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WHO Classifies Burnout as Occupational Phenomenon

The World Health Organization (WHO) has officially recognized workplace burnout as an occupational phenomenon in the latest version of its “International Classification of Diseases” (ICD). This official designation indicates how serious workplace burnout and stress are as an impediment to a healthy, productive work environment, and how important it is for employers to take concrete steps to address it.

Since 1948, the WHO has published the ICD, which “defines the universe of diseases, disorders, injuries and other related health conditions, listed in a comprehensive, hierarchical fashion.” The last published version of the ICD defines “burnout” as a “state of vital exhaustion,” but the forthcoming edition has updated that definition, clarifying that it is a condition that occurs specifically in the workplace.

The new definition includes: “Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. … Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.

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” The three factors the WHO identifies for classifying burnout are:

  1. Feelings of energy depletion or exhaustion,
  2. Increased mental distance from one’s job, or feelings of negativism or cynicism to one’s job, and
  3. Reduced professional efficacy

According to a 2017 Gallup poll, 23% of U.S. employees “reported feeling burned out at work very often or always, while an additional 44% reported feeling burned out sometimes.” When workers suffer from burnout, it can have serious effects on business performance. A 2017 survey conducted by Kronos Incorporated and Future Workplace also noted that “95% of human resource leaders admit employee burnout is sabotaging workforce retention,” and “nearly half of HR leaders (46%) say employee burnout is responsible for up to half (20% to 50%, specifically) of their annual workforce turnover.” This means higher recruiting costs, additional time for other employees and managers involved in the recruitment and training processes, as well as potential business interruptions and lost institutional knowledge.

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Gallup also noted that employees experiencing burnout “are 63% more likely to take a sick day,” and alarmingly, “are 23% more likely to visit the emergency room.

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” Indeed, in 2015, the Harvard Business Review says that workplace stress caused additional physical and psychological healthcare spending between $125 and $190 billion annually in the United States. Given the rising costs of U.S. healthcare and increasing recognition and treatment related to burnout, it is likely that these numbers have only increased.

Gallup reports that the top five factors most highly correlated with burnout are:

  • Unfair treatment at work
  • Unmanageable workload
  • Lack of role clarity
  • Lack of communication and support from manager, and
  • Unreasonable time pressure

The American Psychological Association’s Center for Organizational Excellence has outlined the importance of communication to maintaining a psychologically healthy work environment, both bottom-up and top-down. The APA’s recommendations include “providing regular, on-going opportunities to provide feedback to management,” and “leading by example, by encouraging key organizational leaders to regularly participate in psychologically healthy workplace activities in ways that are visible to employees.” The organization also emphasizes work-life balance, noting that instituting policies like flexible work arrangements and assistance with childcare can provide “benefits in terms of increased productivity and reduction in absenteeism, presenteeism and employee turnover.”

When companies take workplace stress seriously, and implement processes to address burnout and create healthy work environments, they see happier workers, higher retention and greater productivity, as well as lower costs. The WHO officially acknowledging burnout as a serious workplace concern should be a wake-up call for employers.

New Fatigue Reports Awaken Employers to Injury Risks

The National Safety Council (NSC) estimates that roughly 13 percent of workplace injuries are attributable to sleep problems, causing an economic impact of $400 billion. NSC information suggests that employers with 1,000 employees could incur losses of more than $1 million per year in missed workdays, lower productivity and increased healthcare due to employee fatigue.

But rather than merely provide a bunch of statistics and projections that could put you to sleep, the NSC is providing possible solutions to combat the risk in its new report Managing Fatigue: Developing an Effective Fatigue Risk Management System

According to the report, a workplace culture that rewards or tolerates fatigue can indirectly lead to on-the-job injuries. In some high-performance cultures, employees may view fatigue as a sign of weakness or laziness. They may be committed to getting the work done despite long hours, even believing that fatigue doesn’t affect them.

“In our 24/7 world, too many employees are running on empty,” said Emily Whitcomb, NSC senior program manager for fatigue initiatives.

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“Employees are an organization’s greatest asset, and addressing fatigue in workplaces will help eliminate preventable deaths and injuries.”

Strong fatigue risk management systems blend employee education and training with improvements to workplace environments, culture change, and data-driven programs. But implementing a fatigue risk management system is not an easy sell — to the C-suite and possibly also to employees. The report suggests:

It is important that the fatigue management process be transparent and that appropriate information is shared throughout the effort to obtain buy-in from all levels of the organization. Providing open forums that allow employees to share how fatigue affects them is one way to get engagement from the outset.

