Occupational Health and Safety for Small and Medium Sized Enterprises

KKELLOWAYELLOWAY 97818484466949781848446694 PRINT.inddPRINT.indd i 227/10/20117/10/2011 10:2910:29 KKELLOWAYELLOWAY 97818484466949781848446694 PRINT.inddPRINT.indd iiii 227/10/20117/10/2011 10:2910:29 Occupational Health and Safety for Small and Medium Sized Enterprises

Edited by E. Kevin Kelloway Canada Research Chair in Occupational Health Psychology, Saint Mary’s University, Canada

Cary L. Cooper, CBE Distinguished Professor of Organizational Psychology and Health, Lancaster University, UK

Edward Elgar Cheltenham, UK • Northampton, MA, USA

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All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical or photocopying, recording, or otherwise without the prior permission of the publisher.

Published by Edward Elgar Publishing Limited The Lypiatts 15 Lansdown Road Cheltenham Glos GL50 2JA UK

Edward Elgar Publishing, Inc. William Pratt House 9 Dewey Court Northampton Massachusetts 01060 USA

A catalogue record for this book is available from the British Library

Library of Congress Control Number: 2011928594

ISBN 978 1 84844 669 4

Typeset by Servis Filmsetting Ltd, Stockport, Cheshire Printed and bound by MPG Books Group, UK

KELLOWAY 9781848446694 PRINT.indd iv 27/10/2011 10:29 Contents

List of contributors vi

1 Introduction: occupational health and safety in small and medium sized enterprises 1 E. Kevin Kelloway and Cary L. Cooper 2 Obstacles, challenges and potential solutions 7 Sharon Clarke 3 Beyond hard hats and harnesses: how small construction companies manage safety eff ectively 26 Mark Fleming and Natasha Scott 4 Workplace violence in small and medium sized enterprises 48 E. Kevin Kelloway and Michael Teed 5 Hidden occupational fatalities in the agricultural industry 69 Peter Y. Chen and Lorann Stallones 6 Small and medium sized enterprises: health, well-being, stress and stress management 81 Sheena Johnson 7 The work–family nexus and small to medium sized enterprises: implications for worker well-being 106 Michael P. O’Driscoll, Paula Brough and Jarrod Haar 8 Sexual harassment: a big issue for small and medium sized enterprises? 129 Angela M. Dionisi and Julian Barling 9 Small and medium sized enterprises as healthy workplaces 159 Arla Day

Index 189

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Julian Barling, Queen’s University, Canada Paula Brough, Griffi th University, Australia Peter Y. Chen, University of South Australia Sharon Clarke, University of Manchester, UK Cary L. Cooper, Lancaster University, UK Arla Day, Saint Mary’s University, Canada Angela M. Dionisi, Queen’s University, Canada Mark Fleming, Saint Mary’s University, Canada Jarrod Haar, University of Waikato, New Zealand Sheena Johnson, University of Manchester, UK E. Kevin Kelloway, Saint Mary’s University, Canada Michael P. O’Driscoll, University of Waikato, New Zealand Natasha Scott, Saint Mary’s University, Canada Lorann Stallones, Colorado State University, USA Michael Teed, Bishop’s University, Canada

KKELLOWAYELLOWAY 97818484466949781848446694 PRINT.inddPRINT.indd vivi 227/10/20117/10/2011 10:2910:29 1. Introduction: occupational health and safety in small and medium sized enterprises E. Kevin Kelloway and Cary L. Cooper

Although small and medium sized enterprises play a vital role in the economy, issues of occupational health and safety are often ignored in such organizations. Researchers in occupational health and safety, as in other areas of organizational research, typically focus on large businesses where it is relatively easy to obtain large sample sizes. Interventions (e.g. inspections, training) to enhance occupational health and safety often require resources or expertise that are not readily available in smaller businesses and may, in fact, be inappropriate for small business (MacEachen et al., 2008). Moreover, the small business sector is characterized by fi nancial fragility and instability, making it diffi cult to enforce occupational health and safety standards in this environment. Indeed occupational health and safety regulations may specifi cally exempt small businesses from particular provisions. For example, in Canada, joint management– labour occupational health and safety committees are required in virtually every occupational health and safety act but only for businesses with at least 20 employees – a provision that exempts most small businesses from the requirement. As a result of these characteristics, issues of occupational health and safety assume particular importance in a small business. Workplace fatalities are higher in industries characterized by a large number of small businesses (Lentz and Wenzl, 2006; National Institute for Occupational Safety and Health, 1999) and the solutions that are enshrined in contemporary occupational health and safety programming may be ineff ective or irrel- evant in the small business environment. Defi ning the term ‘small business’ is actually more diffi cult than it fi rst appears. Offi cial agencies might cite defi nitions such as businesses employing less than 100 employees (or less than 50 employees for service organizations; see e.g. http://www.ic.gc.ca/epic/site/sbrp-rppe.nsf/en/rd01225e. html), however the reality is that the vast majority of small business is,

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in fact, micro business. In Canada, 75 per cent of all businesses employ fewer than fi ve people and 97 per cent of all businesses employ less than 50 employees (Debus, 2005). In the European Union, 99 per cent of all enterprises are small businesses employing less than 50 people and over 90 per cent are micro-businesses employing less than 10 people (European Commission, 2004). Thirty-two per cent of all employees in Canada (Debus, 2005) and just under 57 per cent of employees in the European Union (European Commission, 2004) are employed in a small business (i.e. less than 20 employees).

THE NATURE OF THE PROBLEM

These statistical observations provide the basis for defi ning the domain of small businesses. However, the implications of size for the implementation of occupational health and safety procedures and programmes requires further explication. When it comes to issues related to human resources, including occupational health and safety, small businesses have no knowledge, no time, and no resources. The lack of knowledge stems from the absence of any professionalized human resource functions – for the most part, the business owner is the human resource department (and every other department of the business). Only in extraordinarily rare cases will the owner have specialized knowledge related to management of occupational health and safety. Second, the multiplicity of roles and the small workforce means that small business owners have no time – programmes that require substantial commitments of time or attempts to educate or inform small business owners through seminars, workshops and other activities that will take them away from their business are likely to have minimal impact. Finally, small business owners have limited resources – they certainly are unlikely to hire consultants to solve problems and will never have the resources to solve problems through experimentation or pilot studies. These concerns are not unique to occupational health and safety – in general small businesses tend to operate without formal work procedures (Aragon et al., 2001; Walters, 1998) and without administrative support (Eakin et al., 2003). In her study of small business owners, Eakin (1992; see also Niewohner et al., 2004) reported that they also did not see occupational health and safety as being within their responsibility. Rather, owners saw issues of health and safety as either ‘bureaucratic’ concerns or issues of personal responsibility for their employees. Responsibility for occupational health and safety is further obscured by subcontracting practices endemic among small businesses (e.g. in

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construction). As a result of these practices the nature of employment relationships (e.g. who is the employer) becomes unclear, as does responsibility for establishing and maintaining occupational health and safety systems (Mayhew and Quinlan, 1997). Within this environment, a strong culture of autonomy and meeting the demands of contracts supersede detailed consideration of occupational health and safety issues.

IDENTIFYING BEST PRACTICES: THE CURRENT VOLUME

Given the characteristics of small businesses described above, it is not surprising to note that research on occupational health and safety in small business is lacking. In their systematic review of health and safety interventions, MacEachen et al. (2008) were able to identify only fi ve high quality quantitative studies and 14 qualitative studies conducted in small businesses. Not surprisingly, research designs tended to be sub-optimal with a lack of control groups and appropriate comparisons. A moment’s consideration points to the diffi culties of conducting research in a small business environment. The size of the business often precludes setting up ‘experimental’ and ‘control’ conditions within a single organization. The culture of small business and the exigencies of business survival do not support the conduct of research. Logistical diffi culties in planning research (i.e. the diffi culties of negotiating entry and obtaining the buy-in of business owners) are magnifi ed in small businesses. In contrast to negotiating entry into one large organization, researchers may have to negotiate entry into 20 or 30 small businesses to obtain an equivalent sample. Organizational diff erences then become an additional analytic challenge as data from multiple small businesses have a nested hierarchical structure that precludes the use of some common methods of statistical analysis. With this volume we hope to advance research on occupational health and safety in small and medium sized enterprises. We have recruited authors with a great deal of expertise and asked them to focus on the nature of occupational health and safety in small and medium sized enterprises, summarizing existing knowledge and research. We also asked authors to go beyond traditional research reviews. Specifi cally, we asked individuals to go beyond summarizing the research results to consider the nature of small and medium sized enterprises and how occupational health and safety might be enhanced in these organizations. In each case, authors have attempted to identify ‘work- able’ and likely to be eff ective solutions to enhance occupational health

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and safety in small and medium sized enterprises. There is considerable agreement among authors that the greatest potential for enhancing occupational health and safety is to capitalize on the informal nature of work in small and medium sized enterprises – focusing on enhancing fl exibility and informal communications in the organization.

OUTLINE OF THIS VOLUME

In general the book begins with a consideration of issues germane to ‘safety’ in organizations and moves to a consideration of issues more related to health and, in particular, psychosocial infl uences on health. However, the dividing line between ‘safety’ and ‘health’ is, at best, an arbitrary distinction. In the initial chapter, Sharon Clarke provides an overview of occupational health and safety issues in small and medium sized enterprises. Based on her consideration of the issues, she points to the fallacy of believing that eff ective occupational health and safety solutions can simply be ‘scaled down’ versions of what works in larger enterprises. Rather, she argues that interventions based on enhancing safety culture are most likely to have a positive eff ect on occupational health and safety in small and medium sized enterprises. Small businesses predominate in some sectors and Fleming and Scott report on a study examining the practices of small businesses within the construction sector. Their innovative study contrasted the diff erences between small businesses with ‘low’ and ‘high’ accident statistics. They identify both formal safety procedures and informal practices that diff erentiate the two types of companies and, in doing so, point the way to eff ective health and safety programming in this environment. Kelloway and Teed consider issues of workplace violence in small and medium sized enterprises. They begin by focusing on the observation that workplace violence is typically perpetrated by members of the public or by clients rather than by co-workers or fellow employees. Small and medium sized businesses are predominant in the service and retail sectors in which employees are most likely to be exposed to the risk factors for workplace violence. Chen and Stallones focus on issues of occupational health and safety in the agricultural industry. Although many of the hazards of agricultural work are well known (e.g. the dangers of working with heavy equipment, exposure to toxic chemicals, etc.), Chen and Stallones highlight what they refer to as the ‘hidden’ hazard – self-infl icted injury. In doing so they focus

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on the psychosocial aspects of agricultural work and issues of occupational culture that may lead to these issues being hidden. Johnson off ers a broader conceptualization of psychosocial issues by reviewing issues of stress and stress management in small and medium sized enterprises. She identifi es the impact that stress-related issues have on work-related outcomes (e.g. absenteeism) and, by extension, on the viability of the business. After reviewing the state of knowledge regarding occupational stress she identifi es specifi c practices and resources likely to help small businesses address these issues. O’Driscoll, Brough and Haar, focus on a specifi c psychosocial stressor – work and family confl ict in small businesses. Again, the focus is on the specifi c nature of small and medium sized enterprises and the identifi cation of practices that are appropriate to, and likely to be eff ective for, small businesses. In contrast to issues of work and family, which are widely recognized as requiring attention, issues of sexual harassment in small and medium sized enterprises have largely escaped research attention. Dionisi and Barling address this issue, arguing that there is no reason to expect that sexual harassment is less prevalent in small and medium sized enterprises than in larger businesses. Indeed, there may be some reasons to suspect that sexual harassment is more prevalent in small and medium sized enterprises. Dionisi and Barling also consider aspects of small business that may provide a ‘protective’ function and suggest interventions and strategies to deal with sexual harassment in small and medium sized enterprises. The last chapter in the volume is authored by Day who considers the possibility of creating a psychologically healthy environment in small and medium sized enterprises. As in previous chapters, Day argues that the available data support the suggestions that (a) practices that ‘work’ in larger organizations may not readily generalize to small and medium sized enterprises, and (b) practices intended to be implemented in small businesses must take into account the nature of the small business environment. We suggest that these themes run through each of the chapters in this volume. Those interested in promoting occupational health and safety in small and medium sized enterprises cannot expect that practices and procedures developed for large organizations will work in smaller organizations. The clear need is for low cost, low tech, non-resource demanding, interventions that can be readily deployed in a small business setting. Such interventions would capitalize on the culture and nature of small businesses and are likely to be eff ective in enhancing occupational health and safety in small and medium sized enterprises.

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REFERENCES

Aragon, A., Aragon, C. and Thorn, A. (2001), ‘Pests, peasants and pesticides on the Northern Nicaraguan Pacifi c Plain’, International Journal of Occupational and Environmental Health, 7, 295–302. Debus, A. (2005), Small Business Profi le: An Overview of Canada’s Small and Mid-sized Business Sector, Ottawa, ON: Canadian Federation of Independent Business. Eakin, J.M. (1992), ‘Leaving it up to the workers: sociological perspectives on the management of health and safety in small workplaces’, International Journal of Health Services, 22, 689–704. Eakin, J.M., MacEachen, E. and Clarke, J. (2003), ‘“Playing it smart”’ with return to work: small workplace experiences under Ontario’s policy of self-reliance and early return’, Policy and Practices in Health and Safety, 1, 19–41. European Commission (2004), SMEs in Europe, 2003, Luxemburg: European Commission. Lentz, T.J. and Wenzl, T.B. (2006), ‘Small businesses with high fatality rates: assessment of hazards and their prevention’, Journal of Occupational and Environmental Hygiene, 3, D8–D14. MacEachen, E., Breslin, C., Kyle, N., Irvin, E., Kosny, A., Bigelow, P., Mahood, Q., Scott-Dixon, L., Morassaei, S., Facey, M., Chambers, L., Couban, R., Shannon, H., Cullen, K. and Amick, B. (2008), Eff ectiveness and Implementation of Health and Safety Programs in Small Enterprises: A Systematic Review of the Qualitative and Quantitative Literature, Toronto: Institute for Work and Health. Mayhew, C. and Quinlan, M. (1997), ‘Subcontracting and occupational health and safety in the residential building industry’, Industrial Relations Journal, 28, 192. National Institute for Occupational Safety and Health (NIOSH) (1999), Identifying High-risk Small Business Industries: The Basis for Preventing Occupational Injury, Illness and Fatality, Cincinatti, OH: NIOSH Special Hazard Review. Niewohner, J., Cox, P., Gerrard, S. and Pidgeon, N. (2004), ‘Evaluating the effi - cacy of a mental models approach for improving occupational chemical risk protection’, Risk Analysis, 24, 349–361. Walters, D. (1998), ‘Employee representation on health and safety committees in small enterprises’, Employee Relations, 20, 164–179.

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INTRODUCTION

The study of occupational safety has traditionally focused on large bureaucratic organizations, which manage high-hazard technologies, such as chemical and nuclear power, mining and transport (Hale, 2003), or within industries with historically high accident rates, such as construction and manufacturing. However, this emphasis has led to the relative neglect of research into occupational safety issues that face small and medium sized enterprises (SMEs). Indeed, there has been a tendency to assume that diff erences between SMEs and large enterprises are simply a matter of scale, and that lessons learnt from the study of large enterprises can be readily transferred to SMEs. This is evidently not the case: SMEs have failed to keep pace with safety improvements achieved within larger businesses and risks to occupational safety remain substantially greater in SMEs, as refl ected in signifi cantly higher workplace accident and injury rates (Fabiano et al., 2004; McVittie et al., 1997). Whilst safety improvements have led to sustained reductions in accident and injury rates for large organizations, SMEs have failed to match these reductions. For example, McVittie et al. (1997) examined the Canadian construction industry from the late 1980s through to the early 1990s; this study showed that whilst the construction industry overall had achieved a signifi cant 44 per cent reduction in injuries, accident frequency was falling at a signifi cantly faster rate in larger fi rms compared to SMEs. Furthermore, for some high-hazard industries, such as quarrying, mining and construction, the risk factor associated with smaller fi rms is particularly high. Based on the analysis of accident data across all Italian industries for the period 1995–2000, Fabiano et al. (2004) found that whilst there was a signifi cant trend for increasing injuries and accidents with decreasing fi rm size across all industries, the accident frequency rate for small companies was four times higher than large fi rms in the mining and quarrying sector, and twice that of large fi rms in construction. Reported

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injuries may only indicate the ‘tip of the iceberg’ in terms of safety issues, given that SMEs, and particularly smaller companies, are more likely to under-report injuries compared to large fi rms (Leigh et al., 2004; Oleinick et al., 1995). Thus, it is evident that, as noted by Swuste (2008), small- sized enterprises are not simply scaled down versions of big businesses; they face their own obstacles and challenges, and consequently this needs to be refl ected in the way that health and safety is managed. Yet, despite the evidence of special issues associated with occupational safety in small organizations, the factors which increase the likelihood of workplace accidents and injuries in SMEs have received comparatively little research attention. This chapter will identify and discuss occupational safety issues for SMEs, including the consequences for employees’ safety perceptions and the safety climate. Ways of developing the safety culture of SMEs are discussed as a means of improving their safety-related outcomes, including occupational injuries and accidents.

OBSTACLES AND CHALLENGES FOR OCCUPATIONAL SAFETY IN SMALL AND MEDIUM SIZED ENTERPRISES

One of the reasons why SMEs experience signifi cantly higher levels of workplace accidents and injuries is due to their relative exposure to risk. There is evidence that SMEs tend to operate in more hazardous work environments than larger organizations, thus directly increasing the likelihood of accidents. For example, Sørensen, Hasle and Bach (2007) found that several aspects of the work environment were related to fi rm size, with ergonomic, physical and chemical hazards signifi cantly greater in SMEs compared to large fi rms. A further issue is that whilst SMEs have signifi - cantly higher accident and injury rates, given their small size and short life span, any small company’s actual experience of serious accidents is likely to be quite limited. This often means that SMEs fail to develop detailed knowledge about the operational risks that they face and so have little understanding about why accidents occur and how they happen. Thus, employers have limited opportunity to develop the type of knowledge that they require to manage risks eff ectively or to appreciate the importance of health and safety; likewise, employees also lack the experience to learn how to recognize and avoid risks in the workplace (Walters, 2004). Given the nature of SMEs as businesses, they often have considerably less fi nancial stability than large fi rms. As such, SMEs are less likely to invest substantially in health and safety: they will have less certainty about the benefi ts of such investments, particularly in the long term. In addition,

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as employers have limited appreciation of its importance, this may lead to the de-prioritization of health and safety as a target for investment. The lack of resources for health and safety features prominently as an obstacle to the reduction of accidents, as identifi ed by owner-managers of small businesses (Champoux and Brun, 2003; Clarke and Flitcroft, 2008a). External pressures on SMEs will increase the need to minimize prevention costs, and to give priority to production over safety (Champoux and Brun, 2003). In interviews with senior managers in UK-based SMEs, Clarke and Flitcroft (2008a) found that the most prominent theme identifi ed as a hindrance to safety was economic change and fi nancial pressure. This is likely to underlie the tendency for SMEs to demonstrate ‘resource poverty’ in relation to safety (Clarke and Flitcroft, 2008a). Lack of investment in resources for health and safety often means that SMEs are unable to employ specialists to manage specifi c aspects of the business. Therefore, senior managers are frequently expected to undertake a variety of management functions, including health and safety, where they may have little experience or formal training. For example, in a survey of Spanish and UK-based SMEs, Vassie, Tomàs and Oliver (2000) found that the majority of respondents did not employ a dedicated health and safety manager, with senior managers in 77 per cent of SMEs involved in health and safety. In addition to their responsibility for occupational safety, managers may have multiple responsibilities, such as fi re protection, security and environmental issues (Tint and Jarvis, 2009). In the smallest fi rms (particularly those with less than 50 employees), owner-managers are most likely to retain control of health and safety responsibilities in their company, rather than delegating this responsibility to other managers (Champoux and Brun, 2003). Furthermore, SMEs may lack contact with supportive organizations that could provide them with relevant information on risk prevention – with managers themselves unable to pursue this information on behalf of the company as they do not have the time, means, or the inclination to do so (Swuste, 2008). Walters (2004) has argued that health and safety issues for SMEs are much more likely related to poor risk management than they are related to the absolute severity of the hazards involved. This is supported by research studies, which have highlighted a range of management-related factors associated with SMEs that appear to contribute to their increased health and safety risk (e.g. Champoux and Brun, 2003; Cheng et al., 2010; Clarke and Flitcroft, 2008a; Sørensen et al., 2007; Vassie et al., 2000). The management approach of SMEs has been found to diff er signifi cantly in comparison to large fi rms, with informal management being the predominant style in SMEs, particularly for companies at the smaller end of the scale (Matlay, 1999). SMEs tend to adopt more informal human resource

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practices and make less use of systematic recruitment and selection procedures, performance appraisals and regular formal training (e.g. Bacon and Hoque, 2005; Cassell, Nadin et al., 2002; Dundon and Wilkinson, 2003). Defi ciencies in organizational processes that are relevant to occupational safety, such as the provision of training, safety management systems, communication, and human resource practices, have been linked with the increased incidence of workplace accidents (e.g. Shannon et al. 1997; Vredenburgh, 2002; Zacharatos et al., 2005). Vredenburgh (2002) examined the eff ects of six management practices: worker participation, safety training, hiring practices, reward system, management commitment, and communication and feedback. Together these management practices signifi cantly predicted injury rates (accounting for approximately 17 per cent of the variation in injury rates). Furthermore, the lowest injury rates were associated with proactive management practices for ensuring safety, especially in relation to hiring practices and training. Shannon et al. (1997) identifi ed a number of organizational practices that were consistently associated with lower injury rates: empowerment of the workforce (in general matters); delegation of safety activities; and an active role (in health and safety) of top management. However, the level and use of discipline for safety violations was found to be consistently associated with higher injury rates. Zacharatos et al. (2005) were also able to demonstrate that human resource practices (employment security, selective hiring, extensive training, teams and decentralized decision making, reduced status distinctions, information sharing, contingent compensation, transformational leadership, high quality work, and measurement of management practices) associated with a high-performance work system (HPWS) accounted for 8 per cent of the variance in lost-time injury rates in a sample of Canadian manufacturing organizations. Therefore, there is substantial evidence supporting the use of proactive management practices in the prevention of workplace accidents. This is particularly pertinent in the case of SMEs, where management practices have been noted as informal and, in many cases, defi cient.

SAFETY CULTURE AND SAFETY CLIMATE IN SMALL AND MEDIUM SIZED ENTERPRISES

A positive organizational ‘safety culture’ is refl ected in the company’s safety policies, procedures and practices; these are largely determined by senior managerial decisions concerning the management of hazards. Indeed, decision-making at a senior management level in relation to hazards has been described as the driving force of an organization’s safety

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culture (Reason, 1997). Consequently, the development of a positive safety culture will be hampered in an organizational context characterized by insuffi cient information, experience and expertise in relation to hazard management. On a day-to-day basis, the infl uence of senior management decisions concerning safety is refl ected in the balance between the priority given to safety versus other organizational goals (such as productivity). Zohar (2008) argues that employees’ safety perceptions are fundamentally shaped by daily interactions that refl ect the ‘trade-off ’ between production and safety. Although little research has explicitly addressed the mechanisms underlying the relationship between organizational and management- related factors and the occurrence of workplace accidents, the concept of ‘safety climate’ has been suggested as an important mediating variable (Zacharatos et al., 2005). Neal and Griffi n (2006) defi ne safety climate as ‘individual perceptions of policies, procedures and practices relating to safety in the workplace’ (pp. 946–947). These perceptions refl ect the priority that employees believe the organization gives to safety issues in relation to other organizational concerns, and so safety climate may be regarded as a manifestation of the underlying safety culture (Mearns et al., 2003). Eff ective organizational processes, such as the safety management system, and perceptions of management concern for employees’ safety and well- being, would be expected to facilitate a positive safety climate amongst the workforce. Perceived organizational support (where employees perceive that the organization values and shows commitment to them) has been found to enhance communication and information-sharing in the workplace, consequently leading to an improved safety climate (Hofmann and Morgeson, 1999; Wallace et al., 2006). At an individual level, research indicates that employees’ perceptions of the safety climate have a signifi - cant relationship with their subsequent safety behaviour and involvement in workplace accidents (e.g. Clarke, 2006; Johnson, 2007; Pousette et al., 2008). Clarke’s (2010) meta-analysis demonstrated a moderate eff ect size for the association between safety climate and safety behaviour (ਭ ϭ .38) and a smaller but signifi cant association with occupational accidents (ਭ ϭ .17). This would suggest that the safety climate acts as a psychological mechanism by which individual and organizational factors interact and may ultimately result in accidents. A positive safety climate, in which employees perceive that safety is prioritized by the organization, reduces an organization’s vulner- ability to accidents. However, much of this evidence is drawn from large organizations, with few studies focusing on safety climate in SMEs. One exception was a study conducted by Zohar and Luria (2005), which examined organizational safety climate and group-level safety climate

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in 36 manufacturing SMEs (average size: 111 employees). They found that organization-level climate was correlated with safety engineering audit scores (r ϭ .46, p Ͻ .01), and group-level climate was correlated with observed safety behaviour (r ϭ .38, p Ͻ .01). These fi ndings would suggest that safety climate within SMEs is associated with measures of organizational safety (at an organizational level) as well as with employees’ safety-related behaviour (at a group level). Furthermore, they found that there was a stronger cross-level relationship between organization and group climate strengths under high procedural formalization; this fi nding indicates that the more highly formalized the safety rules and regulations, the more similar the group-level climate was to the overall organizational climate. This is likely due to the limited opportunity for supervisory discre- tion in implementing formal procedures; where there is greater latitude for supervisors to implement rules and regulations group-level climate is likely to demonstrate more variability between teams. Such fi ndings indicate the importance of both senior and local managers in shaping the safety climate within SMEs, as well as the association between safety climate and safety outcome measures. Reviews have identifi ed some common themes, or dimensions, of a positive safety climate (Clarke, 2000; Flin et al., 2000). The signifi cance of management is refl ected in most defi nitions of safety climate; in particular, many studies have identifi ed employees’ perceptions of management commitment to safety as fundamental (e.g. Brown and Holmes, 1986; Dedobbeleer and Béland, 1991; Cox and Cheyne, 2000). In addition to management commitment to safety, which often emerges as the primary factor, other fi rst-order factors have been identifi ed, including: safety systems, workplace risk, and work pressure (Clarke, 2000; Flin et al., 2000; Guldenmund, 2000). Flin et al. (2000) found that the most typically assessed dimensions relate to management (72 per cent of studies), the safety system (67 per cent) and risk (67 per cent), in addition, themes relating to work pressure and competence appeared in a third of studies. Management commitment to safety is broadly defi ned and includes a range of managerial actions and attitudes towards safety. Safety systems include many diff erent aspects of the organization’s safety management system, such as safety policies, safety committees and safety equipment. Risk is also broadly defi ned and relates to employees’ perceptions of risk and hazards on the worksite. Whilst these are the most common dimensions of safety climate reported in studies, the number and content of the sub-factors can vary substantially between studies, and is often tailored to the specifi c industry, organization or topics under investigation. Recently, researchers have sought to order the importance and relative predictive power of the various dimensions of safety climate in relation to employ-

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ees’ safety behaviour. Morrow, McGonagle, Dove-Steinkamp, Walker, Marmet and Barnes-Farrell (2010) examined safety climate for a sample of US railway workers in terms of three dimensions: management safety, co-worker safety and work–safety tension. Contrary to expectations, work–safety tension demonstrated the strongest association with unsafe behaviour, dominating both management safety and co-worker safety. Although the authors expected management safety to dominate the other two dimensions of safety climate, they argued that work–safety tension best refl ects individual perceptions of safety priority and therefore has a more direct eff ect on individuals’ unsafe behaviour. Kath, Marks and Ranney (2010) conducted a similar study in a sample of Canadian railway maintenance workers, examining the relative eff ects of management safety, work–safety tension and co-worker safety on safety-related behaviour. They found that the dominant predictor of employees’ upward communication to supervisors was management safety, followed closely by work–safety tension, but that co-worker safety contributed little predictive power over other predictors. This study did support the dominance of management safety, however, in this case the safety behaviour was upward communication to supervisors (which is more closely related to safety participation than safety compliance, i.e., following rules and procedures), which may help to explain the diff erence in the fi ndings reported by Morrow et al. (2010).

CHALLENGES FOR SMALL AND MEDIUM SIZED ENTERPRISES: IMPLICATIONS FOR THE SAFETY CLIMATE

Much of the research conducted on safety climate has focused on large organizations. However, there are a few studies that have included organizations of varying sizes, in order to investigate the impact of organizational size on the level of safety climate. Baek, Bae, Ham and Singh (2008) investigated safety climate in Korean manufacturing companies of varying plant size: they found that on three dimensions of safety climate, managers demonstrated no signifi cant diff erences. However, safety climate was lowest on all three subscales (management commitment to safety; merits of health and safety procedures; accidents and near-misses) for managers of plants with less than 99 employees (compared to plant sizes of 100–999 and 1000+ employees). Ma and Yuan (2009) investigated safety climate in Chinese manufacturing companies. They derived a six-factor safety climate scale across the entire sample of employees based in both SMEs and large companies: employees’ safety commitment; management

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support; risk judgement; safety communication; employees’ safety competency; and safety training. They found that the overall safety climate level was signifi cantly lower in SMEs compared to large companies. SMEs scored lower on all six subscales, but the largest diff erences were in relation to safety training and management support. In follow-up interviews, managers and employees in SMEs identifi ed lack of time for safety training to be the most signifi cant issue.

Management Commitment to Safety

The major factor driving the safety climate within SMEs is likely to be the visible commitment that managers demonstrate to safety, particularly given that responsibility for health and safety often falls to the most senior managers in the company (Vassie et al., 2000). Research has suggested that senior managers’ safety attitudes are crucial to an understanding of the type of safety activities supported by an organization (Flin, 2003) and the success of safety interventions (Barrett et al., 2005). Rundmo and Hale (2003) examined the safety attitudes of presidents, vice-presidents and senior managers in a Norwegian off shore oil company; they showed that safety attitudes were strongly related to managers’ behavioural intentions and self-reported behaviours in relation to safety activities, including safety communication, motivating workers and improving safety measures. Safety attitudes that were most important related to high management commitment, high safety priority, high risk awareness, and low fatalism. Safety attitudes and perceptions of senior managers in SMEs are likely to be particularly important in relation to employees’ perceptions of safety. Lack of time and expertise in relation to health and safety may lead to managers taking an informal and ‘hands off ’ approach to safety management. However, research has shown the dangers of passive leadership on safety. Zohar (2002) found that passive leadership styles, namely management-by-exception (passive) and laissez-faire, had a negative impact on safety climate and subsequently led to increased occupational injuries. A further study by Kelloway, Mullen and Francis (2006) found that passive leadership (where the leader waits for things to go wrong before taking action and fails to intervene until safety problems are serious) had an indirect eff ect on safety-related events and occupational injuries via its negative impact on employees’ safety perceptions (safety climate) and their safety consciousness. Thus, passive safety leadership does not have ‘null’ eff ects, but has a signifi cant association with increased occupational injuries. Given external pressures on SMEs, there is often a strong tendency for managers to focus on production as a priority over safety (Champoux and Brun, 2003). Kelloway et al. (2006) argue that it is

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important to understand that leaders may manifest more than one leadership style in relation to diff erent organizational goals: thus, they may demonstrate a transformational style when motivating employees to put extra eff ort into production activities, but simultaneously display a passive style in relation to safety. However, managers may not appreciate the potentially damaging eff ects on safety outcomes, as a passive stance in relation to safety has negative, rather than neutral, impact. These negative eff ects will directly infl uence the occurrence of accidents by reducing safety consciousness and creating a negative safety climate (Kelloway et al., 2006), and indirectly through the creation of negative work conditions, such as role ambiguity, role confl ict and confl icts between co-workers (Skogstad et al., 2007), which increase the likelihood of work stress and consequently workplace accidents.

Effi cacy of Safety Management Systems

Reviews of safety climate models (based on large organizations) have highlighted ‘safety systems’ as a factor in approximately two-thirds of studies (Flin et al., 2000; Gadd and Collins, 2002). This perception of formal safety systems as having a signifi cant infl uence on safety would not be expected in SMEs, where systems are much less formalized. Researchers have demonstrated that the quality of occupational safety organization and the use of workplace risk assessment have a tendency to increase with increasing organizational size (Sørensen et al., 2007). These fi ndings are refl ected in research on the quality of safety management systems operated by SMEs. Clarke and Flitcroft (2008a) found that the UK-based SMEs in their study had only basic safety management systems in place. Similarly, Vassie et al. (2000) reported that the majority of UK-based SMEs (80 per cent) had a written safety policy, as well as formal procedures relating to risk assessment and accident reporting, but little evidence of proactive safety management practices. Champoux and Brun (2003) found that the minor- ity of their respondents (13 per cent) had written prevention activities that focused solely on accident prevention. This was in contrast to preventive activities that had a direct bearing on production, such as equipment maintenance, which were used routinely by all companies. Furthermore, very few (5 per cent) had formal participatory mechanisms (such as health and safety committees), despite these being required by legislation. Clarke and Flitcroft (2008a) found more evidence of preventive activities, such as keeping records of ‘near-misses’ and feedback to staff on health and safety issues, but still little evidence of employee participation and active involvement. In a study which controlled for organizational size, Arocena,

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Nunez and Villanueva (2008) found that the intensity and emphasis on innovation in preventive practices, in conjunction with workers’ empowerment, was associated with lower injury rates in their sample of 213 Spanish industrial organizations. The authors were able to identify a synergetic eff ect between the innovative orientation in safety management and high level of workers’ empowerment; this fi nding would suggest that additional benefi ts are gained from workers’ empowerment when combined with innovative preventive activities, such as risk prevention training, information communicated to workers and the collection of feedback.

Work Environment: Hazards and Risk Management

Given that SMEs are often heavily focused on their own survival, a greater emphasis on managing workplace risks would be expected in contrast to large organizations, where issues around work environment and risk tend to be less prevalent (Flin et al., 2000). Indeed, Clarke and Flitcroft (2008c) found that the factor structure of employee safety climate in SMEs dif- fered from that found in large organizations. Whilst ‘management commitment to safety’ emerged as the major factor common to both SMEs and large organizations, risks in the work environment were refl ected in the fi rst-order factor structure for SMEs, whilst formal safety systems did not emerge as a factor. Such research would suggest that SMEs may prioritize the work environment over formal health and safety systems, and so the safety climate refl ects these diff ering safety foci. Although there is evidence that SMEs tend to operate in more hazardous work environments, there is little indication that SMEs adopt formal risk assessment and control processes to manage those risks eff ectively (Sørensen et al., 2007). Preventive activities in SMEs tend to focus on employee behaviour (such as safety training and an emphasis on rules and regulations). Nevertheless, whilst SMEs believe that safety training is important this is not always refl ected in their fi nancial planning. For example, Clarke and Flitcroft (2008a) found that managers in UK-based SMEs ranked ‘provision of relevant safety training’ as the second most important safety issue in their company (with ‘working in a safe manner’ ranked top), but that only half of those companies surveyed included a training budget within their fi nancial accounts (Clarke and Flitcroft, 2008a). Lack of training is frequently identifi ed by SMEs as an obstacle to improving safety outcomes (Champoux and Brun, 2003; Ma and Yuan, 2009). Furthermore, the negative impact of poor training in SMEs is refl ected in accident and injury rates. For example, insuffi cient safety education and training was found to signifi cantly increase the risk of occupational injury to newly hired construction workers in small Taiwanese

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construction companies (Cheng et al., 2010). The emphasis on employee behaviour within SMEs likely refl ects the belief of owner-managers that it is employees that cause – and are to blame for – workplace accidents (Champoux and Brun, 2003). Research has shown that the implementation of risk control measures is infl uenced by this belief concerning the causation of accidents (Hasle et al., 2009). Hasle et al. (2009) found that owner-managers of small companies most frequently attributed accidents in their companies to unforeseen circumstances, the worker’s fault or a combination of both – that is, they viewed the causes of accidents as beyond their own control. Consequently, eff ective risk control measures to prevent future accidents were rarely implemented. This approach to risk management, which fails to acknowledge the role of managerial and organizational factors in accident causation, leads to inadequate investigation of accidents and subsequently a lack of organizational learning.

