risk of dying from a heart 
attack doubled among permanent employees after a major round of 
downsizing, with the risk growing to five times normal after four years.

Two other studies, led by Dr. Westerlund, the Swedish researcher, 
suggest that other forms of strain in the workplace can also affect 
health. An analysis of medical records for 24,036 Swedish workers from 
1991 to 1996 found that in workplaces that underwent large-scale 
expansions, the workers were 7 percent more likely to take sick leave of 
90 days or more and 9 percent more likely to enter a hospital for some 
reason.

Health risks rose if the expansion, defined in the study as more than 18 
percent annual job growth, continued year after year, he said. Employees 
in companies experiencing moderate growth, on the other hand, were 
slightly less likely to take extended leave, perhaps because the growth 
rate was more manageable.

One explanation for why expansion might lead to poor health, Dr. 
Westerlund said, is that it often involves tumult: in some cases, 
offices expand when the parent company centralizes operations or merges 
offices through downsizing.

In another study, Dr. Westerlund and colleagues gave a series of medical 
tests to 3,904 white-collar employees working in stable businesses and 
workers in other companies in various states of stressful transition, 
including reorganization, downsizing and outsourcing, in some cases 
because the companies were threatened by the difficulties of competing 
in a global marketplace.

The workers in organizations that were in transition had 
higher-than-average levels of cholesterol, high blood pressure and other 
biochemical markers of heart disease risk, the researchers found.

"All forms of structural insecurity or instability may pose risks for 
the health of the employees," Dr. Westerlund and his colleagues wrote, 
"although the mechanisms may vary."

One result of this uncertainty, experts say, is that employees are 
increasingly turning to medication like antidepressants and anti-anxiety 
drugs to help them cope with the added pressures.

"Medication has, for some people, become a coping mechanism to help them 
feel better so they can perform better," Dr. Chaifetz of ComPsych said.

Some researchers are trying to tease out the types of stress that are 
most detrimental to workers. In a large study conducted in the 1990's, 
Dr. David M. Almeida, a developmental psychologist and associate 
professor of human development and family studies at Penn State, 
interviewed 1,500 people, asking about their "daily hassles" and 
"chronic stressors" at work and at home over a period of eight days.

Different types of stress produced different reactions, Dr. Almeida 
found. Tension with co-workers and overbearing bosses was more likely to 
lead to psychological and physical health symptoms, he said, while 
deadline pressure could actually "make you feel masterful."

Central to understanding how much stress the workers experienced, he 
said, was whether they felt in control. Citing research by Robert A. 
Karasek of the University of Massachusetts and colleagues, he said 
workers who felt that they had a measure of control over their 
environment were far less likely to find work stressful than those who 
felt utterly at the mercy of a capricious boss, a child's illness or a 
lurching economy.

That combination effect is well known to psychiatrists like Jeffrey P. 
Kahn, president of WorkPsych Associates, a consulting firm in New York. 
"Stress at home plus stress at work doesn't equal two units" of stress, 
he said. "It equals five."

Dr. Almeida is now starting a second round of surveys, with an 
additional biological dimension: the interviews about daily stress 
levels will be augmented with a twice-a-day self-administered test for 
levels of a stress hormone, cortisol.

The physiological changes associated with stress are part of a complex 
system that once saved the lives of human ancestors, warning them of 
danger, said Dr. Bruce S. McEwen, director of the neuroendocrinology 
laboratory at Rockefeller University. The quick flood of hormones like 
adrenaline and cortisol pump up the body for fight or flight.

"We wouldn't do very well without our stress hormones," he said.

But human physiology, Dr. McEwen said, was not intended to handle the 
chronic stress that is an inescapable accompaniment of modern life. The 
wear and tear of long hours, ringing phones, uncertain working 
conditions and family demands lead to what he calls "allostatic load," a 
stress switch stuck in the half-on position. The result: fatigue, 
frustration, anger and burnout.

