THURSDAY, April 8, 2004 (HealthDayNews) -- Workers and doctors have long known that losing your job can be bad for your mental and physical health.
But a new Swedish study suggests that large-scale expansion of a workforce can also increase employee sickness and hospitalization rates.
While that might seem counterintuitive, there are several possible reasons why adding a lot of workers might not be good for an employee's health, said Hugo Westerlund. He is a researcher at the National Institute for Psychosocial Medicine in Stockholm, and the lead author of the study in the April 10 issue of The Lancet.
One possible explanation: The sudden arrival of a lot of workers in an office or factory might not be a sign of improvement in business, but merely that the company is centralizing its operations, perhaps shedding some workers in the process, Westerlund said.
In the early to mid 1990s, the period covered by the study, "many organizations were centralizing" in Sweden, he said, and that can be a disquieting experience.
Another possibility is that "the amount of work could increase more rapidly than personnel," Westerlund said. "Even though the number of personnel grew, the workload grew more quickly."
Then there's a hypothesis that could explain the unhealthy effects of both downsizing and very fast expansion. "When you reorganize very quickly, the organization becomes unstable. Organizational instability can lead a worker to lose the feeling of 'What I am in this organization,'" Westerlund said.
None of this is certain, and Westerlund said he was planning "a further study, which will look at exactly what are the malevolent factors in expansion."
But the numbers in the report are clear, he said.
They cover the rate of long-term job absence for 24,000 Swedish employees between 1991 and 1996. As expected, downsizing increased long-term absences by an average of 7 percent. But there was the same increase in absences when workplaces were growing by 18 percent or more a year, Westerlund said.
The healthiest situation was moderate expansion of a workforce, between 8 percent and 18 percent a year, which reduced absences by about 9 percent, he said.
The ill effects of workforce changes were greatest for women, the study found. Long-term absence for sickness increased by 18 percent for women in fast-expanding organizations.
Why that should be isn't clear, Westerlund said, because "we simply don't know enough about what makes women ill."
But his guess is that "we have been good at taking care of male risk factors at work, while there has been far less research about female risk factors."
Dr. Lewis D. Pepper, an assistant professor of public health at the Boston University School of Public Health, has done studies on downsizing. He said the Swedish study is consistent with previous reports that any major change in a workplace can have adverse effects on employees' health.
"Some of the things I identified in downsizing operate in expansion," Pepper said. "Economic expansion in itself doesn't guarantee a positive outcome. The less control individuals have over their work process and workplace, the more likely it is that their health status will be affected negatively."
Fast growth can cause "tremendous stress, not only from an expanded workload but also from uncertainty about what a worker should be doing," he said.
The bottom line for employers: Planning for expansion or contraction should include ways of giving workers "some sort of involvement and sense of control," Pepper said.
For advice on handling workplace stress, visit the National Institute for Occupational Safety and Health and the American Psychological Association.