POTENTIAL SOLUTIONS: DEVELOPMENT OF SAFETY CULTURE

Organizational safety culture relates to ‘the fundamental underlying beliefs and values of a group of people in relation to risk and safety’ (Glendon et al., 2006). These beliefs and values are embedded within the organization; they are refl ected in norms and rules for handling hazards, attitudes towards safety and refl exivity on safety practice (Pidgeon, 1991). Perhaps the most important drivers for the development of a positive safety culture in the context of SMEs are employers’ motivation and workers’ participation. SMEs often lack the organizational infrastructure to successfully implement the type of safety interventions that work for large organizations. SMEs require safety solutions that are both uncom- plicated and cost-eff ective. The focus of safety interventions in SMEs is often technical (aimed at controlling the risks associated with a specifi c hazard) or based on safety education and training (where success depends on safety knowledge being transferred to the workplace). However, the most successful safety interventions are likely to engage employer motivation and/or employee participation in order to bring about lasting change in the underlying safety culture.

Direct Cultural Change: Changing Norms and Attitudes

Safety interventions aimed at direct cultural change are rarely reported within the literature. However, Stave and colleagues (Stave et al., 2007, 2008) report on the implementation and evaluation of a safety intervention

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in small farms (located in Sweden), which aimed at improving safety culture and therefore reducing workplace accidents. The intervention aimed to provide social support, enhance perceptions of risk manageability and encourage refl ection on practice. A network of farmers was created so that participants had a forum in which to share information and experiences, which was supported by a change facilitator (to stimulate ideas from farmers, rather than to provide expert advice). In addition, farmers kept ‘incident diaries’ as a means of logging and refl ecting upon their experiences. In order to evaluate the eff ect of the intervention, measures were taken at baseline (pre-intervention) and one year later (post- intervention). Stave et al. (2007) reported signifi cant short-term eff ects on self-reported ‘safety activity’ and ‘risk acceptance (fearlessness)’. Safety activity increased signifi cantly: this meant that farmers agreed that they tried to fi nd methods and equipment to improve safety, co-operated with farm-workers to improve safety, and often discussed how to make work safer. At the same time, risk acceptance signifi cantly decreased. This demonstrated that farmers’ attitudes towards risk had changed – they disagreed with attitudes such as ‘You have to learn to live with the risks at work’ and ‘A farmer/farm worker should be able to take care of himself’. However, other risk perceptions remained unchanged, with no signifi cant diff erences found for ‘risk perception’ and ‘risk manageability’. Stave et al. (2008) reported a further follow-up study where measures were taken fi ve years after the baseline measure (including measures taken from a control group, also surveyed at baseline). This study showed that the short-term eff ects reported by Stave et al. (2007) were sustained for a further four years. Thus, the eff ect of the intervention (i.e. increased safety activity and decreased risk acceptance) remained stable four years after the intervention ended. The data collected for the comparison group showed that there was no equivalent pattern and so the long-term eff ects may be attributed to the intervention.

Changing to an Informed Culture: Communication and Feedback

Reason (1997) argued that a safe culture is an ‘informed culture’, which is built upon the collection of safety-related data (such as accidents, near- misses and safety-related events) and conducting proactive checks (such as risk assessments and safety audits). The collection of such data is often hampered in SMEs by a lack of resources and inadequate reporting and investigation systems (Champoux and Brun, 2003; Clarke and Flitcroft, 2008a). Conducting proactive checks can be a particular challenge for SMEs, as they often lack access to specialist advice and fail to implement sys-

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tematic risk assessment techniques. However, there have been attempts to introduce user-friendly methodologies for identifying and evaluating risks in the workplace, which may be more accessible for SMEs. For example, Jørgensen, Duijm and Troen (2010) investigated the feasibility of collect- ing risk information from employees using hand-held computers (personal digital assistants or PDAs) in a sample of Danish SMEs. This methodol- ogy enabled SMEs to collect data on hazards during ordinary work. It acted as a proactive method of gaining information about hazards and safety barriers, rather than the company only reacting to incidents and accidents after their occurrence. The project also focused on management factors that can motivate SMEs to heighten their risk-awareness and expand their own initiatives. However, although the project was successful, in that employees were able to use the PDAs eff ectively to record information, the authors concluded that SMEs were unlikely to adopt this method of risk identifi cation of their own accord. A further feature of an informed culture is that it depends upon the encouragement of feedback and employee participation, rewarding employees for the provision of safety-related information (rather than blaming individuals when things go wrong), as well as a willingness to learn the right lessons and to implement solutions, and fl exibility in the management of workplace hazards (Reason, 1997). Given the nature of SMEs, especially small and micro-businesses, closer social relationships may be utilized to facilitate enhanced communication and trust in managers. Hofmann and Morgeson (1999) found that close and positive relationships between managers and employees led to increased safety communication, which in turn was associated with lower accident rates. However, Jansen, Stuebing, Ekeberg and Sykora (2006) found that, contrary to their expectations, smaller worksites reported signifi cantly more negative perceptions of site management support. This fi nding may be due to managers of larger worksites benefi ting from more structured communication and support than those at smaller sites (Jansen et al., 2006). Safety interventions have been successfully implemented in UK-based SMEs: Clarke and Flitcroft (2008b) established eff ective means of communicating and gaining feedback from employees within a sample of SMEs. This led to signifi cant improvements in the safety climate over a four- month period. Although close interpersonal relationships within SMEs can have benefi ts in terms of high leader–member exchange and trust, this can also hinder the implementation of risk control measures and organizational learning following accidents (Hasle et al., 2009).

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Changing from the Top: Safety Leadership

Safety leadership will have an important eff ect on safety outcomes. Research has focused on the benefi ts of safety-specifi c transformational leadership, which has been associated with higher safety consciousness in workers and fewer injuries (Barling et al., 2002; Kelloway et al., 2006). This leadership style is characterized by rewarding and encouraging safe behaviour, listening to employees’ concerns, encouraging employee safety participation, and demonstrating visible commitment to safety. Given the crucial role played by senior managers in SMEs, particularly owner-managers of small and micro-businesses, adopting a leadership style conducive to safety is particularly important in terms of reducing health and safety risks. Conchie and Donald (2009) highlight the issue of looking at transformational leadership and trust in managers from a safety-specifi c perspective. As argued by Kelloway et al. (2006), a leader may demonstrate diff erent leadership styles dependent on the domain; thus, a transformational style in relation to production, but a passive style in relation to safety. Conchie and Donald (2009) make a similar point in relation to trust. They found that safety-specifi c trust moderated the relationship between safety-specifi c transformational leadership and safety participation: employees’ safety behaviours were signifi cantly infl uenced by safety-specifi c transformational leadership only in conditions of high (or neutral) safety-specifi c trust, but not in conditions of low safety-specifi c trust. Thus, in order for safety leadership to be eff ective, it must be exercised in the context of high trust. Close social relationships within SMEs have the potential to provide this context of trust in leaders – so that interventions to encourage leaders to demonstrate more transformational behaviours are likely to be successful. There is evidence to suggest that leadership interventions can be eff ective in changing leader behaviour and also impact upon the safety perceptions of employees. Mullen and Kelloway (2009) used leadership interventions to make leader behaviour more transformational (managers gained an understanding of ways to incorporate safety-specifi c transformational leadership behaviours in their daily work). Their research design incorporated three groups of employees: those who received training in general transformational leadership (non-specifi c); those who received training in safety-specifi c transformational leadership, and those who received no training (control group). Training took the form of a half-day workshop instructing participants in the use of transformational leader behaviours in their daily work. The study took measures one week prior to the intervention (pre-test) and three months following the intervention (post-test). Measures of outcomes for the leaders showed signifi cant increases in safety attitudes, self-effi cacy and intentions to promote safety

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(with the safety-specifi c training group having signifi cantly higher scores than both the other groups for both self-effi cacy and safety attitudes). For employee outcomes, perceptions of safety-specifi c transformational leadership, safety climate, safety participation, safety-related events, and injuries all showed a signifi cant increase; no signifi cant eff ects were obtained for safety compliance. Although much of the research has focused on transformational leadership, there is evidence that a range of leader behaviours can encourage safe behaviour. This is consistent with the argument that transformational leadership has an augmentation eff ect in relation to transactional leadership, in which transformational leadership adds signifi cantly to a base of transactional behaviours (Bass, 1998; Judge and Piccolo, 2004). Leader tactics of rational persuasion (using logical arguments and factual evidence), coalition (using co-workers to create pressure to comply) and consultation (involving employees in the decision-making process) have been associated with greater safety participation (Clarke and Ward, 2006). Mearns et al. (2010) demonstrated that aspects of authentic leadership, which is characterized by leader self-awareness, relational transparency, internalized moral perspective and balanced processing (Walumbwa et al., 2008), were signifi cantly related to safety climate in the Norwegian off shore oil industry. Such research indicates that a wide range of leader behaviours contributes to employees’ safety perceptions and safety behaviour, and ultimately infl uences safety outcomes. Leadership behaviour is particularly important within SMEs, where managers and employees are likely to form closer social and working relationships than is often possible within large organizations.

CONCLUSIONS

Accident statistics demonstrate that the occupational injury rate is substantially higher in SMEs compared to large enterprises. However, safety improvements achieved by large organizations cannot be simply ‘scaled down’ to form solutions to the occupational safety issues faced by SMEs. There is evidence to suggest that SMEs have a relatively greater exposure to risk, lack experience in managing hazards, under-invest in health and safety, and lack access to relevant support and expert advice. However, health and safety issues for SMEs are much more likely to be related to managerial and organizational factors than the absolute severity of the hazards involved. SMEs do not have the same safety infrastructures as large organizations, and have less sophisticated organizational processes, especially human resource practices and safety management systems. This

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means that SMEs have failed to achieve the safety benefi ts associated with safety management, risk assessment and high performance work systems. Furthermore, this is refl ected in employees’ perceptions of organizational safety (safety climate), in terms of their perceptions of management commitment to safety, safety systems and risks in the work environment. SMEs would benefi t from interventions designed to develop a more positive safety culture. The main drivers towards a positive safety culture are employers’ motivation and employees’ participation. Thus, developing safety interventions with these objectives are likely to be most benefi - cial. Safety interventions would include: changing management attitudes towards safety; improving communication and feedback; encouraging employee participation; and leadership training to develop a less passive safety leadership style.

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Reason, J.T. (1997), Managing the Risks of Organisational Accidents, Aldershot: Ashgate. Rundmo, T. and Hale, A.R. (2003), ‘Managers’ attitudes towards safety and accident prevention’, Safety Science, 41, 557–574. Shannon, H.S., Mayr, J. and Haines, T. (1997), ‘Overview of the relationship between organizational and workplace factors and injury rates’, Safety Science, 26, 201–217. Skogstad, A., Einarsen, S., Torsheim, T., Aasland, M.S. and Hetland, H. (2007), ‘The destructiveness of laissez-faire leadership behaviour’, Journal of Occupational Health Psychology, 12, 80–92. Sørensen, O.H., Hasle, P. and Bach, E. (2007), ‘Working in small enterprises – is there a special risk?’, Safety Science, 45, 1044–1059. Stave, C., Pousette, A. and Törner, M. (2008), ‘Risk and safety communication in small enterprises: how to support a lasting change towards work safety priority’, Journal of Risk Research, 11, 195–206. Stave, C., Törner M. and Eklöf, M. (2007), ‘An intervention method for occupational safety in farming: evaluation of the eff ect and process’, Applied Ergonomics, 38, 357–368. Swuste, P. (2008), ‘“You will only see it, if you understand it” or occupational risk prevention from a management perspective’, Human Factors and Ergonomics in Manufacturing, 18, 438–453. Tint, P. and Jarvis, M. (2009), ‘The formation of a good safety culture at enterprise’, Journal of Business Economics and Management, 10, 169–180. Vassie, L., Tomàs, J.M. and Oliver, A. (2000), ‘Health and safety management in UK and Spanish SMEs: a comparative study’, Journal of Safety Research, 31, 35–43. Vredenburgh, A.G. (2002), ‘Organizational safety: which management practices are most eff ective in reducing employee injury rates?’, Journal of Safety Research, 33, 259–276. Wallace, J.C., Popp, E. and Mondore, S. (2006), ‘Safety climate as a mediator between foundation climates and occupational accidents: a group-level investigation’, Journal of Applied Psychology, 91, 681–688. Walters, D. (2004), ‘Worker representation and health and safety in small enterprises in Europe’, Industrial Relations Journal, 35, 169–186. Walumbwa, F.O., Avolio, B.J., Gardner, W.L., Wernsing, T.S. and Peterson, S.J. (2008), ‘Authentic leadership: development and validation of a theory-based measure’, Journal of Management, 34, 89–126. Zacharatos, A., Barling, J. and Iverson, R.D. (2005), ‘High-performance work systems and occupational safety’, Journal of Applied Psychology, 90, 77–93. Zohar, D. (2002), ‘The eff ects of leadership dimensions, safety climate, and assigned priorities on minor injuries in work groups’, Journal of Organizational Behavior, 23, 75–92. Zohar, D. (2008), ‘Safety climate and beyond: a multi-level multi-climate framework’, Safety Science, 46, 376–387. Zohar, D. and Luria, G. (2005), ‘A multi-level model of safety climate: cross- level relationships between organisations and group-level climates’, Journal of Applied Psychology, 90, 616–628.

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The rate of non-fatal workplace injuries in the United States has decreased every year since 2003, when annual estimates from the Survey of Occupational Injuries and Illnesses were fi rst reported (Bureau of Labor Statistics, 2009). Similarly, the rate of non-fatal work injuries for Canada has declined each year since 2000 (Association of Workers’ Compensation Boards of Canada, 2008). Despite the decline in reported injuries, improvements to workplace safety still need to occur, as millions of workers continue to be seriously injured every year on the job. As evidence of the need for continued improvements in workplace safety, in 2008 approximately 3.5 million workers were injured on the job in the United States (Bureau of Labor Statistics, 2009). This number represents a non-fatal workplace injury rate of 3.9 cases per 100 equivalent full-time workers (Bureau of Labor Statistics, 2009). In addition, approximately 307 802 Canadian workers were injured on the job in 2008 (Association of Workers’ Compensation Boards of Canada, 2008). Previous research has consistently demonstrated that small companies1 report higher injury rates than large companies (i.e. employing more than 100 workers) (Jeong, 1998; McVitte et al., 1997). Although the exact nature of the relationship between company size and injury rate is not fully understood, a number of diff erences have been found to exist between small and large companies that could infl uence safety performance. In particular, a number of organizational factors unique to small companies have been found to infl uence safety performance.

UNIQUE FACTORS ASSOCIATED WITH SAFETY IN SMALL COMPANIES

Small companies often face a number of additional factors that are less common for larger companies, which can infl uence how eff ectively safety

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is managed, and ultimately the company’s safety record. For example, small companies tend to be less fi nancially secure than large companies (MacEachen et al., 2010). Financial stability can infl uence the extent to which safety practices (e.g. safety training) are implemented. Companies that are less fi nancially stable likely do not have additional fi nancial resources to spend on safety improvements. Furthermore, inherent in the defi nition of small companies (i.e. fewer than 100 employees), is limited personnel. With so few workers, small companies often do not have the capacity to hire health and safety personnel trained to identify and address safety hazards, and implement new safety systems (Cheng et al., 2010). Instead, these tasks are usually performed by the owner of the company who is also responsible for running and managing the day-to-day operations of the business. Small companies also tend to rely on implicit and informal safety practices (Vickers et al., 2003) rather than the formal safety systems required by workplace safety legislation and government regulations. Having informal safety practices may be a result of the informal culture that often exists in small companies (Hasle and Limborg, 2006), or it could also be associated with a lack of knowledge of the regulatory requirements for more formal safety practices. Hasle and Limborg (2006) suggest that owners of small companies are often not up-to-date on safety legislation and regulations that apply to their business. Furthermore, lack of knowledge regarding safety legislation was identifi ed during a recent telephone survey conducted with small business owners and managers in high-hazard industries. The results of this study revealed that only approximately half of the respondents were able to describe the health and safety legislation that applied to their business (Vickers et al., 2003). Occupational safety research is increasingly recognizing the importance of identifying organizational factors associated with superior safety performance (Bentley and Haslam, 2001). Even though small companies have a number of additional unique factors that can aff ect safety performance, they still face the same fundamental safety management challenge as do large companies, of ensuring that eff ective hazard control strategies are in place, and are being properly implemented. Therefore, in addition to the unique organizational factors specifi c to small companies identifi ed above as infl uencing safety records, it is also important to consider other boarder organizational factors which may additionally impact small company’s safety performance. Accordingly, this chapter aims to identify a comprehensive list of organizational factors associated with superior safety performance in small companies. There is a long-standing tradition in occupational safety research of identifying organizational factors associated with safety performance by

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comparing high and low accident rate companies (Chew, 1988; Cleveland et al., 1979; Shafai-Sahrai, 1973; Simard and Marchand, 1994). In particular, studies comparing high and low accident rate companies have identifi ed a number of safety practices that have consistently been associated with low accident companies, while rarely identifi ed as part of high accident company’s safety programmes. As a result, these studies have established a number of organizational safety practices that are associated with superior safety performance. Therefore, the goal of the current study is to review the safety practices commonly associated with superior safety performance of low accident companies, and extend this research by examining the extent to which these practices are present in small companies within a high hazard industry (i.e. construction).

DIFFERENCES BETWEEN HIGH AND LOW ACCIDENT COMPANIES

One of the fi rst studies to compare organizational practices of high and low accident companies was conducted by Shafai-Sahrai (1973). This study compared the practices of 11 pairs of companies. Shafai-Sahrai matched companies in terms of industry and company size; however, the companies diff ered in terms of injury rates. Shafai-Sahrai concluded that low injury claim rate companies had top management who demonstrated a commitment to safety through emphasizing safety audits and inspections, ensuring safety objectives were met, and through communicating the importance of safety at all levels of the organization (e.g. regularly including safety on the agenda of board meetings). Furthermore, Shafai- Sahrai also concluded that low injury claim rate companies were more likely to have fewer employees per supervisor, and a better (i.e. more effi - cient and comprehensive) incident reporting system. The division of safety research at the National Institute for Occupational Safety and Health (NIOSH) conducted a larger-scale study also examining the organizational practices that distinguished low accident rate companies from those with high accident rates. This research was conducted in three phases. The fi rst phase involved sending a questionnaire (Occupational Safety Program Questionnaire) to 42 pairs of plants that were matched in terms of industrial category, size and location, but that diff ered by at least a 2:1 ratio in their injury rate reported to the Occupational Safety and Health Authority (Cohen et al., 1975). The second phase of this research involved a site visit to seven of the pairs from the fi rst study (Smith et al., 1978). The third and fi nal phase involved sending a questionnaire and visiting the site of fi ve of the top performing companies in the US in terms of

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the number of reported injury incidents in an attempt to verify the results of the fi rst two phases (Cohen and Cleveland, 1983). Cleveland, Cohen, Smith and Cohen (1979) used the results from the phase one survey to support their conclusion that low accident companies were more likely to have a greater variety of safety practices in place, provide more opportunities for safety training, and conduct more frequent, although less formal safety inspections than high accident companies. They argued that the results from the site visits conducted during phase two support their conclusion that senior management commitment and management involvement in safety practices was more evident in low accident companies (Cleveland et al., 1979). Furthermore, they concluded that low accident companies had more communication between supervisors and employees in general, and specifi cally around safety as compared to high accident companies (Cleveland et al., 1979). The third and fi nal phase of this research confi rmed a number of the safety practices associated with superior safety performance in the fi rst two phases: namely, strong management commitment to safety and management’s active involvement in the implementation of safety practices was confi rmed as being associated with superior safety performance. Safety training for all levels of employees (e.g. workers, supervisors, managers), and eff ective two-way communication and feedback between managers/supervisors and employees regarding safety were also confi rmed as being associated with superior safety performance (Cleveland et al., 1979). In addition, the authors concluded that having both an effi cient hazard identifi cation process and a safety evaluation process in place were associated with low accident companies in the fi nal phase of this research. In a similar study to the above, Chew (1988) studied 36 matched pairs of high and low accident companies in three Asian countries (India, Singapore and Thailand), to identify diff erences between high and low accident companies. Within each country, six manufacturing industries that were representative in terms of accident rates were examined. Two pairs of companies were selected for each of the six industries, one company of each pair had a high accident rate, and the other had a low accident rate. Data for this study was collected by means of a detailed questionnaire that was completed during a face-to-face interview. The questionnaire covered 12 areas of organizational practices including: action by the fi rst line supervisor of production, transport and other employees; action by a safety offi cer; commitment of top management; functioning of a safety committee; inspecting for safety; training in safety; accident record keeping; use of safety rules; promotional practices; guard- ing of machines; provision of personal protective equipment; and house- keeping. Chew (1988) concluded that, in general, supervisors in both high

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and low accident rate companies were involved in safety, but that supervisors in low accident companies were signifi cantly more involved. Chew reported a statistical relationship between lower injury rates and the level of supervisory participation, and concluded that supervisory participation contributed to better safety performance. Interestingly, Singapore was the only country where supervisors were rewarded for their safety eff orts and this only occurred in low accident companies. Simard and Marchand (1994), investigated if supervisors in low accident manufacturing plants were more likely to use a participative style of management than supervisors in high accident plants. Initially, 258 plants with over 70 employees were selected by systematic random sampling from a population of 1428 plants divided among 20 manufacturing industries from Quebec, Canada. The plants were grouped into high and low accident plants based on their accident rate relative to their industry average. Plants were classifi ed as low accident if they had a lower compensated work accident frequency rate than the average one for their industrial classifi cation (to the sub-sector level). Plants were coded as high accident plants if they had a higher than average work accident frequency rate. The 258 plants selected were contacted by letter and telephone to obtain their participation, and of these 100 agreed to participate. This data was collected by conducting site visits, a series of interviews, and a battery of 13 standardized self-administered questionnaires. A total of 1064 supervisors were asked to report the frequency with which they were personally involved in a number of safety activities and how frequently their employees were involved in the same activities. These safety activities were: (i) inspections; (ii) safety analysis of critical tasks and working methods; (iii) accident investigation; and (iv) training of new employees. The supervisor’s level of participatory behaviour was measured by cross-tabulating their self reported statements about the frequency of his/her personal involvement in the above four safety activities and the frequency of their employees’ participation in the same activities. Simard and Marchand (1994) reported a signifi cant relationship between supervisory style and level of accidents, such that low accident plants had more supervisors with a participatory style than a hierarchical style of supervision. The previous research comparing high and low accident companies identifi ed eight organizational practices associated with superior safety performance. Table 3.1 summarizes the fi ndings from this literature. While these fi ndings support the conclusion that a number of common organizational practices are associated with low accident rates, it is unclear whether these fi ndings can be generalized to small companies. One limitation of the research comparing safety practices of high and

KKELLOWAYELLOWAY 97818484466949781848446694 PRINT.inddPRINT.indd 3030 227/10/20117/10/2011 10:2910:29 (1994) Supervisor involvement in safety inspections) Worker involvement in safety (e.g. inspections, accident investigation) Chew (1988) Simard and Marchand Supervisors rewarded for safety Supervisor involvement in safety practices cation Cleveland et al. (1979) Phase III Management involvement in safety practices Safety communication Safety training (managers, supervisors, workers) identifi process Safety evaluations ed in previous research comparing high and low accident companies Cleveland et al. (1979) Phase II Management involvement in safety practices Safety communication Cleveland et al. (1979) Phase I training Shafai-Sahrai (1973) Management involvement in safety inspections Safety communication Having an incident reporting system involvement in safety inspections communication investigation evaluation involvement in safety inspections in safety Table 3.1 Organizational safety practices identifi Organizational Practice Management Safety Incident Safety TrainingHazard assessment Safety performance Safety Supervisor Worker involvement Hazard

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low accident rate companies is the majority of studies only included large companies. For instance, the fi ve participating companies in phase three of the NIOSH research project ranged in company size from approximately 525 workers to approximately 2300 workers (Cleveland et al., 1979). To date, no study comparing safety practices of high and low accident rate companies has focused exclusively on small companies. Therefore, it is unclear if the organizational practices associated with low accident companies (see Table 3.1) are associated with superior safety performance in small companies. In addition, as noted earlier, small companies diff er from larger companies in several ways and face unique challenges (e.g. fewer resources, more informal culture), and this may infl uence their approach to managing safety. It is therefore important to investigate the extent to which the organizational practices identifi ed in previous research also infl uence safety performance in small companies. The reminder of this chapter describes the study design and results of a recent research project that examined the extent to which the organizational practices outlined in Table 1 are present in small companies, and the extent to which these practices distinguish low and high claim rate companies that employ fewer than 100 workers.

METHOD

This study was conducted in three phases. Phase I involved the development of an interview protocol to assess the safety practices of participating organizations. Phase II involved identifying construction companies with high and low injury claim rates in Nova Scotia, Canada. Phase III involved conducting interviews with a sample of the companies identifi ed in phase II.

Phase I: Interview Protocol

In order to investigate the organizational practices that are associated with eff ective safety management in small construction companies it was necessary to develop an instrument to assess these practices. Table 3.1 summarizes the organizational practices that distinguish low accident companies from high accident companies identifi ed in previous research. These eight practices were used as the starting point for developing the interview protocol for the current study. We increased the number of indicators assessed with the interview protocol from eight to 11 by specifying the target group for two of the practices. Specifi cally, the practice of providing safety training was expanded by separating out training for: (1)

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managers, (2) supervisors, and (3) workers. Furthermore, the practice of safety performance evaluation was expanded to include: (1) managers’, and (2) supervisors’ safety performance evaluations. Therefore, the interview protocol included the following eleven sections:

1. Hazard assessment 2. Incident investigation 3. Worker involvement in safety 4. Manager safety training 5. Manager performance evaluation 6. Manager safety inspections 7. Supervisor safety training 8. Supervisor performance evaluation 9. Supervisor safety inspections 10. Safety communication 11. Worker safety training

The comparison of small construction companies on these organizational safety practices requires a simple framework to classify performance on a continuum from poor to good. There are a large number of models that classify company performance on such a continuum, or by level of maturity. One of the earliest maturity models was the Quality Management Maturity Grid developed by Crosby (1979). This typology consisted of fi ve levels: (1) Uncertainty, (2) Awakening, (3) Enlightenment, (4) Wisdom, and (5) Certainty, to describe an organization’s approach to quality management. The maturity model framework became popular after the very successful Capability Maturity Model was developed for software (Paulk et al., 1993). More recently there has been signifi cant interest in safety maturity frameworks (Ashcroft et al., 2005; Fleming, 2000; Lawrie et al., 2006; Parker et al., 2006). Safety maturity frameworks build on the fundamental assumption that safety can range from poor to good. Maturity models also aid in identifying an organization’s areas of particular strength or weakness (National Patient Safety Agency, 2006), and what actions need to be taken to improve (Paulk et al., 1993). Westrum’s (1984) typology of an organization’s culture identifi es three basic styles of organizations: pathological, bureaucratic and generative. Pathological organizations are described as environments where there is a focus on personal needs, power and glory. Bureaucratic organizations are described as environments where there is a fi xation with rules, positions and departmental territory. Generative organizations are described as environments where there is a focus on the mission, rather than on persons

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or positions (Westrum, 2004). Westrum (1996, 2004) proposes that this typology can be used to categorize organizational culture. Specifi cally, Westrum argues that in pathological cultures, information is only important if it will aff ect personal interests. In bureaucratic cultures, information is only used to advance the goals of the department, and in generative cultures, emphasis is placed on using information to aid in accomplishing the mission (Westrum, 2004). Westrum (1996, 2004) also proposes that this typology can be used to characterize organizations on how they respond to failure. For example, in pathological organizations, information is hidden and failures are dealt with by blaming a scapegoat. In bureaucratic organizations, information may be ignored and failures are explained away or resolved, with no deeper inquiry into them, whereas generative organizations actively seek information and inquiries occur after failures are discovered, which serve to attack the underlying conditions, not just the immediate causes of the failures. Reason (1993) adapted Westrum’s tripartite typology, so that it applied to occupational safety by expanding the typology to fi ve and modifying one element. The two additional levels are reactive and proactive. Reactive organizations state that safety is important to them, but respond only after accidents have occurred. Proactive organizations try to anticipate safety issues before they happen (Reason, 1998). Reason (1993; 1998) also modifi ed Westrum’s model by renaming bureaucratic organizations to calculative organizations, as it provided a better description of how safety is managed within these organizations. Therefore, Reason’s organizational typology describes fi ve levels of safety maturity: pathological, reactive, calculative, proactive and generative (see Table 3.2). Although maturity models describe diff erent approaches to managing safety on a continuum from poor to good, they are not necessarily stage models, which require organizations to progress through each level in sequence. These frameworks facilitate making judgements about the sophistication of an organization’s approach to safety management. At the pathological level organizations are not working to ensure worker safety, the reactive level is typifi ed by a focus on compliance with regulation, the calculative level involves using proven methods to manage common hazards, the proactive level involves anticipating and managing infrequent hazardous situations, and the generative level involves an innovative and comprehensive approach to safety management. Reason’s (1993, 1998) framework provides a useful structure for the interview protocol, as it allows not only for the evaluation of what safety practices are currently present in an organization, but it also provides a

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Table 3.2 Safety culture maturity framework

Pathological No systems in place to promote a positive safety culture. Reactive Systems are piecemeal, developed in response to incidents and/or regulatory or accreditation requirements. Calculative Systematic approach to safety but implementation is patchy and inquiry into events is limited to circumstances surrounding a specifi c event. Proactive Comprehensive approach to promoting a positive safety culture. Evidence based intervention implemented across the organization. Generative Creation and maintenance of a positive safety culture is central to the mission of the organization. They evaluate the eff ectiveness of interventions. Generative organizations drain every last drop of learning from failures and successes, and take meaningful action to improve.

basis for evaluation of the degree of sophistication of each safety practice. Therefore, the 11 organizational practices were mapped onto the maturity framework outlined by Reason (1998), resulting in fi ve possible levels of sophistication for each practice. An example of one of the eleven sections of the interview protocol is presented in Table 3.3.

Table 3.3 Safety practice example from interview protocol: management’s involvement in safety inspections

Safety practice Level Managers do not visit worksite to specifi cally discuss safety 0 Managers visit worksite regularly to discuss safety as specifi ed by a 1 formal policy/ programme There is a formal manager worksite visit programme that specifi es the 2 number of visits to be conducted by each manager and tracks completion There is a comprehensive programme that specifi es how to perform a 3 worksite visit, trains managers how to conduct a visit, evaluates managers to ensure they are competent and tracks frequency of visits and close out of actions 3 There is a comprehensive programme described above plus the quality 4 of the managers’ visits is evaluated by workers and anonymous feedback is provided.

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Phase II: Identifying High and Low Injury Rate Companies

The Nova Scotia Construction Safety Association (NSCSA) and Workers Compensation Board (WCB) of Nova Scotia provided assistance with this project. The WCB provided NSCSA with a database containing the claims data for all Nova Scotia construction companies from 2005 to 2008. NSCSA replaced each company name with a unique numerical code and also indicated if the company had a Certifi cate of Recognition (COR).2 NSCSA gave this database to the research team. We converted the database into SPSS 17 for statistical analysis. The database contained the number of lost time injury claims, medical attention claims, no payout claims (i.e., rejected claims), and total claims for each company. We selected the total number of accepted claims (total claims – no payout claims) from 2005 to 2008 as the safety performance measure. We then selected the total number of accepted claims because it was the broadest measure of safety failures available, and it was less likely to be infl uenced by external factors such as return to work practices. In order to control for company size, we created a claim rate by dividing the total accepted claims by the total assessable payroll for 2005–2008. Total assessable payroll is related to the number of people that a company employs, as each company must pay a proportion of an employee’s salary as a WCB premium. There is a maximum premium per employee, which is based on maximum compensatable earnings (currently CA$50 400). When creating the claim rate, it was noted that while total assessable payroll is related to the number of people employed, it is not equivalent, as it is possible that two companies with the same assessable payroll could have diff erent numbers of employees. For example, Company A could employ 10 people at an annual salary of CA$25 000 and have an assessable payroll of CA $250 000, and Company B could employ fi ve people at CA $50 000 and also have an assessable payroll of CA $250 000. However, while variations in employee compensation are possible, in practice it is unlikely that there would be large variations in salaries of employees who perform similar types of work. Finally, we divided the total assessable payroll by 50 000, in order to make the rate a more manageable fi gure. In summary, we used the following formula to create a claim rate for each company.

total number of claims – claims with no payout $total assessable payroll / $50 000

We cleaned the data set to remove outliers and any construction companies that were currently inactive. We defi ned outliers as having a

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Z-score Ͼ 3. As a result, we reduced the original database of 7080 companies to 4359 companies. The construction industry consists of many diff erent types of businesses, each with diff erent hazards to manage. For example, the hazards involved in residential house construction are very diff erent from road construction, which is diff erent again from demolition. In recognition of the diff erent hazard profi les of the various construction industries the WCB classifi es companies into SIC codes and calculates a premium for each code based on claim experience. Within the construction industry there are 66 separate 4-digit SIC codes. In order to identify high and low claim companies it is important to compare them against companies performing similar work. Companies with a claim rate that was one standard deviation above the mean for their SIC code were classifi ed as high claim rate companies. Low claim rate companies were classifi ed as having a claim rate that was one standard deviation below the mean for their SIC code, or a claim rate of zero. This strategy ensured that high and low claim rate companies had distinctly diff erent claim rates. The degree of development of a company’s safety programme has consistently been identifi ed as an important factor that separates high and low claim rate companies (Smith et al., 1978; Simard and Marchand, 1995). In order to extend our understanding of the organizational practices that separate high and low claim rate companies we controlled for the sophistication of the companies’ documented safety programme. To control for the development of the safety programme we only selected companies that currently possessed a COR to participate in the interview phase of the study. The COR is only awarded to companies who have demonstrated through an independent audit process that their safety programme has met a specifi ed minimum standard. In total, 916 companies in the database currently held a COR. Even though participating in safety audits is an essential component of an organization’s safety management process (Lindsay, 1992), it does not guarantee a low claim rate, as many COR companies were classifi ed into the high claim rate group. Since we did not know the total number of employees for each company, we used the total assessable payroll to select small companies. Therefore, we only included companies with a total assessable payroll of less than CA$5 million in 2008, based on the assumption that any company with more than CA$5 million would have more than 100 employees (interestingly this only excluded 10 companies). In total, 70 companies (35 high and 35 low) were selected as potential interview participants. We sent two lists (one identifying the 35 high claim rate companies, and one identifying the 35 low claim rate companies by the company code assigned by NSCSA), back to NSCSA, so that they could invite these companies to participate in this research study. NSCSA initially contacted their

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representative from each of the 70 companies selected as potential participants for this research to invite them to participant in the study. When a company agreed to participate in the research study NSCSA passed on the company contact details to the research team. NSCSA did not inform the research team of the company’s classifi cation (high or low claim rate) or the company’s code. This process ensured that the research team members were blind to the classifi cation of the participating company, in order to reduce the likelihood of researcher bias infl uencing the interview process.

Phase III: Interviews

A member of the research team initially contacted each of the company representatives who had agreed to participate to explain the interview process and gain informed consent. We selected the NSCSA contact person as the individual to interview, as they were the person within each company who took the lead on safety issues. We selected this approach as we wished to interview the person who was most knowledgeable about the company’s approach to safety management rather than a specifi c job title (e.g. safety manager). As indicated previously, one of the challenges for small companies is that they often lack specifi c health and safety resources. In total, NSCSA provided the contact details of 28 companies, of which 18 participated in the research. One individual declined to participate after the informed consent process. The remaining nine individuals could not be contacted, despite numerous phone calls, or they were unavailable at the agreed upon interview date and time. The fi rst author conducted all of the telephone interviews. The interview commenced by the interviewer introducing himself and providing an overview of the research and the purpose of the interview. Given the sensitive nature of the topic, the interviews were not recorded. The interviewer followed the protocol described above. Firstly, he asked questions about the nature of the work the company performed, and the number of managers, supervisors and workers employed with the company. He then worked through the 11 sections of the interview protocol described in the ‘Interview Protocol’ section of this chapter. For each section of the interview protocol (e.g. hazard assessment), the interviewer began by asking an open-ended question (e.g. ‘Describe your hazard assessment process’). Follow-up questions were asked to provide more detail. For example, ‘What happens to the hazard assessment forms when they have been completed’. Based on the responses to the interview questions, the interviewer circled the level of maturity that was the closest fi t to the process described by the interviewee. For example, one interviewee reported that managers are required to conduct at least two

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safety inspections per month and submit a report to the safety manager. This response was coded as a 2 on the 5-point scale (see Table 3.3). The interviewer then summarized the interviewee’s response by reading the descriptor of the level selected (e.g. ‘There is a formal manager worksite visit programme that specifi es the number of visits to be conducted by each manager and tracks completion’) to the interviewee to confi rm the interviewer had interpreted their responses correctly. Following the interview, a member of the research team entered the coded interview protocol into a database. For each of the 11 indictors, the numerical code on the 5-point scale (0–4) was entered, in addition to any other comments about that aspect of the company’s safety programme. When all the interviews were completed (including coding), the NSCSA sent the original company code for each participating company to the research team so that we could identify each participating company as either a high or low claim rate company.

