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Workplace stress is making us sick. Can we hold bosses responsible?

It is estimated that more than 100,000 Americans die each year from adverse workplace conditions. And many more become sick.Adobe Stock/kieferpix -

I’ve known plenty of people in toxic work environments: unrelenting hours, capricious bosses, lack of control. And I’m sure you have, too.

Dysfunctional jobs can take an enormous toll on what you think of yourself, how you perform at work, and even how you behave when you’re (theoretically) disconnected.

But Jeffrey Pfeffer, a professor of organizational behavior at Stanford School of Business, argues that work is exacting an even greater price than we realize. More than 100,000 Americans die each year from adverse workplace conditions, he says. And many more become sick.

I should note that these deaths and illnesses are over and above physical accidents, like being injured on a construction site or in a coal mine. It’s a much broader phenomenon ― encompassing office workers, as well as traditionally high-stress jobs like nurses and first responders. Pfeffer estimates that “workplace management” was, as of 2018, the fifth leading cause of death in the United States.

“I think we are on an unsustainable path. I think we were on an unsustainable path pre-pandemic. The pandemic’s made everything worse, and something’s got to give,” he says.


Think about that as you return to the office.

Of course, many of us internalize our stress, hide it, compartmentalize it, and assume we can recharge on the weekends. We think of the stress as our fault: Maybe things would be better if we took up running? Or learned more about mindfulness? Or acupuncture?

The problem, Pfeffer says, is that society tends to blame the victim. “So if Kara is in a place that’s making her sick,” he said, roping me into his argument, “it’s Kara’s responsibility to get out of there.”

That sort of blame is absolutely backwards. The onus should be on employers (more on that later).

The United Nations reported in 2019 that, around the world, 2.8 million people die each year due to workplace-related issues. And it noted that lots of sickness and death can be traced solely to long hours.


“Thirty-six percent of workers are working excessive long hours,” said the UN’s Manal Azzi, “meaning more than 48 hours per week... People are increasingly asked to produce more and more, they have no time to rest.” (If you, like me, are thinking “48 hours? That doesn’t seem like a big deal,” we are precisely the reason that the American workforce is in such a sorry, overworked state.)

But how do things like unsupportive bosses, unpredictable hours, and unending e-mails make you physically sick?

Pfeffer, who wrote a book in 2018 called “Dying for a Paycheck,” says there are a few ways. Decades of studies show that stressed-out people are more likely to “overeat, overdrink, smoke, take drugs... So, if you’re in pain, you’re going to take a drug. If you have stress, which is a form of psychological pain... you’re going to do something to numb the pain.”

Second, research has shown that stress has powerful effects on your central nervous system and can affect the regulation of hormones like cortisol and adrenaline, which, as the American Psychological Association has noted, “can increase the risk for hypertension, heart attack, or stroke.” Studies have also linked high stress to colon, stomach, and lung cancer.

Since it was founded about 50 years ago, the Occupational Safety and Health Administration has successfully made workplaces safer, but Pfeffer says it has focused on physical safety, rather than workplace stress. “OSHA has a bunch of people who understand exactly the topic we’re talking about. They do not believe they have the staffing or the mandate to do anything about it.”


But the health consequences of doing nothing have begun careening out of control ― and the fallout is felt by both blue-collar and white-collar workers.

“The economic toll, in terms of lost productivity, lost good years of life, lost days, increased medical expenses,” Pfeffer says, “is on an unsustainable path, and it needs to be stopped. And therefore you need some combination of legislation, regulation, and litigation.”

Early in the pandemic, a Harvard Business School study found that the workday had grown by nearly an hour. Sure, people were saving time by not commuting, but much of that time was being funneled back to their employers. Meanwhile, e-mail and other forms of electronic communication have surged ― a recent report from Microsoft found that users of its office communication product, Teams, sent more than 40 percent more messages than they had in 2019.

Jennifer Moss, author of “The Burnout Epidemic,” believes that the expectation that people field nonstop e-mails and show up for hours and hours of Zoom meetings is nuts. She recommends thanking people for not inviting you to a meeting. And she notes that burned-out workers are far more likely to go to the ER or call in sick.


Pfeffer says we’ve entered a world where, increasingly, “we infantilize many of our highly qualified human beings by telling them how and what to do.”

And part of that infantilization is arbitrary displays of power by insecure bosses.

Samantha Pitre Quillen, a career coach who also advises companies on workplace culture, recalls working for a boss who insisted on keeping track of everything she did. “They used to have me send all of my e-mails to them before I sent them out,” which meant Quillen generally got to the office an hour early, so her e-mails could be approved.

She started staying late, too, and eating lunch at her desk, so she was always available. Her boss would sometimes request reports that needed to be delivered in two hours, which Quillen felt was both impossible and arbitrary. “I remember the boss coming into the ladies’ room and calling my name. I’d be like: ‘Yes? Why are we having this conversation in the bathroom?’”

Quillen says Americans frequently conflate their personal and professional identities, so there’s a real fear of losing part of who you are if you push back against management or quit.

But even if workplace stress is out of control, can anything really be done about it? According to Pfeffer, the answer is to make employers take better care of the people who work for them.

He says that there are lots of reliable, tested, scientific measurements that could gauge employee wellbeing. And he makes a provocative argument: We should hold companies responsible “for the mental and physical health and the wellbeing of their employees. As you would do for the environment.”


“And if you make them ill, we’re going to fine you... If you dump a bunch of crap into the water, we’re going to hold you responsible for that damage. Same parallel. We should treat human sustainability exactly the same way as we treat environmental sustainability,” he says.

Joel Goh, a visiting scholar at Harvard Business School and a professor at the business school at the National University of Singapore, says he does “agree with the idea that firms should be held accountable in some way for promoting or creating stressful workplaces.”

Goh noted that few people truly understand how much workplace stress impacts health, and he believes that America is considerably less attuned to the impact than many European countries.

If, as a culture, we agree that the cost of workplace stress has gotten too high, Pfeffer believes that action will have to come from both citizens and government leaders.

“If you wait for companies to do this on their own,” he says, “good luck.”

Follow Kara Miller @karaemiller.