Most workplaces measure how employees feel about their jobs and their organization, such as engagement surveys, and most ignore measuring the effects of the actual conditions of work, says Dr. I. David Daniels, founder and CEO of ID2 Solutions and author of the book, “Psychosocial Hazards are Real.”

In the U.S., the attitude typically is, “I don’t see this (psychosocial hazard) as a problem. You might. But I don’t,” says Dr. Daniels. No action is taken to give the person in distress relief, despite their insistence abusive behaviors or organizational pressures are hurting them.

These hazards happen every day in workplaces across the country. “We normalize it,” says Dr. Daniels. “Just push through it. Suck it up. Just do it. We’re told we need to be resilient, just toughen up.”

Non-physical hazards are pervasive. More than one in three workers (35%) work more than 48 hours a week, according to the ILO. Its recent report states 23% of employees have experienced at least one form of violence in their working life, often harassment and bullying. Almost one in five employees (18%) have experienced psychological violence.

According to OSHA, more than 80% of US workers have reported experiencing workplace stress, and more than 50% believe their stress related to work impacts their life at home. 

OSHA points to these sources of stress, among others: job security, more frequent or extended shifts, taking on more responsibilities, adapting to new or different workspace and schedules, and facing confrontation from co-workers, supervisors, employers or customers.

Where employers draw the line

For more than 50 years OSHA has addressed physical hazards. None of the sources of stress cited by OSHA are regulated by the agency. Job security, how work is organized, pay and benefits, workload, work pace, task design, scheduling, work-life balance policies and other organizational issues that can become workplace risks have always been the responsibility of management, the prerogative of management, and management would have it no other way. Exhibit A is the ergonomics standard. Industry decried the sweeping standard as too intrusive into operations, forcing job station and task redesigns, and was thrown out by Congress.

Depending on the relations safety and health professionals have with senior leaders, it may or may not be within their scope to influence organizational issues that can be risks and the overall workplace culture that may support those risks.

Is Total Worker Health® the answer?

NIOSH’s Total Worker Health® (TWH) is a model for addressing psychosocial risks. TWH is more than 20 years old, launched in 2003 as the “Worklife Initiative” and renamed TWH in 2011. Issues that fall under the umbrella of TWH contribute to pressure at work:

• the control of exposures and hazards,
• the built environment,
• community supports,
• worker pay and benefits,
• the organization of work,
• company policies,
• job security
• work arrangements (including nonstandard contract, freelance, and “gig” employment), schedules, workforce demographics, company leadership, and workplace technology.

Safety and health pros can use NIOSH TWH resources https://www.cdc.gov/niosh/twh/index.html to point to case studies of companies that:

•  Implement policies that eliminate the root causes of stress, including excessive work demands and workplace bullying, and provide workers with increased flexibility and control over their work and schedules.
• Train supervisors on effective approaches and strategies to reduce stressful working conditions.
• Offer training and interventions for all workers to build resiliency for stress management and reduction.
• Provide access to employee assistance programs (EAPs).

There is no exact figure for the total number of companies that have implemented TWH because the framework is voluntary and there is no centralized registry. The challenge can be formidable and progress incremental. A holistic, integrated worker safety, health protection, and health promotion initiative may take up to 20 years to develop, test, and refine, according to a 2021 paper, “Profiles of Total Worker Health® in United States Small Businesses.”

Still, hundreds of companies have formally adopted TWH principles—such as integrating occupational safety and health with workplace health promotion---and more have adopted individual elements, according to published studies and NIOSH partnerships.

The hierarchy of controls applied to TWH, in order of expected effectiveness, is:

• Eliminate working conditions that threaten safety, health, and well-being.
• Substitute health-enhancing policies, programs, and practices.
• Redesign the work environment for safety, health, and well-being.
• Educate for safety and health.
• Encourage personal change.

Eliminating or reducing hazards is the most effective method of prevention, according to NIOSH. But hazards like shiftwork, workload, job demands and other psychosocial risks can be difficult or impossible to eliminate. NIOSH recommends managing hazards that can’t be eliminated through engineering, administrative, or individual-level interventions.

What safety and health pros can do

Safety and health pros can take steps to help their company recognize and reduce non-physical psychosocial risks, according to OSHA:

• At all levels of the organization, be aware and recognize that people can carry an emotional load unique to their own personal life. They may be experiencing heightened levels of loneliness, isolation, uncertainty, grief, and stress. Some may face additional demands, such as parents caring for children or elderly household members or dealing with their own  existing mental health or substance use challenges.
• Identify factors that make it more difficult for workers to get their jobs done and determine if adjustments can be made.
• Show empathy. This applies to senior leaders, supervisors, safety and health pros and co-workers – everyone in the organization. Ensure individuals that: 1) they are not alone; 2) top managers, supervisors, safety and health pros and co-workers understand the stress they are under; 3) there is no shame in feeling anxious; and 4) asking for help is important. Employers can reassure employees they are open and receptive to discussions about employees’ work stress by creating a safe and trustworthy space and work culture.
• Provide access to coping and resiliency resources, workplace and leave flexibilities without penalty, or other supportive networks and services.

OSHA offers many stress reduction resources at  https://www.osha.gov/workplace-stress/employer-guidance.

Incremental progress

There are signs more organizations are starting to address non-physical workplace hazards. More than one-third of employers, (37%) have “concrete plans” to improve collecting statistics on psychosocial risks and mental health at work in the next five year, according to the ILO report. That’s a start. And 95 percent of HR professionals say workplace mental health is somewhat or very important to their company’s business strategy in 2026, according to Spring Health research. That’s growing awareness.

Approximately 52% of U.S. companies offer some form of employee wellness or well-being program, according to the Harvard Business Review. Adoption rate increases significantly with company size. Nearly 85% to 90% of large U.S. employers (200+ employees) provide health and lifestyle initiatives compared to smaller firms.