Your Workplace is Toxic. Literally.

Harmful office practices like overbearing bosses and frantic deadlines promote out-of-control employee stress and all its attendant harms. But workers aren’t the only ones who lose when they’re grinded into the ground. And the author has the evidence.

By Jeffrey Pfeffer, Ph.D.

You don’t have to work in a coal mine, on an oil rig, in a chemical plant, or in construction to face a possibly toxic, health­-destroying workplace.

In today’s work world, white-collar jobs are often as stressful and unhealthful as manual labor or blue­-collar work—frequently more so. That’s because physical dangers at work have been largely eliminated by the Occupational Safety and Health Administration (OSHA) in the United States and comparable agencies in other countries.

Reprising a lesson from the quality movement that what gets inspected—and measured and reported—gets affected, countries pay attention to workplace fatalities and incidents, such as falls or chemical spills, where bodily harm can be readily ascertained. The result: The rate of workplace deaths in the United States decreased 65 percent just between 1970 and 2015, while the rate of workplace injuries fell some 72 percent over that same time.

Meanwhile, stress at work, not subject to OSHA reporting or intervention, and seemingly invisible and accepted as an inevitable part of contemporary workplaces, just keeps getting worse for almost all jobs, resulting in an ever-higher physical and psychological toll.

For instance, WebMD reported that work is the number-one source of stress, and the American Psychological Association’s 2015 report “Stress in America” noted that the top two sources of stress are money and work, with almost one-­quarter of all adults reporting extreme levels of stress.

Another poll of almost 3,000 people reported that nearly half of employees confirmed missing time at work from work­-related stress, 61 percent said that workplace stress had made them physically sick, and 7 percent said they had been hospitalized because of workplace stress and its physiological effects.

If the aggregate statistics are disturbing, the individual stories are truly horrifying. Talk to the person in a senior finance role working in a rapidly growing medical services provider. Confronting almost impossible work demands that required frequent all-nighters, she began taking stimulants, moved on to the exceedingly available cocaine, and numbed the constant workplace stress and abusive supervision with alcohol.

Her (ultimately successful) detox process from workplace-induced alcohol and drug addiction required enormous amounts of psychological and financial resources—and, of course, leaving her toxic place of employment.

Or interview the television news producer who demonstrated organizational loyalty and commitment by being willing to go anywhere in the world at any time on almost no notice to help get the story. That person gained 60 pounds in a short period from not having the time to eat properly, let alone exercise. The unrelenting job demands jeopardized the person’s marriage and the relationship with their child as well as their physical and mental health.

Or converse with the person receiving workers’ compensation while on disability leave after being diagnosed with post-­traumatic stress disorder caused by their job at the electric utility Southern California Edison. The PTSD came from excessive work demands—too much work given, too lean staffing levels, and the unrelenting pressure from supervisors to complete the impossible workload.

The Unhidden Costs of a Toxic Office

The stories are almost endless and the costs, to people, their employers, and the larger society, are enormous. For example, the American Institute of Stress maintains that job stress costs U.S. employers more than $300 billion annually.

The ill health from workplace stress adversely affects productivity and drives up voluntary turnover. One poll found that nearly 50 percent of the respondents reported “having changed jobs to escape the stress.” The costs to just the U.S. health­care system approach $200 billion a year, and maybe more.

Unfortunately, the problems from what IESE Business School professor Nuria Chinchilla once aptly called social pollution seem to be getting worse, not better. Possibly the saddest part of the tale: Even as organizations of all kinds regularly permit, if not encourage, management practices that literally sicken and kill their employees, these same employers also suffer because toxic management practices and unhealthy workplaces do not improve organizational profitability or performance.

On the contrary, unhealthy workplaces diminish employee engagement, increase turnover, and reduce job performance, even as they drive up health insurance and healthcare costs. All too many workplaces have management practices that serve neither the interests of employees nor their employers, truly a lose-lose situation.

People’s needless suffering occurs even as companies tout their environmental bona fides. Ironically, companies have developed elaborate measures to track their progress on environmental sustainability with little thought given to the companies’ effects on human sustainability. Although environmental sustainability obviously is essential, so is human sustainability—creating workplaces where people can thrive and experience physical and mental health, where they can work for years without facing burnout or illness from management practices in the workplace.

