Healthy at Work

This chapter provides a brief introduction to the concepts of culture, particularly organizational culture; the latter emphasizes the meanings, orientations, and symbolism shared by people in organizational settings. We argue that many health issues can be productively conceptualized as cultural phenomena. Health is understood in a variety of ways in various societies, organizations, occupations, and other groups, with correspondingly varying implications for action. The cultural meanings of health guide the ways in which organizations, managers, and professionals try to influence people and improve how they deal with health issues. We discuss the expansion of the meaning of the term “health” and a change in its focus to include “right” attitude to work; these changes have resulted in “health” being incorporated into the sphere of well-being by managerial and professional regimes. Here it is important to consider both innocent well-intentioned activities and issues of power and control.

This chapter draws on an empirical study to describe the importance of context in the prevention of accidents and illness in the work-place. The empirical data are based on individual and group interviews with employers and employees of small and medium-sized enterprises as well as with occupational health and safety experts. The analysis shows that cultural aspects and internal communication processes have a major impact on how prevention is understood and implemented. The results can be condensed into the proposition that prevention may come into conflict with the practices that generate belonging in the work-place. Questions that arise from this include “Which communication processes and emotional meanings are realized with belonging?” and “How do these meanings interact with rules concerning prevention?” Further, it is suggested to describe the concept of belonging in terms of “stereotypes”, “degree of empathy”, “coherence”, and “continuity”. These considerations result in suggestions on how inhibiting and facilitating factors for illness prevention might be examined in future comprehensive studies of work-place interventions.

Confronted with progressively increasing demands for greater flexibility, organizations apply organizational and managerial practices that build on their employees’ self-organization and self-discipline, thereby increasing their employees’ control over achieving their everyday work tasks. Although these practices offer opportunities for personal growth and coordination of work and private life, the resultant demands for increasing autonomy and self-organization may overtax employees’ capacities, leading to stress. Furthermore, employees are increasingly reacting in ways that are self-exploitative and detrimental to their own health in response to large work-loads and strong demands for self-organization. This chapter introduces the concept of self-endangering work behavior; namely, behaviors that may be functional with regard to attaining work goals but dysfunctional with regard to health and long-term ability to work. We propose that self-endangering work behavior can be viewed as a form of coping reaction when workers are confronted with large work-loads and strong demands for self-organization. Based on the transactional stress model and regulation of behavior theory, we propose that self-endangering work behavior may mediate the effect of large work-loads and strong demands for self-organization on impaired well-being. We summarize empirical findings that confirm the detrimental role of self-endangering behaviors and their capacity to increase the detrimental effects of work demands. Finally, we discuss the benefit of assessing self-endangering behavior with the aim of taking preventive measures.

Work-places inherently contain various anxiety-provoking characteristics, including rivalries between colleagues, control issues with supervisors, demands for achievement, dangerous environments, and uncertainty concerning future developments. Work-related anxieties can present in various guises and include situational anxieties, social anxieties, anxiety about being inadequate or underachieving at work, health-related anxieties, or—in the worst case—complex work-place phobias. Work-related anxieties lead to problems with participation in work resulting in (long-term-) sick leave or even disability pensions. In 10 years of research on work-related anxieties, we have found that 30–60 % of individuals undergoing medical/vocational rehabilitation have work-related anxieties that often pose barriers to returning to work. Even 5 % of mentally healthy employees admit that they sometimes ask for a sick leave certificate when experiencing work-related anxieties. Future research on work-related mental health problems should not only focus on rehabilitation and treatment of work-related anxieties, but also earlier stages. The concept of work-related anxieties gives rise to ideas that can be useful for mental health-oriented job analysis, employee–work-place fit, and job design for employees with different psychological constitutions and capacities.

In Germany as well as in most Western industrialized countries, the work-force is rapidly “aging”. Modern companies therefore increasingly need to abandon established approaches to occupational safety and pursue preventive strategies to protect and restore well-being, work ability, and good health across the entire lifespan. Hence, effective occupational health management needs to encompass strategic work and career designs. In response to these challenges, an interdisciplinary group of researchers at the Jacobs Center on Lifelong Learning and Institutional Development of the Jacobs University Bremen has zoomed in on two concepts that have so far received little attention in research on occupational health management; namely, person–environment fit and work–task mobility. Person–environment fit refers to the fit between individuals (e.g., abilities, behaviors, goals, attitudes) and their work environments (e.g., job profile, demands, support structures, culture). Work–task mobility refers to careers involving repeated intra-organizational changes of work tasks at the same level of job complexity (no promotion or demotion). This chapter reports on two research projects, Demopass and Mobilis, that aim to investigate person–environment fit and work–task mobility, respectively, as two important tools for systemic and dynamic occupational health management in times of demographic change.