Dr. McEwen and other stress researchers have linked persistent stress to 
a variety of conditions, including obesity, impaired memory, suppressed 
immune function and hardening of the arteries.

What is more, chronic stress contributes to behavior that makes it 
harder to recover, he said. For example, sleep deprivation may increase 
hunger, causing a stressed-out worker to seek comfort in a midnight bowl 
of pasta or a nightcap, which can lead to further weight gain or 
cardiovascular troubles.

Researchers are also finding links between stress and disease at the 
molecular level. At Ohio State University, for example, Dr. Ronald 
Glaser, a viral immunologist, and his wife, Dr. Janice Kiecolt-Glaser, a 
psychologist, are reaching across disciplines to understand how stress 
causes illness.

Working with other researchers at Ohio State, they have studied the 
immune response of people who live with an enormous burden of stress: 
people who care for a spouse who is suffering from Alzheimer's disease, 
and who are, on average, 70 years old. The immune systems of the 
caregivers are clearly compromised, they found.

"What we know about stress is that it's probably even worse than we 
thought," Dr. Kiecolt-Glaser said.

Their most recent work focuses on cytokines, molecules produced by white 
blood cells, and in particular interleukin 6, which plays a beneficial 
role in cell communication. Like cortisol and adrenaline, interleukin 6 
can damage the body in large and persistent doses, slowing the return to 
normal after stressful events. It has been linked to conditions that 
include arthritis, cardiovascular disease, delayed healing and cancer, 
Dr. Glaser said.

The immune systems of the highly stressed subjects, Dr. Glaser said, 
"had the levels of Il-6 that we saw in the controls that were 90 years 
old," which suggests that their experiences "seemed to be aging the 
immune system" drastically.

These results might be especially important for older workers.

"If you're 50 years old and you hate your job, you're going to be 
stressed; that probably translates into immune changes," he said.

Stressful working conditions can have more indirect effects, worsening 
illnesses that are already present.

Libbi Lepow, who lives in Kensington, Calif., worked at a dot-com that 
epitomized the 24/7 lifestyle. Her days, she said, were dominated by 
"action junkies," who she said lived on adrenaline.

"There has to be a crisis, or these folks feel that they aren't doing 
anything," she said.

Before long, Ms. Lepow said she was gaining weight and getting by on 
junk food and soda.

By March 2001, the combination of stress, lack of sleep and poor 
nutrition apparently contributed to a flare-up of multiple sclerosis, a 
condition that she had lived with at a low level for years.

The company, she said, was "very kind to me," and allowed her to 
continue working from home, but work continued to affect her.

"I never took a nap without the two phones in the room," she said, and 
people called constantly. "It was still exhausting," she said. She 
resigned in June 2002 and now lives on disability.

The Benefits of Slowing Down

Recognizing workplace stress might be as simple as counting the broken 
pencils on a desk, but doing something about it is harder.

"We cannot stop change," Dr. Westerlund said, although it may be 
possible to "help the people cope with the environment."

The advice that most experts offer is deceptively simple: Dr. McEwen, 
for example, recommends getting enough sleep, avoiding cigarettes and 
alcohol, eating sensibly and exercising.

Emotional support can also make a difference, Dr. Kiecolt-Glaser said.

By "overworking, not spending time with family and friends, you're 
limiting the things that are most likely to do you good," she said.

Career consultants tell clients to examine the degree to which they 
themselves are the ones cracking the whip.

"Consider the possibility that you are colluding in your own demise," 
said Rayona Sharpnack, founder of the Institute for Women's Leadership 
in Redwood City, Calif. "Suffering," she said, "is optional."

Ms. Lepow, whose work stress contributed to her disability, calls her 
illness "a kind of gift," because without it, she said, "I could have 
lived my whole life without stopping."

She recalled striding across her deck to her home office without ever 
taking in the view.

"It took something like this disease to make me stop and slow down," she 
said.


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