We should care about people, not just endangered species or photogenic polar bears, as we think about the impact of corporate activity on our environments. And as companies obsess over their carbon footprint, they would do well to consider their effects—their footprints—on the human beings, a carbon-based life­form, who work for them.

How to Cure a Sick Culture

If anything is going to change with respect to workplace well­being and employee physical and mental health, some or a combination of the following things will need to occur.

  1. Employees Must Stop Being Complicit
    Current and prospective employees must understand what constitutes health risks in their work environments, and that includes the psychosocial risks that are today more omnipresent and dangerous than the risks of physical injury. Armed with that information, people must then begin to select and deselect their employers at least partly based on stress-related dimensions of work that profoundly influence their physical and mental health.
  2. Employers Must Put a Price on Culture
    Employers will need to understand and measure what their toxic management practices are costing them, both in direct medical costs and in lost productivity and increased turnover. That understanding and quantification of the costs of toxic work environments seems like a necessary first step toward change.
  3. Governments Must Incentivize Healthy Workplaces
    Governments at all levels will need to first acknowledge—and measure—and then do something about the externalities created as employers offload people who were physically and psychologically damaged at work onto various parts of the public health and welfare system. The public costs of privately created workplace stress and unhealthy workplaces have already prompted policy attention and action in the United Kingdom and in many Scandinavian countries, in part because with government-funded health care, it is in the economic interests of public agencies to reduce unnecessary health care costs, including preventable costs from workplace stress.
  4. Societies Must Prioritize the Greater Good
    Societies will need social movements, or maybe several social movements, that make human sustainability and people’s work environments as important as environmental sustainability and the physical environment have become. Decades ago, companies regularly dumped pollutants into the air, water, and ground. Then people decided that preserving the physical environment and having businesses pay for the external harm they were causing were worthy social goals. Because of the environmental movement, publicity, and political pressure, governments all over the world passed laws and nations developed norms that curtailed many actions that polluted the physical environment. In a similar fashion, societies would benefit from movements that resolutely take the importance and sanctity of human life and people’s physical and psychological well-being more seriously—not just at life’s very, very beginning or at its very, very end, but throughout people’s lives, including their lives at work.

And Another Inconvenient Truth

Several interrelated events caused me to delve into the topic of work organizations and their effects on human health, while undertaking the research that resulted in my book, Dying for a Paycheck.

First, many decades of research and teaching by both myself and colleagues around the effect of high-commitment or high-­performance work practices on productivity and other dimensions of organizational performance had resulted in little to no positive change.

Notwithstanding the publication of numerous books, including some of my own, on this topic, workplaces were, if anything, getting worse with less employee engagement and satisfaction and diminished trust in institutional leadership. Books, articles, and talks on the connections between people and profits seemingly weren’t going to change management decisions or organizational practices. What might?

As I participated in meetings of the Hewitt Human Capital Leadership Council (prior to Hewitt’s merger with Aon), a group of senior human resource leaders from large corporations, and as I served on the Stanford Committee for Faculty and Staff Human Resources, I couldn’t help noticing something. The conversations often focused on healthcare costs. Employers seemed obsessed with and relentlessly focused on reducing these costs. The thought crossed my mind that many of the management practices that produced higher levels of employee loyalty, engagement, and performance—things such as job security and decision­making discretion—might also produce healthier workplaces.

If that were the case, perhaps employee health and health­care costs could become the lever to increase the adoption of high-­commitment work arrangements, management practices that had been advocated for so long but were so infrequently embraced and quickly abandoned in times of economic stringency. If companies and countries were going to “bend the cost curve” of health, to use an oft-heard phrase, changing work environments just might be one of the best places to focus efforts and attention.

Second, as I sat on the various committees just mentioned, I was struck by how everything was always about “costs” and “resources,” particularly when it came to people. To take just one example, because of the recession that began in 2007, Stanford University laid off between 400 and 500 people and, earlier in the decade, had instituted a wage freeze in the face of a budget shortfall, notwithstanding the university’s enormous endowment.