Keeping employees physically and psychologically healthy and thriving has increasingly become a challenge for organizations. Because poor health is associated with various negative consequences for the individual as well as at organizational level, researchers have started to investigate pathways for fostering, retaining, and restoring health and well-being in the work-place. Various studies underline the important role of leaders in creating work-place conditions that either positively or negatively influence employee health and well-being. In this chapter, we therefore differentiate between relationship-oriented and task-oriented leadership behaviors while providing an overview of the association between established leadership theories and indicators of employee health. Moreover, we focus on health-specific leadership styles, which are assumed to have a more direct effect on followers’ health than more general styles. We have assumed that health-focused leadership skills complement general leadership skills. Avenues for future research are discussed and practical conclusions provided.

We here present a management model developed by Spiess and Stadler. It is employers’ responsibility to protect the health of their employees, and employees’ well-being is a core resource for organizational success. Indeed, an organization cannot achieve long-term success without healthy employees. High-quality results can be achieved most effectively by healthy, motivated employees. Spiess’ and Stadler’s management model has four levels. The first, the heart of the model, is described as goal- and task-oriented management, in which leadership is defined as goal-oriented exertion of influence. The second level comprises staff-oriented management and support. The third level relates to the design of work and organizational processes, another important indicator of a good leadership culture. The fourth level refers to the creation of a health-promoting management and organizational culture. The consequences of using this model will be discussed.

Health-promotion in the work-place is becoming increasingly important in the face of rising absences caused by psychological issues. This chapter proposes health-promoting leadership as a means of improving employees’ well-being. Health-promoting leadership is defined as leadership behavior that provides job resources and limits high job demands and thus has the potential to increase followers’ well-being and motivation. Moreover, implications for the design of training programs with a focus on health-promoting leadership and guidelines for their successful implementation are presented.

Leadership behavior is an important factor for employee well-being. Research about occupational health promotion has shown that the support of managers is crucial to the success of measures for improving employee health and well-being. However, little interest has been paid to the psychological effects of dynamic environments on employee and management health. To address this gap, we will review publications concerning the interplay of environmental dynamism, employee uncertainty, leadership sensemaking, and employee well-being. We argue that change(s) in economic systems promotes personal uncertainty, which affects employee well-being. More specifically, we focus on leadership behaviors that diminish uncertainty in times of dynamic environments. In this chapter, we will describe two alternative routes for leadership influence on employee well-being and argue that environmental change has to be actively managed. Possible implications that can be derived from our concepts are: (1) that preserving employee well-being through leadership sensemaking in turbulent economic times could contribute to maximizing employee performance; and (2) that especially designed leadership trainings could provide organizations with means of dealing with employee uncertainty stemming from rapidly changing economic environments.

Because of various demographic changes, the health care sector is currently facing increasing demands and decreasing resources, which is leading to increasingly greater demands on nurses and compromises in patients’ quality of care. These upcoming changes as well as sector-specific frameworks are affecting leadership in the health care sector and resulting in certain requirements for leaders. As there is considerable evidence that leadership has a positive influence on employees’ health, it seems reasonable to take leaders into account when considering the increasing demands on nurses. Healthy leadership aims to support employees’ health and be an adequate instrument for health promotion in the work-place. In addition to a healthy leadership style, leaders have to consider the specific circumstances of the sector, mainly legal regulations and limited resources. New techniques for leadership development and implementation of health promotion in the work-place may be necessary to enable health care companies to combat these restrictions. This chapter gives an overview of current and future challenges in the health care sector and describes how leaders can address these challenges by having healthy leadership styles and taking sector-specific conditions into account.