RESULTS

Demographic

In total, 18 companies participated in the study. Based on the initial interview questions pertaining to general information about the company, we were able to identify the number of employees for each company. Two of the companies employed over 100 employees (134 and 150), and were therefore excluded from all further analyses. The median number of employees in the 16 remaining companies was 30, the number of employees per company ranged from 12 to a maximum of 50. The initial list of 28 companies provided by NSCSA contained 13 high claim rate companies and 15 low claim rate companies. The 16 companies included in the study consisted of ten low claim rate companies and six high claim rate companies.

Comparison between High and Low Claim Companies

Figure 3.1 presents the mean and standard deviations for the high and low claim rate companies for each of the 11 indicators included in the interview protocol. We conducted a series of Mann-Whitney U tests to examine diff erences between high and low claim rate companies on the 11 indicators. High and low claim rate companies are signifi cantly diff erent on four of the 11 indicators: incident investigation (Mann-Whitney U test; z ϭϪ2.66, p Ͻ .05); employee involvement (Mann-Whitney U test;

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High 4 Low

3.5

2.5 2.3 2.2 2.1 2.1 2. 1.8 1.7 1.6 1.7 1.7 1.5 1.6 1.5 1.3 1.2 1.2 1.0 1.0 1 0.8 0.9 0.9 0.6 0.7 0.5 0.5

0.0 0.0 0

Overall*

Manager training Communication* Hazards assessment Supervisor training Incident investigation* Employee involvement* Employee safety training Manager safety inspections* Supervisor safety inspections Manager performance evaluation Supervisor performance evaluation* Significantly different at p > 0.05

Figure 3.1 Comparison between low and high claim rate

z ϭϪ2.74, p Ͻ .05); manager safety inspections (Mann-Whitney U test; z ϭϪ2.31, p Ͻ .05); and communication (Mann-Whitney U test; z ϭϪ2.26, p Ͻ .05). We also created an average overall score for each participating company, by aggregating their score on the 11 indicators. Low claim rate companies had signifi cantly higher aggregate scores than high claim rate companies (Mann-Whitney U test; z ϭϪ2.66, p Ͻ .05).

DISCUSSION

Our fi ndings are consistent with previous research investigating the organizational practices that distinguish high and low accident companies. Specifi cally, low claim rate companies reported more sophisticated systems for incident investigation, employee involvement, manager safety inspections, and safety communication. In addition, low claim rate companies’ average score for all indicators was signifi cantly higher than high claim rate companies, further supporting the fi nding that low claim rate companies, on average, have more sophisticated safety systems in place.

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Figure 3.1 shows that mean scores were higher (although not signifi cantly) for all but one of the 11 indictors (supervisor safety training). It is interesting to note that there were no signifi cant diff erences between high and low claim rate companies on the three supervisor indicators (i.e. supervisor safety training, supervisor performance evaluation, and supervisor safety inspections). This is surprising as supervisor involvement in safety has been consistently identifi ed in previous research as a factor that distinguishes high and low accident rate companies (Chew, 1988; Cleveland et al., 1979; Simard and Marchand, 1997). This may be a unique feature of small companies, as many of the participating companies had relatively fl at hierarchies and did not employ supervisors, or if they did, supervisors had limited responsibilities. The results provide support for the argument that eff ective safety management involves ensuring that hazard management strategies are used in practice. The challenges associated with eff ective safety management, and getting individuals to do what they are supposed to do is not unique to large companies. This study was the fi rst attempt to examine whether the safety management strategies used by large companies are also eff ective for small companies. The results of this study do provide evidence that the strategies used by large companies are also eff ective for managing safety in small companies. Furthermore, safety management in small companies can be enhanced by supporting the adoption of more sophisticated safety management practices. Specifi cally, practices including, incident investigations, involving employees in safety, having managers conducting safety inspections, and communicating about safety, may be particularly relevant to small companies. Low claim rate companies reported a more comprehensive approach to incident investigation. Specifi cally, safer (i.e. low claim rate) companies reported investigating all safety failures, including near incidents, fi rst aid and property damage. Low claim rate companies also reported that they used a systematic approach to incident investigation, including how to identify underlying causes and ensuring corrective actions are in place, while high claim rate companies reported only investigating lost time injuries. Furthermore, low claim rate companies also reported that their investigation process was based on incident report forms that collected information including the person injured, type of injury, activity being performed, and corrective actions to prevent reoccurrence. Typically high claim rate companies did not indicate that identifying underlying causes of the incident was a part of their incident investigation process. Safer companies also reported having more sophisticated systems to involve employees in safety. Typically low claim rate companies reported that employees were involved in incident investigations to ensure the

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accuracy of conclusions and the practicality of the corrective actions resulting from the investigation. Safer companies also reported actively encouraging employees to report safety concerns or to make safety improvement suggestions. Conversely, high claim rate companies reported less opportunity for employees to be involved in safety and the opportunities that did exist required employees to be proactive and seek out opportunities on their own (e.g. contact the safety manager), instead of being encouraged to become involved in safety. Management commitment to safety has consistently been identifi ed as a key factor in accident prevention (Flin et al., 2000). One way managers can demonstrate commitment is by visiting the worksite to ensure safety arrangements are in place and working. Our fi ndings are consistent with previous research in showing that low claim rate companies report more sophisticated systems to ensure that managers conduct workplace safety inspections. Safer companies reported that managers were required to conduct a specifi c number of safety inspections per month and had a system in place to monitor the completion of workplace safety inspections, while less safe companies reported no formal requirement for managers to conduct safety inspections. Finally, the sophistication of safety communication processes also distinguished low claim rate from high claim rate companies. Specifi cally, low claim rate companies reported more formal systems for communicating with employees, including regular safety meetings attended by all personnel. Safer companies also reported more formal and regular toolbox talks, while higher claim rate companies reported relying on safety representatives and the safety committee to communicate to employees about safety. This study extends previous research comparing high and low accident companies by advancing the assessment of organizational practice to include an evaluation of the level of sophistication of each practice measured. The structured interview protocol was an eff ective method for assessing the sophistication or development of a company’s organizational practices. Even with low power for the statistical tests, due to a small sample, low claim rate companies had a signifi cantly higher score than high claim rate companies, supporting the validity of the protocol. Interestingly high claim rate companies typically reported that they also promoted these organizational practices, but to a lesser extent. For example, the overall average for high accident rate companies is 0.9 (on a 5-point scale ranging from 0 to 4), which means that most high claim rate companies had Level 1 practices in place. This suggests that if participants had only been asked if they had practices in place, with no consideration given to the various degrees of implementation, or level of practices, then diff erences between the groups may not have been apparent. It is therefore

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important to not only investigate the presence or absence of organizational practices, but also the sophistication of these practices. Although small companies face some unique challenges, the organizational practices that support eff ective health and safety management are similar to those used by large organizations. This raises the question, why do some organizations allocate resources to implementing more sophisticated practices to support health and safety management? This was not the focus of the current study, and therefore we did not collect systematic evidence about the motives of low claim rate companies. However, during the course of the interviews a number of the interviewees volunteered information about why they put eff ort into safety. A number of the low claim rate companies, recounted dramatic events that resulted in an important turning point in their approach to safety. For example, two companies reported that a workplace fatality or serious injury highlighted the importance of safety, while another interviewee reported that losing their COR acted as a wake-up call. In addition, other interviewees of low claim rate companies cited pressure from customers to ensure high safety standards as a motivating factor. While these anecdotes are interesting they are of limited value as participants were not explicitly asked about their motives, therefore we are cautious not to generalize this information to all low claim rate companies within this study. However, it is possible that if all interviewees from low claim rate companies were asked about their underlying motives for having sophisticated safety practices, they may have recounted similar events or motives.

Limitations and Future Research

This is the fi rst study to specifi cally compare organizational practices between high and low claim rate companies that employ fewer than 100 workers (i.e. small companies). Although the results of this study provides evidence that small companies with low claim rates, have many of the same safety practices as large companies with low claim rates, these results are based on interviews with representatives from only 16 companies in total. Therefore, caution in interpreting these results, and generalizing the results to all small, low claim rate companies is warranted due to the small sample size. Furthermore, although the research team sought an equal number of participants from both high and low claim rate companies, unfortunately this was out of the control of the researchers and not achieved. More low claim rate companies agreed to participate in this study than high claim rate companies (the sample was comprised of ten low claim rate and six high claim rate companies). The higher participation rate for low claim rate companies is not surprising, given that these companies have more

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sophisticated safety practices in place, and place a higher value on promoting and talking about safety. In fact, communication about safety was one of the four practices found to be signifi cantly diff erent between low and high claim rate companies in this study. Future research focusing on the organizational practices of small companies that distinguish high and low claim rate companies in which larger samples of equal representation is obtained would enhance the understanding of the practices related to superior safety performance in small companies. The interview protocol developed for this study was an eff ective tech- nique in gathering information about which organizational practices were in place, and the level of development of each practice. Future research should explore techniques which would enable the collection of more objective data, to corroborate the self-report data collected through the interview protocol. It is possible that participants exaggerated the practices they have in place. Furthermore, it is also possible that the low claim rate companies simply have more knowledge of the systems that they should have in place. The fi ndings from this study support the argument that safer companies have more sophisticated practices in place to manage safety. This poses the question: why do some organizations put more eff ort into safety than their counterparts. Future research should investigate what motivates organizations to prioritize safety. It may be a function of awareness in that companies with poor safety records may not be aware of important safety practices; although it also could be a more fundamental issue of the motivation of senior managers and owners. Finally, the results from this study only provide evidence of a relationship between certain organizational practices and low claim rates for companies, and therefore do not provide evidence of any causal direction. Intervention studies are needed to demonstrate that implementing sophisticated organizational practices actually leads to an improvement in safety performance (e.g. reduction in claim rates).

Implications for Small Companies

This research identifi es a number of practical steps small companies can take to increase the sophistication of their safety systems, which do not require a lot of additional fi nancial or personnel resources. For example, low claim rate companies in this study had signifi cantly better safety communication practices than high claim rate companies. Small companies can improve their safety communication simply by making an eff ort to talk more with employees about safety issues, and the importance of working safely. Setting aside specifi c times to hold safety meetings, requir-

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ing all employees to attend safety meetings, and increasing the number of toolbox talks can help improve safety communication. Actively involving employees in safety is another practice that is inex- pensive as it does not require many additional resources. In fact, involving non-managerial employees in safety may be easier to implement in smaller companies as there are fewer employees overall. Furthermore, many small companies do not have specifi c safety personnel, so there is greater opportunity and need for employee involvement in safety. The results of this study also provide evidence of the importance of having management visibly involved in safety (e.g. conducting worksite safety inspections). This can be particularly challenging for small companies as the manager is often the owner of the company, and responsible for every other aspect of the business in addition to safety. Requiring managers to conduct regular safety inspections and tracking completion is one way to encourage management involvement. Finally, small construction companies may improve their safety performance by implementing a structured incident investigation process. This process should formally require employee involvement and focus on the underlying cause of the incident. Companies could review the sophistication of the practices they have in place for each of the 11 aspects of safety covered in the interview protocol. Through a structured self-assessment process small companies can assess their current strengths and weaknesses and develop strategies to improve safety within their company.

CONCLUSIONS

This study is the fi rst attempt to compare the organizational practices of high and low claim rates that are specifi c to small companies (i.e. employing fewer than 100 workers). Four of the 11 organizational practices identifi ed in previous research as distinguishing high and low accident rates for mainly large companies were identifi ed as also distinguishing high and low claim rates for small companies. Specifi cally, smaller companies with more sophisticated safety systems which include safety communication processes, managers conducting workplace safety inspections on a regular basis, a formal incident investigation process, and processes for involving workers in safety, were found to be safer (i.e. had low claim rates).

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NOTES

1. For the purpose of this chapter, small companies are defi ned as those employing fewer than 100 workers. 2. COR is awarded to companies with a safety programme that meets a specifi ed standard that is verifi ed through independent audit. CORs are issued annually to companies as long as they continue to meet the required standard.

REFERENCES

Ashcroft, D.M., Morecroft, C., Parker, D. and Noyce, P. (2005), ‘Safety culture assessment in community pharmacy: development, face validity, and feasibility of the Manchester Patient Safety Assessment Framework’, Quality and Safety in Health Care, 14, 417–421. Association of Workers’ Compensation Boards of Canada (2008), Number of Accepted Time-loss Injuries, by Jurisdiction, 1982–2008. Available at: http:// www.awcbc.org/common/assets/nwisptables/lti_summary_jurisdiction.pdf. Bentley, T.A. and Haslam, R.A. (2001), ‘A comparison of safety practices used by managers of high and low accident rate postal delivery offi ces’, Safety Science, 37, 19–37. Bureau of Labor Statistics (2009), Workplace Injuries and Illnesses, 29 October. Available at: http://www.bls.gov/iif/oshsum.htm. Cheng, W.C., Leu, S., Lin, C. and Fan, C. (2010), ‘Characteristic analysis of occupational accidents at small construction enterprises’, Safety Science, 48, 698–707. Chew, D.C.E. (1988), ‘Eff ective occupational safety activities: Findings in three Asian developing countries’, International Labour Review, 127, 111–125. Cleveland, R., Cohen, R.C., Smith, M. and Cohen, A. (1979), Safety Program Practices in Record-Holding Plants, National Institute for Occupational Safety and Health (NIOSH), Publication No. 79-136. Cohen, A. and Cleveland, R.J. (1983), ‘Safety practices in record-holding plant’, Professional Safety, 9, 26–33. Cohen, A., Smith, M. and Cohen, M.H. (1975), Safety Program Practices in High versus Low Accident Rate Companies – An Interim Report (Questionnaire Phase), National Institute for Occupational Safety and Health (NIOSH), 1–184. Crosby, P. (1979), Quality is Free, New York: McGraw Hill. Fleming, M. (2000), Developing a Draft Safety Culture Maturity Model, Suff olk: HSE Books. Flin, R., Mearns, K., O’Connor, P. and Bryden, R. (2000), ‘Measuring safety climate: identifying the common features’, Safety Science, 34, 177–192. Hasle, P. and Limborg, H.J. (2006), ‘A review of the literature on preventive occupational health and safety activities in small enterprises’, Industrial Health, 44, 6–12. Jeong, B.Y. (1998), ‘Occupational deaths and injuries in the construction industry’, Applied Ergonomics, 29, 355–360. Lawrie, M., Parker, D. and Hudson, P. (2006), ‘Investigating employee perceptions of a framework of safety culture maturity’, Safety Science, 44, 259–276.

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Lindsay, F.D. (1992), ‘Successful health and safety management: the contribution of management audit’, Safety Science, 15, 387–402. MacEachen, E., Kosny, A., Scott-Dixon, K., Facey, M., Chambers, L., Breslin, C. et al. (2010), ‘Workplace health understanding and processes in small business: a systematic review of the qualitative literature’, Journal of Occupational Rehabilitation, 20, 180–198. McVittie, D., Banikin, H. and Brocklebank, W. (1997), ‘The eff ect of fi rm size on injury frequency in construction’, Safety Science, 27, 19–23. National Patient Safety Agency and a team from the School of Psychological Sciences at the University of Manchester (2006), Manchester Patient Safety Framework. Available at: http://www.nrls.npsa.nhs.uk/resources/?entryid45ϭ59796. Parker, D., Lawrie, M. and Hudson, P. (2006), ‘A framework for understanding the development of organisational safety culture’, Safety Science, 44, 551–562. Paulk, M.C., Curtis, B., Chrissis, M.C. and Weber, C.V. (1993), Capability Maturity Model for Software, Version 1.1, Software Engineering Institute. Reason, J. (1993), ‘The identifi cation of latent organizational failures in complex systems’, in J.A. Wise, V.D. Hopkin and P. Stager (eds), Verifi cation and Validation of Complex Systems: Human Factors Issues, Berlin: Springer-Verlag. Reason, J. (1998), Managing the Risks of Organizational Accidents, Ashgate: Aldershot. Shafai-Sahrai, Y. (1973), ‘Determinants of occupational injury experience: a study of matched pairs of companies’, MSU Business Studies, East Lansing, Michigan. Simard, M. and Marchand, A. (1994), ‘The behaviour of fi rst-line supervisors in accident prevention and eff ectiveness in occupational safety’, Safety Science, 17, 169–185. Simard, M. and Marchand, A. (1995), ‘A multilevel analysis of organizational factors related to the taking of safety initiatives by work teams’, Safety Science, 21, 113–129. Simard, M. and Marchand, A. (1997), ‘Workgroup’s propensity to comply with safety rules: the infl uences of micro-macro organizational factors’, Ergonomics, 40, 172–188. Smith, M.J., Cohen, H., Cohen, A. and Cleveland, R. (1978), ‘Characteristics of successful safety programs’, Journal of Safety Research, 10, 5–15. Vickers, I., Baldock, R., Smallbone, D., James, P. and Ekanem, I. (2003), Cultural Infl uences on Health and Safety Attitudes and Behaviour in Small Businesses, Research report 150, HSE Books, UK. Westrum, R. (1984), Complex Organizations: Growth, Struggle, and Change, Englewood Cliff s, NJ: Prentice-Hall Inc. Westrum, R. (1996), ‘Human factors experts beginning to focus on organizational factors in safety’, ICAO Journal, 51, 6–8. Westrum, R. (2004), ‘A typology of organisational cultures’, Quality and Safety in Health Care, 13, ii22–27.

KKELLOWAYELLOWAY 97818484466949781848446694 PRINT.inddPRINT.indd 4747 227/10/20117/10/2011 10:2910:29 4. Workplace violence in small and medium sized enterprises E. Kevin Kelloway and Michael Teed

Research on workplace violence has proliferated in recent years (Kelloway et al., 2005) refl ecting the concerns that all organizations share about the risks entailed. Suffi cient data have now accumulated to allow a clear picture of what the risks of workplace violence actually are, and to dispel the many myths that have grown up around issues of workplace violence (Barling et al., 2009). In this chapter we review this burgeoning literature with a specifi c focus on the risk of workplace violence in small and medium sized enterprises. We begin by defi ning, and commenting on the prevalence of, workplace violence. We then review the risk factors for workplace violence, highlighting the specifi c risks that are attendant in many forms of small business. Finally we conclude by examining research that has specifi cally focused on the risk of violence, and the implementation of violence prevention strategies in small and medium sized enterprises.

DEFINING WORKPLACE AGGRESSION AND VIOLENCE

There are a variety of behaviors that comprise the construct domain of workplace aggression, including seemingly minor, non-physical behaviors such as being glared at, more serious non-physical behaviors such as verbal threats, and actual physical assaults with or without the use of a weapon. Given this range of behavior, it is not surprising to fi nd inconsistencies in the literature regarding how workplace aggression has been conceptualized and operationalized. Some researchers, for example, have narrowly operationalized aggression by considering only physically aggressive behaviors, such as assaults (e.g. Kraus et al., 1995), whereas others have also included threats of assault (e.g. Jenkins, 1996) and behaviors refl ecting psychological aggression, such as being yelled at or being cursed (e.g. Baron and Neuman, 1998; Rogers and Kelloway, 1997; Schat and Kelloway, 2000, 2003).

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Schat and Kelloway (2005) defi ned workplace aggression as ‘behavior by an individual or individuals within or outside an organization that is intended to physically or psychologically harm a worker or workers and occurs in a work-related context’ (p. 191). They suggested that this defi nition: (a) was consistent with defi nitions of aggression used in the general human aggression literature (e.g. Baron and Richardson, 1994; Berkowitz, 1993; Geen, 2001); (b) general enough to include a wide range of physical and non-physical behaviors that comprise the construct of workplace aggression; and (c) encompasses aggressive behavior enacted by a variety of sources both within (e.g. supervisors, co-workers) and outside (e.g. clients, customers and patients) the organization (e.g. Greenberg and Barling, 1999; LeBlanc and Kelloway, 2002). Although it is common to use the terms workplace aggression and workplace violence interchangeably, it is important to distinguish between the two. Schat and Kelloway (2005) suggest that workplace violence is a distinct form of workplace aggression that comprises behaviors that are intended to cause physical harm (e.g. physical assaults and/or the threat of assault). Accordingly, all violent behaviours are, by defi nition, aggressive, whereas not all aggressive behaviours are violent. Again this is a distinction commonly made in the study of both general (e.g. Anderson and Bushman, 2002) and workplace (e.g. Greenberg and Barling, 1999; Neuman and Baron, 1998) aggression. Empirical support for this distinction comes from Schat and Kelloway (2003) who provide factor analytic evidence that physically and non-physically aggressive behaviours are empirically distinguishable. Recently, a number of researchers have included sexual harassment behaviors in their defi nitions and operationalizations of workplace violence and aggression (e.g. Barling et al. 2001; Richman et al., 1999; Rospenda, 2002). Therefore, consideration of the relationship between workplace aggression and sexual harassment is warranted. Based on the Schat and Kelloway (2005) defi nition, workplace sexual harassment – which consists of gender harassment, unwanted sexual attention and sexual coercion (Gelfand et al., 1995) – is a unique form of workplace aggression that is characterized by sexualized or sex-related behavior. Recent factor analytic evidence suggests that sexual harassment is empirically distinct from, but related to, generalized work harassment (Fendrich et al., 2002).

THE PREVALENCE OF WORKPLACE VIOLENCE

Until recently, estimates of the prevalence of workplace violence varied widely and were of dubious credibility. Accurate surveillance of the forms

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and frequency of workplace violence requires representative sampling procedures and standardized defi nitions, measures and reporting mechanisms (Peek-Asa et al., 1998). Although the literature contains numerous estimates of the prevalence of workplace violence, the data on which these estimates are based have a number of methodological limitations, preclud- ing the drawing of valid conclusions about the degree to which members of the workforce are exposed to violent behavior.

The Accuracy of Prevalence Estimates

These methodological limitations include, data sources that contain inaccuracies, small and convenience samples that are not representative of a broad or specifi c population, reporting periods that vary across studies, and inconsistent defi nitions and operationalizations of workplace violence. In addition, few of the estimates provide data related to demographic, occupational, or other predictors of exposure to the various forms and sources of workplace violence, information that is critical to identifying the workers at greatest risk and developing intervention programs to address and prevent exposure to such behavior.

Sampling limitations Much of the data on the prevalence of workplace violence comes from survey data. Ideally, these surveys would be based on probability samples to ensure that the prevalence rates derived from the data accurately represent a well-defi ned population of workers (e.g. all construction workers in a country, all customer service representatives in the fi nancial industry, or all paid workers in a country). However, most surveys of workplace aggression and related constructs are conducted to empirically test specifi c theoretical propositions and not necessarily to provide population-level information about prevalence. Many such surveys are based on convenience or purposive samples that are limited with respect to their geographical location, occupational characteristics, organizational setting and other variables. As a result, such fi ndings are not generalizable beyond the sample at hand and their utility for providing information concerning the wider prevalence of exposure to workplace aggression is limited.

Inconsistent defi nitions and operationalizations One of the major limitations of the workplace violence literature is the considerable variation that exists regarding terminology, defi nitions and operationalizations. One common source of confusion is whether or not threats of assault or attack with a weapon are ‘counted’ as incidents of workplace violence or not (see e.g. Schat et al., 2006). Similarly, some

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studies would count damage to property as an example of workplace violence while others would exclude the same behaviors. In addition to the conceptual challenges introduced by the use of different constructs and operational defi nitions of workplace violence, the data suggest that the way in which questions are asked may infl uence the resultant prevalence rates. For example, Schat et al. (2006) noted that higher overall prevalence rates for physical assault emerged in surveys that included a larger number of questions tapping a number of specifi c, concrete behaviors (e.g. ‘have you been kicked’, ‘have you been hit’) than emerged from asking a general question (e.g. ‘have you been a victim of workplace violence’). It may be that in surveys of this nature, the use of a large number of behaviorally specifi c questions increases the likelihood that respondents will recall such behavior if it occurred, yielding higher prevalence rates than surveys that use few questions and/or broad behavioral categories. In addition to variation in the types of aggressive behavior, the reporting period is another important factor to consider when assessing and interpreting the prevalence of exposure to workplace aggression. Although a one year timeframe appears to be used in the majority of studies, some studies have asked respondents to report their experience of aggression over shorter and longer periods. Two issues are particularly important to consider in this regard. First, and most obvious, a survey that uses a longer reporting period will yield a higher prevalence rate than an otherwise equivalent survey using a shorter reporting period. Second, a longer reporting period increases the likelihood that memory decay will adversely aff ect the accuracy of participants’ responses. This is particularly likely to occur with certain psychologically aggressive behaviors that are less salient – and perhaps more susceptible to memory decay – than more serious acts of aggression such as assault. Such memory decay could produce either over- or underestimates, the nature of which may be infl uenced by survey characteristics such as the response formats that are employed (Schwarz, 1999).

Prevalence Estimates

Bearing these three limitations in mind, the most accurate estimates of the prevalence of workplace violence will be derived from large samples that are constructed so as to represent a known population. In the past three years, data from three such surveys (one American and two Canadian) have become available.

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US prevalence data Schat et al. (2006) reported a detailed analysis of a large, nationally representative sample of workers in the United States. They asked a series of questions about the respondents’ experience of both workplace violence and workplace aggression. Their operational defi nition of workplace violence focused purely on physical assaults (i.e. excluding threats). Respondents were asked to indicate how frequently somebody at work had: ‘(a) Pushed you, grabbed you, or slapped you in anger; (b) Kicked you, bit you, or hit you with a fi st; (c) Hit you with an object, tried to hit you with an object, or threw an object at you in anger; and (d) Attacked you with a knife, gun, or another weapon’. Overall, Schat et al. (2006) reported that 6 percent of the sample – corresponding to just under 7 million American workers, experienced these forms of workplace violence in the course of a year. Turning to the four specifi c physically aggressive behaviors examined in the survey, assault with an object was the most common, being reported by 4.2 percent of respondents. Being pushed, grabbed, or slapped in anger was reported by 3.9 percent of respondents; being kicked, hit, or bitten was reported by 3 percent; and being attacked with a knife, gun, or other weapon was reported by 0.7 percent.

Nova Scotia Stress Survey Although there are no comparable national studies of workplace violence in Canada, Francis and Kelloway (2006) conducted a large (N ϭ 1400) study of Nova Scotian workers. The sample was drawn to match population parameters in terms of gender and geographic distribution within the province. Respondents provided data on the frequency of their (a) being hit, kicked, punched or shoved, (b) having an object thrown at them, (c) being threatened with physical assault, and (d) being threatened with a weapon. The results of this study suggested a much higher prevalence of workplace violence than did the results of the Schat et al. (2006) study. Just under 21 percent of the respondents reported experiencing some form of physical violence:

● 9 percent reported being hit kicked punched or shoved ● 12 percent had objects thrown at them ● 12.6 percent had been threatened with physical assault ● 2.7 percent had been threatened with a weapon.

Statistics Canada Victimization Study Leseleuc (2004) re-analyzed data from the 2004 General Social Survey (GSS) to derive estimates of criminal victimization in Canadian work-

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places. The GSS asked individuals to report on diff erent forms of victimization including sexual assault (i.e. forced sexual activity), robbery involving a weapon or where there was violence or threats of violence, and direct physical assault. Just under 24 000 responses to the survey were collected in 2004. Leseleuc (2004) reports that 17 percent of all violent victimizations reported by respondents occurred in the workplace. This represents approximately 356 000 workplace violence incidents in a 12-month period in Canada. Of these, 71 percent were physical (i.e. non-sexual) assaults. Leseleuc (2004) notes considerable provincial variation in these estimates. Forty percent of vicitimizations in Newfoundland and Labrador hap- pened in the workplace but only 11 percent of victimizations in Nova Scotia occurred in the workplace. In Saskatchewan and Alberta, 20 percent of reported victimizations occurred in the workplace. As Leseleuc (2004) notes, these estimates vary across industry and occupation and this may account for the diff erent estimates across provinces. For example, a higher percentage of respondents in Newfoundland were drawn from high risk industries (i.e. health care, social assistance, accommodation and food services) than in other provincial jurisdictions. Anomalies in the way the estimates are derived systematically excluded some (high risk) occupations (e.g. cab drivers, transit operators) suggesting that the data systematically underestimate the extent of workplace violence in Canada.

SOURCES OF WORKPLACE VIOLENCE

The Cal OSHA Framework

A widely cited categorization of workplace violence focuses on the relationship between the assailant and the victim (Cal OSHA, 1995). In this view, various ‘types’ of violence are considered based on classifying the perpetrator. Type I violence is associated with criminal activity – an assault or homicide that occurs in the context of a robbery is an example of Type I violence. Type II violence is also committed by a non-organizational member, but is not typically associated with other forms of criminal activity. Sometimes referred to as ‘client-perpetrated violence’, an example of Type II violence would be assaults on health care personnel by patients (see e.g. Lanza, 2006). Type III violence is violence perpetrated by organizational ‘insiders’ and includes behaviors such as co-worker assaults or tragedies such as the post offi ce murders of the 1990s (see United States Postal Service Commission on a Safe and Secure Workplace, 2000).

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Prevalence by Source

Although researchers have attempted to estimate the prevalence of workplace violence by source, the most common distinction is between violence perpetrated by co-workers (Type III in the Cal OSHA framework) and violence perpetrated by members of the public (Types I and II in the Cal OSHA framework). Results of these analyses uniformly suggest that workplace violence is overwhelmingly perpetrated by members of the public. For example, 67 percent of workplace homicides occur during a robbery (Sygnatur and Toscano, 2000). Respondents to the Canadian Public Service Employment Survey reported that violence was most likely from clients, residents or other members of the public (approximately 71 percent of those reporting workplace violence) rather than from co- workers (approximately 34 percent of those reporting workplace violence;1 Statistics Canada, 2002). Schat et al. (2006) suggested that an individual is four times more likely to be assaulted by a member of the public than by a co-worker.

Occupational Risk Factors

The majority of workplace homicides in the United States are perpetrated by members of the public during the commission of a robbery or similar crime (see e.g. Bureau of Labor Statistics, 1998). Individuals employed in the retail (e.g. convenience stores), service (e.g. restaurants), security (protective agencies) and transportation (e.g. taxi) industries are at highest risk (e.g. Casteel and Peek-Asa, 2000; Castillo and Jenkins, 1994; Peek-Asa et al., 2001). While robbery is the primary risk factor for occupational homicide, it is not the primary risk factor for non-fatal assaults – providing service, care, advice or education can put employees at increased risk for assault (e.g. Amandus et al., 1996; CCOHS, 1999; see also LeBlanc and Kelloway, 2002), especially if clients, customers, inmates or patients are experiencing frustration, insecurity or stress (see Lamberg, 1996; National Institute for Occupational Safety and Health [NIOSH], 2002; Painter, 1987). Industries reporting high rates of non-fatal assaults include health care, education, social services and law enforcement (Casteel and Peek-Asa, 2000; Hearnden, 1998; NIOSH, 2002; Occupational Safety and Health Administration [OSHA], 2004). LeBlanc and Kelloway (2002) and others (Canadian Centre for Occupational Health and Safety [CCOHS], 1999; Castillo and Jenkins, 1994; Davis, 1987; Kraus, 1987; Leseleuc, 2004) have suggested that there is a list of risk factors for workplace violence that includes:

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● Dealing with the public ● Denying a service ● Making decisions that infl uence others’ lives ● Supervising/disciplining others ● Security functions/physical control ● Working nights, weekends, alone ● Dealing with items of value ● Working with alcohol ● Providing physical/emotional care ● Going into peoples’ homes.

It follows from these observations that individuals in occupations involving more of the risk factors are more likely to experience workplace violence. LeBlanc and Kelloway (2002) found exactly this pattern of results.

Gender Most of the available data suggest that men are more likely than women to both experience (Duhart, 2001) and commit violence (Geen, 2001; McFarlin et al., 2001). Hurrell, Worthington and Driscoll (1996) surveyed 2525 women and 2324 men about their experiences of workplace violence. Approximately 17 percent of the men reported that they had been physically assaulted at work in the preceding year. In contrast, approximately 9 percent of the women reported being assaulted during the same time period. Guterman, Jayaratne and Bargal (1996) found that male social workers were more likely to report both assaults and physical threats than were female social workers in an American sample. However, they found no diff erences between genders in an Israeli sample of social workers. Safran and Tartaglini (1996) also found that males were more at risk of physical assault than females in their study of workers in an urban jail setting. Although these data are reasonably consistent in suggesting that men are more at risk for workplace violence than women, at least two observations would suggest that other factors may be obscuring the relationship. First, occupational diff erences in violence are well established and it is clear that the workforce is gender segregated. For example, nurses and those who work in health care settings are at greater risk of workplace violence than are members of other occupations (see Lanza, 2006) and are more likely to be female than male. Second, it is clear that partner violence or domestic violence can be expressed in, or have consequences for, the workplace (Friedman et al., 1996; see also Swanberg et al., 2006) and is more likely to occur among women than men (Tjaden and Thoennes,

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2000). Empirically, Schat et al. (2006) reported a bivariate association between gender and workplace violence such that men experience more violence than women – however, after controlling for other factors (e.g. occupation), this relationship became non-signifi cant. Based on their review, Hewitt and Levin (1997) concluded that women were more at risk for non-fatal workplace assaults but that men were more at risk for workplace homicide. Based on his analysis of data from the National Crime Victimization Surveys, Warchol (1998) concluded that men were more likely than women to experience violence at work but that women were more likely than men to experience sexual assaults and assaults perpetrated by acquaintances (as opposed to strangers) outside of work. Results from the Northwestern National Life Insurance Company (1993) study suggested that women were more likely than men to experience verbal harassment at work, whereas men were more likely than women to experience physical threats at work. Thus, although the general conclusion is that men are more at risk for violence, this observation is conditioned by the type and source of violence and may be confounded with occupational characteristics.

Age When it comes to the risk of experiencing workplace violence, the general conclusion is that younger adult workers are at greater risk. For example, Hurrell et al. (1996) found that for both women and men, assault victims were younger than non-victims. In contrast, Guterman et al. (1996) found no eff ect of age, but reported a signifi cant eff ect of work experience such that less experienced workers were more likely to report receiving threats and being assaulted. As with gender, the risk for violence experienced by younger workers may be related to occupational characteristics. For example, younger workers are more likely to be employed in the fast- food industry and may experience a high rate of workplace aggression as a result (see e.g. Mayhew and Quinlan, 2002). In their national study of workplace violence Schat et al. (2006) reported a negative relationship indicating that young workers experience more incidents of workplace violence than do older workers. Together, these fi ndings suggest that there is considerable variation in the frequency of workplace violence and aggression across occupational and demographic groups. As noted above, these are not independent groupings. The workforce is both gender and age segregated such that these groups are disproportionately represented in high risk occupations (e.g. youth in retail and fast-food services, women in nursing). Moreover, demographic and occupational characteristics may combine to place individuals at risk.

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Violence in Small Business

By far the most common source of violence is individuals who are ‘outside’ the organization (Schat et al., 2006) and engaged in either committing a criminal act (Type I violence) or receiving services (Type II violence) from the organization. It is not surprising, therefore, to fi nd that small businesses are particularly prone to some types of workplace violence. For example, a large number of retail operations are small or medium sized businesses and are at particularly high risk for robbery with attendant consequences in terms of workplace violence (Castillo and Jenkins, 1994; NIOSH, 1993). Moreover, small businesses lack the resources to develop policies and programs designed to prevent workplace violence Klotz and Buckley (2010). Despite this, small businesses also possess resources (e.g. the development of personal relationships, fl exibility) that actually may reduce the incidence of co-worker on co-worker violence. In short, the risk for small business is primarily in terms of violence that is perpetrated from outside the organization and we now turn our attention to interventions designed to address these risks.

