Health problems and stress in Information Technology and Business Process Outsourcing employees.

Stress is high in software profession because of their nature of work, target, achievements, night shift, over work load. 1. To study the demographic profile of the employees. 2. To access the level of job stress and quality of life of the respondents. 3. To study in detail the health problems of the employees. All employees working in IT and BPO industry for more than two years were included into the study. A detailed questionnaire of around 1000 IT and BPO employees including their personal details, stress score by Holmes and Rahe to assess the level of stress and master health checkup profile were taken and the results were analysed. Around 56% had musculoskeletal symptoms. 22% had newly diagnosed hypertension,10% had diabetes, 36% had dyslipidemia, 54% had depression, anxiety and insomnia, 40% had obesity. The stress score was higher in employees who developed diabetes, hypertension and depression. Early diagnosis of stress induced health problems can be made out by stress scores, intense lifestyle modification, diet advice along with psychological counselling would reduce the incidence of health problems in IT sector and improve the quality of work force.

Information Technology (IT) industry in India has got a tremendous boost due to globalization of Indian economy and favorable government policies. IT and IT related professionals are at a constant pressure to deliver services efficiently and have to be cost effective.

Employees working in IT industry are prone to develop a lot of health problems due to continuous physical and mental stress of their work. Diseases are either induced, sustained or exacerbated by stress. The common health problem due to stress are acid peptic disease, alcoholism, asthma, diabetes, fatigue, tension headache, hypertension, insomnia, irritable bowel syndrome, psychoneurosis, sexual dysfunction and skin diseases such as psoriasis, lichen planus, urticaria, pruritus, neurodermatitis etc. Globalization and privatization have brought new work relationships, job insecurity, insecurity regarding future working conditions and rapid obsolescence of skills are causes of stress. IT industry has become one of the fastest growing industries in India. Strong demand over the past few years has placed India among the fastest growing IT markets in Asia-Pacific region. The reason for choosing particularly IT and ITES employees is that the level of stress these employees face is comparatively higher than other employees. Any kind of a job has targets, and an employee becomes stressed when he or she is allotted with unachievable targets and are unable to manage a given situation. Thus, the main aim of this article is to bring to limelight the level of stress with IT and ITES employees in Chennai.

Aim

To screen IT employees by a questionnaire that include details of health illnesses, family history of illness, diet, lifestyle, exercise and yoga activities and health checkup reports.

To assess the severity of stress using Holmes and Rahe Stress Scale scoring which would measure stress with the number of life change units and the final score would give a rough estimate of how stress affects health of IT employees.

Material and Methods

This is a cross-sectional study involving IT employees in Chennai.

As there are no such studies available, I have done a pilot study with 30 IT employees and collected data from 1,000 IT employees. The study was started after getting Ethical Committee approval and getting consent from the employees in IT industry. The employees enrolled voluntarily to the study should be working for at least 2 years in the industry. A detailed questionnaire, including the health history, diet pattern, lifestyle and stress score was given to them-Holmes, and Rahe stress score scale. A complete master health checkup was done, and the results were analyzed.

Results

Around 56% had musculoskeletal symptoms. 22% had newly diagnosed hypertension, 10% had diabetes, 36% had dyslipidemia, 54% had depression, anxiety and insomnia, 40% had obesity [Figure 1]. Musculoskeletal symptoms included cervical and lumbar strain with or without disc disease, polyarthralgia, and muscle spasm and heel pain.

Figure 1

Percentage of health problems in IT and BPO employees

The stress score was higher in employees who developed diabetes, hypertension, dyslipidemia and obesity. Most of the employees who were obese had a higher stress score. Of the metabolic disorders employees with higher stress score had dyslipidemia, followed by hypertension and diabetes [Figure 2].

Figure 2

Health problems and stress scores in IT, BPO employees

To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual's life are added and the final score will give a rough estimate of how stress affects health.

Score of 300+: At risk of illness.

Score of 150-299: Risk of illness is moderate (reduced by 30% from the above risk).