The present article aims at showcasing how cooperation with important stakeholders and building linkages with key policy actors can increasingly bring safety and health to the forefront of the OSH agenda. Despite of the disease burden, it is unfortunately not yet well known amongst policy-makers that occupational skin diseases (OSD) are the most frequently recognized occupational diseases in Europe with a share of 35 % of all work-related illnesses. While recent studies have shown that preventive interdisciplinary intervention can significantly reduce the burden, there is still a lack of targeted preventive measures and coordinated efforts to improve options for risk assessment and specific dermatological interventions. Through awareness raising and building partnerships improvements can however be reached and lead to a win-win situation for all actors involved.

There is now considerable evidence that work is good for you. Positive effects include improved financial prosperity, social participation, self-esteem and improved physical and mental well-being. Overall, the benefits of work appear to outweigh the risks and to be much greater than the detrimental effects of prolonged sickness absence or long-term unemployment. Given the cost of sickness absence to business and that of worklessness to the tax-payer, there has been a drive in the UK to reform provision of welfare and occupational health (OH). Most health care within the UK is provided by the tax-funded National Health Service (NHS), free at the point of delivery. Historically, however, the NHS did not provide OH; rather, it was provided either as in-house OH services by larger organizations (public and private sector) or externally by specialist OH companies. Consequently, many small and medium-sized enterprises received no such services. The result has been patchy OH provision across the UK and a lack of a “joined-up approach”. This chapter describes the changing face of OH provision in the UK over recent years, using the OH service provided by GO Health Services, Grampian, as an exemplar model.

This chapter provides an insight into the research project InnoGema that has been undertaken at the University of Applied Science Berlin (Hochschule für Technik und Wirtschaft Berlin) since 2007. The overall goal of InnoGema is to develop a specific support structure for small and medium-sized enterprises (SME) with the aim of facilitating the implementation of sustainable occupational health management. The main concept of InnoGema and its network approach are outlined, as is the offline and online support being provided to SME by InnoGema’s supraregional service center. In addition, information about the expansion of the InnoGema network from Berlin to Brandenburg is presented.

The collaborative project Zukunft:Pflege seeks to promote long-term employability through the development of skills and competences, enhancing motivation and preserving the health of outpatient care workers. To this end, work process-related and organizational learning strategies for small- and medium-sized enterprises were drawn up and systematically linked together and enhanced by developing and mobilizing resources at a network level. This chapter deals with the coordination aspect of the Zukunft:Pflege network. This network comprises outpatient nursing, long-term care services, and so-called value partners such as continuing education providers and outpatient care associations in the Bremen region. In general, inter-organizational networks tend to waver between cooperation and competition. The primary objective of cooperation can be attained provided the coordinators succeed in promoting the development of human and relational potentials and ensuring relationships of trust. To this end, the network agency places emphasis on interactive learning processes among the network partners. Building on experiences from such cooperation, knowledge transfer via the network can be encouraged, potentials and expectations promoted, and the basis for cooperation further strengthened. The main functional focus of the network agency lies in coordination of the various interests of the network members, identification of synergy potentials and thence development of possible courses of action for promoting long-term employability in outpatient nursing and long-term care work.

Small and medium-sized enterprises (SMEs) in particular benefit from occupational health services because these may help to reduce the potential costs of accidents or illnesses at work, support staff retention and recruitment, and decrease wage costs. Nevertheless, SMEs, especially microenterprises (<10 persons employed), rarely offer these services to their employees. The innovation incubator’s project “Healthy at Work” offers research-based advice to private service units to support SMEs to provide occupational health services in the region of Luneburg. This chapter describes how we use an Adaptive Choice-Based Conjoint Analysis combined with a short willingness to pay (WTP) questionnaire to elicit SMEs’ preferences regarding occupational health services. We found that the optimal approach is to offer a comprehensive service package tailored to the needs of the individual company on a pay-per-use basis. The private supplier benefits from cooperation with a social insurance provider: either a health insurance fund or occupational accident insurer. Further, we found that employers are willing to pay for services. Within the group that is willing to pay, WTP increases with company size. It is therefore particularly important to offer appealing and affordable occupational health services to microenterprises, preferably in cooperation with social insurance providers.