INTERVENTIONS

Type I Violence

Because most workplace homicides occur during the commission of a robbery, actions aimed at preventing robberies will likely reduce the number of workplace homicides (see Amandus et al., 1995). Robbery reduction strategies typically focus on increasing the risks, reducing the rewards, and increasing the eff ort associated with robbery (Desroches, 1995; Hendricks et al., 1999; OSHA, 1998). Because risk factors for robbery will diff er among workplaces, no single strategy is appropriate for all organizations (OSHA, 1998) and prevention strategies must be cus- tomized to worksites (Mayhew, 2000b). That being said, three principles – increasing visibility, reducing rewards, and target hardening – underlie most robbery reduction strategies (Mayhew, 2000a, 2000b; OSHA, 1998). Collectively these techniques are known as Crime Prevention Through Environmental Design (CPTED) (Casteel and Peek-Asa, 2000; Jeff rey, 1971; Peek-Asa et al., 2004).

Increasing visibility Increasing visibility is thought to increase the perceived risks for potential criminals, thereby deterring crime. For taxi drivers, means of increasing

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visibility include the use of global positioning systems that show the location of a driver in distress (OSHA, 2000), external emergency lights (Mayhew, 2000a) and in-car surveillance cameras that allow the potential identifi cation of perpetrators (Appleby, 2000; Mayhew, 2000a). Data from both Australia and Canada confi rm the eff ectiveness of surveillance cameras. In Perth, a 60 percent reduction in assaults followed the man- datory introduction of surveillance cameras (see LeBlanc et al., 2006). Crimes against taxi drivers have been reduced by more than 50 percent since the implementation of a bylaw in Toronto, Ontario requiring taxi owners to install either security cameras or GPS in their cars (Calleja, 2002). In retail establishments, increasing visibility has meant increasing the chances of someone witnessing a crime (see Purpura, 1993). Most crimes occur late at night when there are few potential witnesses (e.g. D’Alessio and Stolzenberg, 1990). Keeping windows clear of signs (e.g. advertise- ments) to allow passers-by to see inside (Purpura, 1993), and locating the cash register in a place that can be seen from the outside (e.g. in the center of the store) are means of increasing visibility. Hendricks et al. (1999) found that poor visibility to the inside of stores and cash registers located along the wall of stores rather than in the center of stores were strongly associated with increased risk of robbery. Closed circuit television (CCTV) and video cameras may also deter criminal behavior by increasing would-be robbers’ perceptions of risk (OSHA, 1998). Clerk behavior can also communicate visibility. Common recommendations are that clerks should make eye contact with customers and greet them as they enter the store (e.g. Desroches, 1995; Gabor and Normandeau, 1989) thereby making would-be robbers feel conspicuous (Desroches, 1995; Gabor and Normandeau, 1989). OSHA (1998) suggests that employing two clerks during evening shifts may also reduce the incidence of robberies, although this is a controversial recommendation (see Amandus et al., 1996) that is not supported by either the National Association of Convenience Stores (NACS) or the National Institute for Occupational Safety and Health (see Richman et al., 1999). Critics of OSHA’s (1998) two-clerk condition argue that there is limited empirical evidence supporting the validity of the two-clerk provision, hiring two clerks is expensive, and employing more than one clerk potentially increases the number of workers exposed to robbery-related violence (see Casteel and Peek-Asa, 2000). While there is some support that stores employing two clerks during late-night shifts experience fewer robberies (e.g. Calder and Bauer, 1992), more research is required before a decision can be made about whether this is an eff ective strategy for reducing robberies (Casteel and Peek-Asa, 2000). Commercial establishments should

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have practices in place to ensure the safety of employees who work alone (e.g. routinely checking on individuals who work alone; Mayhew, 2000b).

Reducing rewards Cash handling practices such as carrying minimal amounts of money, making frequent cash deposits (Gill, 2000) and using drop safes (see Desroches, 1995; Gill, 2000; OSHA, 1998) are eff ective means of reducing robberies. In their comparison of 400 robbed and 1201 non-robbed convenience stores, Hendricks et al. (1999) found that cash handling policy exhibited the strongest association with robberies, such that stores that were categorized as having good cash handling policies were at a signifi - cantly reduced risk for robbery.

Target hardening Target hardening strategies focus on making it diffi cult to assault employees through physical design. For example, protective screens have been found to reduce the number of assaults experienced by taxi drivers (Stone and Stevens, 1999) although opinions on screens remain mixed (Appleby, 2000; Mayhew, 2000a). Many taxi drivers and customers do not like them because they can restrict air circulation, leave little leg room, and limit communication between drivers and passengers (see Appleby, 2000; Mayhew, 2000a). In retail environments, strategies that reduce the ease of escape (Gill, 2000), making it diffi cult for criminals to fl ee from the scene of the crime may deter robbery (Desroches, 1995). Potential strategies to make retail stores less attractive targets include blocking off lane ways and using speed bumps in parking lots (Desroches, 1995). Revolving doors and longer rather than shorter distances between the cash register and the exit may also help to deter crime (Gill, 2000). In addition to preventing robberies, some target hardening strategies may also reduce the likelihood that employees will be hurt during the commission of a robbery. Installation of high and wide counters, with raised fl oors on the employee side, to prevent robbers from jumping over counters to assault employees (Desroches, 1995; Mayhew, 2000b), and provision of bullet resistant barriers (Desroches, 1995; Mayhew, 2000b) are eff ective means of protecting workers. Employee training is also a form of target hardening that deals with the behavior of employees. Training typically focuses on both general safety precautions and behavior during a robbery or threatened assault. Having instructions on how to behave may give employees a sense of control of the situation and lessen the possibility that they will be injured. Employee training should stress cooperation with robbers, since there is ample evidence that employees who cooperate with robbers sustain fewer injuries

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(e.g. Faulkner et al., 2001). Workers should also be told not to make any sudden moves during a robbery, to keep their hands in plain sight at all times, and to inform the robbers of what they are doing when they are doing it (see Tyler, 1999). Staff should also be told to activate the silent alarm only when it is safe to do so (see Tyler, 1999). Employees should also be aware that it is not constructive to confront shoplifters.

Eff ectiveness of CPTED Peek Asa et al. (2004) reported on a large-scale evaluation of workplace violence prevention programs based on principles of CPTED. Based on data from 314 intervention sites (i.e. stores that had implemented a CPTED program) and 96 control sites (i.e. stores with no program), they found that stores that implemented a CPTED program experienced a signifi cant decrease in violent crime and robberies. These results held despite a general increase in the crime rate. Moreover, the extent of compliance with the program (i.e. degree of implementation) was associated with decreased risk suggesting a dose–response relationship whereby stores that more fully implemented the CPTED program experienced decreased risk. These results strongly suggest the eff ectiveness of CPTED-based programs in decreasing the eff ectiveness of workplace violence.

Type II Violence

Service providers – health care workers, teachers, social service workers, prison guards, and police offi cers – are among the most common victims of non-fatal workplace violence (University of Iowa Injury Prevention Research Center, 2001). In the United States in the year 2000, 48 percent of all nonfatal assaults occurred in the health care and social service industries (see OSHA, 2004). While the average rate of non-fatal assaults in the private sector was 2 per 10 000 full-time workers, nursing and personal care facility workers had a rate of 25, and social service workers had a rate of 15 (see OSHA, 2004). However, the actual number of incidents is likely much higher because of underreporting (University of Iowa Injury Prevention Research Center, 2001). Generally we think of health care (for example) taking place in the context of large institutions such as hospitals. However, these services are increasingly provided in sites that share many features of small and medium sized enterprises. Thus private practices and ‘walk-in’ clinics are eff ectively small businesses. Moreover, health care and, to some extent, social services, are increasingly delivered through home care services in which single workers go out to clients’ homes, with attendant risks of workplace violence (Barling et al., 2001).

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There are generally three approaches to preventing or dealing with Type II violence (e.g. Merchant and Lundell, 2001; Peek-Asa et al., 2001): environmental, organizational or administrative and behavioral. There are several factors that increase employee risk for care or service providers. For example, staff may be at risk when they attempt to set limits on behavior (e.g. tobacco use; NIOSH, 2002); particularly if the employee’s actions are perceived as being unfair or unreasonable (see e.g. Boyd, 1995). Violence can also occur when a client is involuntarily admitted into hospital, or confi ned (NIOSH, 2002). Long waits for service may result in frustration and increase the propensity for patients and visitors to become aggressive (e.g. Hoag-Apel, 1998; Levin et al., 1998).

Environmental strategies Security devices that may reduce employee risk include metal detectors, surveillance cameras, and bullet-resistant glass surrounding reception areas and nursing stations (NIOSH, 2002; OSHA, 2004). Other suggestions include eff ective lighting both inside and outside hospitals and curved mirrors at hallway intersections (OSHA, 2004). The presence of security personnel may also be eff ective at preventing assaults (e.g. Levin et al., 1998). Card-controlled entrances and security checks for identifi cation could be used to limit public access to restricted areas (Levin et al., 1998; NIOSH, 2002; OSHA, 2004). Given long waiting times, hospitals, clinics and medical offi ces should provide patients and their families with comfortable waiting rooms designed to minimize stress (e.g. soothing colors on walls; toys for children to play with; reading materials; NIOSH, 2002). Waiting areas and patient care rooms should also be designed with safety in mind: furniture should be lightweight, have few sharp edges, and be laid out to ensure that staff cannot be trapped in rooms (OSHA, 2004). Rooms and waiting areas should also be sparsely decorated with accessories (e.g. few pictures on the walls or vases on the tables) to limit the number of possible weapons that can be used against staff (see OSHA, 2004). Patient care rooms should have two exits and be equipped with phones and panic buttons (OSHA, 2004).

Organizational/administrative strategies Organizations should have policies and practices in place to prevent aggression. A written policy should outline what constitutes unacceptable behavior in the workplace (Scalora et al., 2003), and patients, visitors and employees should be aware of the document. Policies that encourage reporting of violence are also necessary, and management should stress to employees the importance of reporting acts of aggression. Management

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should also take all reports of aggression seriously, and they should ensure that employees are aware of their commitment to safety. Levin et al. (1998) found that nurses in their study were consistent in dismissing any benefi ts that reporting violence to management might have on preventing future incidents of aggression. It is not uncommon for employees to express concerns about reporting incidents of violence, because they fear their employers will assume that they provoked the incident (see Boyd, 1995; Elliott, 1997; Scalora et al., 2003). Organizations also need to have detailed plans for dealing with violent attacks when they occur (Health Services Advisory Committee, 1987) and should develop procedures to ensure the sharing of information about violent or potentially violent clients (Levin et al., 1998). When service providers such as health care workers, work inside their patients’ homes, access to protections that are aff orded to employees who work within traditional organizational settings is delayed or limited at best (Barling et al., 2001). Hence, organizations need to have policies and procedures in place that are targeted at home health care providers. For example, home care workers could be required to keep a designated colleague informed of their whereabouts throughout their work shift (OSHA, 2004). Workers should also be accompanied to a patient’s home by a co-worker or a police escort if their personal safety may be threatened (Health Services Advisory Committee, 1987; OSHA, 2004). In a similar vein, employees should be prohibited from working alone in emergency areas or walk-in clinics, especially during late night and early morning shifts (Elliott, 1997; NIOSH, 2002; OSHA, 2004). Policies and practices should also be in place to restrict public (e.g. patients, visitors) movement in hospitals (NIOSH, 2002).

Behavioral/interpersonal strategies In addition to providing staff with necessary knowledge and skills, training may give employees the confi dence to deal with potentially dangerous situations (Health Services Advisory Committee, 1987; Levin et al., 1998). Schat and Kelloway (2000) found that hospital workers who received training targeting workplace violence reported higher levels of perceived control compared to workers who did not receive training. In their study, perceptions of control were positively correlated with employee emotional well-being and negatively associated with employee fear of future violence. Staff should be taught customer service skills, how to resolve confl icts, how to recognize escalating agitation, and how to manage and respond to aggressive behavior (DelBel, 2003; NIOSH, 2002; OSHA, 2004). Since violence is related to wait times (see Hoag-Apel, 1998; Hunter and Love, 1996; NIOSH, 2002), staff should provide patients and their families with suffi cient information when there are long delays for service (e.g. explain

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how long the delay will be and why there is a long delay; see Health Services Advisory Committee, 1987). Employees who have direct patient contact (e.g. security guards, nurses, orderlies) should also be trained on how and when to physically restrain patients (Health Services Advisory Committee, 1987).

CONCLUSION: WORKPLACE VIOLENCE IN SMALL AND MEDIUM SIZED ENTERPRISES

There is no doubt that employees of small and medium sized enterprises are at risk of workplace violence. The available data strongly suggest that these risks are for Type I and Type II violence; that is, violence that is committed by individuals who are not members of the organization. The notion that individuals are most at risk from their co-workers is largely a myth (Barling et al., 2009) that has little support in the data. Given this understanding of the risk factors, eff ective strategies for small and medium sized enterprises involve primarily environmental and behavioral solutions. Environmental solutions aimed at reducing crime-related violence are based on principles of CPTED and have been shown to be eff ective in reducing incidents of violent crime. When aimed at preventing violence from clients, environmental interventions focus on reducing environmental risks and providing protection for workers. In both instances, behavioral interventions typically focus on training staff to recognize and respond appropriately to the risk of workplace violence.

NOTE

1. Note that participants could report violence from both sources.

REFERENCES

Amandus, H.E., Hunter, R.D., James, E. and Hendricks, S. (1995), ‘Reevaluation of the eff ectiveness of environmental designs to reduce robbery risk in Florida convenience stores’, Journal of Occupational and Environmental Medicine, 37, 711–717. Amandus, H.E., Zahm, D., Friedmann, R., Ruback, R.B., Block, C., Weiss, J., Rogan, D., Holmes, W., Bynum, T., Hoff man, D., McManus, R., Malcan, J., Wellford, C. and Kessler, D. (1996), ‘Employee injuries and convenience store robberies in selected metropolitan areas’, Journal of Occupational and Environmental Medicine, 38, 714–720.

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Schwarz, N. (1999), ‘Self-reports: how the questions shape the answers’, American Psychologist, 54, 93–105. Statistics Canada (2002), Public Service Employment Survey, Ottowa, ON: Statistics Canada. Stone, J.R. and Stevens, D.C. (1999), ‘The eff ectiveness of taxi partitions: the Baltimore case’. Available at: http://www.taxi-library.org/stone_abs.htm. Swanberg, J.E., Logan, T.K. and Macke, C. (2006), ‘The consequences of partner violence on employment and the workplace’, in E.K. Kelloway, J. Barling and J.J. Hurrell (eds), Handbook of Workplace Violence (pp. 351–380), Thousand Oaks, CA: Sage Publications. Sygnatur, E.F. and Toscano, G.A. (2000), ‘Work-related homicides: the facts’, Compensation and Working Conditions, Spring, 3–8. Tjaden, P. and Thoennes, N. (2000), Extent, Nature, and Consequences of Intimate Partner Violence, Washington, DC: U.S. Department of Justice, National Institute of Justice. Tyler, K. (1999), ‘Targets behind the counter’, HR Magazine, 44, 106–111. United States Postal Service Commission on a Safe and Secure Workplace (2000), Report of the United States Postal Service Commission on a Safe and Secure Workplace, New York: National Center on Addiction and Substance Abuse at Columbia University. University of Iowa Injury Prevention Research Center (2001), Workplace Violence: A Report to the Nation. Available at: http://www.public-health.uiowa.edu/iprc/ resources/workplace-violence-report.pdf. Warchol, G. (1998), Workplace Violence, 1992–1996, Washington, DC: U.S. Department of Justice.

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Agricultural work is accompanied with diverse hazards in the process of plowing, planting, growing, fertilizing, harvesting, packing, loading, repairing pens and gates, raising livestock, milking, breeding, birthing, tending sick or injured animals, mixing feed, feeding, moving animals, cleaning stalls and corrals, and so on (Cigularov et al., 2009). Many farm workers apply pesticides and fertilizers to crops, and operate and repair farm equipment. Most of the above activities are physically challenging. During planting and harvesting of crops, workers are in the fi elds for many hours and often work every day of the week. Those involved in livestock operations, particularly in dairy operations must also work long hours every day of the week tending to the cows. Based on the United States Department of Agriculture (USDA, 2010), there were 2.2 million farms that had generated approximately $331 billion in 2009. Of these farms, more than 90 percent were owned by individuals or families. Most farms involve relatively few acres, with 54.4 percent operating 1–99 acres and 31 percent operating 100–499 acres. The critical contribution of the agricultural industry to the society, however, is accompanied by an unacceptable loss of workers’ lives. Over the past two decades, this industry has been ranked as the most dangerous occupation (National Institute for Occupational Safety and Health [NIOSH], 2010) based on rates of fatal and non-fatal injuries. The fatality rate for farm workers is approximately six times higher than the average rate for all industries (22.5/100 000 vs. 3.8/100 000) (National Safety Council [NSC], 2001). According to the NSC, an average of 740 farm workers lose their lives each year and another 130 000 workers become temporarily or per- manently disabled as a result of hazards on farms. These hazards include, but are not limited to, toxic chemical exposures, entrapment in confi ned spaces, electrocution, tractor overturns, technological changes in operating equipment, repetitive exposure to musculoskeletal strains and sprains, animal handling, etc.

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SUICIDE IN THE AGRICULTURAL INDUSTRY

In this chapter, we attempt to continue raising awareness about a hidden occupational fatality, self-infl icted injury. Self-infl icted fatality, or suicide, is arguably viewed as a hidden occupational fatality because suicide is not defi ned as occupationally related unless the worker chose to end his or her life at their place of employment (Bureau of Labor Statistics [BLS], 2004a). In reality, approximately 75 percent of suicides occur in a house or apartment, followed by natural areas, streets or highways, or in motor vehicles (Colorado Department of Public Health and Environment, 2007). Thus, it is not surprising that few suicides at work are seen in the BLS Census of Fatal Occupational Injuries database. For instance, there were 242 occupational fatalities in the State of Colorado from 2004 to 2006. Among them, there are only 11 suicide cases that occurred at the workplace. It has long been suspected that suicidal tendencies may, to some degree, be aff ected by occupation (Blachly et al., 1963; Kposowa, 1999; Liu and Waterbor, 1994; van Wijngaarden, 2003). High rates of suicide in the agricultural industry in diff erent countries have been reported over many years, with farm workers often among the highest reported. Based on all suicide records in New Zealand between 2001 and 2005, Gallagher, Kliem, Beautrais and Stallones (2008) revealed that workers in farming, fi sheries, or forestry had high suicide rates compared to workers in other occupations. Page and Fragar (2002) also reported higher suicide rates among male farm workers in Australia than rates in the male national population, and rates in the rural population. Recently we compared suicide rates among farm workers in Colorado, with Colorado population for two time periods: 1990–1999 (derived from Colorado death certifi cate fi les) and 2004–2006 (derived from Colorado Violent Death Reporting System). Part of our initial fi ndings (Stallones et al., 2010) showed that the average annual suicide rate per 100 000 was 263.9 for male farm workers vs. 31.5 for the general male population, 56.1 for female farm workers vs. 8.1 for the general female population between 1990 and 1999; 226 among male farm workers vs. 67.3 among the general male population, and 37.4 among female farm workers vs. 18.5 among the general female population from 2004 to 2006. The high rate of suicide among farm workers sends an alarming signal for four main reasons. First, suicide rates among farm workers seem disproportionately high, compared to other occupations, considering farm workers represent less than 0.7 percent of employees in 2009 (BLS, 2004b). Second, it has been estimated that there are 25 suicide attempts for every suicide completion (American Association for Suicidology, 2006). In other words, high suicide rates for farm workers only refl ect the tip of iceberg,

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which suggests that mental health problems may be much more severe in the agricultural industry than has previously been acknowledged. Third, people who attempt suicide and survive often have disabling injuries such as brain damage, para- or quadriplegia, organ failure, depression, and other mental health problems. Finally, suicide aff ects the health and safety of families, job sites and the farming community. In the situation of farm workers the impact most likely falls on the surviving family members and in the case of a farm owner, the family may not be able to keep the farm operating with the loss of a key contributor to the farm work. In addition, farming communities can be small close-knit groups and a suicide death in the community may have a profound impact on the well-being of the overall community. Neighbors, friends and family as well as other farm workers may feel shock, anger, guilt and depression. The medical costs and lost wages associated with suicide as well as those who are aff ected would take a great toll on the industry (Centers for Disease Control and Prevention, 2008).

RISK FACTORS OF SUICIDE

Despite extensive research, there is no universally accepted theory to explain the occurrence of suicide. A number of risk factors have been reported as associated with increased risk of suicide in the general population and in the farm population, including age (increased rates with increased age), race (white and Asian populations), sex (males with higher rates except among Asian populations), family history of attempts, alcohol/substance abuse, maltreatment as a child, interpersonal loss or rejection, cultural and religious beliefs, mental disorders, physical illness, economic problems, lack of mental health services, and access to lethal means such as fi rearms or pesticides (Boxer et al., 1992; Charlton, 1995; Cubbin et al., 2002; Gregoire, 2002; Gunderson et al., 1990; Hawton et al., 1998; Kelly and Bunting, 1998; Thomas et al., 2003). Although risk factors or plausible factors associated with suicide in general are documented in the suicide prevention literature, it is still not yet clear why farm workers report higher rates of depression and have such high suicide rates compared to other occupations (Grosch and Murphy, 1998). Based on the nature of the farm work, two unique yet critical factors, exposure to farm stressors (Fraser et al., 2005; Schenker, 1996) and organophosphate pesticides (Jaga and Dharmani, 2007; Stallones and Beseler, 2002), may account for higher depression (a potential trigger for suicide) in the agricultural industry. In the next two sections, we will fi rst review a unique set of stressors farm workers face, and their potential

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linkage with depression and suicide, followed by the focus on exposure to organophosphate pesticide at workplaces, and how the exposure may link to the high rate of suicide in the agricultural industry.

EXPOSURE TO FARM STRESSORS

Stressful experience resulting from job stressors (i.e. stressful events or incidents) is often unavoidable, and has become part of work life. Potential adverse impacts of job stressors include the decrease of cognitive function (Proctor et al., 1996) and the increase of mental and physical fatigue and depression (Suwazono, et al., 2007), which may likely lead to mental illness and suicide (e.g. Amagasa et al., 2005). Compared to job stressors reported in general industries (e.g. time pressure, job insecurity, confl ict between diff erent work roles, situational constraints [Spector et al., 2000]), those experienced among farm workers are rather unique, and tend not to be captured by conventional job stress models (Cornish and Gerrard, 1995; Sonnentag and Frese, 2003). Specifi cally, underlying causes of job stressors (e.g. time pressure or job insecurity) in the agricultural industry tend to be aff ected by circumstances which are not necessarily directly related to the job per se, yet these conditions could have a profound impact on one’s work and experience. More often job stressors faced by farm workers are unpredictable and uncontrollable. For instance, workers need to harvest crops quickly due to sudden changes in climatic conditions, which cannot be easily controlled, prevented, or eliminated through job designs, engineering control, pre- task planning or active coping. Stressors such as fi nancial crisis or farm foreclosures caused by socio-economic factors (e.g. low market price) tend to lead workers or owners to blame themselves and lose hope (Gerrard, 1995). In addition, the destocking or culling of livestock due to epidem- ics (e.g. Ovine Johne’s disease in Australia or foot-and-mouth disease in Great Britain) not only causes fi nancial loss, but also severely aff ects the psychological well-being of farmers and their families, who often experience a sense of failure, as well as feelings of guilt, shame, helplessness or anger (Hall et al., 2004) Considering more than 90 percent of farms are relatively small, and owned by individuals or families, farm work has been traditionally interwoven with family life. Empirical fi ndings have revealed that family problems are one of the most frequent stressors experienced by farmers (Booth and Lloyd, 2000). Yet, work–family initiatives proposed by work and family researchers (e.g. Kelly et al., 2008) such as work–life policies and benefi ts (e.g. family leaves, fl exible work arrangements and depend-

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ent care supports) and work redesign (‘no work on weekends’) may not be compatible with farmers’ work and lifestyle. Furthermore, conventional social support systems such as emotional or problem-solving support provided by supervisors and co-workers (Chen et al., 1999) may not be applicable due to the unique organizational structures and mobile workforce in small and medium sized farms. In sum, the agricultural industry faces a unique set of stressors that are not typically encountered by other industries, yet prevention approaches and mental health services have not been adequately investigated, developed, and provided for this population (Gunderson, 1995; Hall et al., 2004).

EXPOSURES TO ORGANOPHOSPHATE PESTICIDES

Suicide using pesticides as the agent of harm has been a primary focus of many studies of suicide in various countries (e.g. Eddleston and Philips, 2004; London et al., 2005). Yet, the focus of our review is to what extent pesticide exposure at work may be responsible for suicidal behavior. It has been reported in several epidemiological studies over the past two decades that higher rates of suicide have appeared among farmers and others exposed to organophosphate pesticides at work (e.g. Gunderson et al., 1990; Hawton et al., 1998; Kposowa, 1999; Stallones, 1990, 2006). The possible link between organophosphate exposure and suicide is also recognized by physicians (Royal College of Physicians and Royal College of Psychiatrists, 1998). Organophosphate pesticides were fi rst introduced in the 1940s. Deaths from exposure to these compounds were reported as early as 1949 (West, 1968). In moderate exposure cases, the symptoms were followed by headache and insomnia with excessive dreaming and nightmares, and the symptoms in extreme exposures were followed by ataxia, tremor, drow- siness, diffi culty concentrating, mental confusion, disorientation, and changes in speech characterized by slurring, diffi culty in forming words and in self-expression and repetition (Durham et al., 1965; Grob et al., 1950). Apathy, anxiety, uneasiness, withdrawal and depression were also reported to occur (Dille and Smith, 1964; Gershon and Shaw, 1961). Ahmed and Davies (1997) have proposed a long-term neuropsychiatric syndrome resulting from organophosphate exposure. The syndrome is called chronic organophosphate-induced neuropsychiatric disorder (COPIND) which is characterized by the following symptoms: one or more episodes of severe fl u-like symptoms lasting more than three days following exposure (and sometimes hypersalivation, abdominal cramps and diarrhea); mood destabilization; suicidal thinking; cognitive

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impairment; language disorder including word fi nding and expressive disorders; alcohol intolerance including marked increase in the inebriating eff ects of alcohol, severe hang-over and quasi-allergic eff ects; heightened sense of smell; handwriting deterioration; sensitivity to exposure to low concentrations of organophosphates; and decreased exercise tolerance refl ected in initial normal muscle power but inability to maintain it and no evidence of generalized weakness. While comparing exposed farmers to unexposed farmers, Levin et al. (1976) reported that the former tended to report high anxiety. Reidy et al. (1992) also found that twice poisoned migrant farm workers scored higher on anxiety and depression symptom checklists one to two years after the poisoning episode. Similar patterns were found from studies comparing exposed individuals or workers vs. controls (London et al., 1997; Rosenstock et al., 1991; Wesseling et al., 2010) in various countries (e.g. in South African fruit farms or among Costa Rican banana workers). Unfortunately, the adverse eff ects of organophosphate pesticides do not just aff ect farm workers. For instance, Kamel and Hoppin (2004) reported neurological symptoms associated with pesticide exposure among pesticide applicators from Iowa and North Carolina recruited between 1993 and 1997. High frequency and low frequency use of organophosphate pesticides was compared and high frequency use was signifi cantly associated with a wide range of symptoms including: fatigue, tension, insomnia, depression, diffi culty concentrating, loss of appetite, and diffi culty speaking among white male applicators. In the same cohort (Beseler et al., 2006), female spouses of pesticide applicators were diagnosed with depression more often in the presence of a history of a pesticide poisoning than spouses whose partner had not been poisoned (odds ratio 3.26, 95% CI 1.72, 6.19), after controlling for state of residence, age, race, off - farm work, alcohol consumption, cigarette smoking, physician visits and solvent exposure. Among the pesticide applicators, the odds ratio of diagnosed depression comparing those with a history of poisoning to those with no history, after controlling for the variables listed above, was 2.57 with 95% CI range from 1.74 to 3.79 (Beseler et al., 2008).

ADDRESSING THE HIDDEN OCCUPATIONAL FATALITIES

The goal of this chapter is to raise awareness about the hidden occupational fatality, suicide, in the agricultural industry, and to review two contributing factors of depression and suicide among farm workers. In the remaining section, we attempt to propose a few suggestions for future

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research and practice to address this occupational safety and health challenge. Foremost, the defi nition of occupational self-infl icted fatality currently employed by government agencies (e.g. NIOSH, OSHA and the Bureau of Labor Statistics) and society is too limited to guide the development of a valid occupational surveillance tool as well as prevention strategies. This work-oriented defi nition (i.e. workers die by suicide at work) ignores the fact that boundaries between work and life are intertwined, particularly in the agricultural industry. Our fi ndings and other research (Gallagher et al., 2008; Stallones et al., 2010) have shown farmers have higher suicide rates than other occupational groups. Similarly, farming populations have long been reported to have higher rates of depression than other occupational groups (Gregoire, 2002; Linn and Husaini, 1987; Scarth et al., 2000; Stallones et al., 1995; Thomas et al., 2003). However, it has been consistently shown that farmers are reluctant to seek medical care for mental health and stress-related problems (e.g. Judd et al., 2006). More often they rely on their families and friends, prayer and non-professional help as preferred alternate ways to deal with mental health problems (Kirkwood and Peck, 1997). In addition, the culture in the farming communities emphasizes staying positive and strong in the face of challenges, and it is not acceptable for farm workers and their families to be negative or to complain. The need to combat the above barriers cannot be unstated. Research and practice need to utilize innovative approaches to build the capacity of culturally competent suicide intervention and prevention services in rural farming communities, to improve the ability and skills of farm workers and/or their families to respond to suicide risk in neighbors and family members, and strengthen mental health infrastructures. Prevention initiatives to address the above issues have been studied by our research team for diff erent populations (see Chen et al., 2009; Stallones and Moore, 2010) Third, people who are depressed tend to seek medical attention for physical issues more often than those who are not depressed (Cockerham et al. 1988; Rowen et al., 2002). Depression can manifest in a number of somatic symptoms which may lead people to seek medical care for those symptoms rather than for their mental health problems (Meyer et al., 2000; Stoudemire et al., 1985). Increasing the awareness of medical care providers of the likelihood that mental health problems may be manifested through somatic symptoms may ultimately increase treatment options for depressed agricultural workers and reduce the risk of severe adverse outcomes such as suicide. It has been postulated that the likelihood that someone will engage in suicidal behavior in the presence of stressors may be lowered or raised

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(Kamali et al., 2001), depending on other risk factors (e.g. genetic predis- position, personality traits, biochemical factors in a person’s metabolism, the emotional state of hopelessness, or the presence or absence of ongoing support systems). The role of the such risk factors have not been incorporated in studies of mental health among agricultural workers in a systematic way, and would be of help in assessing potential prevention strategies. The integration of studies on depression, stressors and environmental exposures may provide a better understanding of the complex nature of gene and environmental interactions in agricultural workers.

ACKNOWLEDGEMENTS

Preparation for this chapter is supported by Occupational Health Psychology Training, US NIOSH (1T42 OH009229-01) awarded to Peter Chen and Lorann Stallones. Its contents are solely the responsibility of the authors and do not necessarily represent the offi cial views of NIOSH. This chapter is dedicated to the memory of J. Byler Nuckols, Mike Nowacki and Dane Menger.

REFERENCES

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INTRODUCTION

The workplace has been shown to have an infl uence on human health and well-being. Uncertainty, job stress and work organization being major factors, particularly in knowledge economies such as the UK (Schulte and Vainio, 2010). The importance of well-being at work is increasingly being recognized nationally, as evidenced by reports such as the UK’s 2008 report by Dame Carol Black Working for a Healthier Tomorrow, and internationally, as demonstrated, for example, by the ‘Towards Better Work and Well-being’ conference with contributions from more than 30 countries (Schulte and Vainio, 2010). This chapter will discuss well-being in terms of stress and stress management with a particular focus on small and medium sized enterprises (SMEs). It will look at organizational factors (e.g. stress and stress management as experienced in SMEs) and the societal context (e.g. the regulatory issues surrounding workplace well-being). The chapter will not present defi nitions and detailed descriptions of health, well-being, and workplace stress in recognition of the general understanding of these terms. The focus will instead be on specifi c problems facing SMEs and ways in which these can be addressed. The interested reader may fi nd these sources useful if more detailed background information is needed (see e.g. Cartwright and Cooper, 2009; Dewe et al., 2010). A UK perspective is taken in terms of the regulations and advice available to companies regarding health, well-being, stress and stress management. However, the general themes and the underlying research are applicable internationally. The chapter will: discuss the reasons why SMEs should pay attention to health, well-being and stress; give an overview of the diff erent types of stress management available; describe the diff erences between large companies and SMEs in terms of stress and

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stress management; detail the potential causes of stress in SMEs; discuss the impact of stress on self employed managers/owners; investigate the impact of the recession and economic climate on stress and stress management; and provide an overview of the regulations and advice available to SMEs. The chapter will conclude with a discussion of what SMEs should do about stress at work, alongside links to resources available online.

WHY SHOULD SMALL AND MEDIUM SIZED ENTERPRISES PAY ATTENTION TO HEALTH, WELL-BEING AND STRESS?

The costs of ill-health in the working age population are estimated in the UK at about £100 billion a year (Black, 2008) with mental ill health costing around £28 billion (National Institute for Clinical Excellence [NICE], 2009) and absence alone costing around £16.8 billion (Confederation of British Industry [CBI], 2010). Indeed, mental health problems have been identifi ed as a key cause of both long-term and short-term absence (CBI, 2010), and NICE (2009) estimate that eff ectively managing mental health at work in an organization with 100 employees could save as much as £250 000 per year. These fi gures clearly demonstrate the importance of stress and stress management in the workplace given the known links between stress and poor health (both mental and physical). In their 2010 report, the Trades Union Congress (TUC) suggested that a total of 1 200 000 people currently working believe they suff er from work-related ill health and that although many people are on long-term sick leave, many others continue to work despite ill health, which is of particular concern with regard to stress-related ill health and its likely impact on performance. Both absenteeism and presenteeism are recognized as presenting signifi cant costs and problems to companies. Absenteeism is a common result of experiencing stress at work, with stress being the top cause for long-term absence in non-manual workers, and the fourth most common cause of long-term absence in manual workers (Chartered Institute of Personnel Development [CIPD], 2008). Costs relating to absence include sick pay, replacement labour, rehabilitation, operational disruption, impact on performance, management/ investigation time, personal injury claims, higher insurance premiums, and the cost of measures implemented in response to incidents (Haslam et al., 2010). The CBI reported that in 2009 the cost of workers in the UK taking sick days was an estimated £3.7bn (CBI, 2010). The eff ects of absenteeism are signifi cant for both SMEs and large organizations, although a CBI (2010) survey revealed levels of absence and

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absence costs were generally higher in large organizations. Nevertheless, the potential for signifi cant problems to arise as a result of absence is high in SMEs since they often rely on a small group of workers, and it can be diffi cult to reshuffl e job roles if a member of staff is absent. The loss of organizational knowledge when individuals leave a company is also signifi cant, with SMEs particularly badly hit by this, as just one employee leaving can represent a signifi cant proportion of the workforce. Presenteeism, where employees continue to work despite suff ering poor health, is increasingly recognized as of growing concern to organizations, since employees are likely to be not fully engaged or productive while at work. Indeed it is estimated that the negative consequences of presenteeism may cost organizations twice as much as absenteeism (NorthWest Public Health Observatory [NWPHO], 2010). Legal costs as a result of stress cases can be high and this is likely to threaten small fi rms more than large ones since they are less likely to be insured against action (Johnson, 1995). Insurance is seen as a signifi cant business expense (Haslam et al., 2010). Adhering to health and well-being recommendations and proactively tackling workplace stress issues can decrease the risk of legal action being taken against a company. Other reasons why organizations should invest in health and safety include: protection of staff well-being for moral reasons; compliance with legislation; managing human resource issues; maintaining corporate image; avoiding fi nes and other legal implications; external pressures such as customer/client requirements (commercial companies); government targets (public sector); and the infl uence of the insurance industry (Haslam et al., 2010). Despite the importance of the above, it is the fi nancial benefi ts of addressing employee health and well-being that are likely to be the biggest incentive for change. However, SMEs do not typically recognize the cost benefi t of health and safety investments (Haslam et al., 2010) with only 12 per cent of SME representatives recognizing the benefi ts, compared to two-thirds of those from large organizations. Promoting the business case for investment in well-being at work is therefore important to enhance the understanding in SMEs of the need to tackle stress issues and the benefi ts this can engender for the company. Organizational benefi ts include increased performance, staff morale and productivity, and reduced legal risks, absenteeism, presenteeism, staff turnover and recruitment costs. Individual benefi ts include improved health, increased income, engagement, personal growth and learning (CBI, 2010; NWPHO, 2010; Schulte and Vainio, 2010). Emphasizing the business case of stress management will act as an incentive to organizations to address these important issues. Economic evaluations should

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specifi cally target and relate to the SME sector, since evidence in this area is currently almost non-existent (Martin et al., 2009).