Score <150: Only have slight risks of illness.

Among IT employees with health problems 67% were men and 33% were women [Figure 3].

Figure 3

Health problems and sex wise distribution

Discussion

Stress at work has been linked with coronary heart disease and metabolic syndrome in retrospective and prospective studies.[12] The biological mechanisms remain unclear.[3] The pathophysiological mechanisms involve direct neuroendocrine effects and indirect effects mediated by adverse health behaviors.[456] The metabolic syndrome is a cluster of risk factors that increases the risk of heart disease and type 2 diabetes.[7] Characteristics of the metabolic syndrome are abdominal obesity, atherogenic dyslipidemia (raised triglycerides, small low-density lipoprotein particles, and low concentrations of high-density lipoprotein cholesterol), high blood pressure (BP), insulin resistance (with or without glucose intolerance), and prothrombotic and proinflammatory states. Studies have found a social gradient in work stress and the metabolic syndrome,[89] suggesting a greater exposure to working stress among less advantaged social groups. Cross-sectional studies have linked work stress with components of the syndrome,[1011] but this association is not consistent.[412]

Technostress is the word used to explain the phenomenon of stress arising due to the usage of computers. It is a modern disease of adaptation caused by the inability to cope with new computer technologies in a healthy manner.

Transduction is the translation of emotional distress to physiological change and then to a physical symptom. Complex autoimmune, humoral and neuromuscular mechanisms mediate this reaction, and may itself affect the environment by a social response that may yield a positive or a negative response. Effects of stress on mind and body are due to increased sympathetic nervous system activity and increased secretion of adrenaline, cortisol and other stress hormones.

Occupational (job, work or workplace) stress has become one of the most serious health issues in the modern world (Lu et al., 2003, 479), as it occurs in any job and is even more present than decades ago. Namely, the world of work differs considerably from the working environment of 30 years ago: longer hours at work are not unusual, frequent changes in culture and structure are often cited, as well as the loss of lifetime career paths (Cooper and Locke, 2000 in Fotinatos-Ventouratos and Cooper 2005), which all leads to greater presence and levels of stress.

Hans Selye was one of the founding fathers of stress research. His view in 1956 was that “stress is not necessarily something bad – it all depends on how you take it. The stress of exhilarating, creative, successful work is beneficial, while that of failure, humiliation or infection is detrimental.” Selye believed that the biochemical effects of stress would be experienced irrespective of whether the situation was positive or negative.

Job stress occurs in response to both workplace and employee factors, but the characteristics of the workplace likely play the primary role. “Job stress can be defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources or needs of the worker. Job stress can lead to poor health and even injury.” (Stress at work, United States National Institute of Occupational Safety and Health, Cincinnati, 1999).

A Canadian graduate school study[13] suggested companies should invest in IT specific employee assistance programs. Survey conducted by Techweb Network Research on behalf of Op Tier quantified how stressed managers are. This survey showed the greatest cause of job stress were complexity of company IT infrastructures and poorly defined goals. 264 women employees were studied by Aziz to explore the level of stress. Resource inadequacy role overload and personal inadequacy were the main causes of stress. There was a difference between married and unmarried women. Working in IT calls for a high degree of accuracy over the long period of time, and a small lapse would be disastrous.

Studies have shown that employees with chronic work stress (three or more exposures) were nearly twice as likely to develop the metabolic syndrome[14] than those with no exposure to work stress. Women with chronic work stress were over five times more likely to have the metabolic syndrome. Greater exposure to job stress over 14 years was linked to greater risk of the metabolic syndrome, in a dose-response manner. The association was robust to adjustment for occupational status and health behaviors.[15] It is unclear whether the development of risk seen here is due in part to the direct effects of chronic stress on insulin resistance, resting BP, and lipoprotein metabolism, although this interpretation is supported by Whitehall II and other studies.[3516]

Stress and its types

We cannot have a stress-free life. Stress is, of course, essential for every human being as it is considered as a boost that takes an employee to the highest ladder in the organization. The various types of stress is mentioned below:

Eustress is a type of short-term stress that provides immediate strength. It is a positive stress that arises when motivation and inspiration are needed.