In spite of a wide range of support measures for companies that should contribute to the implementation of the German occupational safety and health (OSH) law the number of companies fully complying with the core requirements of safety organization and risk assessment exceeds the number of companies running non-mandatory workplace health promotion programmes only moderately. This picture drawn by most recent findings provoked new questions in implementation research. Accordingly, it seems no longer sufficient considering the relationship between policy instruments and workplace health and safety outcome only. In fact, the understanding of employer motivation for compliance needs to be improved by asking why and how companies of different size and sector are to enhance their working environment. This is exactly what the presented research project is doing by a mixed methods approach. Since the project will be finished in 2017 this contribution is mainly confined to the description of theoretical pre-assumptions, basic objectives, research design and alignments. Nevertheless an insight is provided in preliminary conclusions based on first analyses of qualitative interviews already conducted with managers and key OSH agents in 50 companies. Interpretive patterns are to be found in the verbal material. In order to identify both implementation barriers and enablers, these patterns will be condensed into types of attitudes facilitating a subsequent quantitative validation.

This chapter examines whether parenthood is causally related to an individual’s health, specifically for the workers in the USA. Although society values employment and parenthood individually, there is widespread public concern that a combination of the two may be too much of a good thing, especially in the case of mothers of young children. Against this background, this chapter outlines a sociological framework for analyzing the health impact of parenthood. The hypothesis that children have a detrimental impact on employees’ health is derived. The exceedingly modest public and private policies for supporting working parents in the USA are described briefly and it is argued that neither are likely to mitigate the theoretical relationship. Some quantitative research has indeed shown a negative impact of parenthood. However, many studies have found no relationship or even positive impacts. Possible reasons for these apparent contradictions are discussed. Despite the unclear state of research, the following three clear recommendations are made. First, occupational health management should, for now, desist from introducing specific health promotion for employees with children. Second, public policy should expand existing measures to support working parents. Third, more rigorous research that utilizes more appropriate methods for causal analysis than have been implemented previously is needed in this field.

During the past few years, the Internet has started to change lifestyles and affect all life domains, including working life. It is also increasingly used for targeting mental health issues. The “application of information technology in mental and behavioral health” (Andersson G, Riper H, Carlbring P (2014) Editorial: Introducing Internet interventions—a new open access journal. Internet Intervent 1:1–2) is becoming common in health-care; interventions have already been incorporated into routine care in countries such as the Netherlands, Sweden, the UK, Australia, and the USA. As a next step, Internet interventions in the area of occupational health are progressively emerging. They may offer an evidence-based, cost-effective, and convenient way of promoting workers’ mental health on a large scale. Currently, Internet interventions for workers are the most promising approach in the field of occupational e-mental health. The evolution of occupational e-mental health is embedded in interdisciplinary research, practice, and policy. In the first section of this chapter, the origins of occupational e-mental health will be outlined and a definition proposed. Following this, different approaches to occupational e-mental health will be described and their potentials elucidated. A comparison between Internet interventions and traditional stress-management trainings will provide further insights into the design and characteristics of the most elaborated approach in occupational e-mental health. Subsequently, various Internet training programs will be introduced and the evidence for their efficacy summarized. Finally, important topics for further research and implementation will be outlined.

To monitor the mental health status of their employees, businesses rely on ready-made tools that are easy to use, effective and not only assess their employees’ mental health, but also provide clues about the origins of any difficulties, thus facilitating choice of appropriate interventions. In this chapter, we describe the development and validation of an instrument for measuring mental health at work that we call Work Health Audit Instrument (WHAI) and provide an overview of its reliability and validity. We propose 18 WHAI factors that measure distinct causes for mental health difficulties at work and show that these factors relate to various relevant outcome criteria within businesses, such as work satisfaction, work engagement, irritation, and mental health. Thus, this chapter aims to give employers reasons for using this tool to measure the mental health of their employees. Additionally, we suggest that the WHAI factors can be used in further scientific inquiry, for example as a screening tool for studies on intervention effectiveness.

Geriatric nursing is demanding in both physical and psychological senses. A 3-year intervention program aimed at preventing the health-related early retirement of geriatric nurses has been designed.

Chronic stress, burnout, and major depression are currently major health challenges in Western cultures. Mindfulness is defined as the ability to voluntarily direct attention towards the present moment in an accepting and non-judgmental manner. This ability seems to help to train the mind to detach from the excessive or negative thinking (rumination) that plays a major role in the onset of burnout and depression. Having successfully been implemented in clinical settings, mindfulness trainings are becoming increasingly popular in organizational settings. In this article, we aim to provide a general map of mindfulness trainings in the work-place. Following some necessary background information on the roots of mindfulness, we continue with a short outline of some training formats that are being offered in work-place settings. We will then review recent, selected empirical findings on the impact of such training in work settings, and discuss the perils and promises of integrating mindfulness into the work-place.