STRESS MANAGEMENT

Stress management can be defi ned as putting in place interventions in the workplace designed to increase well-being and have a positive infl uence on health. There is an increasing evidence base that workplace interventions can be eff ective, although more research is needed, particularly in the SME sector (Schulte and Vainio, 2010). Stress management can be split into two broad areas with a focus on either the individual or the work environment (Semmer, 2008). The key to long-term stress management is likely to rest with identifying the underlying causes (i.e. workplace factors) rather than focusing on stress management initiatives that are aimed primarily at the outcomes of stress (e.g. counselling). Person-focused stress management is dominated by Stress Management Training (SMT) which is focused upon diagnosing stress, identifying its causes and learning how to deal with it. Examples of stress management training include relaxation and cognitive behavioural skills training. Approaches linked to more specifi c issues are also used, such as coping strategies, training in assertiveness, confl ict resolution, problem solving and time management (Semmer, 2008). Overall, the eff ects of stress management training have been shown to be moderately successful, although the strength and type of eff ect depends on the type of intervention (Semmer, 2008). Reviews and meta-analyses on the eff ects of SMT can be found in Giga et al. (2003), Lamontagne et al. (2007) and van der Klink et al. (2001). There are a number of types of person-focused stress management strategies (Dewe and Kompier, 2008), as follows:

Relaxation techniques:

● Progressive muscle relaxation ● Meditation/mindfulness ● Biofeedback.

Cognitive behavioural skills training:

1. Identify triggers 2. Analyse stress response 3. Modify response.

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Specifi c training:

● Assertiveness ● Confl ict resolution ● Problem solving ● Time management ● Anger management ● Health circles ● Participatory ● Action research.

Work environment (organization-focused) stress management concentrates on identifying working conditions that impact upon well-being and designing changes to these environmental factors in a bid to improve the health and well-being of employees. Approaches can be focused on the nature of tasks, the work environment, or social relationships in the workplace (Semmer, 2008). Examples of work environment stress management include: ensuring tasks are interesting and provide some variety and autonomy; ensuring workload is adequate (i.e. people are not over or under worked); and strategies designed to improve communication within an organization. Generally the aim is to develop an organizational culture in which management consider health and well-being to be a priority. The eff ects of work environment stress management strategies are shown to be generally positive but can be inconsistent (Semmer, 2008). Reviews and reports can be found in Giga, Noblet, Faragher and Cooper (2003), Kompier, Cooper and Geurts (2000), Lamontagne et al. (2007), Murphy and Sauter (2004) and Semmer (2003, 2006). Types of organization-focused stress management strategies (Dewe and Kompier, 2008) include:

● Active involvement ● Careful analysis of specifi c problems ● Quality implementation.

These strategies are focused on:

● Early diagnosis ● Empowerment ● Eff ective delegation ● Better people management ● Flexible work arrangements ● Job redesign.

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It is widely accepted that stress management strategies can be useful tools and both person- and organization-focused strategies are promoted as good practice and have been shown to have positive eff ects at the individual level, in terms of reducing the experience of stress and improving health. In addition to this, organizational benefi ts result from stress management programmes, such as reduced absenteeism and reduced employee turnover. However, it has been proposed that whilst person-focused strategies are more likely to yield results at the individual level, work environment stress management and combined approaches are more likely to result in organizational improvements (Semmer, 2008). This suggests that from a business-case perspective, paying attention to work environment factors is likely to result in the best outcome, that is one that benefi ts both the individual and organization directly. A further classifi cation of job stress interventions is primary (organization-focused), secondary and tertiary (person-focused) (Lamontagne et al., 2007). Primary interventions are organization-wide and preventative and aim to reduce work stressors and improve the working environment (e.g. job redesign; improved communication strategies). Secondary interventions target individuals and are ameliorative, aiming to help employees to cope with work stressors (e.g. relaxation or exercise classes; counselling). Tertiary interventions also target individuals but are reactive and aim to treat or rehabilitate those with enduring stress-related conditions (e.g. return-to-practice schemes). The most commonly provided stress management activities include: access to counselling; employee assistance programmes; subsidized gym membership; and fl exible working (NWPHO, 2010). Three-quarters of employers operate well-being policies with occupational health advice and personal counselling the most common activities, and many employers off er support regarding stress (CBI, 2010). However, the uptake of stress management in SMEs is generally not known, as research has predominantly focused on large organizations. This limits our knowledge of both the experience of stress in SMEs and our ability to select appropriate stress management techniques. The next section will present our current understanding of stress and stress management in direct relation to SMEs.

STRESS AND STRESS MANAGEMENT: FROM LARGE COMPANY TO SME

Much of the research into stress and stress management has been derived from large organizations, thus limiting its direct applicability to SMEs (Haslam et al., 2010; Johnson, 1995). There have been very few studies

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that have directly looked at the experience of stress and stress management in SMEs, with the result that SMEs are a neglected sector in occupational health research (Martin et al., 2009). Those studies that have been done are dated (e.g. Akande, 1992; Buttner, 1992) and therefore cannot address recent changes in advice, regulation and experience of stress and stress management. The relevance and impact of these changes to SMEs therefore remains unknown (Haslam et al., 2010). Dame Carol Black (2008) in her review of the health of the UK working population, described how SMEs employ the largest proportion of the workforce and contribute enormously to the economy. However, she also discussed how the number and diversity of SMEs make it diffi cult to identify a single approach to managing health and well-being in the workplace that is applicable to all businesses. To improve take-up of stress management interventions in both SMEs and larger organizations there should therefore be a focus on methodologically sound evaluations that can further inform the business case for stress management (Semmer, 2008). It was recognized by Schulte and Vainio (2010) that current research into well-being and well-being interventions neglects to adequately address SMEs, who are the employers of the majority of employees. It was recognized that one of the issues is that SMEs often have fewer resources and expertise in these areas. Schulte and Vainio called for three direct eff orts to be made in relation to well-being and SMEs:

1. A larger portion of research resources should be focused on SMEs. 2. The distinctions within SMEs should be researched and characterized (there are important diff erences in resources and capabilities). 3. The business case should be used as a motivator for employers.

Lack of sustained management support is one of the main problems facing successful stress management interventions. There is a clear need to communicate the business case for stress management to managers of SMEs, as seeing the cost benefi ts of such measures is likely to increase usage of stress management techniques which will not only have fi nancial benefi ts but also are likely to provide benefi ts to employees at an individual level (i.e. through better health and related factors such as increased control at work). Studies have reported that organizations are not monitoring the cost of occupational illness (such as stress) in the same way as they monitor the cost of occupational accident or injury (Haslam et al., 2010). Furthermore the same study reported that SMEs, unlike most large organizations, do not see the cost benefi ts of these types of measurements, and are less aware of the tools available to assist cost benefi t calculations. It has been further noted that there is a lack of availability and desire

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of SME employees to attend training or interventions (Martin et al., 2009) with Semmer (2008) reporting that Stress Management Training (SMT) is more likely to be available to more highly qualifi ed people (e.g. health professionals, teachers and white-collar workers). This is likely to be in part due to the focus on stress management in large organizations. Stress management training and cognitive behavioural training interventions, often used by large organizations, can be diffi cult to implement in smaller organizations and are thus infrequently adopted by SMEs (Martin et al., 2009). Other restrictions facing SMEs are the high cost of face-to-face interventions, and diffi culty accessing services from remote or rural areas (Martin et al., 2009). Corporate wellness programmes and policies are often used as part of stress management, although these are predominantly seen in large organizations. SMEs typically seem to have a lack of both awareness and inclination to address these issues, although there is an increased push to raise SME awareness and to implement these more widely. Later in the chapter a mix of regulations and advice that may be useful to SMEs are outlined.

CAUSES OF STRESS IN SMALL AND MEDIUM SIZED ENTERPRISES

There are confl icting views of what it is like to work in a SME, with some theorists describing opposing viewpoints, for example: SMEs are happy places to work, more informal than larger organizations and with good working conditions (e.g. Goss, 1991) and; SMEs are places of exploitation with often poor and dangerous working conditions and poor employee relations (e.g. Wilkinson, 1999). The truth is likely to be a mixture of the two, with some excellent small employers and some not so good. There are positive and negative points to both small and large employers. There is a general lack of research specifi cally looking at health and well-being in SMEs although some prescient points are discussed below. People are likely to face some similar types of stressors regardless of whether they work in a large or smaller organization. Issues such as work overload, role confl ict, unsupportive managers, lack of job clarity, career worries, are evident in organizations of all sizes. However, there are some issues that are more likely to aff ect a small business, such as not having another supervisor/manager to turn to if there is a personality clash between an employee and a manager, having reduced training opportunities, and having a reduced social network of employees with whom to interact. Chuang (2006) suggested that small businesses may be understaff ed

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compared to larger organizations, as a result of issues such as lack of capital to adequately staff the workplace, insuffi cient knowledge of human resource needs and smaller payrolls. Understaffi ng will result in overload for employees thus increasing stress exposure. It has been posited that one of the major sources of stress in small businesses may be work overload as a result of the unique nature of the business and the requirement that employees take on multiple roles and tasks (Chuang, 2006). Whilst larger organizations typically have customer service departments, IT support, and cleaning staff and so on, smaller companies often do not, and individuals are expected to take on all roles. Whilst it is possible that this may lead to increased demands and stress, the counter argument is that these additional tasks will add variety to job roles, and may increase the amount of control an individual feels they have over their working life. This can serve to reduce the amount of stress experienced. The message here then is that there will be an optimum level of demands, control and variety, up to which point employees will be incen- tivised and motivated, but beyond which there is likely to be overload and a stress reaction. The challenge for managers is therefore to fi nd the right balance for what will work for their employees. Small businesses face challenges to compete within a growing global market. Extreme situations such as facing bankruptcy or loss of credit can be tremendously stressful for the individuals involved, particularly since owner-managers have often invested everything they have into their company and so may be facing more than the loss of a job should the company fail. Added to this is the strain of supporting other people (employees) and trying to protect their jobs and well-being in an increasingly diffi cult market. The stress an owner/manager may experience is explored further in the section below. There is a signifi cant risk of work–life imbalance in small fi rms, with family fi rms especially at risk (George and Hamilton, 2010; Johnson, 1995). When family members share the same occupational stage there is increased opportunity and likelihood for friction and rivalry. If companies are based in the family home (as many are) this can result in high levels of friction and little opportunity for real time away from the ‘workplace’. This is further exacerbated when the fi nancial well-being of the family is dependent on the company. There are many positive elements of SMEs as employers. The TUC (2010) propose that close working relationships between worker and owner can be benefi cial, and the closeness of the owner to the business also results in their having a good understanding of the job and risks involved. However, it is also possible that the close working relationship between owner and employee could cause problems if there is perceived psychological contract

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breach and subsequent lack of trust. The role of ‘emotion contagion’ has been discussed (Martin et al., 2009), as SME employees are typically in a closer working relationship with their manager. The leader’s attitude towards health and well-being, and the infl uence of this on the health and wellbeing culture of the organization, is therefore likely to be a signifi cant determinant of employee well-being in SMEs. Lower sickness rates are reported by smaller employers compared to larger ones (CBI, 2010; TUC, 2010) which could be indicative of reduced health issues. However, the lower reporting is also likely to be a result of many of these organizations being one-person businesses or not having occupational sick pay schemes. Not having a sick pay scheme means that many workers have to either bear the fi nancial cost of ill health themselves, or continue to work despite ill health. Employees in smaller organizations may also be less likely to take time off if they know their absence may cause their colleagues high workloads (CBI, 2010).

SELF EMPLOYED OWNER-MANAGERS

It has been reported that salaried employees are better off in terms of experiencing less job stress and psychosomatic health problems than self-employed workers (Jamal, 1997). This section explores some of the reasons why this may be the case and looks at the stress experience of owner-managers/self employed. Positive aspects of self employment include the high degree of power, autonomy and independence it allows individuals, in addition to: the freedom to make decisions about the business; being accountable only to yourself; higher potential for fi nancial rewards; increased opportunities to face interesting challenges; escape from the subordinate employee position; and feelings of achievement and pride (Jamal, 1997). In support of this, some studies have reported that owners/self employed had greater work satisfaction than non-owners (Bradley and Roberts, 2004; Tetrick et al., 2000). Jamal proposed that self employment off ers relatively high job security, but given the recession and current economic climate this is arguably no longer the case (discussed further below). Negative aspects of self employment include the domination of work and its demands on the lives of self-employed people and the diffi culty of achieving a clean separation between work and non-work. Other disadvantages include: long working hours, including disrupted weekends; high levels of uncertainty; the risk and fear of failure requiring high investment of both emotional and physical resources; high degree of responsibility for others; and loss of psychological well-being (Jamal, 1997).

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It has been proposed that stress is an adjunct to entrepreneurship and therefore can be an almost inevitable outcome of owning and managing your own business (Johnson, 1995). The qualities required to form your own business (e.g. vision, risk, desire for independence) are not the same as those needed to successfully run a business (e.g. administrative qualities). The demands on individuals are therefore high, as is the likelihood of experiencing stress. It has also been argued that the more successful a business is, the less time owner-managers have to do what they initially set out to do with the business and the more time they spend on general management of the company. This can, in itself, lead to increases in stress. Furthermore, there is a requirement that owner-managers be good at ‘selling’ their company and/or product, and adept at building good networks and managing the interface between the organization and external people. These tasks and expectations can also be a source of stress as the owner-manager is constantly managing multiple relationships and has to present themselves and their business carefully to others (e.g. employees, customers, suppliers). This type of work can be likened to ‘emotional labour’ or ‘emotion work’, where the management of emotions is required for successful completion of a job or task. Emotion work has been shown to be inherently stressful (Zapf and Holz, 2006). Self employed managers are faced with multiple tasks and roles throughout their working day, with subsequent implications for work overload and increased stress. A study of managers and time allocation (Florén, 2006) revealed that, compared to managers in large organizations, SME managers had more fragmented tasks and greater task brevity, and experienced regular interruptions and switching between multiple roles. It was also reported that SME managers less often used managerial procedure tools and had poorer networks, which has implications for the uptake of procedural tools to assist with stress management and for the support available to SME managers to prevent them from feeling isolated. Technology, whilst off ering many advantages in the workplace, has also contributed to adding to the workload of both managers and employees. For example, email, multiple business oriented social networking sites, mobile communication technology (phone and internet) have all increased the potential for overload, making it harder than ever to have time away from work or to be uncontactable outside working hours. This is likely to have the most impact on managers within SMEs as they are often the main point of contact for all aspects of the business. Technology has allowed us to be almost always available. The need to keep an eye on work issues and being the person who ultimately makes the decisions about the business can mean the manager eff ectively never has completely free time away from work demands. This has signifi cant health implications.

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The performance of a business can be strongly linked to the self-concept of a self-employed manager (Johnson, 1995). The performance of the business is likely therefore to aff ect the well-being of a self-employed manager to a much higher intensity than that of an employed manager. The self- employed manager has invested highly in their company and may see it as their ‘baby’. In times of hardship then, if a business experiences problems, the impact of this on self-employed managers can be signifi cant in terms of health and well-being. In a volatile environment, such as that currently being experienced post-recession, a manager’s self-concept can be signifi - cantly impacted upon, with high risk for negative business experiences and subsequent negative health impacts. Having responsibility for others is recognized as contributing to the experience of stress at work and self-employed managers have high levels of responsibility for their employees. How well the business performs will aff ect the livelihood of everyone on the payroll (Johnson, 1995) and this can be a signifi cant source of stress for owner-managers who may feel personally responsible for the well-being of their employees. Experiencing ill health and/or having time away from the company because of stress related factors can lead to further problems in that the demands on the owner-manager are likely to increase whilst their ability to manage is negatively impacted. Owners may fi nd it more diffi cult to manage everyday tasks and challenges, and be more prone to disagree- ments and confl icts at work. These kind of issues can create a cycle where stress-related problems in eff ect lead to further problems, thus increasing the negative impact on owners (both in terms of their business and their health). Managers will also fi nd it harder to support their employees if they themselves are suff ering from stress or poor mental health (Martin et al., 2009). Being an owner-manager can be an isolating experience with limited opportunities for social support, with often nobody within the organization with whom to discuss problems, and a lack of time and opportunity to seek external support (e.g. through small business networks).

IMPACT OF RECESSION AND ECONOMIC CLIMATE

SMEs face severe challenges as they compete ever harder to retain market share and manage a workforce that is becoming increasingly disillusioned with the current economic situation. Employees may be experiencing decreased well-being as a result of a wide range of issues, for example the threat of job loss, pay cuts, reduced working hours, changes to pension age and entitlement, and other fi nance-related non-work issues such as

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increased VAT and reduced income through cuts in child (and other) benefi ts. It was suggested by the NWPHO (2010) that signs of poor health and well-being may additionally be masked as people fear losing their jobs if they were to take sick leave. Indeed absence did fall between 2008 and 2009, which the CBI (2010) interpreted as indicative of a ‘real resilience during challenging times’ (p. 4), although of course this could also be a sign of presenteeism. Furthermore, although absence levels have dropped the cost of absence to organizations (both direct costs and indirect costs), have risen (CBI, 2010). Anticipating job loss can increase anxiety and decrease work performance, and the survivors of job cuts, that is those employees still working within an organization, can face high pressure from the fear of further job cuts, increased workloads and the loss of work colleagues (Ivancevich et al., 1985). As well as having a direct impact on increased workloads there are also potential knock-on eff ects to other stressors, such as increased work–home confl ict, and decreased opportunities for social support. People may also work longer hours because they are scared of losing their jobs, with one study revealing that 40 per cent of people reported doing this (Isles, 2005). Often small businesses have to invest every resource into the company and do not have vast sums of money to fall back on in hard times. The recession has led to cash fl ow problems within companies who do not have reserves of funds to draw upon, further compounded by the reluctance for lending seen in fi nancial institutions over recent years. These are signifi - cant problems for small businesses which could, and indeed do in many cases, result in the folding of the business. Managing and working in these diffi cult and uncertain conditions will undoubtedly have increased stress and strain for individuals within small businesses. The risk of business failure is generally recognized as a signifi cant stressor; conversely the role of stress in business failure is less well understood, although conceptually it would seem clear that high stress levels are likely to cause problems within a company that could increase the likelihood of business failure, or lead the owner-manager to take the decision to cease trading. The pressures facing an owner/manager as a result of their having responsibility for other people was discussed above, and can be a signifi - cant source of stress. The negative outcomes of the recession, such as loss of jobs and pay reductions, are therefore likely to aff ect managers negatively as they are increasingly faced with making and acting upon decisions that are detrimental to their employees. Clearly, fi nance is a key concern for SMEs during times of fi nancial hardship. Organizations are likely to be concerned about any costs relating to health and well-being policies and advice, regardless of their opinion

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as to the moral and business case. Indeed cost was the second most important factor reported to inhibit the adoption of a well-being policy, after uncertainty about the benefi t of well-being programmes (CBI, 2010). However, it was reported by the NWPHO (2010) that despite the current economic climate there remains a strong business case for creating healthier workplaces, with benefi ts such as improved morale and service quality, and reduced sickness absence. The Marmot review (2010) similarly states that the economic climate should not deter employers from trying to create ‘good jobs’, especially given the potential benefi ts.

REGULATIONS AND ADVICE AVAILABLE TO SMALL AND MEDIUM SIZED ENTERPRISES

There is a legal duty for organizations to assess the risk of stress-related ill health arising from work activities, described in the Management of Health and Safety at Work Regulations, 1999 (Health and Safety Executive [HSE], 1999). Employers have a ‘duty of care’ that employees not be made ill by work, and employers with over fi ve employees must have a written health and safety policy. Other requirements of organizations include: performing regular risk assessments; alleviating monoto- nous tasks; adapting work to the individual; and tackling the causes of work-related stress (NWPHO, 2010). Employers have a legal duty to identify and assess risks and remove or reduce them wherever possible. The TUC (2010) describe four concepts which form Britain’s health and safety stance:

1. It is the employer who controls the workplace so they should be responsible for controlling risk. 2. They should do that by identifying and assessing what risks there are, how likely they are to occur and the likely impact. 3. Those signifi cant risks should be removed or reduced as far as reasonably practical. 4. The workforce should be involved in the process.

Risk assessment is aimed at identifying and assessing the risks inherent in a workplace. The complexity of this will depend on the type of work but many employers conduct their own risk assessments (i.e. without assistance from external experts). This is likely to be the case for many SMEs for a number of reasons, for example: the nature of their business (i.e. typically not high risk); the cost of external risk assessment; and the low numbers of employees. Indeed, the HSE in the UK have produced a model

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for risk assessments designed to help companies proactively address health and safety issues, including stress and stress management (HSE, 2010) The HSE fi rst produced their Management Standards in November 2004. The Management Standards look at work-related stress and ways in which managers and organizations can tackle it. Guidance specifi c to SMEs is available on the HSE website. The key messages from these, aimed at managers, are:

● Everyone in the organization has responsibility for tackling work- related stress. Involving unions, staff representatives and employees is critical to raise awareness and improve employee health and well- being. ● Employers underestimate the extent to which employees are suff ering from stress or other forms of mental illness. ● Most organizations will have some form of stress-related problems, the key is to fi nd out where and what the problems are, and how and why they happen. The Management Standards help managers decide how to make changes and is a way to measure performance. ● Recognize that work-related stress is a legitimate health and safety issue and can be dealt with like any other health and safety risk. ● Managers may play a critical role in specifying task and job requirements and allocating individual job roles; their actions and behaviour could have an impact on the quality of working life of the team. ● Managers should play a major role in communication, ensuring information goes both ways between senior staff and employees.

An indicator tool designed for direct use by organizations, and reporting on the psychosocial working conditions within organizations, was also developed and launched by the HSE. This tool provides managers with feedback on the key areas of work design that, if they are not properly managed, are associated with workplace stress (Demand, Control, Managerial Support, Peer Support, Role, Relationships and Change), and provides insight into the organizational culture surrounding stress and stress management. An investigation of the acceptability of the HSE’s Management Standards for SMEs was conducted between 2004 and 2006, as it was thought that smaller organizations may fi nd it more diffi cult to implement the guidance for risk assessment than larger organizations, where it had been trialled (Gaskell et al., 2007). This was a limited study, with only ten SMEs involved, all of whom had existing problems with stress. Overall, the SMEs gave favourable views of the materials but the HSE website was felt to be non- user-friendly. It was proposed that the printed versions (as used in the study)

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were more accessible to SMEs. The most liked elements of the material were those that could be directly applied in the workplace, that is, the indicator and analysis tools. SMEs also reported a desire to have a wider range of tools available to assist them with addressing workplace stress. The implications are that more material is needed and printed versions rather than web-based ones would likely help SME uptake. A later study supported these early fi ndings with only 8 per cent of SMEs reporting being aware of the HSE tools available to calculate business costs (Haslam et al., 2010). A report on psychosocial working conditions in Britain (Packham and Webster, 2009) looked at the working conditions linked to the HSE Management Standards, namely Demand, Control, Managerial Support, Peer Support, Role, Relationships and Change. Comparing annual survey results between 2004 and 2009 indicated that working conditions have not generally changed, and although initially it appeared there was a down- ward trend of stress reporting this is no longer apparent (one possible explanation for this could be the recession). Finally, and importantly in terms of assessing the impact of the HSE Management Standards, there seems to be little change in employee awareness of stress initiatives, with only around a third of respondents reporting initiatives on stress in the last year. Suggestions for this lack of impact include a long latency between implementation and seeing benefi ts as a result, and any eff ects being masked by other economic and social factors (for example as discussed in the above section on economic climate). It was concluded that some eff ect of the Management Standards would have been expected to appear around 2008 or 2009 and yet there is to date no evidence they have had an impact. This indicates that whilst the Management Standards may prove useful to organizations, a lot more work needs to be done in order to facilitate working solutions into the workplace. It is arguable that this work should directly focus on SMEs as an under-investigated area in terms of stress and stress management. The need to directly target SMEs to provide support with both advice and access to a range of services relating to health and well-being was further highlighted in a recent report from NICE (2009), and echoed by the recent CBI survey (2010).

WHAT SHOULD SMALL AND MEDIUM SIZED ENTERPRISES DO ABOUT STRESS AND STRESS MANAGEMENT?

In 2005 the Employer Survey Report from the Workplace Health and Safety Survey Programme (Clarke et al., 2005, p. 6) reported that: ‘Whilst

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work related stress is the second most prevalent self-reported work-related ill-health condition, only 3% of workplaces rank stress as one of their top three most common risks and the same proportion rank it as one of their three most severe risks’. There appears, therefore, to be a mismatch between the amount of stress being experienced and the problems this can cause, against the action being taken to combat it. The report goes on to reveal that stress is believed to be less well controlled than other workplace hazards and it is acknowledged that more action needs to be taken. Ignoring the impact stress can have on individuals and an organization is short-sighted and could result in negative outcomes such as reduced productivity, poorer work performance, lower morale, and even increased legal costs if employees choose to take legal action as a result of being placed in excessive and unnecessary positions of stress. SMEs need to recognize that stress is a real issue in the workplace, and is likely to be of particular concern during times of economic uncertainty. Stress is something that can be tackled in the workplace and whilst it is probably not possible to eliminate it completely, there is enough knowledge about the causes of stress and stress management to enable managers to take positive steps to reduce stress and thus reduce negative health and organizational outcomes. Understanding the business case for tackling stress at work is something from which SMEs would benefi t. If implemented eff ectively, it could increase the competitiveness of the business and provide signifi cant benefi ts for both individuals and the organization. As described earlier there are numerous stress management strategies that can be implemented aimed at reducing stress at work and increasing organizational eff ectiveness, broadly split between individual- and work- environment-focused interventions. What is appropriate for a particular business will depend on numerous things such as the type of work, size of workforce, money available for stress management, and time available. Managers have been identifi ed as one of the major causes of work- related stress because of the impact of a lack of skills in managing staff and stress (NWPHO, 2010). It is essential, therefore, that people in management positions (including owner-managers) have appropriate training in the skills and competencies that are required of them. An example of this is training to reduce absences. Whilst it is recognized that accessing such training can be problematic, there are increasingly resources that can be accessed to assist with self-training, such as the advice and resources detailed in this section, or more specifi c tools such as the free online Tackling Absence Management Toolkit which was designed with SMEs in mind (CIPD, 2006). Raising the awareness of health and well-being in a company, means that problems should be recognized early, allowing them to be addressed

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quickly and ensuring that people are referred to the appropriate support (e.g. stress management courses such as relaxation, counselling, or the provision of fl exible working). The more transparent a company’s health and well-being procedures are, the more likely employees are to feel that they can report and discuss problems with their manager. A word of caution: although there is a need for rules and regulations in relation to health and safety, and in particular stress and stress management, it should be noted that the requirements of implementing new procedures and regulations can in itself be a source of stress for owner managers (Johnson, 1995), thus highlighting the need for good advice and support networks for SMEs to prevent the addition of further stress through unrealistic or poorly thought-out requirements. Paying attention to the core components of ‘good jobs’ can be a good approach to work design, and it has been proposed that these ‘core components’ will protect or promote health (Marmot, 2010), being broadly similar to the areas of work design important to managing stress reported in the Management Standards. Good jobs are those in which staff have:

● A living wage ● A degree of control over their work ● Opportunities for skills building and promotion ● Mechanisms for participating in organizational decision-making ● The option of meeting any confl icting demands between work and outside factors (such as one’s family) ● The support they need to return to work following illness ● Protection from adverse working conditions ● Equality and lack of discrimination in the workplace.

The HSE’s Management Standards propose that the specifi c role of SMEs with regard to tackling workplace stress should be:

● Training: Use training to familiarize all managers with the key ideas. ● Policies and procedures: Make sure your organization has eff ective policies and procedures. You could include a section about stress and mental health issues in your health and safety policy, which is a legal requirement. You also have other legal duties, including the responsibility to carry out risk assessments. ● Listen: Consider any proposals you receive, and think about the business, moral and legal cases for action. ● Business case: Look at the current cost of an issue, such as stress and consider how much it would cost to tackle it and the fi nancial benefi ts of a successful outcome.

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● Moral case: Many organizations now realize that some aspects of work can make workers ill, and that things can be done that can help them feel better and improve their health. ● Legal case: there is a clear legal requirement to carry out a suitable and suffi cient risk assessment and to take steps to address any risks that are identifi ed. ● Audit: Work out what is already being done and what else needs to be done to meet your requirements as a duty holder. ● Commit: Your commitment is vital for the success of the process. Be willing to commit suffi cient resources to run the project and to put solutions in place. ● Communicate your vision: Tell your employees what you would like to see happening, and keep telling them throughout the project. ● Support: Support those people in the organization who manage the project day-to-day. ● Encourage: Encourage employees to take part so that they feel that their ideas and suggestions have value. ● Monitor: Check on progress by getting regular feedback from the project manager and staff . ● Update: Make sure that you have up-to-date systems and policies for dealing with individual concerns. Work with your human resource and occupational health advisers if you have them. ● Be aware: Recognize that the behaviour of senior staff has an impact on staff . ● Be positive: Show a positive and helpful attitude towards stress and mental health issues at individual levels.

A number of these were reiterated by the NWPHO (2010) as being critical factors in creating healthy workplaces and supporting employees in ill health, that is: commitment at board level; worker involvement; eff ective line management; early intervention; multi-disciplinary support; work- focused healthcare. Also discussed was the potential for stress management strategies to improve health and work outcomes in employees who have not yet developed a mental health condition. This suggests that introducing stress management strategies is likely to benefi t all employees, and not only those experiencing high stress. The report concluded with the recommendation that there is a need for a cultural change in organizations, from services focused upon ill-health to those focused on promoting good health, the recognition that SMEs require assistance to adopt good working practices, and fi nally that fl exible working should be made available in all employment. The numerous reports discussed in this chapter indicate that several

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diff erent initiatives are recommended for organizations to try and improve health and well-being. In general terms organizations should:

● Take a strategic approach to health and well-being ● Make regular assessments of well-being ● Identify and monitor health and well-being key performance indicators ● Train leaders and managers in how to deal with health and well- being issues ● Take a broad view of employee engagement that includes health and well-being.

The following are some simple suggestions for steps SMEs can take with regard to stress management, drawn from the information discussed in this chapter:

● Recognize that stress in owner-managers of SMEs is common and take time to address this if it is a problem. The health of the manager of a company is very important to the health of the company, and of other employees. ● Business groups can be good sources of support, particularly for owner-managers who may be experiencing isolation as they manage their own companies. Examples of these include chambers of com- merce and industry specifi c groups. ● Access and utilize the tools available which are designed to assist with managing employee health and well-being, stress and stress management (see Resources section below). Where possible provide feedback on how useful these are to your company so SMEs can guide future tools to best suit their needs. ● Consider ‘self-training’ if accessing training is problematic. For example Martin et al. (2009) proposed that the utility of self-administered cognitive behaviour therapy has been demonstrated, and the promotion of these treatments may make this type of stress management more accessible to SME employees. Some self-training such as Tackling Absence Management is available for free (CIPD, 2006). ● The role of immediate/line managers in creating a positive working culture in an organization should not be understated. Raising staff morale can help to reduce stress levels to some extent. Factors believed to be important to increased morale include: giving praise for a job well done; giving employees infl uence (control) over their work; providing development opportunities; giving honest feedback; and providing eff ective performance management (CBI, 2010).

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● Good levels of communication are believed to infl uence a positive working culture and can demonstrate to employees the importance being placed on health and well-being. ● Ask employees for suggestions about stress management. They may have some suggestions you have not considered. ● Implement fl exible working where possible as it has been repeatedly shown to be eff ective in improving well-being and reducing stress. ● Try to make work well organized and ensure people know what they are responsible for. ● Encouraging and making time for leisure opportunities has been shown to be an eff ective coping strategy for workplace stress (Trenberth et al., 1999). ● Health and safety representatives can help to develop a positive health and safety culture. However, smaller companies are much less likely than larger ones to have health and safety representatives (TUC, 2010). Companies could consider allocating health and safety roles to employees as a demonstration of the importance placed on these issues.

HEALTH AND WELL-BEING RESOURCES

Listed below are examples of some of the resources that may be useful to SMEs when considering how best to tackle health and well-being in general, and stress and stress management in particular.

● Five-minute stress check for small organizations: http://business mentality.org.uk/stress-check-tool ● Management Competency Tool: http://www.hse.gov.uk/stress/mcit. htm ● The HSE Management Standards Indicator Tool pack: http://www. hse.gov.uk/stress/standards/pdfs/indicatortool.pdf ● HSE Management Standards Analysis Tool: http://www.hse.gov. uk/stress/standards/pdfs/analysistool.xls ● Securing management commitment leafl et: http://www.hse.gov.uk/ stress/standards/pdfs/securing.pdf ● Health and Safety Performance Indicator: http://www.businesslink. gov.uk/bdotg/action/haspi?furlnameϭhealthsafetyindicator&furlpa ramϭhealthsafetyindicator&refϭhttp% ● Health4Work advice line: http://www.health4work.nhs.uk/

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Other web resources for creating healthier workplaces are:

● Working for Health (the offi cial site of the UK government’s Health, Work and Well-being initiative), including a tool to calculate the business costs of ill-health: http://www.dwp.gov.uk/health- work-and-well-being/ ● Advisory, Conciliation and Arbitration Service (health, work and well-being pages): www.acas.co.uk ● National institute for Health and Clinical Excellence (guidance on evidence for workplace interventions): http://guidance.nice.org.uk ● Chartered Institute of Personnel Development (absence management): www.cipd.co.uk

SUMMARY AND CONCLUSION

The issue of stress is as relevant to SMEs as it is to large organizations, despite the lack of research that has focused on SMEs, and the general lack of awareness within SMEs of the importance of health, well-being and stress. It has been noted that both SME employees and owner-managers are at risk from stress, with subsequent risks posed to the company as a result of the negative outcomes that can arise (e.g. reduced performance and poorer working relationships) if it is not managed appropriately. The impact of the recession and current economic climate on stress was also explored with risks identifi ed for employees, managers and companies. A number of drivers to encourage SMEs to pay more attention to stress issues have been discussed, such as improved health and productivity, and reduced absence. The promotion of the business case for stress management is especially highlighted as important, although other factors, such as the moral case for addressing stress management, should not be ignored. There is a need for research to be conducted in this area that specifi cally focuses upon SMEs in order to widen knowledge and make stress advice more appropriate and available to SMEs. This includes paying attention to how the information available to companies (e.g. legal requirements, regulations) can be made more attainable. The chapter concludes with a discussion of the health, well-being and stress management resources that are freely available to SMEs. Some steps that SMEs could take to help manage stress in their workplace are also proposed.

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Tetrick and J.C. Quick (eds), Handbook of Occupational Health Psychology, Washington, DC: American Psychological Association. Semmer, N.K. (2006), ‘Job stress interventions and the organization of work’, Scandinavian Journal of Work, Environment and Health, 32, 515–527. Semmer, N.K. (2008), State-of-Science Review: SR-C6 Stress Management and Wellbeing Interventions in the Workplace. Mental Capital and Wellbeing: Making the Most of Ourselves in the 21st Century, Foresight Project, Government Offi ce for Science. Available at: http://www.bis.gov.uk/assets/bispartners/foresight/ docs/mental-capital/sr-c6_mcw.pdf. Tetrick, L.E., Slack, K.J., DaSilva, N. and Sinclair, R.R. (2000), ‘A comparison of the stress-strain process for business owners and nonowners: diff erences in job demands, emotional exhaustion, satisfaction and social support’, Journal of Occupational Health Psychology, 5 (4), 464–476. Trades Union Congress (TUC) (2010), ‘The case for health and safety’, 6 September. Available at: http://www.tuc.org.uk/workplace/tuc-18416-f0.cfm (accessed 6 October 2010). Trenberth, L., Dewe, P. and Walkey, F. (1999), ‘Leisure and its role as a strategy for coping with work stress’, International Journal of Stress Management, 6 (2), 89–103. van der Klink, J.J.L., Blonk, R.W.B., Schene, A.H. and van Dijk, F.J.H. (2001), ‘The benefi ts of interventions for work-related stress’, American Journal of Public Health, 91, 270–276. Wilkinson, A. (1999), ‘Employment relations in SMEs’, Employee Relations, 21 (3), 206–217. Zapf, D. and Holz, M. (2006), ‘On the positive and negative eff ects of emotion work in organizations’, European Journal of Work and Organizational Psychology, 15, 1–28.