Distress, on the other hand, is a negative stress brought about by constant readjustments and alternatives in a routine. Distress creates feelings of discomfort and unfamiliarity.

Hyper stress occurs when an individual is pushed beyond what he or she can handle. It results from being overloaded or overworked.

Hypo stress occurs when an individual is bored or unchallenged. People who experience hypo stress are often restless.

Stages of work stress

According to Pestonjee (1992) work stress progresses through a series of five stages.

The honeymoon stage: Euphoric feeling if excitement, enthusiasm, challenges and pride on getting a new job. Dysfunctional processes include the depletion of energy reserves in coping and adapting to the new environment.

The full throttle stage: Going full swing leads to a depletion of resources. Other symptoms include dissatisfaction, sleep disturbances, overeating, drinking or smoking.

The chronic symptom stage: Development of chronic symptoms like physical illness, anger and depression.

The crisis stage: Persistence of symptoms leads to disease, chronic backache, headache, high BP, insomnia, etc., would develop.

Hitting the wall stage: No person can continue under strain for too long and one may reach the end of one's professional career. Burnout stress syndrome takes over.

The opposite: Rust our stress syndrome occurs under extreme hypo stress. This is likely to occur when the gap between one’ capabilities and environmental demands becomes too wide.

Biology of stress

Prolonged exposure to work stress may affect the autonomic nervous system and neuroendocrine activity directly, contributing to the development of the metabolic syndrome.

A case–control study showed that participants in the Whitehall II study with the metabolic syndrome had raised cortisol and normetanephrine output, and also had reduced variability in heart rate.[5] Decrements in cardiac autonomic function have been linked to the metabolic syndrome in other populations and to low job control and social isolation among men in the Whitehall II study.[61718] Psychobiological studies have also shown that heightened stress reactivity and impaired recovery after stress, assessed by BP and inflammatory markers, predict the 5 years progression of the metabolic syndrome.[18]

Chronic psychological stress may reduce biological resilience and thus disturb homoeostasis. Altered adrenocortical function can influence hepatic lipoprotein metabolism and insulin sensitivity at target organs.[1519]

Cortisol is an insulin antagonist, and cortisol output is increased in the metabolic syndrome.[5]

Low concentrations of high density lipoprotein cholesterol and glucose intolerance have been linked with high basal secretion of cortisol.[20]

Stress at work is associated with coronary heart disease, but the biological mechanisms underlying this association are unclear

Information Technology industry causes stress among employees in many ways:

Software packages used as the operating system for companies releases 3-4 updates in a year. The employee has to learn about these updates each time. Otherwise they would lag behind others causing pressure on the employee and increased job risk if he fails to perform well.

Training program sanctioned by the company is not employee oriented as each employ

Another form of stress is called technologist. People do not communicate or interact with their colleagues as before. This can cause alienated feelings among colleagues.

Employees working in IT industry need to work with a high degree of accuracy over a long period. A small lapse can lead to disastrous effect for the company. They need to have an outlet to manage their stress.

Conclusion

The daily impact of IT on our lives continues unabated. As innovations and computer capacities increase this influence will continue to grow in the coming years at an increasing rate. As technology advances, there is also increased stress that is associated with it called as “technology stress.” IT is here to stay. This brings extra pressure on people to adapt to new advancements and update their knowledge in their field.

Annual stress scoring has to be done and a score above 300 needs stress management program like yoga, meditation and other destressing activities like aerobics, dance etc., would prevent or reduce risk of disease due to stress in IT people which in turn will produce a healthy community.

To manage stress these people need to play sport, have a hobby or just have a good holiday. Stress score helps us to screen who would be prone to stress related physical illness and people with a score more than 300 are at risk of illness and care should be taken at the earliest to relive their stress. Healthy employees mean better performance by employee that in turn produce a healthy community. Annual stress scoring has to be done, and employees are having a score more than 300 should be involved in active antistress management.