This chapter describes the development and evaluation of a concept for trainings in skin-care tailored to the specific needs of small and medium-sized enterprises (SMEs) in rural regions. It covers SME in industries in which employees work in wet or damp environments or are exposed to strong chemical or allergenic substances or both; these risk factors frequently lead to work-related skin problems. Florists, outpatient and inpatient care providers, hairdressers, bakers, and metalworkers were recruited to our study. Overall, 72 SMEs participated. The first research step was to explore company owners’ expectations of the training and the requirements particular to their organizations. Trainings on skin-care were developed and tailored to the specific needs of the SMEs and surveyed industries. For evaluation purposes a randomized controlled trial was conducted in which the effectiveness of the trainings was quantitatively assessed by employees of the participating SMEs completing three waves of written surveys. A significant reduction in skin-related symptoms, a positive effect on skin-care and cleaning, and a significant positive effect on participants’ knowledge in the area of occupational skin protection were found. However, the dermatological training did not have a positive effect on the participants’ satisfaction with their work. The average cost of the intervention per participant was approximately 63.50 €; foregone working time not included.

Psoriasis, a systemic, immune-mediated disease associated with significant comorbidities, has a strong negative impact on quality of life. The aim of this study was to evaluate the occupational category of individuals with psoriasis and establish a correlation between this disease and patients’ occupations. Selected clinical variables and characteristics of work-places of 1236 individuals diagnosed with psoriasis in an outpatient clinic over 8 years (2004–2011) were assessed and documented. Of the 1236 study patients, 669 (54.13 %) were men and 567 (45.87 %) women, the male to female ratio being 1.18/1. The median age at diagnosis was 29.34 ± 15.24 years (mean ± standard deviation [SD]). Retired persons were the most strongly represented category (149, 12.05 %), followed by primary and secondary school students (112, 9.06 %), unskilled workers/laborers (108, 8.74 %), engineers (87, 7.04 %), students (70, 5.66 %), managers (56, 4.53 %), self-employed persons working from home (54, 4.37 %), professors (53, 4.28 %), drivers (46, 3.72 %), salespersons (39, 3.16 %), economists (38, 3.07 %), health-care professionals (32, 2.59 %), unemployed persons (71, 8.77 %) and all others types of work (321, 25.97 %). The present study yielded no conclusive evidence that psoriasis is an occupational or occupation-induced disease. Thus, we believe that psoriasis is a constitutional disease that may be triggered by occupational factors.

Because of demographic changes in Germany, the average age of the workforce is progressively increasing. In an attempt to reduce pressure on the labor market, Germany recently changed the retirement age to 67 years. At the same time, economic constraints are forcing companies to reduce the number of employees. Thus, older workers are required to do physically demanding work involving heavy weights. In response to these factors, the Hamburg Sewage Company recently set a goal of creating working conditions that would enable their existing aging personnel to fulfill their duties efficiently and to a high quality while ensuring that their employees’ health would not be at a risk. As a prerequisite to achieving this goal, quantitative data on work load, physical and mental effort required to meet job demands, and age-related changes in physical and mental strain were required. To this end, a combination of complementary measures aimed at achieving an in-depth analysis that would enable appropriate adaptations of working conditions for the aging workforce have been implemented.

Work–life balance is one of the challenges of a globalized world. The study described in this chapter aimed to identify the factors influencing the work–life balance of working mothers. Additionally, we will describe differences and similarities between the well-being and working styles of German and US-American working mothers. It is particularly difficult for mothers to be successful, because to do so, they must master the double burden of work and family. In this study, 320 working mothers were surveyed, 142 in Germany and 178 in the USA. It was found that the cultural concepts of work–life balance of these working mothers are comparable. Furthermore, differences in working styles were identified: US-Americans valued both well-being and work–life balance more strongly than Germans. In both cultures, younger mothers felt more burdened by work than older mothers. This may indicate that competences are learned with an increasing age, enabling a more successful mastery of challenges, even though an increasing age usually has a negative effect on health. The number of children, family status and education did not influence work–life balance. These findings are further discussed in this chapter.