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INTRODUCTION

As illustrated in other chapters in this volume, small and medium sized businesses represent the majority of companies and organizations glo- bally, although unfortunately there is no unitary, consistent defi nition of the concept ‘small to medium sized enterprise’. Several diff erent criteria have been utilized to categorize organizations as SMEs, and the criteria also vary somewhat across countries. Nevertheless, it is important to qualify the nature of SMEs and to adopt an operational defi nition. For the purpose of this chapter, we have followed the OECD and European Union (2009) defi nitions, which are outlined here. The European Union (2009) defi ned businesses with less than ten staff as micro enterprises, while those with fewer than 50 employees are small enterprises, and under 250 employees as medium sized enterprises. Similarly, the OECD (2005) puts the upper limit designating an SME at 250 employees, noting that some countries set the limit at 200 employees, while in the United States organizations with less than 500 employees are considered SMEs. The OECD (2000) reported that 99.8 per cent of all enterprises in European Union countries were SMEs (under 250 employees), while the fi gure is 99 per cent in the United States (under 500 employees), and 99 per cent in Japan (under 300 employees). Small to medium sized enterprises are universal, with countries of varying sizes having quite similar proportions of smaller sized businesses. For example, New Zealand, with a population of just over 4 million people, has been found to have a similar proportion of SMEs as Germany with 82 million and the United States with 307 million. Mills and Timmins (2004) noted that ‘once zero-employee and one-year fi rms have been removed, the proportion of small fi rms in the New Zealand population is

106

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broadly within the OECD range’ (p. 9). They go on to state: ‘New Zealand seems to have a slightly lower proportion of small organizations than the USA and the UK (where small is defi ned as fewer than 20 employees): 96.8% of New Zealand fi rms have fewer than 20 employees, as compared with 97.2% for the USA and 97.6% for the UK’ (p.15). The purpose of the present chapter is to refl ect upon the signifi cance of work–life balance issues for people who work in SMEs, whether as owners, managers or employees, and to discuss some possible interventions that might be implemented to reduce confl ict between work and life outside the job, and to enhance their work–life balance. As with larger organizations, the introduction of work–life balance policies or practices is not without diffi culty in SMEs, but there is growing evidence that increasing work–life balance for workers has substantial benefi ts not just for individual workers and their families, but also for the organization as a whole. Nevertheless, attending eff ectively to this issue can be a signifi cant challenge for SMEs in particular, especially as they have fewer employees and hence typically have less capability to rotate people through diff erent roles that are essential for the business to function and fl ourish. In addition, again due to their smaller size, the absence of employees (for whatever reason) can have a greater impact on the day-to-day functioning of SMEs. The notion of work–life balance has received considerable attention in the organizational literature in recent years, and has been closely linked with occupational health and well-being. Until relatively recently, the majority of research on the work–family nexus tended to focus on confl ict or interference between work and family roles, although over the past ten years or so attention has also been given to enrichment or facilitation of work and family domains. The defi nition and conceptualization of work–life ‘balance’, however, has been marked by controversy and diff erent perspectives. While some investigators have defi ned balance in terms of the amount of time (or energy) invested in work and other (typically family) roles (Greenhaus et al., 2003), others have viewed it in relation to role enactment and the ability to satisfactorily perform roles in both domains (Carlson et al., 2009). A third conceptualization is that balance is simply the individual’s perception that the various components of his or her life are in a state of equilibrium, and that he/she is satisfi ed with the time and energy expended in each domain (see Guest, 2002). Each of these viewpoints has merit and draws attention to potentially important aspects of work–life balance. In practice, most researchers have adopted an approach which amalgamates various aspects of these (somewhat diff erent, albeit complementary) conceptualizations. For the present chapter, of greater importance are the established linkages between work–life balance and individuals’ psychosocial health and well-being. Irrespective of which

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defi nition of work–life balance is adopted, there is consensus that this is an important issue for both individuals and organizations, and that lack of balance can have a detrimental impact not only on individuals’ well-being, but also on organizational productivity. We begin by discussing some of the factors which contribute to work–life balance and some of the major outcomes of imbalance between work and other (especially family) roles.

ANTECEDENTS AND CONSEQUENCES OF WORK– LIFE BALANCE

Organizational researchers assessing the impact of the psychosocial work environment upon outcomes such as occupational stress, employee well- being, engagement and commitment, increasingly include measures of non-work demands within their investigations (e.g. Brough et al., 2009). A number of theoretical research models exist which defi ne work–life balance and its antecedents and consequences. Recent reviews of this literature have been useful in ascertaining common relationships among the key constructs (e.g. Allen et al., 2000; Brough et al., 2007; Eby et al., 2005). For example, evidence is generally consistent in identifying work and family demands and resources, and dependent responsibilities, as key antecedents of work–life balance, and satisfaction, job performance and levels of both physical and psychological health as the core consequences of work–life balance. In this next section we briefl y review these core antecedents and consequences of work–life balance. It is important to note that these common causes and consequences of work–life balance apply to small, medium and large organizational contexts. In this section we discuss research fi ndings on work–life balance and their application to SMEs. The (now extensive) literature on the work–family interface has demonstrated that several factors contribute to work–life balance, either positively or negatively. Below we focus on some of the predominant issues which have emerged from this line of research. We also illustrate how they might apply to people working in SMEs, either as owners/managers or employees.

Time Demands

A signifi cant cause of work–life balance (or imbalance) is time demands. The pressures exerted by time (such as the ‘juggling’ of multiple demands within a set timeframe) are a widely recognized antecedent of work–life balance. One impetus for the recognition (about 30 years ago) of work–life

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balance as an important issue was the increasing trend of work spilling over into the home domain (Kanter, 1977). In contrast to earlier time periods, time at home was no longer wholly non-work related, but instead technology, increasing workloads and greater performance pressure resulted in work increasingly being conducted within the home domain (e.g. Brough et al., 2007). Thus, working hours were no longer purely restricted to time physically spent at work, but encroached upon an employee’s leisure and family time also. This encroachment can be benefi cial, for instance in the provision of fl exibility of the work location and enabling a mobile labour force. Nevertheless, as discussed by O’Driscoll et al. (2010), there are also growing concerns about the ‘dark side’ of this technology, which on the one hand has increased fl exibility, but on the other hand also can exert greater demands on the individual to spend more time working, which in turn can lead to negative impacts on individual well-being. One signifi cant issue experienced by many workers, for example, is how technology has truncated their time, both in terms of their increased accessibility during non-work hours and the increased speed at which work is now expected to be performed. The implications for workers’ psychological health, physical health and levels of work–life balance in relation to these increased time demands are now being assessed. The actual time spent at work (working hours) has been widely linked with health outcomes (for a recent review, see Brough, O’Driscoll, Kalliath et al., 2009). Long working hours are generally associated with low levels of work–life balance and signifi cant health issues. Major, Klein and Ehrhart (2002), for instance, demonstrated that working long hours was a direct predictor of work–family confl ict and that work hours also mediated the relationships between a number of work and family characteristics and work–family confl ict. Brough, O’Driscoll, Kalliath et al. (2009) reviewed the positive and negative consequences of work addiction, which is often attributed to owners and workers of SMEs in particular. Increasing numbers of workers are expected to be available and responsive 24 hours a day and have to be ready to accommodate their personal lives with that of clients and colleagues located in diff erent time zones. Scott, Moore and Miceli (1997) provided a useful description of the three dimensions that commonly categorize workaholics: (1) the tendency to spend time at work sacrifi cing family and social life; (2) the tendency to have obsessive thoughts about work when not at work; and (3) the tendency to work long hours above and beyond organization performance expectations or fi nancial needs. The defi nition of a workaholic also commonly includes their levels of psychological involvement with work, personal work enjoyment and an inner pressure or drive to work (Spence and Robbins, 1992). Thus, individual levels of drive and enjoyment are commonly perceived as

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the two main characteristics of workaholics (McMillan et al., 2002). These two characteristics distinguish individuals who work long hours because they are passionate about their job from those individuals who work long hours because they feel an uncontrollable inner drive or pressure to work, but do not necessarily enjoy their work. Owners/managers of SMEs may fi t into either of these workaholic categories. In a comparison of the work hours, job characteristics and outcomes, including work–life balance (work–family confl ict) of US business owners, self-employed workers and salaried workers (employees), Prottas and Thompson (2006) reported that business owners worked the longest hours (an average of 52 work hours per week, with a maximum of 72 hours per week), followed by employees (an average of 45 work hours per week) and then self-employed workers (an average of 42 work hours per week). The business owners also reported signifi cantly higher levels of job autonomy compared to the other two groups, while employees reported the lowest job autonomy levels, as generally expected. Prottas and Thompson pointed out that one way to manage family demands is to increase levels of job autonomy, especially control over work hours, by becoming self- employed (owners or workers). The recent increase in the numbers of female small business owners (especially) attests to this point that becoming self-employed is widely perceived as an eff ective method for balancing work and family time demands (e.g. Kirkwood and Tootell, 2008; Walker et al., 2008). See also our later discussion of entrepreneurs.

Dependents

A second signifi cant antecedent of work–life balance is the responsibility for dependents. Traditionally the focus has centred on young (pre-school age) children and, to a lesser extent, older children in regards to their care in non-school hours (e.g. Major et al., 2002). However, recent discussions have broadened the scope of dependents to also include responsibilities for elderly parents and spouses and/or other relatives experiencing ill-health (Brough, O’Driscoll, Kalliath et al., 2009). This broader defi nition is in response to the increasing numbers of workers who are responsible for both young children and elderly parents, the so-called ‘sandwich genera- tion’ (Markel, 2008). It is widely accepted that the presence of dependents produces a signifi cant increase in home demands and often an associated reduction in paid employment (Brough, O’Driscoll and Biggs, 2009). For instance, Brough and Kelling (2002) compared the working hours of women with and without dependents and found that the latter group were employed for signifi cantly longer hours (40 hours compared to 36 hours per week,

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respectively). Similarly, Nordenmark (2002) also reported that the number of children in a family was linearly associated with the desire for both parents to reduce their working hours and to spend more time with their children. As noted above, owning a business, especially a business initially managed from home, is often perceived as an eff ective method of balancing work and family demands. Kirkwood and Tootell (2008) explored the eff ectiveness of this strategy in a sample of New Zealand entrepreneurs. The authors found that, for female entrepreneurs especially, owning a business off ered them increased fl exibility, particularly in terms of where and when to work. However, Kirkwood and Tootell also noted that the reality of being self-employed was often diff erent from initial expectations, and importantly did not necessarily result in increased levels of work–life balance. One principal reason for this was the longer than anticipated work hours required to successfully manage a small business. Similar observations regarding this aspect of the ‘double-edged sword’ of small business ownership have also been made elsewhere (e.g. Prottas and Thompson, 2006; Walker et al., 2008). In addition to examining factors which may contribute to work–life balance (or imbalance), numerous studies have also assessed some of the critical outcomes of having high or low balance between work and life (usually family) demands and responsibilities. Below we summarize two relevant concerns, relating to (a) individual health and psychosocial well- being, and (b) role performance (both at work and outside of work).

Health and Well-Being

One important outcome of work–life balance is the experience of good physical and psychological health. The stress literature clearly recognizes that a chronic (ongoing) stressor has signifi cant deleterious eff ects on individual levels of health and performance. Perceived stress arising from time demands, dependent responsibilities, fi nancial concerns or other work and non-work stressors may increase levels of anxiety and insomnia, elicit coping responses such as avoidance or drinking alcohol, can result in myriad health consequences such as depression, weight loss, migraines, physical illnesses such as colds and infections, and is also associated with burnout, heart disease, and cancers (Brough and O’Driscoll, 2005). The specifi c stressor of (between) role confl ict is a common focus of work–life balance research (Greenhaus and Parasuraman, 2002). The successful management of personal roles and responsibilities infl uences perceived stress and well-being outcomes (Friedman and Greenhaus, 2000). One interesting observation is that stress arising in one domain (e.g. at work) can infl uence health and performance in the other domain (e.g.

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family life). Thus chronic family demands can adversely infl uence workplace functioning, and vice versa. Westman’s research into crossover expands this premise by describing how stress can be passed from a worker to their spouse or work colleagues by a process of emotional contagion, defi ned as ‘a bi-directional transmission of positive and negative emotions, mood, and dispositions between intimately connected individuals such as spouses or organizational team members’ (Westman et al., 2009, p. 589). This process explains how the spouses and children of stressed workers also experience strain reactions, and similarly how a stressed worker may ‘infect’ their colleagues with their anxiety. Westman et al. describes how stress and burnout (as well as positive attitudes such as engagement and satisfaction) can be contagious among colleagues and team members, reducing health, morale and performance levels beyond those of the single individual. Such stress contagion may be especially prevalent in SMEs, and therefore organizations need to actively reduce the psychological stress levels of their employees via a consideration of suitable supportive policies and interventions (discussed in more detail below). It is apparent, for example, that some employees who have access to only limited work- life balance policies express dissatisfaction and may move to employment off ering improved work–life balance employment conditions (e.g. Brough, O’Driscoll and Biggs, 2009).

Work Performance

As noted above, stress arising from a number of antecedents, including work–life imbalance, can signifi cantly impact on health and performance in both the work and home domains. One of the main performance consequences is negative attitudes, typically expressed by job dissatisfaction or disengagement and also withdrawal behaviours (e.g. lateness, absenteeism). Research has generally demonstrated that the relationship between work–life balance and turnover behaviours is stronger than the association between job satisfaction and balance (e.g. Allen et al., 2000; Eby et al., 2005). This is likely related to the point noted above where one solution to chronic imbalance is to seek alternative employment with a more ‘family- friendly’ employer. The voluntary turnover of female staff , especially, is strongly associated with the absence of accessible family-friendly programmes (Brough et al., 2008). The benefi ts of the accessibility to supportive work–life balance organizational policies have been demonstrated. Brough, O’Driscoll and Kalliath (2005), for instance, demonstrated that the use of organizational family-friendly resources positively predicted levels of both employee family satisfaction and job satisfaction over time in a heterogeneous sample of New Zealand workers.

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The specifi c culture of an organization and especially the perceived supportiveness of immediate supervisors have also been found to infl uence levels of employee performance and work–life balance. In this respect, workplace culture can be either supportive or hindering (Dikkers et al., 2004). A supportive culture values workers’ non-work responsibilities and seeks to accommodate the multiple needs of workers (for instance, by recognizing the importance of work–life balance to individuals’ health and well-being) so that they will be psychologically present for work tasks. In contrast, a hindering culture requires workers to prioritize work over their non-work responsibilities. This can take the form of expectations that workers will put extra time into ensuring that work will be completed, or norms where workers get a clear message that prioritizing personal needs will have negative consequences for their career progression. The attitudes of supervisors and their role as ‘gate-keepers’ enabling employees to access organizational policies are fundamental in perceptions of the organizational culture (Casper et al., 2004; Thompson et al., 2006). For instance, workers employed in a hindering culture and/or who have unsupportive supervisors may be deterred from accessing work–life balance polices due to perceived repercussions for their careers and for the additional burdens their colleagues may have to contend with (O’Driscoll et al., 2004). Although SMEs typically have fewer formal work–life policies than larger organizations, the supportive or hindering culture of an SME can nevertheless have a substantial bearing on its employees’ access to such initiatives. In fact, given the more informal processes that frequently operate in SMEs, the supportiveness of the owner/manager for work–life balance is even more critical.

ENHANCING WORK–LIFE BALANCE WITHIN SMALL AND MEDIUM SIZED COMPANIES

The provision of eff ective organizational work–life balance policies is commonly linked with organizational cost benefi ts, such as staff attraction and retention, and increased organizational commitment and performance (Brough, O’Driscoll, Kalliath et al., 2009; Eby et al., 2005), and is also associated with individual employee benefi ts such as improved psychological and physical health outcomes, increased perceptions of support and job satisfaction (Allen et al., 2000; Brough and O’Driscoll, 2005). The majority of interventions aimed at improving levels of organizational work–life balance typically focus on four human resource policies: (1) the provision of employee services such as health and fi tness centres, onsite child-care, and dry cleaning services; (2) the provision of employee benefi ts

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such as paid parental leave and spouse/partner benefi ts; (3) job restructur- ing such as part-time work and fl exible work hours; and (4) organizational development initiatives such as supportive leadership development and diversity training (Harrington and James, 2006). However, a recent review of work–life balance organizational interventions (Brough and O’Driscoll, 2010) noted that new work–life balance organizational interventions can be classifi ed into three main groups: (1) initiatives addressing working time and/or working hours; (2) collaborative action research focused on improving workplace equity and performance levels; and (3) initiatives to embed work–life balance within organizational cultures. Such interventions occur in both small and large businesses, although it has been noted that, compared to large organizations, SMEs are both more innovative in their approach to human resource polices but also more conservative (Maxwell et al., 2007). Approaches that address work–life balance specifi - cally within SMEs are briefl y reviewed here. Recognition of the specifi c diffi culties experienced by SMEs when adopting work–life balance policies have also been described elsewhere. For instance, Malik et al. (2010) identifi ed the most common challenges experienced by SMEs to be limited resources, recruitment and retention issues, and sickness and absence costs, all balanced against daily workforce management and economic business pressures. These factors need to be given consideration alongside the desire to introduce practices that will enable workers to better balance their work commitments and life outside the job. One of the more common work–life balance policies implemented by SMEs is the introduction of fl exible working arrangements. Maxwell et al. (2007) reviewed the incidence and impact of fl exible working arrangements in 210 Scottish small businesses. The authors noted that the most common fl exible options off ered were: part-time work, time off in lieu, staggered working hours and shift swapping, although general fl exibility in work hours was also available to employees who requested it. They also noted that such provisions were off ered both formally and informally (i.e. as the need arose) by SMEs. Maxwell et al. found that managers of SMEs perceived more benefi ts than disadvantages in the provision of fl exible working arrangements, and the most common benefi ts were identifi ed as improvements in staff retention, employee relations, recruitment and motivation. In a study of ten UK-based SMEs, Dex and Scheibl (2001) also noted that fl exible working arrangements were most commonly off ered, specifi cally parental leave, job sharing, part-time work and tele- commuting. Reasons for introducing these fl exible working arrangements focused on maintaining the well-being of employees, as well as legislative considerations.

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Related to the issue of fl exible work arrangements is the use of compressed work weeks, shift-work, and part-time work arrangements, which many organizations now utilize as mechanisms for both improving productivity and reducing operational costs, but which can also serve to enhance work–life balance for some employees. Implementation of a compressed working week, for example, has been found to lead to greater satisfaction among employees in larger organizations, as well as providing the opportunity for individuals to spend more time with their families and hence achieve a better balance between their work demands and home commitments (Lambert et al., 2008). Similarly, while shift-work is typically regarded as being disadvantageous for many workers, especially if it disrupts family routines and the opportunity to engage in family and other activities, it can have positive benefi ts for some workers and can help result in perceptions of greater work–life balance. For instance, Willis, O’Connor and Smith (2008) noted that people vary in their preferences, and that for some individuals shift-work may be the preferred option. However, for SMEs the introduction of shift-work arrangements may not be feasible. Part-time work may be a more feasible possibility, especially if the hours of work required from employees in the SME are fl exible. Indeed, this arrangement may be benefi cial for both the SME and its employees. Malik et al. (2010) described the development of a toolkit to assist SMEs to manage work–life balance policies. The toolkit provides practical guidance and describes relevant (UK) work–life balance policies, including parental leave, time off for dependents and guidelines on fl exible working arrangements. Malik et al. also discussed how SMEs can avoid a ‘one size fi ts all approach’ for work–life balance provisions and instead evaluate employee needs concerning work–life balance in accordance with the business/operational requirements. Importantly, the authors emphasize that work–life balance occurs across the lifespan and that SMEs should not limit their provision to the traditional working mother balancing child-care responsibilities. As refl ected in the theoretical work–life balance literature (discussed earlier), work–life balance policies are also relevant to other employees, including fathers, employees with other care responsibilities, employees seeking career or personal development, and older workers in pre-retirement years. Malik et al. suggested that most SMEs need to consider increasing their provision of suitable work–life balance benefi ts to these groups of workers. This point is also refl ected in the growing awareness of the importance of paternal leave by (mostly European) governments and its incorporation into policies by some large and small organizations (e.g. Haas and Hwang, 2009; Lammi-Taskula, 2008; O’Brien, 2009).

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In contrast, research has also demonstrated the high costs experienced by SMEs for the provision of work–life balance initiatives and, importantly, that for some SMEs these fi nancial costs outweigh any human resource benefi ts. In a small review of the provision of paid parental (maternity) leave within eight Australian SMEs, Barrett and Mayson (2008) found that none of the organizations off ered any paid parental leave to their employees. All eight SMEs off ered a maximum of 12 months unpaid leave, which was (then) the statutory requirement in Australia. Employers saw no benefi t in off ering any additional paid leave, as employees were already obligated to return to the same job after completion of their unpaid entitlements. These employers therefore perceived no other advantage in terms of staff retention to justify the off ering of any paid leave. Interestingly, in an investigation of Australian and New Zealand employed new parents sampled from a variety of large and small businesses, Brough, O’Driscoll and Biggs (2009) noted that for some employees the lack of paid parental leave and other work–life balance provisions (e.g. fl exitime) was an inducement for them to seek alternative employment elsewhere. Hence it is the long-term retention of employees (rather than just short-term return to work obligations) that should be the focus in any cost–benefi t analysis of work–life balance provisions. Similarly, research conducted by Villanueva and Djurkovic (2009) on workers employed in four Australian SMEs also noted that (generic) organizational support had a signifi cant infl uence on employees’ turnover intentions. Where support was strong, turnover intentions were reduced. This fi nding refl ects similar observations within the wider occupational stress literature (e.g. Brough and Frame, 2004; Brough et al., 2005). Finally, research has also explored how the specifi c cultures of SMEs infl uence a variety of human resources initiatives, including work–life balance policies. Generally, human resources policies within SMEs tend to be more informal compared to those in large organizations and are often prioritized below other operational demands. For example, Jack, Hyman and Osborne (2006) in their review of organizational culture within SMEs noted that informality and owner-led individualism have a pervasive impact on the adoption of human resources policies, including work–life balance. Jack et al. argued that for successful long-term survival, SMEs should ensure that their human resource management systems comply with current legislative changes, are formalized, and are integrated into the growth of the business. Woodhams and Lupton (2009) proff ered a similar conclusion in their investigation of diversity within 80 SMEs in the UK. These authors noted that while many managers of SMEs recognized and sought the employment of female workers, their human resource policies, and in many cases the informal organizational culture, demonstrated a

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lack of support for (or even overt hostility towards) female employees. Flexible working arrangements, for example, were scarce. Importantly, these researchers found that female employees were also classifi ed as either useful ‘career’ types or ‘family’ women, and were treated in accordance with that perception. Woodhams and Lupton provided an interesting discussion of the implications for equality and diversity of the workforce within SMEs.

ENTREPRENEURS AND THE WORK–FAMILY NEXUS

We now turn to a particular kind of small business, or more accurately, business person – the entrepreneur. Entrepreneurs diff er in several respects from other types of worker or organization, although they do share some common features with SMEs. Carland et al. (1984) defi ned an entrepreneur as ‘an individual who establishes and manages a business for the principal purpose of profi t and growth [and] is characterized principally by innovative behavior and employs strategic management practices’ (p. 358). In contrast, a small business owner ‘is an individual who establishes and manages a business for the principal purpose of furthering personal goals’ (Carland et al., 1984, p. 358). The study of entrepreneurship has gained momentum since being recognized by Schumpeter (1934) as a vital area of study due to its signifi cant benefi cial economic outcomes (Shane and Venkataraman, 2000). Low and MacMillan (1988) stated that ‘the key to entrepreneurial success lies in the decisions of the individual entrepreneurs who identify opportunities, develop strategies, assemble resources and take initiatives’ (p. 142). Overall, there is a large body of literature on who and what an entrepreneur is (Venkataraman, 1997), with Shane and Venkataraman (2000) noting that researchers of entrepreneurship are fundamentally concerned about opportunities and their utilization. However, although research typically focuses on understanding how and why some entrepreneurs succeed (e.g. Aldrich, 1999; Aldrich and Martinez, 2001), there is a dearth of information on how entrepreneurs balance their work and family commitments. Despite the apparent importance of entrepreneurs, little is understood regarding how they manage the work–family interface. One study testing entrepreneurs’ stress and business failure found that stress was signifi - cantly linked to the probability of venture failure (Williams, 1985). Walker and Brown (2004) noted that employees may become entrepreneurs to escape the pressures and stress of their job, believing that as entrepreneurs they will confront fewer stress-related problems. Overall, however,

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research has found few signifi cant diff erences between entrepreneurs and organizational managers. For example, personality diff erences between entrepreneurs and managerial personnel have frequently been investigated and relatively complex models have been developed to test the ‘trait theory’ approach to entrepreneurship (see e.g. Baum and Locke, 2004; Baum et al., 2001; Rauch and Frese, 2007). Research by Baum and colleagues was infl uential in drawing attention to new traits, including new resource skill, passion, tenacity, communicated vision, self-effi cacy and goals, with all these aspects being found to directly or indirectly relate to venture success. Despite the recent evidence suggesting entrepreneurs may have traits diff erent from the rest of the population, there have been few studies exploring how entrepreneurs may diff er from the population of other workers with regard to job and other outcomes. What diff erences have been found are briefl y discussed below. There is no doubt that entrepreneurs function in a considerably different context than do managers in large business enterprises. Clearly, larger sized enterprises have signifi cant fi nancial advantages over small businesses (Ebben and Johnson, 2005), including economies of scale and market power (Bowen and Wiersema, 2005), greater access to fi nancial resources and capital, stronger bargaining power with buyers and suppliers, and greater experience curve eff ects (Dean et al., 1998; Rajan and Zingales, 1995). Consequently, we might expect larger sized enterprises to have more human and fi nancial resources to apply to managing work– family issues. For example, Mishina, Pollock and Porac (2004) suggested that being larger is desirable for organizations, due to the benefi ts of heightened visibility and prestige and having more experienced management expertise, which should make them more equipped to plan and implement work–family policies and practices. However, Stavrou (2005) tested business size and the association between fl exible work arrangements and employee turnover and found no signifi cant eff ect by size, suggesting that smaller businesses may be as able as larger sized organizations to benefi t from work–family policies. Reasons for this might be that entrepreneurs, especially within SMEs, are better able to manage work–family issues through direct ‘hands on’ interventions, such as implementing fl exitime for all employees. Despite these presumed advantages, like other small businesses, entrepreneurs need to understand and deal with work–family issues, and they can experience specifi c challenges that are not experienced by managers and workers in other types of organizations. In their study of business owners, Parasuraman et al. (1996) showed that work-to-family confl ict and family-to-work confl ict had signifi cant eff ects on both career success and personal well-being among entrepreneurs. Similarly, Shelton (2006) observed that work–family confl ict had

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a negative eff ect on an entrepreneur’s well-being. Based on these fi ndings, Shelton (2006) suggested that a work–family confl ict management plan should be a key component for entrepreneurs in the venture-creation process. An interesting exploration of why female entrepreneurs tend to own smaller businesses (in terms of employment, revenue and income levels), in comparison to male entrepreneurs, was conducted by Jennings and McDougald (2007). These authors noted that the detrimental impact of work–life balance is experienced more often by female than male entrepreneurs and furthermore these experiences constrain the growth of the SME. Shepherd and Haynie (2009) identifi ed the need for ‘distinctiveness’ as a key driver for entrepreneurial behaviour. It was found that the need for distinctiveness in entrepreneurial activity also creates a void, or lack of belonging, which has a direct eff ect on the personal well-being of the entrepreneur. Brewer (1991) found that individuals act to fulfi l psychological needs by creating a perception of diff erences or uniqueness, which represents a fundamental human need that is central to well-being (Snyder and Fromkin, 1980). While entrepreneurs aim to fulfi l this need by creating a business, they may inadvertently forgo the need for belonging (Shepherd and Haynie, 2009; Tajfel and Turner, 1986). Consequently, entrepreneurs may be more prone to psychological stress due to the very nature of their craft – the creation of new enterprises. In contrast, however, Marcketti, Niehm and Fuloria (2006) found that small business ownership directly enhanced the entrepreneur’s quality of life. Quality of life was assessed by markers such as economic, health and venture success factors. As such, well-being extended beyond the self to include the successful operation and life of their business venture. Bradley and Roberts (2004) confi rmed that, by being self-employed, entrepreneurs enjoyed greater job satisfaction due to increased levels of self-effi cacy and lower levels of depression. Similarly, Cooper and Artz (1995) also found that the particular goals, attitudes and background of the entrepreneur were likely to lead to the entrepreneur having greater satisfaction in their ventures. Finally, Wiese and Freund (2005) showed that for entrepreneurs personal well-being can signifi cantly improve when goal achievement is experienced in their work. A large body of research has explored well-being and the psychological health of workers (e.g. Parasuraman and Simmers, 2001). However, little is known about the experiences of self-employed people in relation to these issues (Loscocco, 1997). Early research reported little or no signifi cant diff erence in psychological well-being between entrepreneurs and organizational employees (Eden, 1975), although our understanding of entrepreneurs and their associated traits has only recently become clearer

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(e.g. Baum and Locke, 2004; Baum et al., 2001). While it has been argued that business owners enjoy higher levels of fl exibility, autonomy and satisfaction than organizational employees (Parasuraman and Simmers, 2001), entrepreneurs have also been found to work considerably longer hours and have more personal commitment to their business (Parasuraman et al., 1996). Consequently, comparisons have found that business owners may also report higher work–family confl ict and lower family satisfaction than organizational employees (Parasuraman and Simmers, 2001), and several factors can lead to poorer well-being among entrepreneurs. Many researchers agree that the journey of creating, developing and maintaining a business is so demanding that a large amount of personal satisfaction is entwined with its achievements and success (DeCarlo and Lyons, 1980; McClelland, 1965). Ahmet (1980) stated that entrepreneurs ‘with strong achievement motives would seek out situations in which they could get achievement satisfaction’ (p. 295). In contrast, some literature associates need for achievement with dissatisfaction (DeCarlo and Lyons, 1980). For example, it is suggested that entrepreneurs can over-confi dently set challenging goals at unrealistic and unattainable levels, and therefore are more likely to experience dissatisfaction from non-achievement and poor performance (DeCarlo and Lyons, 1980; Wu et al., 2007). Research has also highlighted that entrepreneurs, due to the very nature of entrepreneurship, are more prone to experience detrimental physical and mental health eff ects (Bradley and Roberts, 2004; Buttner, 1992; Kaufmann, 1999). Pratt (2001) argued that ‘the very traits that infl uence entrepreneurial success – drive, ambition, creativity, independence and a zest for change – can also set you up for failure’ (p. 37). Conversely, a number of studies support the notion that entrepreneurs are actually more satisfi ed with their careers and may have greater physical and mental health, largely due to the autonomy aff orded to them by being self- employed (Bradley and Roberts, 2004). Blanchfl ower and Oswald (1998) found that the ‘self-employed really are happier’ (p. 49), both in themselves and showing greater job satisfaction. Bradley and Roberts argued that there would not be a high incidence of depression among entrepreneurs because depressed people are unlikely to be decisive and act upon opportunities and therefore would not become entrepreneurs. Furthermore, if pessimism goes hand in hand with depression (Seligman, 1991) then pes- simistic individuals are likely to ‘fall out’ of the entrepreneurial process as they will not foresee entrepreneurial success as achievable. Stephan and Roesler (2010) asserted that entrepreneurs experience signifi cantly higher job control and job demands compared with employees, and compared entrepreneurs’ health with employees’ health in a national representative sample from Germany. Entrepreneurs showed signifi cantly lower overall

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lifetime prevalence of any somatic and mental disorder, blood pressure and prevalence rates of hypertension, and higher levels of well-being and favourable behavioural health indicators. In summary, the limited empirical literature has supported the notion that entrepreneurs experience diff erent levels of well-being than their counterparts working for larger organizations, and that overall their health and well-being are more likely to be positively (rather than negatively) aff ected by the type of work they are engaged in. For instance, although entrepreneurs in SMEs are more likely to work longer hours and have greater work demands placed on them, they are also more likely to have the freedom and autonomy to achieve more balance among their business and family roles, thus enabling greater well-being benefi ts. Perhaps entrepreneurs also enjoy greater enrichment (Greenhaus and Powell, 2006) from their work roles, especially due to the nature of creating, nurturing and succeeding in their business venture. If entrepreneurs are more passionate about their work, as Baum and colleagues suggest, it is likely that this passion and enthusiasm allow them to work demanding hours while maintaining a healthy work–life balance. Some mechanisms for entrepreneurs and other workers functioning in SMEs include the following:

● Optimizing their autonomy, being fl exible and taking time away from work for family and personal activities (e.g. physical and recreational activities) ● Creating and utilizing a social support network, including family, friends, networks of other entrepreneurs, their employees and seeking professional advice (e.g. business professionals, such as marketing) ● Being aware of and maintaining work–non-work boundaries. While an entrepreneur may wish to take work home with them, this may have a negative spill-over to their partner and family, hence limiting interference from work to family life is important.

CONCLUSIONS

In this chapter we have endeavoured to summarize some major themes emerging from research on work–life balance and psychosocial well- being, and to describe how fi ndings from this line of research may also apply to small and medium sized businesses, as well as to entrepreneurial enterprises. There is now clear evidence that: (a) striving to achieve a level of work–life balance is important to individual workers and their families; (b) organizations recognize the importance of this issue not just for

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their employees’ well-being, but also for overall organizational functioning and productivity; and (c) although SMEs clearly diff er from larger organizations in respect of their needs and modi operandi, there are some approaches which might be implemented in order to optimize work–life balance among employees. In particular, we have focused here on interventions which increase the fl exibility of work conditions, especially time, including the provision (where feasible) of compressed working weeks, part-time work, and allowing parents time off for child-care (and perhaps elder-care). This fl exibility can function to enhance work–life balance and ultimately worker psychosocial health and well-being in both SMEs and larger organizations. Other interventions might also be practical in SMEs. For instance, Malik et al. (2010) outlined several possible strategies which can be adopted to assist employees balance their work and family commitments. Malik et al. highlighted that work–life balance is a relevant issue for non- parents as well as parents. They especially noted that attention to the needs of employees is critical when designing work–life balance policies and programmes, since what may be useful for some workers may not be appropriate for others. Understanding employees’ needs and preferences is therefore an essential component of any work–life balance initiative, especially in an SME environment where there are fewer employees. Given that smaller numbers of workers are employed in SMEs, it may be relatively easier for these organizations to introduce benefi ts which align with the needs of their employees. On the other hand, it must be acknowledged that fi nancial and other costs may place constraints on the implementation of formal work–life balance programmes in an SME, perhaps more so than in larger organizations. For instance, formal policies on issues such as parental leave, sick leave and fl exitime may be diffi cult to sustain in an environment where there are few employees and where the absence of even one worker may be problematic. Again, we would emphasize that fl exibility is the key issue, for both employers and employees, along with clear understanding (on both sides) of what is appropriate and possible. Developing a collegial environment underpinned by trust is critical for the survival and development of SMEs, and this applies to work–life balance as much as to other aspects of human resource management. Increasing control over work conditions is one mechanism which has been consistently demonstrated to improve work–life balance outcomes for individual workers and their families (see e.g. Kelly and Moen, 2007; Valcour, 2007). For instance, Mauno et al. (2006) found that high levels of perceived control over the job buff ered the negative impact of work–family confl ict on well-being and job attitudes. Other studies have

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obtained similar buff ering eff ects. Identifying ways to increase perceptions of personal control may therefore be a priority for SMEs trying to enhance the work–life balance of their workers. Developing mechanisms for increasing personal control may have the additional benefi t of creating perceptions that the organization is supportive of its employees’ needs, which is another factor demonstrated to lead to better work–life balance (Lapierre et al., 2008). Ultimately, as we have illustrated in this chapter, attention to work– life balance and associated issues will be benefi cial for SMEs as well as their employees. Although there is relatively sparse research on work–life balance and its correlates in these organizations, many of the fi ndings obtained from larger companies are applicable to SMEs. It may not be feasible to implement formal work–life balance programmes in smaller organizations, but more informal approaches might be more feasible and just as eff ective in enhancing work–life balance in such organizations, and hence improve the health and well-being of their employees and managers.

