September 2023

Managing Psychosocial Risk in the Workplace: It’s Time for Progress (pdf)

Contributed by Marnie Dobson, Ph.D., Center for Social Epidemiology/Healthy Work Campaign

Over 40 years of robust international scientific research provides compelling evidence that documents the negative impact of work-related stressors (also known as job stressors or “psychosocial hazards”). Examples of these hazards include high job demands, low job control (job strain), long work hours, work-life conflict, effort-reward imbalance, organizational injustice, workplace bullying, etc. Job stressors contribute to workplace injuries, musculoskeletal disorders, poor mental health, cardiovascular disease, and mortality1. Harvard and Stanford economists found that work stressors resulting from “the way workers are managed'' contributed to over 120,000 deaths annually and $180 billion in U.S. health care costs2. Work stress contributes to over half of annual lost working days and an estimated US$150 billion in lost productive work time3. Ignoring these costs and their implications is no longer an option.

Stress, burnout and poor mental health are reaching epidemic proportions (American Psychological Association (APA) Stress In America 2022 survey), but unfortunately little is being done to manage work-related psychosocial hazards in the U.S. This is not the case in most other countries, including the European Union (EU) OSHA, United Kingdom, Canada, Japan, Australia, South Korea, Colombia, Chile and Mexico. These countries have laws or regulations that legally require employers to assess and/or prevent psychosocial hazards or manage work stress.

The European Union’s OSH Directive “Framework Agreement” (1989) guarantees a minimum health & safety requirement for all member countries that includes addressing psychosocial risks. Several EU member states, especially in Scandinavia, implemented national legislation decades earlier, (e.g. Sweden’s Work Environment Act (1977). In 2015, Japan launched the “Stress Check Program.” The law mandates a stress screening of all workplaces with 50 or more employees. The United Kingdom’s Health & Safety Executive (HSE) states that employers have a legal duty to protect employees from work stress by implementing risk assessments. The UK’s “Management Standards” for work-related stress launched in 2004, guide employers in addressing six areas of work design to prevent work stress, ill health and loss of productivity, including:

  1. demands
  2. control,
  3. support,
  4. relationships
  5. role
  6. organizational change

Colombia, Mexico and Chile have also implemented various forms of national legislation that require assessment and prevention of psychosocial risks by employers. The National Standard of Canada for Psychological Health & Safety in the Workplace was introduced in 2013 as a set of voluntary guidelines, tools, and resources to guide organizations in preventing psychological harm at work. The first of its kind in the world, it offers an extensive set of resources for employers to establish psychological health and safety programs. A comprehensive description of international efforts in managing psychosocial hazards and job stress is provided by Cobb4.

The U.S. lags behind other nations in regulating or providing formal guidelines for the assessment and prevention of psychosocial hazards. The NIOSH Total Worker Health® Program, “job-related factors such as wages, work hours, workload, interactions with coworkers and supervisors, and access to paid leave impact the well-being of workers” and are important social determinants of health. The NIOSH Healthy Work Design & Well-being Cross Sector Program explicitly addresses “the design of work, management practices, and the physical and psychosocial work environment.” While NIOSH may not be able to promote regulations, it is possible to promote guidelines on the assessment and management of psychosocial hazards, similar to those in Canada or the recent International Standards Organization (ISO) 45003 Psychological Health & Safety at Work.

Just in the last year, some US government agencies have made inroads. The U.S. Surgeon General released a Workplace Mental Health & Well-Being Framework, with five essential work components to improve employee well-being;

  1. Protection from Harm
  2. Connection & Community
  3. Work-life Harmony
  4. Mattering at Work
  5. Opportunity for Growth

In the past year, OSHA launched a new webpage Workplace Stress: Make Work Better – Mental Health Matters, and the Department of Labor launched its Good Jobs Initiative that offers federal funding for projects that promote job quality.

While these recent efforts are promising, none explicitly call for standards or guidelines for employers to assess whether they are providing good, healthy jobs, or to what extent employees are experiencing various forms of work-related stress. There is a need for standardized tools for identification of psychosocial hazards and a clearinghouse of real-world solutions. Some examples of such tools can be found as part of the Healthy Work Campaign.

Apart from national laws and guidelines, collective bargaining, and worker cooperatives are examples of methods to manage or reduce work stress, and are components of the International Labor Organization’s (ILO’s) efforts to promote “Decent Work.” To achieve tangible advancements in psychological health & safety, and foster healthy and decent work environments, collaboration among labor, business, the occupational health & safety and scientific community is imperative. Together, they must advocate for education, negotiation and lobbying efforts aimed at enacting laws and regulations that promote the health and well-being of workers in their workplaces.


  1. LandsbergisLandsbergis P, et al. Occupational Psychosocial Factors and Cardiovascular Disease. In Tetrick LE, Fisher GG, Ford MT, Quick JC (Eds.) Handbook of Occupational Health Psychology, Volume 3. Washington, DC: American Psychological Association, 2023 (in press).
  2. GohGoh J, Pfeffer J, Zenios SA. The Relationship Between Workplace Stressors and Mortality and Health Costs in the United States. Management Science. 2015;62(2):608-628.
  3. HassardHassard J, Teoh K, Cox T, et al. Calculating the cost of work-related stress and psychosocial risks. Luxembourg: Publications Office of the European Union; 2014.
  4. CobbCobb, EP. Managing Psychosocial Hazards and Work-Related Stress in Today's Work Environment: International Insights for U.S. Organizations. Routledge 2022.

Marnie Dobson is the Director of the Healthy Work Campaign, as well as the Associate Director of the Center for Social Epidemiology since 2005. With more than 15 years of experience conducting worker-centered occupational stress research at the University of California, Irvine, Center for Occupational and Environmental Health as an adjunct professor, she continues to publish academic articles and book chapters and present at scientific conferences around the world.

CPH-NEW is a NIOSH Center of Excellence for Total Worker Health. CPH-News & Views is a quarterly blog written by center researchers and guest authors on emerging topics related to healthy workplaces. We welcome your responses and discussions. Please send all comments by email to:

Total Worker Health® is a registered trademark of the U.S. Department of Health and Human Services (HHS). Participation by CPH-NEW does not imply endorsement by HHS, the Centers for Disease Control and Prevention, or the National Institute for Occupational Safety and Health (NIOSH). This publication was supported by NIOSH Grant Number 1 U19 OH012299. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIOSH or CPH-NEW.