The NSC lists key components in creating a fatigue risk management system:

  1. Education and training. This raises awareness of risks, create motivation to prioritize rest, and provide information on how to manage fatigue and get proper rest.
  2. Policies and practices. Clarify roles and expectations and institute policies and practices for hours of work and rest based on science that recognizes the physiological need for sleep and circadian rhythms.
  3. Shared responsibility. Employers and employees should cooperate when it comes to understanding the sleep needs of the employee, while the organization should expect output from a well-rested worker.   
  4. Fatigue mitigation. A workplace with positive environmental controls promotes better overall working conditions and should be less physically stressful in ways that contribute to on-the-job fatigue.
  5. Data-driven programs and continuous improvement. With the system in place, seek employee feedback, facilitate monitoring mechanisms, check the data and apply lessons learned. Understand why the system was or was not successful and modify from there.  

Complementary to Managing Fatigue, the Campbell Institute – the center for environmental health and safety (EHS) excellence at the NSC – released results from a pilot study conducted among renowned safety organizations to assess worker fatigue and effective countermeasures. In Understanding Fatigue Risk: Assessment and Countermeasuresthe Institute identifies a persistent gap between how employers and employees view fatigue and argue for changing a culture to enhance safety.

According to the study, about one-third of workers surveyed reported sleeping between one to five hours per weekday, and not the expert-recommended seven to nine hours.

“This indicates that a large proportion of workers at these sites are chronically sleep deprived, which when coupled with longer work days and work weeks than scheduled means that the risk of a fatigue-related injury is significantly increased,” the report said.

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Additional information about workplace fatigue is available at nsc.org/fatigue.

Fatigue in National News

The timing of these reports should be welcome news for employers. Earlier this month, the National Transportation Safety Board (NTSB) unveiled its 2019-2020 Most Wanted List of Transportation Safety Improvements. One of the 10 items included the need to “Reduce Fatigue-Related Accidents.”

The NTSB’s Open Safety Recommendations describes fatigue as “a pervasive problem in transportation that degrades a person’s ability to stay awake, alert, and attentive to the demands of safely controlling a vehicle, vessel, aircraft, or train.” There are currently 27 open recommendations for railroad, aviation, highway and marine operators in an effort to curb fatigue-related accidents.

“We do not simply come up with these recommendations based on a whim,” NTSB chairman Robert Sumwalt said during the list’s unveiling in Washington, D.C. “It’s a data-driven approach based on the results of our investigation and the tragic and senseless deaths we investigate.

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Follow-Through Needed for Effective Safety Culture

The concept of a culture of safety can be stalled by employers that say they want to be safer, but do little to implement real change.

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For example, a company hoping to understand the causes of fatigue, but won’t adjust its schedules, can set itself up for injuries and hazards.

A new report, Making a Safety Culture Truly Cultural, published by KPA, a risk management consultancy found that:

  • 90% of employers want to understand root causes of employees’ fatigue,
    but only 55% say they will adjust schedules or tasks.
  • 51% assign a night shift to an employee immediately before or after a day shift.
  • 60% that know rest is important lack a designated area for employees to do so.

“You may think a workplace fatality is unlikely, but put it into perspective,” the report says. “The Centers for Disease Control and Prevention estimate that a fatal injury could cost nearly $1 million. And the National Safety Council estimates the cost at $1.4 million. Also, factor-in the indirect costs of lost productivity, employee replacement, insurance and attorneys, and the cost jumps to $3 million on average.”

The study offers tips for employers trying to embed safety into their organizational DNA. It also explores how employers who invest time, funds and effort into reshaping their culture can save millions in structural and legal damages.

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The report puts safety under a microscope to discuss:

  • Its current state in U.S. workplace
  • Where it needs to change
  • How to create a new culture
  • Return on investment
  • How behavioral changes can be key to preventing injuries

The report features case reviews where employers were both proactive and reactive in their efforts to make their workplaces safer. Some were in conjunction with a 2015 OSHA initiative and included adding hands-free tools, re-engineering control systems and installing metal guards to prevent contact with moving machinery.

These actions caused small habit changes that contributed to the larger goal of creating a culture of safety, the report says. Even changing a bad habit such as slow reporting into prompt reporting has proven to reduce future injuries. Addressing one safety issue at a time rather than several concurrently, KPA contends, is the most effective sequence for reshaping a culture.

Habit loops and how cues within those loops translate into the workplace were also explored.

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“It’s hard to change habits, but we can fiddle around with the components of the habit loop,” KPA says. “When behaviors become good habits—part of our routine and organizational DNA—that is a clear sign of developing a true safety culture.”

The report is currently available to RIMS members. To download the report, visit the RIMS Risk Knowledge library at www.RIMS.org/RiskKnowledge. All downloads of this publication will be shared with the sponsor, KPA.

To learn about other RIMS publications, educational opportunities, conferences and resources, visit www.RIMS.org.