REFERENCES

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Most organizational research continues to focus almost exclusively on large fi rms (Cooper and Otley, 1998; Wilkinson, 1999), and perhaps we should not be surprised. After all, large corporations are the subject of much media interest, and attract more attention from legislation, lob- byists and labor than do small and medium sized enterprises (SMEs). In addition, organizational scientists do not necessarily research the aspects most relevant to a vibrant economy and healthy employees (O’Leary and Almond, 2009). While we of course do not deny the need for comprehensive information on large organizations, the neglect of SMEs in the organizational sciences leaves a sizable and consequential gap in our knowledge. Much remains unknown when it comes to the companies that employ the majority of working individuals in the United States (Headd, 2000) and Canada (Wong, 2009), their working experiences, and associated well-being. Recognizing that the unique nature of SMEs and the environments in which they function may limit the generalizability of empirical fi ndings derived from larger fi rms, some organizational scholars have begun to focus specifi cally on SMEs (e.g. Bacon and Hoque, 2005; Deshpande and Golhar, 1994; Heneman et al., 2000; Katz et al. 2000; Wilkinson, 1999). Despite this new focus, we still know very little about issues that aff ect the health and well-being of employees and managers in these organizations, especially when it comes to matters of aggression and victimization. This gap in knowledge becomes even less acceptable when we realize that employee health and well-being in large organizations has been extensively researched, as is evident from the attention given to this issue in specialist academic journals (e.g. the Journal of Occupational Health Psychology and Work and Stress), handbooks on work stress (Barling et al., 2005) and workplace violence (Kelloway et al., 2006), and occupational health psychology (Quick and Tetrick, 2010). Recognizing this gap in knowledge, our goal in this chapter is to expand our understanding of one threat to employee well-being in SMEs, namely

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sexual harassment. Previous research in larger organizations has revealed much about the prevalence of this problem, its antecedents, and the signifi - cant costs it produces for employees and organizations alike (for a review, see Cortina and Berdahl, 2008). Given the substantial lessons learned from this literature, we are now well placed to investigate the prevalence of sexual harassment within SMEs, identify risk factors, and consider how this form of workplace aggression might be reduced and prevented within these unique organizational environments. To this end, we fi rst briefl y review what is currently known about sexual harassment in general. Thereafter, we focus on sexual harassment in SMEs, fi rst outlining the limited literature that has been produced to date on this topic, followed by a discussion of several SME characteristics that we believe may impact the prevalence and eff ects of sexual harassment in these fi rms. More specifi - cally, we emphasize the role of the workplace climate for sexual harassment in SMEs, and factors associated with the workforce composition of these organizations. While we will suggest that in many cases these variables leave SMEs more vulnerable to the problem of sexual harassment, we also draw attention to situations where the nature of SMEs may actually thwart the occurrence, and minimize the eff ects of this type of victimization. Finally, ideas for research will be suggested, and practical recommendations will be off ered for practitioners looking to reduce or prevent sexual harassment from occurring in their SMEs. The time has come for sexual harassment scholars to focus their attention on SMEs, take what has been learned from larger organizations, and use it to help produce new knowledge pertinent to the unique conditions and challenges faced by SMEs. In so doing, we off er ideas and suggestions that will directly enhance the safety and well-being of SME employees, and indirectly facilitate the survival and growth of these organizations.

WHAT IS SEXUAL HARASSMENT?

Although numerous defi nitions of sexual harassment have been proposed, Louise Fitzgerald and her colleagues’ contribution has been particularly infl uential in our understanding of this construct, off ering the formal defi nition that is most widely accepted in current research. Thus, sexual harassment represents any ‘unwanted sex-related behavior at work that is appraised by the recipient as off ensive, exceeding her resources, or threatening her well-being’1 (Fitzgerald et al., 1997, p. 15). Furthermore, it is now accepted that sexual harassment comprises three separate but related dimensions: (1) gender harassment (e.g. insulting verbal/non- verbal behavior conveying hostile or degrading attitudes); (2) unwanted

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sexual attention (e.g. touching, repeated and unreciprocated requests for dates); and (3) sexual coercion (e.g. sexual bribes or threats) (Fitzgerald et al., 1995). This represents a signifi cant advance in our understanding of this phenomenon, as the original conceptualizations of sexual harassment developed in the 1970s solely acknowledged quid pro quo harassment – the loss or denial of job-related benefi ts for refusal to cooperate sexually. Today, more encompassing and nuanced understandings of sexual harassment exist, moving us away from the exclusive focus on sexually harassing behaviors, towards the recognition of hostile environments and more psychologically-based conduct (Cortina and Berdahl, 2008). Considerable advances have also been made in our understanding of sexual harassment victimization and perpetration. No longer is sexual harassment seen as something that solely aff ects women or those directly targeted, nor is this phenomenon one that is only perpetrated by men. Instead, it is now understood that sexual harassment can be directed against males (e.g. Berdahl et al., 1996; Waldo et al., 1998), perpetrated by females and same-sex individuals (e.g. Gerrity, 2000; Stockdale et al., 1999; Waldo et al., 1998), and can be detrimental to employees who are not the direct targets, but who are vicariously exposed to sexual harassment (e.g. Glomb et al., 1997; Miner-Rubino and Cortina, 2004, 2007; Raver and Gelfand, 2005). Recent investigations have also concluded that equal status co-workers, clients, and even subordinates, can and do, sexually harass others (e.g. Barling et al., 2001; DeSouza and Fansler, 2003; Gettman and Gelfand, 2007). Previous research in larger organizations has revealed the pervasiveness of sexual harassment. The general consensus from this research is that between 23 and 68 percent of all women (Gruber, 1997; Schneider et al., 1997; USMSPB, 1987, 1994; Welsh and Nierobisz 1997), and between 10 and 19 percent of all men (Cortina and Berdahl, 2008; USMSPB, 1994), will experience sexual harassment while at work at least once over the course of their careers. When we consider that sexual harassment is linked to job-related outcomes (e.g. decreased productivity, satisfaction, commitment; Barling et al., 2001; Gruber, 1992; Shaff er et al., 2000), as well as psychological (e.g. increased anxiety, depression, fear, self-blame, post-traumatic stress disorder, drinking and drug use; Barling et al., 2001; Dansky and Kilpatrick, 1997; Harned and Fitzgerald, 2002; Richman et al., 2002; Vogt et al., 2005), and somatic (i.e. sleep disturbance, nausea, headaches; Gutek and Koss, 1993) costs to victims, the importance of understanding and preventing sexual harassment is clear. Further still, sexual harassment exerts costs on organizations through employee absenteeism, turnover, reduced productivity (Faley et al., 1999; Sims et al., 2005), legal expenses incurred in defending itself and its offi cers, and the

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considerable psychic drain and time required of those involved in dealing with sexual harassment complaints. But what causes sexual harassment? Numerous theories have addressed this question in an attempt to illumi- nate the underlying factors responsible for the problem of sexual harassment. The ‘nurture’ or socio-cultural perspective (e.g. Studd and Gattiker, 1991) for instance, argues that harassment is caused by the socialization of negative sex role stereotypes and associated cognitive and attitudinal biases that demean and devalue women. Alternatively, the ‘power’ perspective conceptualizes sexual harassment as a consequence of the power diff erences (both organizational and social) that exist between males and females, and the way that such inequalities enable men to sexually coerce and objectify the less powerful (e.g. Cleveland and Kerst, 1993; Farley, 1978; MacKinnon, 1979). Combining these approaches, the ‘nurture x power’ perspective maintains that sexual harassment results from the desire to protect valued social identities (e.g. Berdahl, 2007; Dall’Ara and Maass, 1999; Franke, 1997). Although each of these theories has contributed to our understanding of the causes of sexual harassment, theoretical approaches that off er organizational-level explanations for this phenomenon are particularly relevant to this chapter, as the size of SMEs renders their environments unique in many ways. Whether asserting that this form of aggression results from gender-role expectations becoming equated with work roles (i.e. sex-role spillover; e.g. Gutek, 1985; Tangri and Hayes, 1997; Stockdale, 1996), numerically skewed sex ratios in workgroups (e.g. Gruber 1998), the organization of work and/or its culture (e.g. Fitzgerald et al., 1997; Hulin et al., 1996; Kauppinen-Toropainen and Gruber, 1993; Miller, 1997; Hearn and Parkin, 1987), or an interaction between various personal and situational factors (e.g. Dekker and Barling, 1998; Pryor et al., 1993), organizational-level theories of harassment reveal much about the contextual variables in need of attention, to understand and manage sexual harassment.

SEXUAL HARASSMENT IN SMALL AND MEDIUM SIZED ENTERPRISES

Like so many other areas of organizational inquiry, the amount of knowledge about sexual harassment that has emanated from large organizations stands in stark contrast to what is known about sexual harassment in SMEs. Of the few studies that have addressed sexual harassment in these organizations, the focus has primarily been on the beliefs that owners and managers have about the nature and extent of this problem. For example, in a national study on the perceptions of small business professionals

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about ethical conduct within organizations, Vitell and colleagues (2000) found that sexual harassment was not seen to be much of a problem by those in SMEs. Further, less than half of the managers/owners surveyed indicated that they would create formal sexual harassment policies for their organization, and only half said that they would take disciplinary action if cases of harassment were brought to their attention. Wagar (1998) and Eberhardt and colleagues (1999) confi rm the hesitation of many SME stakeholders to implement formal sexual harassment policies. Their data suggest that only one third and approximately one half (respectively) of the small businesses surveyed in their studies had human resource practices specifi c to sexual harassment. Even more revealing, perhaps, are the fi ndings that less than 25 percent of organizations with such guidelines had them posted, less than 15 percent off ered sexual harassment prevention training, and only around half included procedures for investigating complaints about sexual harassment (Eberhardt et al., 1999). Thus, it is likely that very few SME stakeholders believe that sexual harassment is a serious workplace issue; certainly the policies in place in SMEs would suggest this is the case. Of course, if sexual harassment was not an issue, the lack of policies would not be a problem – but all indications suggest that this is not true. For example, according to Wagar (1998, p. 20), ‘. . . a number of small business owners have found themselves embroiled in sexual harassment litigation due to a failure to recognize what constitutes sexual harassment and an incomplete understanding of the legal rights of employees and employers in sexual harassment cases’. Further, from a business perspective, the lack of formal attention given to sexual harassment by SMEs is surprising, given that all federally regulated organizations in Canada (including SMEs) are covered by the Canadian Human Rights Act and the Canada Labour Code (III), while any organization in the US with 15 or more full-time employees is covered by the Civil Rights Act, and is thus subject to sexual harassment lawsuits (Robinson et al., 1998). Further, in many states, legislation has been implemented to prohibit workplace sexual harassment regardless of the number of individuals employed (Robinson et al., 1998). We believe that a major factor underlying the failure to implement relevant policies is not a lack of care on the part of SME stakeholders, but rather a lack of awareness. If SME owners and managers understood the extent and eff ects of sexual harassment, they would be much more likely to actively confront this issue and strive to improve workplace conditions. As such, the remainder of this chapter will be dedicated to identifying both the characteristics of SMEs that make them more susceptible to sexual harassment and its eff ects, as well as those that may encourage stakeholders to fi ght back against this problem.

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A Cautionary Note

We begin with an important cautionary note. Critiques of SME research caution against the homogenization of the way in which we think about these organizations (e.g. Wilkinson, 1999; Woodhams and Lupton, 2006). The idea that all SMEs are similar in light of their unique size obscures how both internal (e.g. management style) and external (e.g. technology, ownership, industry characteristics, economic factors, regional culture) factors shape the social dynamics that occur within these organizations (e.g. Goss, 1991; Kinnie et al., 1999; Wilkinson, 1999). Thus, SMEs not only diff er from larger organizations, but there is also a remarkable degree of variation within SMEs. As such, the arguments we present in this chapter are neither meant to suggest that all SMEs possess the same contextual risk factors that leave them vulnerable to the occurrence of sexual harassment, nor that all SMEs will be aff ected by sexual harassment in the same way. Rather, we off er this discussion as a fi rst step towards understanding how climate and workforce composition factors might dif- ferentially infl uence the prevalence and experience of sexual harassment in these unique organizations. In so doing, our goal is to lay the foundation for additional discussion and empirical research, potentially resulting in preventive steps for SMEs.

SEXUAL HARASSMENT CLIMATE

In an infl uential and widely accepted model of sexual harassment, Fitzgerald and her colleagues (1997) fi nd support for the argument that sexual harassment is primarily a function of organizational and job characteristics. More specifi cally, they showed that organizational climate was among the most infl uential environmental factors for the occurrence of sexual harassment. Referring to the meaningful representations and perceptions of organizational structures, processes and events that reside within individuals and groups (Parker et al., 2003), the concept of climate describes organizational settings (i.e. its policies, procedures and practices) in psychological terms (Joyce and Slocum, 1984), and provides an important link between higher-order contextual factors, and the actors embedded within them. From our perspective, sexual harassment climate is interesting and important as it enables us to understand employees’ perceptions of their environments (whether personal or shared) and the routines that an organization implements, rewards and supports (James et al., 1988; Naumann and Bennett, 2000; Schneider, 1990; Schneider and Reichers, 1983). Thus, sexual harassment climate refers to employee beliefs about

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the organizational policies, procedures and practices in place for dealing with this form of aggression (Kath et al., 2009) – or in other words, the organizational characteristics that communicate whether a company and its stakeholders tolerate sexually harassing conduct (Hulin et al., 1996). Previous research has documented the powerful impact of organizational tolerance for sexual harassment on its occurrence in the workplace (e.g. Fitzgerald et al., 1997; Glomb et al., 1997; Gruber, 1998; Hesson- McInnis and Fitzgerald, 1997; Willness et al., 2007). In one study, for example, Williams, Fitzgerald and Drasgow (1999) showed the predictive importance of implementing policies for sexually harassing conduct, procedures for fi ling complaints and investigating incidents, and practices to punish perpetrators, for both the prevalence of sexual harassment and outcome severity. Willness, Steel and Lee’s (2007) meta-analytic fi ndings provide further support, showing again that climate for sexual harassment was the strongest antecedent of this phenomenon in their analysis. Findings have also shown that men are signifi cantly less likely to engage in sexual harassment if they believe the organization has policies and sanctions against sexually harassing conduct (e.g. Dekker and Barling, 1998; Pryor et al., 1993). Importantly, perceptions of organizational tolerance for sexual harassment go beyond predicting whether the behavior is likely to occur or not; they are also related to the consequences of sexual harassment. Hulin and colleagues (1996), for instance, showed that climate for sexual harassment predicted the outcomes experienced by targets, more strongly than did their actual experience of victimization. Subsequent research by Williams and colleagues (1999) also showed how, in many cases, individual perceptions of harassment climate moderate the eff ects of sexual harassment. When employees believe that the organization will tolerate conduct of this nature, the negative impact of sexual harassment on the work-related outcomes of commitment and satisfaction with work, supervisors and co- workers is worsened signifi cantly. Further, any eff ects of believing that the organization will tolerate sexual harassment are even more widespread, having a negative impact not only on the direct victims of harassment, but also on other employees who witness these events. Several studies by Miner-Rubino and Cortina (2004, 2007) document the role played by perceptions of organizational unresponsiveness in reducing bystanders’ commitment to the organization, job satisfaction, and health.

Climate for Sexual Harassment and SMEs

Given that climate for sexual harassment is related to both the prevalence and severity of this workplace problem, how can these fi ndings from

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research benefi t SMEs? We suggest that the lesson to be learned concerns the importance of developing and implementing policies, procedures and practices that communicate organizational intolerance of sexual harassment, and provide employees with channels for obtaining organizational support if faced with this issue. Notwithstanding this, and consistent with survey data showing that sexual harassment is not a priority for SME stakeholders, only rarely will one fi nd formal policies, procedures and practices in place in SMEs to address this issue. Indeed, the problem may even be more complex and widespread than sexual harassment; research exploring Human Resource Management (HRM) more generally within SMEs has consistently revealed that a lack of resources, expertise, and/or beliefs in the legitimacy of HRM often results in failure to implement any formal control systems in these organizations (Katz et al., 2000; Matlay, 1999; Ritchie, 1993; Wilkinson, 1999). Instead ‘informal routinization’ seems to characterize SMEs (Scott et al., 1989), resulting in inconsistent practices within and across these organizations, and what would appear to be – to employees at the very least – an indiff erence towards human resource issues in general, and the occurrence of sexual harassment in particular (e.g. Ritchie, 1993). The fi nding that many SMEs lack HR departments may not be surprising, as there is a close association between the size of the organization, the likelihood that there will be an HR department, the size of the HR department, and the intensity of traditional HR activities in the organization, such as staffi ng selectivity, training opportunities and the presence of grievance procedures (Delaney and Huselid, 1996). Further still, for many SMEs in the ‘start-up’ phase or those that are trying to establish a fast-paced and entrepreneurial character, HR policies may be seen as limitations that hinder the autonomy of the founder and/or CEO, and impede rapid growth and change. As such, for these SMEs the absence of HR departments and policies is again not surprising.

SME climate for sexual harassment: incidence and eff ects Unfortunately, as HR departments invariably hold primary responsibility for developing, implementing, managing and enforcing the policies, procedures and practices creating psychological climates that could limit workplace sexual harassment, we suggest that the absence of such a department will leave many SMEs vulnerable to this form of interpersonal aggression. Without a formal department charged with the responsibility to proactively address the issue of harassment, the likelihood increases that the guidelines necessary to encourage appropriate workplace conduct, and the penalties for dissuading improper behavior, will be absent. As such, SMEs would become more vulnerable to experiencing increases in the

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prevalence of this type of aggression. Any lack of formalized attention given to this issue may also have indirect negative eff ects on employees’ perceptions. More specifi cally, the absence of sexual harassment policies, procedures and practices may implicitly communicate to workers that their employer condones this behavior and similar forms of mistreatment and unfairness. Reasoning that formal steps to address sexual harassment would be taken if those in positions of legitimate authority were concerned about this issue and employee well-being, the perception that management does not care about staff may result, which in turn, may produce a number of detrimental secondary eff ects (e.g. reduced loyalty and satisfaction, perceptions of injustice, reduced performance). Thus, tolerant sexual harassment climates may not only encourage more frequent expressions of sexually harassing behaviors, but also exacerbate the suff ering of targets and detrimentally impact organizations.

SME climate for sexual harassment: target coping The impact of organizational tolerance for sexual harassment may have even more wide-ranging eff ects for SME employees, as previous research has demonstrated a link between climate for sexual harassment and target coping. In one study by Malamut and Off ermann (2001), for example, the more that targets of sexual harassment perceived their organizations were tolerant of harassing conduct, the more likely they were to use avoidance- denial coping strategies to counteract their victimization. This fi nding is important, because avoidance-denial coping strategies are among the least eff ective in ending sexual harassment, likely because they involve tactics such as ‘ignoring the behavior, going along with the behavior, treating the incident as a joke, or doing nothing’ (Knapp et al., 1997, p. 691). Similarly, Cortina and Wasti (2005) found that women who perceived their organizations to be tolerant of sexual harassment, tended to behaviorally avoid and cognitively deny their adverse circumstances. In contrast to avoidance-denial coping, research fi ndings also show that targets who use more assertive coping strategies, such as reporting harassment, are more satisfi ed with the outcomes they experience than those who use the more passive strategies common in organizational environments that tolerate harassment (Cochran et al., 1997). Extending these research fi ndings, Gruber and Smith (1995) demonstrated that women respond more assertively to being victimized (fi le a grievance or tell someone in authority about their mistreatment) when the organization has practices in place (i.e. training, complaint procedures, pamphlets and posters displayed) to address incidents of sexual harassment. Finally, research also suggests that the sexual harassment climate impacts organizational and perpetrator responses to particular coping

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behaviors. Bergman and colleagues (2002), for example, found that employee perceptions of organizational tolerance for sexual harassment are signifi cantly and positively related to organizational minimization of the problem (i.e. ignoring the report of sexual harassment), and retaliation against employees for fi ling reports. Taking these fi ndings together, we argue that many SMEs may be inadvertently encouraging victims of sexual harassment to use maladaptive coping strategies to address their suff ering, which in turn, could worsen any negative consequences already being experienced.

SME climate for sexual harassment: bystander intervention Intriguingly, the climate for sexual harassment in SMEs may also infl u- ence the suff ering of harassment victims through its eff ects on those who are not the directly targeted with harassment, but instead witness it (i.e. see it, hear about it). In their discussion of the factors that increase or decrease the likelihood that bystanders will intervene in cases of sexual harassment, Bowes-Sperry and O’Leary-Kelly (2005) suggest that witnesses to this aggression often determine whether taking action is appropriate or necessary, from characteristics within their social and organizational environments. This is consistent with fi ndings on bystander intervention in general (e.g. Latané and Darley, 1970), as well as social information processing theory – which explains how and why the social environment signals to individuals what beliefs, attitudes and opinions are socially acceptable, and provides cues to employees that are used to construct and interpret events (Salancik and Pfeff er, 1978). That said, when one must interpret and respond to an ambiguous or disconcerting situation encountered at work (such as an instance of observed sexual harassment), employees will look to the organization to make sense of what they perceive (i.e. answer the questions ‘Is what I just witnessed sexual harassment?’ ‘Is what I just witnessed serious enough to warrant intervention?’ etc.). The presence or absence of an organization’s sexual harassment policies and procedures would undoubtedly be a powerful source of information regarding what is appropriate, desirable and normative within an SME, and, by extension, determine the extent to which bystanders feel compelled to intervene. In situations where no sexual harassment policies or procedures are in place, SME employees are likely to interpret this to mean that such behaviors are not problematic, and thus conclude that intervention is unnecessary. Furthermore, as we know that individuals who are close to each other typically come to agree with one another in their perceptions of organizational events and environments (e.g. Klein et al., 2001), and that bystanders in SMEs will also look to one another for cues in choosing how to respond (Salancik and Pfeff er, 1978), beliefs in the needlessness of intervention will

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fast become systematic and self-perpetuating. Taken together, we argue that climate for sexual harassment should therefore impact the extent to which victims are left to suff er on their own, thus exacerbating any negative consequences they experience. Although fi ndings from research on bystander intervention and social information processing theory seem to suggest that sexual harassment may be more frequent and damaging in SMEs, we would be remiss if we did not acknowledge that the smaller workforce present in these organizations might also reduce the likelihood of sexual harassment and its negative eff ects. Again resorting to the bystander intervention literature, we learn that bystanders (e.g. to sexual harassment) feel a greater responsibility to intervene in situations in which they cannot pass responsibility on to others; the fewer the bystanders, the greater the felt obligation. Thus, consistent with research exploring the diff usion of responsibility among those who witness emergency events (Gottlieb and Carver, 1980; Latané and Darley, 1968), employees in SMEs may feel more inclined to intervene if they see or hear about incidents of sexual harassment, as the pool of other observers is smaller. Further, this diff usion of responsibility becomes more likely when bystanders share cohesive ties, as individuals feel more accountable for the well-being of others with whom they are close (e.g. Levine et al., 2002). Based on these well-established fi ndings, it could thus be argued that the size of SMEs, coupled with the cohesive ties that typically result from smaller work groups, will create conditions that increase feelings of accountability and mutual responsibility among organizational members, encouraging them to intervene in a situation involving the harassment of a colleague. Finally, Bowes-Sperry and O’Leary-Kelly (2005) point out that observers are also more likely to intervene if they believe there is no one else in their environment who is more qualifi ed to do so (Cramer et al., 1988; Pantin and Carver, 1982; Schwartz and Clausen, 1970). Without an HR department or organizational authorities formally appointed to deal with issues of sexual harassment, employees in SMEs may again feel more compelled to extend assistance to victims of harassment. To the extent that bystanders intervene on behalf of a colleague following an incident of victimization, target suff ering should be reduced – both as a result of tangible assistance in dealing with the harassment, the potential discouragement of future acts, and in light of the positive psychological consequences that are associated with social support (Cohen and Wills, 1985). Thus, when thinking of whether bystander intervention might occur in the face of sexual harassment in SMEs, a double-edged sword exists. On the one hand, a psychological climate that implicitly communicates a tolerance for sexual harassment may send messages to employees that

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discourage them from helping a colleague. On the other hand, the small size of these organizations may create conditions that increase perceptions of one’s felt responsibility to act. So which is it? Do SMEs encourage or discourage bystander intervention? Unfortunately, there are no research fi ndings that would guide us in answering this question. However, as bystander intervention likely plays an important role in reducing sexual harassment and preventing some of its negative eff ects in SMEs, we suggest that researchers should confront this question, investigating the extent of witness involvement in SMEs, and examining factors that could encourage such behavior. In summary, while there is no research that would directly inform our understanding of sexual harassment in SMEs, a large body of related work suggests that the climate for sexual harassment likely present in many of these organizations, may leave employees more vulnerable to this form of aggression. Specifi cally, the perception that an SME is tolerant of sexual harassment may increase the likelihood that this form of aggression will occur in the fi rst instance, encourage maladaptive coping strategies by the targets of sexual harassment, exacerbate its negative impact on victims, and discourage bystander helping behavior. At the same time, however, we do note that the small size of SMEs could also increase the likelihood of bystander intervention, thus helping to counteract some of the climate’s negative eff ects.

WORKFORCE COMPOSITION OF SMALL AND MEDIUM SIZED ENTERPRISES

Any attempt to understand SMEs will eventually reveal the widespread existence and infl uence of a family business culture within these organizations – a characteristic that will be important when considering sexual harassment in SMEs. Even when SMEs are not characterized by employees who share blood relations, the ideology of the ‘family’ often prevails within these fi rms, infl uencing the social relationships that take place within them (Ram and Holliday, 1993). Previous research has documented both the advantages and disadvantages that a ‘family’ culture can have on an SME. In fact, wider literature on SMEs tends to characterize these unique organizations as one of two types, each of which refl ects a potential manifestation of the family ideology. According to the fi rst – the ‘small is beautiful’ perspective (e.g. Ingham, 1970) – the small size of SMEs provide intimate environments that value closeness and the cultivation of strong ties. Refl ecting the image of a ‘happy family’, such workplaces are believed to promote and benefi t from interpersonal trust and commit-

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ment, increased fl exibility, reduced confl ict and facilitated communication (Ram, 1994; Schumacher, 1973; Wilkinson, 1999). In sharp contrast, the ‘bleak house’ perspective suggests that SMEs might also be characterized by dictatorships that expose employees to poor working conditions, low levels of unionization, and limited employee autonomy and control (Dundon and Wilkinson, 2003; Rannie, 1989; Wilkinson, 1999). Within the ‘bleak house’ perspective, the ‘family philosophy’ is thought to be simply a front for authoritarianism, as loyalties create a sense of obligation to accept the status quo, however undesirable it may be for the individual employee. While SMEs are, of course, far more complex than any dichotomous representation can convey (Wilkinson, 1999), we question how the familial relations and ideologies that permeate many SMEs infl uence the manifestation and experience of sexual harassment. Might the characteristics of the ‘happy family’ or the ‘bleak house’ work against the occurrence of this aggression and the severity of its negative eff ects, or instead could they contribute to the silencing of victims and the dismissal of sexual harassment as an issue that negatively aff ects employees’ well- being?

Blurring the Boundaries: SME Workforce Composition and Harassment Spillover

Contrary to a more traditional Parsonian conception of work as an aspect of life that is distinct and separate from one’s private, social experiences (Parsons, 1952), research reveals the opposite; work and family roles are inextricably linked (Barling, 1990) – a pattern of fi ndings that has been replicated for decades (Bellavia and Frone, 2005; Grzywacz et al., 2008). When specifi cally focusing on SMEs, we now appreciate how readily work and family intersect for employees in these organizations, largely as a result of their recruitment processes. Indeed, previous research has revealed the centrality of personal connections and the informal networks of those already employed by such fi rms in the hiring of new employees (Dick and Morgan, 1987; Kitching, 1997). In one study, for instance, Matlay (1999) found that the vast majority of the 540 small business owners/managers who were interviewed, relied exclusively on informal channels of recruitment involving family members, friends, relatives and neighbors. Similarly, in describing fi ndings from their ethnographic research exploring the role of the family in small manufacturing fi rms, Ram and Holliday (1993) note that the ‘grapevine’ is still the most utilized system of recruitment in these organizations. According to the researchers (1993, p. 640), ‘. . . Generally, the process involved the owners asking their workers to encourage friends and relatives to come to work for them. The

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whole process was very informal . . . These particular channels of recruitment made it more likely that the workers recruited would be from the workers’ familial and social milieu’. Given this fi nding, it should not be surprising that many SMEs are characterized by a familial culture (Ram and Holliday, 1993), which, as noted, may be a blessing or a curse for these organizations and their employees. However, the important point from our perspective is that the resulting familial nature of many SMEs blurs the boundaries separating work and personal life, ultimately fostering conditions that worsen the experience of sexual harassment victims. More specifi cally, we suggest that as many employees in SMEs will have deep personal relationships with one another that extend beyond their shared employment, it is probable that individuals who are victimized while on the job may be in a situation where they must continue to have contact with their harassers after work hours. Findings by Handy (2006) concerning the sexual harassment experiences of employees working in small towns are informative in this regard. Handy (2006) showed how contextual factors such as population size can result in sexual harassment diff using from the job to non-work situations. For example, in some cases workplace sexual harassment continued when women were shopping or interacting with friends or family. The fact that harassment could continue outside of the work environment ‘. . . meant that women could, in the worst instances, be literally trapped in their own homes, knowing they would experience harassment if they ventured into town’ (Handy, 2006, p. 17). Although Handy’s (2006) research focused on the permeability of workplace boundaries as a result of the residential environment within which the organization is located, we suggest that these fi ndings inform our understanding of sexual harassment within SMEs more generally. Thus, in light of the recruitment and staffi ng procedures commonly used in SMEs, we expect that the social networks of SME employees – including the targets and perpetrators of sexual harassment – will intersect outside of the workplace, creating opportunities for sexual harassment to reach well beyond the organization, and to persist long after work hours. As previous research has demonstrated how the pervasiveness of sexual harassment is associated with the severity of its eff ects, the implications of harassment spillover into the personal domain must be considered. Langhout and colleagues (2005) revealed how victims experiencing harassment more frequently and for longer durations of time, appraised their circumstances as more stressful, and experienced greater declines in psychological, health and job-related well-being. Earlier research by Stockdale (1998) and Malamut and Off ermann (2001) also revealed the role played by sexual harassment frequency in exacerbating the negative consequences faced

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by victims. As such, we suggest that the ‘family-friendly’ hiring practices that characterize SMEs will blur the boundaries between work and home life for employees, will promote sexual harassment spillover, and will thus worsen consequences for victims. Importantly, this spillover from work to non-work situations is not uni-directional. Instead, just as sexual harassment may spillover into the private lives of SME employees, so too might the consequences of any victimization occurring outside of the workplace spillover into SMEs. Previous research has shown that the diff usion of intimate partner violence (IPV) – aggressive acts committed by a spouse, ex-spouse, or current or former boyfriend or girlfriend (National Center for Injury Prevention and Control, 2003) – into the organizational context is anything but rare. For example, 19 percent of male employees and 30 percent of female employees have experienced IPV at some point during their working lives, while 70 percent of employed victims say their abusers have harassed them at work (e.g. O’Leary-Kelly et al., 2008). Whether manifesting as job interference before or after employment hours (e.g. cutting up clothes so the victim cannot go to work; threatening to cause harm for something done at work) or physical and/or non-physical acts of harassment that actually take place on the job site (Swanberg and Logan, 2005; Swanberg et al., 2006), we argue that IPV, including sexualized violence occurring at home, may be a concern for SMEs. Subsequent research has shown how IPV that spills over to the workplace has negative eff ects on women’s withdrawal both from work, and at work (Leblanc et al., 2010). As the recruitment and staffi ng processes of SMEs make the co-employment of intimate part- ners more likely than in larger organizations, it is probable that SMEs are environments where sexualized IPV can enter the workplace quite readily. Although our focus is on sexual harassment specifi cally, previous work has found that IPV can include various forms of sexual victimization such as forced sexual acts, threats for refusing to have sex, forcing one to use or look at pornographic materials and demeaning verbal insults (Pico-Alfonso et al., 2006; Straus et al., 1996; Swanberg et al., 2006) – all behaviours that have also been included within the defi nition of sexual harassment (Fitzgerald et al., 1997). Further, as previous work has documented the detrimental consequences of this form of aggression to both individual employees and the larger organizations for which they work (e.g. LeBlanc et al., 2010; Reeves and O’Leary-Kelly, 2007; Swanberg and Logan, 2005; Swanberg et al., 2006), addressing this issue in our discussion of sexual harassment in SMEs is critical. In summary then, we argue that the family nature of many SMEs can foster an environment wherein IPV is more likely to cross organizational boundaries, ultimately producing detrimental consequences for the organization and employees.