During that time, as I drove through the campus one day, I noticed enormous specimen trees sitting in planter boxes awaiting planting in the ground. About a decade earlier, there had been much publicity about the demise of a 300-year-old large heritage oak near the Stanford Family Mausoleum on campus. This tree had been the object of much care and affection and had received heroic efforts to save its life.

Some years later, a Palo Alto news article remarked on the apparently newsworthy event of the cutting down of an oak tree near the soccer stadium because it could not be saved—but it would be replaced by six new trees. Observing all this, I commented to several people that at Stanford, you were better off being a tree than an employee. At too many workplaces, trees—or maybe landscaping—fare better than people.

Language, the terms people use to describe the world, tells a lot. When we talk about people at business, we often use terms such as human resources and human capital. When people describe wages and health benefits, employee or healthcare is often followed by the word costs.

Years ago, independent power producer AES’s cofounder, Dennis Bakke, told me that he objected to one of my book subtitles that read “Building profits by putting people first.” Bakke said that putting people first should not be solely or maybe even at all in the interests of profits, or costs. Instead, Bakke argued, people, as human beings, as living creatures, deserved to have their welfare and well­being receive some priority in management decision making, independent of the effect of that prioritization on costs or profits. We need to change the language routinely used in business.

Well­being and physical and mental health need to become much more focal in conversations and policies. As Bob Chapman, CEO of the privately owned $2.5 billion manufacturing company Barry Wehmiller, likes to say, corporate leaders have a responsibility to steward the lives of the employees who are in their hands. The people who come to work are the husbands and wives and sons and daughters of family members who love them. Leaders should ensure that at the end of the day, their employees return home in good shape, prepared to live fulfilled lives outside of work.

Third, in political discourse in the United States and some other countries, there is vigorous, ongoing discussion of “pro­life” policies. But such debates and the laws, appropriations, and regulations that accompany them seldom consider what happens to people during most of their lives, when they are working. If we take seriously the fundamental sanctity and importance of human life and well-being, I concluded that there is a moral, ethical reason to be concerned about human health and well­-being in the workplace. And if I was concerned about people’s welfare and how that was affected by work environments, I ought to understand the magnitude and dimensions of the issue.

I had these ideas already in mind when IESE professor Nuria Chinchilla asked me to participate in a conference she was organizing on the general theme of work and family. Chinchilla had talked to me about social pollution and had commented that the real “inconvenient truth” was not just the destruction of the physical environment but also the degradation of the social environment, in part through how employers operated.

The conference never occurred, but that paper, which began my exploration of the issue of the workplace and human health, appeared in a respected journal and laid out some of the first ideas on the topic of human sustainability. From that point on, I have gathered information from interviews and epidemiological data, and elicited the collaboration of outstanding operations research colleagues to help estimate the aggregate effects of harmful workplace exposures. Dying for a Paycheck represents what I have learned from these efforts.

I can summarize this learning in a few short sentences. The workplace profoundly affects human health and mortality, and too many workplaces are harmful to people’s health—people are literally dying for a paycheck.

Most important, the situation is worse than I had imagined, affecting people in numerous occupations, industries, and geographies, and cutting across people of various ages and levels of education. What I learned and the people I encountered in my research have fueled my passion and commitment to bring both the data and the stories to light. I do this in the hope that the information will stimulate the many important but attainable changes required to stop the unnecessary psychological and physical carnage occurring in workplaces all over the world.

Simply stated, work environments matter. We know they matter for people’s engagement, satisfaction, turnover intentions, and performance—findings that constitute a vast research literature in the domain of organizational behavior.

Work environments also matter for people’s physical and mental health, and for their well-being. It follows that concern for life and human sustainability, as well as a focus on costs and productivity, needs to include a focus on the workplace and its effects.

Jeffrey Pfeffer, Ph.D., is the Thomas D. Dee II Professor of Organizational Behavior at the Graduate School of Business at Stanford University, where he has taught since 1979. He is the author or coauthor of 15 books.

This article was adapted from Dying for a Paycheck: How Modern Management Harms Employee Health and Company Performance—and What We Can Do About It by Jeffrey Pfeffer. Copyright 2018 by Jeffrey Pfeffer. Published on March 20, 2018 by HarperBusiness, an imprint of HarperCollins Publishers. Reprinted with permission.