Psychosocial risks at work: why they must be treated as core occupational safety and health hazards

These include excessive workloads, job insecurity, workplace bullying, long working hours, and lack of control over how work is done. They are not secondary wellbeing issues.

They are occupational safety and health hazards that directly affect both physical and mental health.

Recent International Labour Organization (ILO) estimates show that 840,000 people die every year from cardiovascular diseases and mental disorders, including suicide, associated with exposure to five major work-related psychosocial risks: job strain, effort-reward imbalance, job insecurity, long working hours and bullying.

However, this estimate captures only part of the broader burden of psychosocial risks at work, as it considers only five selected risk factors among the wide range of psychosocial risks that may be present in the workplace.

Manal Azzi, Team lead – occupational safety and health policy and systems at the International Labour Organization (ILO)

These figures underline a clear reality: psychosocial risks are not abstract concepts. They are measurable and preventable occupational hazards.

Psychosocial risks reflect how work is designed, organised and managed

A key challenge is that psychosocial risks are often misunderstood as individual mental health issues or interpersonal workplace conflicts. In reality, they often arise from how work is designed, organised and managed.

They can be understood across three interconnected levels.

The first is the job itself: the responsibilities placed on workers and the nature of job demands, whether cognitive, emotional or physical, including task design, and whether workers’ skills match job requirements. Some jobs, such as emergency response or healthcare, are inherently demanding and require specific safeguards to prevent sustained stress.

The second is how work is managed and organised: how tasks are allocated, supervised, and supported. Key factors include clarity of roles, distribution of workload, support from supervisors, such as by providing access to resources and feedback, and worker autonomy.

We can see how this level is closely connected to the job itself, as even well-designed tasks can become harmful if they are poorly managed, while good management can prevent or reduce much of the strain that arises from demanding work. 

The third is the broader policies, practices and procedures that govern work: working time arrangements, job security, opportunities for development, performance management systems, surveillance and digital monitoring, an OSH policy and management system, and mechanisms for addressing violence and harassment at work. 

It is often at this level that structural risks are embedded – and where prevention is most effective.

Too often, responses focus on individual resilience rather than structural causes. However, evidence consistently shows that effective prevention should address the risks at their source.

The scale of the health burden

The health impact of psychosocial risks is significant and well established.

Beyond the global estimates of cardiovascular diseases, such as ischaemic heart disease and stroke, and mental disorders, including depression and suicide-related outcomes, scientific studies link various psychosocial risks to a wider range of health impacts.

The ILO estimates that more than 44 million healthy life years are lost globally each year due to psychosocial risks at work. Photograph: iStock

These include anxiety, burnout, sleep disturbances and fatigue, unhealthy coping behaviours such as alcohol consumption, smoking, overeating and physical inactivity, musculoskeletal disorders, digestive problems, metabolic disorders, and reproductive and perinatal outcomes.

The ILO estimates that more than 44 million healthy life years are lost globally each year due to psychosocial risks at work.

These risks rarely occur in isolation. Job strain – where high demands are combined with low control – often coexists with effort-reward imbalance, bullying, excessive workload, and insecure employment.

Over time, these exposures accumulate and compound their health impacts.

The consequences extend beyond individuals. Organisations experience higher absenteeism, presenteeism, turnover, and reduced productivity. In essential services such as healthcare and education, psychosocial risks also affect service quality and system performance.

A changing world of work is increasing exposure

The nature of work is changing rapidly, reshaping psychosocial risks.
Digitalisation and constant connectivity have blurred the boundaries between working time and personal life, increasing work intensity and reducing recovery time. Algorithmic management and digital monitoring can reduce autonomy and increase pressure if not properly regulated.

Flexible working arrangements can improve inclusion and work-life balance, but without safeguards they can also extend working hours and increase isolation.

These developments make it essential to manage psychosocial risks systematically within occupational safety and health frameworks, rather than treating the issue primarily as one of individual worker wellbeing or resilience.

From reactive responses to prevention at source

A central message from the ILO’s work is that psychosocial risks must be prevented at source.

Many organisations still rely on reactive measures such as employee assistance programmes or stress management training. While these may provide support, they do not address root causes.

Effective prevention requires action on work design and organisational systems.

At the job level, this means reducing excessive demands where possible, ensuring appropriate task design to promote the effective use of workers’ skills, and providing sufficient task variety to support engagement and meaningful work.

When considering how work is managed and organised, this requires revising roles so that they are clearly defined, providing adequate resources and supportive supervision, and allowing sufficient worker autonomy.

The broader policies, practices and procedures that govern work must, at a minimum, integrate psychosocial risks into occupational safety and health management systems, including risk assessment, prevention measures, and continuous improvement processes.

Further measures involve establishing flexible working time arrangements where possible, ensuring transparent performance management and recruitment processes, and implementing clear mechanisms to prevent and address violence and harassment.

The role of governments and employers

Governments play a critical role in ensuring psychosocial risks are explicitly recognised within occupational safety and health legislation. This includes establishing clear employer obligations to identify, assess, and prevent psychosocial hazards, supported by effective labour inspection and enforcement.

It also requires improved data collection on work-related psychosocial risks and associated physical and mental health outcomes, and stronger integration between occupational safety and public health systems.

Employers must move beyond fragmented wellbeing initiatives and embed psychosocial risk management into core organisational processes. This includes reviewing work design, performance systems, working time arrangements, and workplace culture.

Worker participation is essential. Workers are best placed to identify how work is experienced in practice. Meaningful consultation, including through social dialogue and collective bargaining, is critical to effective prevention.

A defining issue for occupational safety and health

Psychosocial risks are not emerging concerns – they are already embedded in the modern world of work.

The question is no longer whether they exist, but whether they are addressed with the same level of attention and prevention as other occupational safety and health risks, such as physical hazards.

Occupational safety and health systems have shown that workplace harm is not inevitable. Through regulation, enforcement, and prevention, significant progress has been made in reducing injuries and fatalities. The same systematic approach must now be applied to psychosocial risks.

A safe and healthy workplace is not only one that prevents physical harm. It is one that ensures work is designed, organised, and managed to protect both physical and mental health.

Recognising psychosocial risks as core occupational safety and health hazards is not a future ambition. It is a present necessity.

Download the report, The psychosocial working environment: Global developments and pathways for action, here

Manal Azzi is team lead – occupational safety and health policy and systems at International Labour Organization (ILO)