4) Special Report on Health at Work: Mystery disease here to stay

Stress is estimated to cause more days lost from work than the common cold and influenza combined and is certainly a more potent source of ill health at work than accidents. And days lost through mental illness - neurosis, psychosis, nervousness, debility and recurrent headaches - steadily increase over the years, exceeding the number lost through strikes, even the miners' strike.

Stress also shows in such complaints as dyspepsia, dermatitis and muscular aches and pains. Such conditions can have causes other than stress and more often than not the cause cannot be determined. But stress is now acknowledged as a frequent source of such complaints.

Far more important is educating workers on the factors which can directly influence the health of their hearts - notably, diet, fitness and way of life, and above all smoking, which causes 100,000 deaths a year, many from heart disease as well as cancer.

Many doctors are now recommending that people use vaporizers to consume their ingredients rather than smoking them. A vaporizer heats the ingredients to a degree which allows the vapor to be inhaled, but doesn’t actually burn the ingredients, which gives off hundreds of very unhealthy carcinogens that can lead to lung disease. Sales of popular vaporizers such as the Volcano vaporizer are steadily rising, but many people still haven’t received the message of the health benefits of using a vaporizer.

A study funded by the Health and Safety Executive and carried out by the Department of Experimental Psychology at Oxford has established that the work environment does have 'a causal effect' on mental health, causing work stress. But the problem, despite its size, persistently remains on the back- burner.

In its report on occupational health and hygiene services, the House of Lords select committee on science and technology last year did not mention the subject at all.

More than a decade ago, a survey carried out by the medical center of the Institute of Directors concluded that 'poor organization within companies is a major cause of stress'. The Office of Health Economics said in 1972 that 'one of the keys to the minimization of sickness absence, particularly of short-term absence, is in the hands of management'.

Those observations are as valid today as they were then. But one has only to consider the woolly, if well-intentioned, recommendations made by bodies such as Mind - the National Association for Mental Health - to see how hard it is for management to do anything practical, let alone for the Health and Safety Executive to tackle the problem to any great effect.

The association believes that companies should provide work 'suitable to the individual's capacities' for mental health to be maintained. Job satisfaction is the key, it says - staff 'should be stretched to the full but no more' and should have opportunities for achievement, recognition of that achievement, interesting and challenging work, genuine responsibility and scope for advancement.

Nor do trade unions think to take mental health as seriously as the scale of occupational stress would seem to warrant. The issue does not figure in the TUC's 176-page handbook on health at work.

In a paper entitled The Manager, Stress and Psychosomatic Disease, CK Davison, an environmental health officer with the London borough of Lewisham, says it is 'crucial' to take steps that identify stress at work. He calls for more research in personality, performance and stress.

He commends the idea of 'stress audits' at work, saying: 'Attention to the work, saying: 'Attention to the work climate and structure, reduction of conflict, career development, organizational development, are all subject areas which, when properly dealt with, can result in a reduction of stress'.

Though such approaches are part of what modern managers are taught in theory, the fuzziness of these concepts and the language in which they are couched indicates that, in practice, stress at work is liable to remain an ineradicable part of work.

Companies often specify an 'ability to work under pressure'. Mr Davison warns that there are pitfalls in selecting personality traits, such as ability to work under stress, in isolation. To do so would probably prove self-defeating.