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‘Family’ Loyalties: SME Workforce Composition and Whistle-Blowing

Although the workforce composition characterizing many SMEs is likely to enable sexual harassment to cross organizational boundaries, it is also possible that the unique nature of the labor force within SMEs may make exposing sexual harassment diffi cult. Previous research exploring whistle- blowing has highlighted the moral dilemma that often arises when employees must decide whether to expose the misconduct of colleagues (Dozier and Miceli, 1985; Henik, 2008; King, 1997; King and Hermodson, 2000; Trevino and Victor, 1992). Defi ned as ‘the disclosure by organization members (former or current) of illegal, immoral, and illegitimate practices under the control of their employers, to persons or organizations that may be able to aff ect action’ (Near and Miceli, 1985, p. 4), whistle-blowing is a phenomenon that is diffi cult for those who engage in it. We argue that when the unethical behavior (i.e. sexual harassment) is being perpetrated by a close peer or even family member (as is likely to be the case in many SMEs), choosing to blow the whistle will become even more demanding. When immersed in an organizational environment that values strong ties and closeness, reconciling personal feelings about the wrongness of sexual harassment with group norms of loyalty and solidarity can produce moral confl ict in would-be whistle-blowers (Dozier and Miceli, 1985; Schwartz et al., 1969). Faced with the decision of whether to report a family member, neighbor, or friend to organizational authorities, employees in SMEs who witness or experience sexual harassment by close others may opt to preserve their bonds with members of the group – or even the perpetrator – rather than risk disrupting the cohesiveness and trust of the collective. Support for this assertion derives from a study by King (1997), who found that employees were reluctant to report a friend’s misconduct, only doing so when the behavior was perceived to be very serious. Likewise, studies have shown that pressure from peers to stay silent in the name of group unity, can prevent employees from choosing to report instances of wrongdoing. Research by Greenberger and colleagues (1987), for example, shows the social disapproval of co-workers around ‘tattling’ behavior. When the individual being implicated belongs to a cohesive group, the condemnation for whistle-blowing is likely to be severe. Finally, as existing decision-making models of whistle-blowing suggest (Dozier and Miceli, 1985; Gundlach et al., 2003), witnesses to misconduct must fi rst conclude that a wrongdoing has taken place, before they can contemplate a course of action. However, in light of the close and personal relationships shared by many SME employees – including targets and perpetrators of sexual harassment – bystanders may question whether what they are witnessing is harassment at all, or simply horseplay and/or joking

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between friends. Previous research has demonstrated that bystanders are less likely to become involved in altercations between individuals believed to share a personal relationship (e.g. Levine, 1999; Moriarty, 1975). For instance, when observing an aggressive interaction between a man and a woman, bystanders are less inclined to intervene if they believe the two individuals are husband and wife (Shotland and Straw, 1976). Bowes- Sperry and O’Leary-Kelly (2005, p. 295) summarize this counterintuitive situation, noting that ‘intimate relationships somehow legitimate violence, causing it to be perceived as less harmful and as “none of my business”’. Taken together, it would thus seem that blowing the whistle on sexual harassment within contexts characterized by a family culture (and its associated structure), is something that would prove to be quite challenging. However, extending the ‘small is beautiful’ approach to SMEs outlined above, it is also possible that the close and intimate ties resulting from a smaller workforce and familial ideology may create conditions that encourage whistle-blowing. First, the smaller size of SMEs facilitates communication among colleagues, and makes employee behaviors more visible (Knapp et al., 1997). As such, employees within smaller fi rms are more likely to witness sexual harassment occurring in their midst, and feel a responsibility to intervene in some way on behalf of the victim. In addition, the sense of interpersonal closeness and trust fostered within SMEs by personal and perhaps familial relationships, may create safe environments that support victims and/or witnesses of harassment who choose to blow the whistle. While fear of retaliation for whistle-blowing often prevents this action from being taken (Gutek and Koss, 1993; Gwartney- Gibbs and Lach, 1992; Miceli and Near, 1985, 1988; Miceli et al., 1991), targets or witnesses of harassment who feel cared for and supported by their colleagues may have fewer concerns about reprisals. Having the support of peers may even facilitate whistle-blowing in light of the social power it gives employees. In line with Near and Miceli’s (1995) model of eff ective whistle-blowing, power plays an important role when it comes to exposing wrongdoing, as those with greater power are more likely to believe they can bring about change, and fear retaliation less (Knapp et al., 1997). Thus, the ‘power in numbers’ that derives from close ties and shared group membership, may make whistle-blowing more likely in SMEs. The ‘small is beautiful’ perspective provides yet another explanation for why the motivation to blow the whistle on sexual harassment might be greater in SMEs. According to social identity theory (Hogg and Abrams, 1988; Tajfel and Turner, 1986), people come to understand and evaluate themselves based on the social groups to which they belong, and the extent to which these social groups are valued compared with relevant others (Hogg and Terry, 2000). The organization to which one belongs serves as

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one such reference group, and the smaller and more cohesive this group is, the more salient it becomes in identity formation. While this might create pressure to protect one’s ‘own’, the black sheep eff ect (Marques and Paez, 1994; Marques et al., 1988) remains possible. When a member of one’s social group behaves in a deviant or disgraceful way, concerns about being perceived in a similarly undesirable manner arise, and some form of corrective action is taken (Cooper and Jones, 1969; Eidelman and Biernat, 2003; Neuberg et al., 1994; Taylor and Mettee, 1971). Research exploring this black sheep eff ect has demonstrated that members try to protect valued group identities by derogating the group member who threatens the esteem of the collective. According to Eidelman and Biernat (2003, p. 603) ‘those who share group memberships with unfavorable others may also appear “guilty” simply by way of their resemblance. Harshly evaluating an unfavorable group member indicates dissociation and limits the likelihood of being cast in the same negative light’. As sexual harassment can disgrace a group and discredit its members, employees in a close-knit SME may choose to report colleagues responsible for perpetrating such acts, regardless of their in-group status. Previous research has also demonstrated the role of empathy – a senti- ment that is experienced when people recognize aspects of themselves in other individuals – in promoting helping behavior (Batson, 1991; Davis, 1996), and this might be of importance in SMEs. According to Stürmer and colleagues (2006, p. 944) ‘group-level similarity indicates that the target is “of one’s kind”, which renders his or her welfare of immediate self-relevance’. As such, when SME employees see their colleagues being sexually harassed, empathetic concern is likely to arise, which in turn, will engender helping behavior. Previous work by Stürmer and colleagues (2005, 2006) provides support for the notion that in-group membership facilitates empathy-motivated helping. Victor, Trevino and Shapiro (1993) also found that the inclination to report a peer for misconduct (and in turn, actual whistle-blowing) was associated with perceptions that other group members were being harmed. Thus, the drive to preserve a positive social identity, as well as to protect valued members of the social group, might motivate employees in SMEs who are faced with the sexual harassment of a close colleague, into some form of positive action. Taken together, any eff ects of the family culture and cohesive workforce characteristic of SMEs are complex, and seemingly contradictory. On the one hand, this unique workforce and its associated alliances may make whistle-blowing diffi cult for targets and bystanders, but on the other hand, may also foster heightened feelings of in-group solidarity, effi cacy, and provide support to the whistle-blower – all of which would enhance the motivation to put a stop to sexual harassment.

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RECOMMENDATIONS

Understanding the nature, antecedents and consequences of sexual harassment in SMEs is an important goal in itself. However, accumulating knowledge about this issue is also critical to the extent that it forms the basis for actions to prevent sexual harassment from occurring in these organizations, and reducing its negative consequences for employees. While we have deliberately pointed to the absence of data specifi c to sexual harassment in SMEs throughout the preceding discussion, we suggest that enough is known at this stage about the phenomenon of sexual harassment more generally, and about the unique organizational environments of SMEs, that several recommendations can be made that may benefi t these organizations and their stakeholders.

Develop and Implement Policies, Procedures, and Practices to Limit Sexual Harassment in SMEs

Data from a variety of sources strongly suggest that the development and implementation of policies, procedures and practices for sexual harassment (e.g. codes of conduct, sexual harassment training, formalized grievance process) is a necessary fi rst step for SME management, in reducing and preventing this form of victimization. Such policies, procedures and practices will not only directly infl uence the psychological climate for sexual harassment (i.e. employees’ perceptions of the organization’s tolerance for sexual harassment), but in turn, will impact employee behavior (e.g. discourage sexually harassing conduct, encourage positive coping behaviors and target reporting/bystander intervention), and indirectly infl uence employees’ feelings of being supported by the organization. Nonetheless, while critical, it is also important to recognize that merely having such policies in place is not suffi cient. Previous research also reveals that SME owners and senior leaders must essentially ‘practice what they preach’ when it comes to sexual harassment, publically demonstrating a commitment to the elimination of this issue, adequately communicating any policies, procedures and practices that have been implemented, and modeling appropriate behavior (Murry et al., 2001; Off ermann and Malamut, 2002). Research by Adams-Roy and Barling (1998) also demonstrates the importance of procedural fairness in the way that policies, procedures and practices are enacted. In essence, it would seem that sexual harassment policies are only as good as the leaders who implement them, thus pointing to our second recommendation.

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Ensure Leaders are Adequately Trained to Deal with Sexual Harassment

In general, SMEs have fewer resources available to them than do larger organizations, and training and development for leaders and leadership would be no exception. Yet SME owners and managers are still expected to lead by example, despite the resource constraints and role overload they experience (Dekker and Barling, 1995). In general, owners and senior leaders in SMEs would benefi t considerably from training and development opportunities, and would benefi t even more if these opportunities included knowledge about sexual harassment, its eff ects on employees and organizations, and how management might respond most eff ectively. The direct and indirect eff ects of such training on employees and SMEs would help reduce the occurrence of sexual harassment in the fi rst instance, as well as mitigate the harm to victims (Murry et al., 2001; Off ermann and Malamut, 2002). As such, it follows that sexual harassment interventions and training must also be directed at senior level managers and leaders. Importantly, as suggested above, the fi rst two recommendations we off er are not mutually exclusive. Instead, we would propose that they be implemented simultaneously.

Collect Data on Organizational Size

As noted, sexual harassment is pervasive within larger organizations, and a substantial body of research has addressed this phenomenon. In contrast, there is a dearth of research on sexual harassment in SMEs. While there are simply insuffi cient fi nancial resources and researchers to redress this empirical imbalance in the short term, SMEs and their employees are suffi ciently dissimilar to large organizations (Headd, 2000), to warrant their own unique body of sexual harassment research. While we do put forth a general call for more work on sexual harassment in SMEs, we acknowledge that this may not currently be feasible for some researchers. As such, as a fi rst step that can be implemented immedi- ately, and would provide valuable information at no cost, we call upon researchers to ensure that in describing their research participants, they automatically include information on the size of the organization(s) from which respondents were drawn. Were this information available, statistical analyses could be conducted to develop a more formidable body of knowledge on the nature, prevalence and eff ects of sexual harassment in SMEs.

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CONCLUSION

Sexual harassment in SMEs has largely escaped the interest of organizational researchers. This would be acceptable if sexual harassment did not occur within SMEs – but there is no reason to suspect that this is the case. In fact, drawing on diverse bodies of research, we have identifi ed a number of factors that suggest sexual harassment is quite likely to take place within these organizations. Further, based on our analysis it also seems probable that the damaging impact of sexual harassment on employee well-being, could be aggravated by a number of contextual variables present in many SMEs. Interestingly, it may also be possible that the smaller size and unique employee composition typical of these organizations, could work to counteract the harm caused by sexual harassment. In light of these pos- sibilities, we encourage researchers to consider this important occupational health issue, developing theoretical insights and empirical knowledge that can help us understand what sexual harassment looks like in SMEs, and in what ways their unique organizational environments moderate the eff ects of this aggression. In this chapter we have highlighted the importance of implementing policies, procedures and practices to confront sexual harassment in SMEs, and off ering training and support to both the employees and leaders within these organizations. Going forward, it will be critical for researchers and management alike to acknowledge the reality of sexual harassment in SMEs, build a base of knowledge about this topic that is specifi c to these organizations, and then implement the lessons learned from this research within these contexts. It is not until these things occur, that the well-being and health of SME employees can be enhanced, and the survival and growth of SMEs will be facilitated.

NOTE

1. While this defi nition solely makes reference to female victims, research shows that males are also often the victims of sexual harassment (e.g. Berdahl et al., 1996; Stockdale et al., 1999; Waldo et al., 1998).

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Over 90 percent of employees believe that their employer should be responsible for creating a healthy working environment; however, almost one third of employees also believe their workplace may inhibit a healthy lifestyle (World Heart Federation, 2010). We have been aware of the consequences of ‘unhealthy’ work on employee well-being for many years: over 20 years ago, the National Institute for Occupational Safety and Health (NIOSH) in the US reported occupational stress as one of the ten leading causes of workplace death (Sauter et al., 1990), and it has been described as an epidemic (Quick et al., 1997). More recently, NIOSH found that 40 percent of employees in the US rated their jobs as ‘very’ or ‘extremely’ stressful (NIOSH, 2006), and 74 percent of employers in the UK indicated that their workers are exposed to stress (Health & Safety Executive, 2006/2007). However, just as developing healthy individuals should involve more than ‘fi xing what is wrong’ such that we are ‘building what is right’ (Seligman, 2002, p. 3), developing a healthy work environment should involve more than minimizing problems and stress. That is, healthy work should involve supporting and building employees’ physical and psychological well-being (Turner et al., 2002). But what do we know about healthy workplaces? And, more specifi cally, given the focus of this book and given the large numbers of employees who work in small and medium sized enterprises (SMEs), what do we know about the healthy workplace components that would be eff ective, practical and feasible in SMEs? Many of the specifi c workplace components that are integral to the healthy workplace construct have been reviewed separately throughout this book. That is, Sharon Clarke reviews the literature on health and safety in small business, and in separate chapters, Mark Fleming and Natasha Scott, and Peter Chen and Lorann Stallones look at safety in specifi c industries. Cary Cooper and Kevin Kelloway review the stress management literature, and O’Driscoll et al. addresses work–life issues in SMEs. The other two chapters also are indirectly related to healthy workplaces: Dionisi and Barling’s work on

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harassment, and Kelloway and Teed’s chapter on violence and aggression both deal with aspects of ‘unhealthy’ workplaces. Therefore, I refer readers to the other chapters for a more detailed overview of each topic. In my review of healthy workplaces in SMEs, I will touch on these issues, examining the general defi nitions and models of healthy workplaces, and focusing on the integrative literature on healthy workplaces. I will use a model of healthy workplaces as an organizing framework to assess healthy workplace practices in SMEs.

DEFINING HEALTHY WORKPLACES

Despite the criticality of employee health, and despite the amount of literature on specifi c components of health and safety, there are relatively few comprehensive defi nitions and models of healthy workplaces. Over the years, the term ‘healthy workplace’ has been expanded to become more broad and inclusive in its defi nition of ‘health’. Historically, the term healthy workplaces was used mainly in the context of occupational health and safety, and it focused on the physical safety of employees in terms of reducing physical hazards (e.g. poor air quality, falls, exposure to toxic substances) and improving physical safety procedures (Stokols et al., 1996). Over the years, there have been major initiatives in this area, and substantial improvements in providing safe physical work environments. Although physical safety is still a major focus when creating healthy workplaces, a focus solely on physical health and safety is too narrow, ignoring the other aspects of health. Therefore, promoting healthy behaviors as a means of creating healthy workplaces has become popular (e.g. Cooper and Patterson, 2008; Lloyd and Foster, 2006). Such health-promotion programs can be defi ned as initiatives that focus on health awareness, behavior change, and on creating environments that support healthy behaviors and practices (Aldana, 2001). Examples include fi tness programs, smoking cessation programs, gym memberships, healthy eating options at work, and health services, such as fl u shots, breast screening programs, and cholesterol screening (Griffi ths and Munir, 2003; Stokols et al., 1996). In general, health-promotion programs are popular and have shown some eff ectiveness (Bertera, 1990; Mills et al., 2007), and thus are a necessary component of a healthy workplace. However, critics argue that health-promotion initiatives involve a ‘blame- the-employees approach’ without taking employers’ behaviors and actions into account (Burton, 2004; Griffi ths and Munir, 2003). Their primary focus still tends to be on the physical health of employees, and they may not take into consideration the direct impact of the work on health.

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There is a substantial literature that demonstrates the negative psychosocial impact of work factors (e.g. workload, job control, role stressors, job content, career concerns and organizational culture; Sauter et al., 1990), and interpersonal issues (e.g. poor communication, bullying and aggression, and leadership factors; Off ermann and Hellman, 1996) on employee health (e.g. Sauter et al., 1990). Therefore, any defi nition or model of healthy workplaces needs to consider these factors and their role in employees’ psychosocial and physical health. Moreover, healthy workplaces must move beyond simply minimizing these negative workplace stressors and demands and incorporate positive workplace resources to improve health (Kelloway and Day, 2005b; Turner et al., 2002). One of the most commonly used healthy workplace defi nitions comes from Sauter, Lim and Murphy (1996), who defi ned a healthy workplace as an organization that ‘maximizes the integration of worker goals for well- being and company objectives for profi tability and productivity’ (p. 250). Their defi nition is broad, and it highlights a dual focus on general physical and psychological well-being, but also on the operational organizational performance and eff ectiveness. In their operationalization of the concept of healthy workplaces, Kelloway and Day (2005b) incorporated these perspectives and argued for a holistic approach to employee health:

In our quest for healthy workplaces, we must be careful to ensure that we incorporate a holistic approach to health. That is, a healthy workplace must encompass the physical, psychological, and social contributing factors. Moreover, we must assess the eff ectiveness of healthy workplaces using multiple indices of individual health (i.e., psychological, physical, and behavioural), multiple indices of organizational health (e.g., productivity, turnover, customer perceptions), and multiple societal indices. (p. 309)

A couple of advisory agencies and institutes have defi ned healthy workplaces in a similar manner, incorporating multiple contributing factors. For example, the National Quality Institute (NQI) in Canada has taken a holistic view of workplace health, defi ning a healthy workplace as one that:

considers all aspects of an employee’s life, and works to respect and protect every individual in the organization. A ‘healthy workplace’ considers the physical environment and the occupational health & safety, the health and lifestyle practices of the employees, as well as the workplace culture, ensuring a psychologically safe, supportive and mentally healthy environment. (Murray, 2011, p. 3)

The NQI supports the dual focus of Sauter et al.’s (1996) defi nition, by defi ning healthy outcomes both in terms of achieving healthy individual

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outcomes (e.g. having a healthy lifestyle) and healthy organizational outcomes (e.g. good customer service), all within a safe work environment. Likewise, the American Psychological Association (APA) has defi ned a psychologically healthy workplace in terms of what it can provide to employees (e.g. implementing initiatives that promote employee health and well-being) using multiple components (e.g. health and safety, work– life balance), while concurrently ensuring high organizational performance (PHWP, n.d.).

HEALTHY WORKPLACE MODELS

In addition to the models that focus on a single component of the construct of a healthy workplace, there are several conceptualizations of a more global construct. Some of this work encompasses both safety and psychosocial factors. For example, when asked to identify aspects of healthy workplaces, employees consistently identifi ed factors pertaining to interpersonal relationships (e.g. respect, fair treatment, and a good relationship with supervisor and co-workers; friendly co-workers and good communication with them); autonomy, work–life balance, as well as a safe work environment (Lowe et al., 2003). Wilson et al. (2004) identifi ed three potential work-related psychosocial predictors of health: job design; organizational climate; and job future. In a small qualitative study, employees identifi ed four factors they thought were important in developing healthy workplaces, including a good work environment, active keep-fi t measures, functional leadership, and individual responsibility in terms of their own health attitudes and behaviors at work (Arwedson et al., 2007). In related research, Drach-Zahavy (2008) created a measure of workplace health friendliness with nursing staff and their supervisors from hospitals in Israel. Workplace health friendliness is defi ned as ‘insti- tutionalized, structural, and procedural arrangements as well as formal and informal practices aimed to design, create, and maintain healthy work environments that allow individuals to foster their health in their workplace’ (p. 197). The themes identifi ed specifi c practices (e.g. free medical procedures, such as vaccinations), as well as process issues (e.g. policy changes to pricing of their fi tness centre), health promotion practices, and staff empowerment (Drach-Zahavy, 2008). However, the measure was developed specifi cally for this environment such that the themes and items are context specifi c and not easily generalizable to other workplaces. Although quantitative data is lacking for several of these models, they provide valuable information regarding the specifi c components that can be used in comprehensive models of healthy workplaces.

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Employee Culture of support, involvement & respect, & fairness development

Work–life Work content & balance characteristics

Safety of work Interpersonal environment relationships at work Healthy Workplace

Societal Individual outcomes outcomes Organizational outcomes

➢ ➢ Psychological National health-care costs ➢ ➢ Physiological ➢ Turnover Government programs ➢ Behavioral ➢ Performance ➢ Reputation ➢ Customer ➢ satisfaction ➢ ‘Bottom line’

Figure 9.1 Kelloway and Day’s (2005a) comprehensive model of the antecedents and outcomes of healthy workplaces

Based on Sauter et al.’s (1996) defi nition and taking a holistic view of ‘health’, Kelloway and Day (2005a) developed a comprehensive model of the antecedents and outcomes of healthy workplaces. They identifi ed six contributing factors to a healthy workplace: (1) health and safety of the work environment; (2) a culture of support, respect and fairness, (3) positive interpersonal relationships; (4) employee involvement and development; (5) work content and characteristics; and (6) work–life balance (see Figure 9.1). According to the model, health and safety focuses on employees’ physical safety and health (e.g. removing hazards and toxins, providing safety training, having an ergonomically designed workspace, health promotion). The model addresses two categories of social interactions: having positive interpersonal relationships with colleagues, supervisors, and clients, as well as a more broad culture of support and respect that fosters these types of positive interactions. The importance of leadership is clear in these situations: without leaders who are supportive of a

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healthy workplace initiative, and who strive to create a positive culture and workplace, many (if not all) of these initiatives would fail (Kelloway and Day, 2005a). Involving employees in decision making regarding work and organizational life, and supporting and developing the employees’ abilities provide opportunities for them to grow and to have meaningful input into their work. Specifi c characteristics of the job and work tasks (e.g. having meaningful work and job control; reasonable working hours) can directly and indirectly aff ect worker health. Finally, organizations also should help employees promote good work–life balance, to help employees balance their work and non-work activities. Although this model is more comprehensive in its approach, some of the facets (e.g. lifestyle and health promotion) need to be outlined more explicitly. Kelloway and Day’s (2005a) model also included the impact of healthy workplaces on diff erent constituents: (1) individual employees (and their families); (2) organizational functioning; and (3) society. That is, a healthy workplace may not only improve employee well-being, but also the well- being of the employees’ family, both directly by providing family health benefi ts and day-care benefi ts, and indirectly, by creating happier, more engaged employees who have a better work–life balance. Furthermore, a healthy workplace is also concerned about the positive outcomes for the organization (e.g. good fi nancial performance, productivity, customer satisfaction and reputation), which refl ects Sauter et al.’s (1996) inclusion of organizational performance in their healthy workplace defi nition. A high-performance work environment is necessary for the success and survival of the organization, which obviously impacts employee well-being. Finally, although Kelloway and Day don’t explicitly make the connec- tion with corporate social responsibility and performance, the ‘societal’ outcomes in the model may be defi ned in this manner. Corporate social performance incorporates corporate social responsibility and responsive- ness, and it involves positive initiatives aimed at the environment, employees, and community relations that benefi t the community and society in general (Carroll, 1991). Interestingly, having a healthy workplace and being socially responsible may have reciprocal eff ects: for example, healthy workplace initiatives often involve aspects of socially responsible activities, and social responsibility activities that are directed at employees often involve issues of personal fulfi llment and work-related development (Sverke et al., 2010), which can be viewed as employee development, a component of healthy workplaces. Based on the APA defi nition and framework, Grawitch et al. (2006) developed another comprehensive model of healthy workplaces, which they labeled a ‘psychologically’ healthy workplace model. This model is similar to the Kelloway and Day (2005a) model, and it clusters psychologi-

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cally healthy workplace practices into fi ve categories: (1) employee involvement, which involves empowering employees, involving them in decision making and giving them autonomy (e.g. the setting up of self-managed work teams); (2) work–life balance, which involves supporting employees to help them balance the multiple demands of their lives (e.g. providing fl exible work arrangements, child-care benefi ts); (3) employee growth and development, which involves providing employees with the opportunity to develop their knowledge, skills and abilities, as well as to advance in their careers (e.g. tuition reimbursement; in-house training); (4) health and safety, which involves assessing both the physical and psychological health risks, preventing these health risks, and treating physical and psychological health issues (Grawitch et al., 2006; e.g. Employee and Family Assistance Programs [EFAPs] and safety training); and (5) employee recognition, which involves formally and informally recognizing and rewarding employees’ achievements and contributions to the organization (e.g. company milestones; banquets; monetary rewards; Grawitch et al., 2006, 2007). These models provide a good basis for further developing the area of healthy workplaces, although research should study the components and psychometric properties of scales based on these models more closely. Even Grawitch et al. (2007) acknowledged that the scale based on their model has ‘not undergone rigorous psychometric development’ (p. 281).

Summary

Although the construct of a healthy workplace is still in its infancy, and requires further study, several models provide a solid foundation for its development. Some models deal with specifi c components of overall, comprehensive models of healthy workplaces, whereas others are more comprehensive. Despite the somewhat fragmented literature, and despite the use of diff erent labels, there are several overall themes that can organize the specifi c components. A comprehensive model of a healthy workplace should incorporate at least three overarching themes: a physical health and safety component of the work environment; a focus on lifestyle and healthy behaviors; and a focus on the psychosocial well-being of employees. The last category has some variability in how it has been addressed across diff erent models, although several common areas have emerged, including having positive interpersonal communications and culture, engaging and developing employees, creating a supportive and respect- ful environment, encouraging autonomy and control over work, and balancing work with other life areas. Focusing on more global constructs, rather than specifi c practices, should be most benefi cial to this area.

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THE IMPACT OF HEALTHY WORKPLACES

There is little research using comprehensive healthy workplace models, and very little empirical evidence on the eff ects of overall healthy workplace factors on employee outcomes and organizational performance. In one of the few studies to examine a model of psychologically healthy workplaces, Grawitch, Trares and Kohler (2007) examined the extent to which university staff and faculty were satisfi ed with fi ve healthy workplace components (i.e. work–life balance; recognition; involvement; growth and development; and health and safety). They found that satisfaction with these fi ve types of practices were associated with positive employee outcomes, such as higher well-being and lower turnover intentions. Randell, Day and Kelloway (2010) surveyed organizational representatives from organizations in terms of their healthy workplace practices, using a three-component model based on the Kelloway and Day (2005a) model. After controlling for organizational characteristics, the three healthy workplace components (i.e. positive communication; control; and health and safety) accounted for incremental variance in organizations’ self-reported fi nancial/operational performance, employee attitudes and employee withdrawal behaviors. When focusing on employees’ views about their workplace, Day (2011) summarized a program of research she conducted with her colleagues, noting that employees who reported their workplace as being healthy also reported higher engagement and commitment, and lower absenteeism, health symptoms and turnover intentions. Although these studies contribute to our knowledge about healthy workplaces, the use of cross-sectional designs and a single source of data inhibit the utility of the results. Grawitch et al. (2006) also concluded that there is a lack of consistent standards with which to evaluate the eff ectiveness of healthy workplace initiatives. Despite the lack of research with the overall healthy workplace models, there is a substantial literature focusing on specifi c healthy work characteristics. Although we typically think of the negative eff ects of workplaces on employee health, the presence of some workplace factors is associated with more positive employee outcomes. Therefore, it is important to look at how both the presence and absence of factors infl uence employee physical and psychosocial health.

Workplace Characteristics: Physical and Psychosocial Health

There is solid evidence in the job stress literature about the specifi c work characteristics that are associated with negative employee outcomes (for an overview, see Sonnentag and Frese, 2003). For example, job stressors

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are associated with negative behaviors, such as increased alcohol consumption and alcohol-related problems (Grunberg et al., 1999), eating disorders (Quick et al., 1997) and decreased physical exercise (e.g. Payne et al., 2002). All of these factors may exacerbate the negative eff ects of stress, thus creating a negative health spiral for the individual. Job stressors also are related to physiological problems, such as cardiovascular disease (Theorell and Karasek, 1996), increased risk of infectious disease (e.g. Schaubroeck et al., 2001), and suppressed immune functioning (O’Leary, 1990). Having high demands and low levels of decision-making authority and support at work, are associated with major depression symptoms (Wang and Patten, 2001). Experiencing harassment at work is associated with increased cognitive diffi culties (e.g. having diffi culty concentrating; Barling et al., 2001), which can lead to decreased workplace safety (Duff y and McGoldrick, 1990). Similarly, workplace stressors, such as poor leadership, role overload and ambiguity, and time pressures, are all associated with increased safety incidents, accidents and injuries (e.g. Barling et al., 2002; Griener et al., 1998). Moreover, these negative job stressors may have a direct eff ect on important organizational outcomes, such as absenteeism and health-care costs. That is, employees reporting high work stressors tend to neglect their job duties (Schat and Kelloway, 2000). Cooper and Dewe (2008) reported data from HSE’s national health and safety statistics stating that approximately 40 percent of all sickness-related absences in the UK were due to job stress (see Health & Safety Executive, 2006/2007). Job stressors have been found to be associated with decreased patient satisfaction (Garman et al., 2002). Finally, given the positive relationship between stress and physical health symptoms, it is not surprising that job stressors are also related to increased health-care utilization and costs (e.g. Ganster et al., 2001). These studies highlighting the individual and organizational outcomes of specifi c workplace factors demonstrate that there are substantial costs associated with unhealthy workplaces. Conversely, work can also impact employees through the presence of healthy factors, which are associated with positive employee outcomes. That is, work can act as a health resource, either by directly infl uencing employee outcomes, or by buff ering the negative impact of stressors on employee outcomes. Jahoda (1980) argued that work may provide individuals with several positive benefi ts, including a sense of purpose and social contact, which are important for positive mental health. There is evidence supporting the benefi cial impact of many of the individual components of a healthy workplace on positive employee outcomes. For example, job autonomy is associated with employees’ sense of mastery (Parker and Sprigg, 1999). Similarly, organizational and co-worker

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support are associated with increased employee well-being (Viswesvaran et al., 1999), and may even buff er the negative eff ects of job stressors (for a review, see Kahn and Byosiere, 1992). Having transformational leaders may improve employees’ self-effi cacy, which, in turn, can improve mental health outcomes (Sivanathan et al., 2003). The evolving areas of positive psychology at work (e.g. positive organizational behavior, positive organizational scholarship, positive psychological capital) emphasize how positive aspects of individuals and workplaces can create benefi ts for individuals and the organization (Luthans, 2002). For example, certain work characteristics may increase employee effi cacy, optimism and hope, and these employee characteristics act as resources, thus enhancing well-being, which may in turn be related to satisfaction and performance (Luthans, 2002; Luthans et al., 2007; Youssef and Luthans, 2007). The link between positive work factors and organizational outcomes may be mediated by employee outcomes. In their meta-analysis, Harter, Schmidt and Hayes (2002) found that employee engagement and job satisfaction (assumed to be a function of positive work factors) were linked to multiple indicators of organizational success, such as increased productivity, customer loyalty, profi tability, and lower rates of turnover. These studies involving the positive organizational factors highlight Kelloway and Day’s (2005a) argument that healthy workplaces should not be simply a function of the absence of job stressors, but they must be a function of the presence of positive organizational resources to promote employee engagement and balance. Various researchers have noted that the eff ectiveness of healthy workplace practices must be examined in terms of the context in which the organization operates. For example, according to the contingency approach, the eff ectiveness of these practices is based on the extent to which the practice is consistent with organizational factors (such as structure, policies and practices; Delery and Doty, 1996). Although the premise of healthy workplaces applies to all organizations, regardless of their industry, size or location, based on this perspective, the specifi c challenges and resources can vary substantially depending on the size of the organization, which may ultimately infl uence the eff ectiveness of healthy workplace practices. Therefore, it is important to look at small businesses in this context.

SMALL AND MEDIUM SIZED ENTERPRISES

As noted elsewhere in this book, SMEs constitute a large proportion of the organizations across various geographical locations, and their exist-

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ence is critical for employees. Small fi rms are making ‘an increasingly important contribution to economic growth and employment’ (North and Smallbone, 1996, p. 151). Despite their impact, most of the literature on workplace health promotion has focused on large organizations (Meggeneder, 2007). The defi nition of small and medium sized enterprise varies slightly across countries (Harms-Ringdahl et al., 2000). In Canada, micro is defi ned as fewer than fi ve employees, small is defi ned as fewer than 100 employees, and medium is defi ned as fewer than 500 employees (Industry Canada, 2010). In the United States, small can be defi ned as fewer than 500 employees (SBA Offi ce of Advocacy, 2011). According to European Union (EU) legislation guidelines, the labels of micro-, small, and medium sized enterprise are based not only on the number of employees, but also on their balance sheet. That is, a microenterprise employs fewer than 10 people, and its balance sheet is less than EUR 2 million; a small enterprise employs fewer than 50 people, and its balance sheet is less than EUR 10 million; a medium sized enterprise employs fewer than 250 people, and its balance sheet is less than EUR 43 million (European Commission, 2010). Regardless of these variations in defi nitions, the results are very similar: there are a large number of SMEs that employ a large number of people, and make a signifi cant impact on the economy and on workers’ lives. For example, according to Statistics Canada (2010), almost half of the private sector labor force in Canada work for small enterprises (enter- p rises with fewer than 100 employees), with almost 40 per cent of the labor force in enterprises with fewer than 50 employees. According to the United States Small Business Administration Offi ce of Advocacy, small businesses (those who employ less than 500 employees) in the US make up over 99 percent of all fi rms and employ just over half of the country’s private sector workforce (SBA Offi ce of Advocacy, 2011). They pay out 44 percent of total US private payroll, and they have generated 65 percent of all new jobs over the past 17 years. Moreover, they employ 43 percent of all high-tech workers (e.g. scientists, engineers, computer programmers; SBA Offi ce of Advocacy, 2011). Across the non-fi nancial business sector in the EU, SMEs comprised 99.8 percent of all enterprises (European Commission, 2010). Of these SMEs, 91.8 percent are classifi ed as micro, and 6.9 percent are classifi ed as small. These fi gures are very consistent across EU countries: that is, SMEs comprise over 99 percent of all enterprises in every EU country (European Commission, 2010). Across the EU, these SMEs employ 67.4 percent of all employees (with 30 percent being employed by micro enterprises; 20.1 percent by small; and 17 percent by medium sized; European Commission, 2010). There was, however, some variation in terms of the number of

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workers employed, SMEs in some countries employed fewer employees (e.g. SMEs in the UK employ 54.8 percent of all employees; European Commission, 2009c), whereas SMEs in other countries employed more employees (e.g. SMEs in Spain and Greece employ almost 80 percent and 87 percent, respectively, of all workers; European Commission, 2009a, 2009b). Given the ubiquitous nature of SMEs, the fi nancial impact they have on the economy, and the large proportion of employees they employ, it is important to examine whether SMEs are faced with the same healthy workplace issues, and the extent to which they have incorporated healthy workplace initiatives into their businesses.

HEALTHY WORKPLACE COMPONENTS IN SMALL AND MEDIUM SIZED ENTERPRISES

Are the components used in general conceptualizations of healthy workplaces refl ected in the workplaces of SMEs? Some research suggests certain organizational practices may be eff ective for all organizations. For example, Delery and Doty (1996) found a universal eff ect across organizations (regardless of size) for three initiatives that they labeled as healthy workplace practices (i.e. profi t sharing, results-oriented appraisals and employment security). That is, these specifi c practices may be universal and valued by all employees; hence they are eff ective both in SMEs as well as larger organizations. However, there may be diff erences not only in the outcomes of healthy workplace initiatives, but also the frequency and types of initiatives off ered in large and small businesses. For example, compared to larger worksites, smaller worksites were half as likely to off er health promotion programs to employees, and ‘the breadth and depth of programs is generally less than what is found at larger worksites’ (Wilson et al., 1999, p. 364). Randell et al. (2010) found that compared to smaller organizations, larger organizations reported off ering more formal psychologically healthy workplace practices. Based on the integrative literature on healthy workplaces, I will use Kelloway and Day’s (2005a) healthy workplace model as an organizing framework for examining the healthy workplace components in SMEs: (1) health and safety; (2) culture of support and respect; (3) positive interpersonal relationships; (4) employee involvement and development; (5); work content; and (6) work–life balance. Within this framework, I will focus on organizational characteristics that may lend themselves to special consideration in terms of the implementation and eff ectiveness of healthy workplace initiatives in SMEs. Some of these characteristics may aid the

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development and promotion of healthy workplaces (cf. Meggeneder, 2007), and other characteristics may create challenges for SMEs in their striving for healthy workplaces (cf. Champoux and Brun, 2003).

Health and Safety in the Work Environment

Part of the defi nition of healthy workplaces involves the extent to which organizations engage in initiatives aimed at health and safety. Champoux and Brun (2003) noted that there is relatively little research pertaining to small businesses in North America, particularly with attention to Occupational Health and Safety (OHS), although more work has been done in Europe. There have been many arguments made about how SMEs may have unique health and safety issues. Some of the issues may be due to the organizational characteristics and some may be due to employee characteristics. For example, compared to large organizations, SMEs may have a higher proportion of employee illness and injuries (Marsh, 1994; Rutsohn et al., 1981), and may be less likely to report injuries (Champoux and Brun, 2003). It also has been suggested that SMEs have a large number of employees who may be at a greater risk of injury because of a lack of experience and bargaining power (e.g. younger and non-unionized workers; Eakin and MacEachen, 1998; Sutcliff e and Kitay, 1988). Because of the smaller number of employees (and, thus, the potential for much fewer accidents than larger organizations), SMEs may not focus on OHS to the same extent as larger organizations (Champoux and Brun, 2003). These factors may make development of a safe environment more challenging. Patterson et al. (2005) argued that employees working in SMEs may be at a greater risk for substance abuse and accidents for many reasons: SMEs may have fewer resources, be less likely to communicate OHS- related information, have less human resource development, and be reluctant to seek outside advice (Eakin, 1992). For example, employees in small businesses were less likely to know about smoking restrictions and were more reluctant to intervene in their co-workers smoking (Ashley et al., 1997). To exacerbate this situation further, many of the SMEs may not have adequate OHS governance, and they are exempt from some of the OHS regulations and legislation (Eakin and MacEachen, 1998). Finally, many of these regulations are not tailored to address the unique needs (as well as the unique demands and challenges) of SMEs (Eakin and MacEachen, 1998). Champoux and Brun (2003) argued that some OHS legislation may not apply to small organizations, or may apply diff erently to them, and, in some situations, the legislation may not provide any incentive for small

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fi rms to focus on the management of the OHS systems and practices. Harms-Ringdahl et al. (2000) reviewed a 1995 OECD report indicating that SMEs may not have the ‘same access to information, expertise, and other resources related to chemical safety’ that is typically available to larger organizations. Champoux and Brun (2003) echoed this concern about the lack of resources with respect to OHS, arguing that ‘small fi rms have serious problems aggravated by limited access to human, economic, and technological resources’ (p. 301). However, this commonly held assumption has been challenged. For example, in their descriptive overview of 136 small process plants from fi ve countries (Finland, Germany, Italy, Sweden and the UK), Harms-Ringdahl et al. (2000) found that many of the plants reported fewer problems than was expected, suggesting that ‘the average stereo- type of small enterprises and small process plants seems not to generally be true’ (p. 79). Approximately 66 percent of the small process plants in the study indicated that they had suffi cient resources to deal with health and safety issues. However, many of the organizations reported that they thought it was impossible for small businesses (and process plants in particular) to be knowledgeable about and comply with all of the legislation. Harms-Ringdahl et al. (2000) concluded that even though there may be a small percentage of fi rms facing problems, this percentage represents a large number of fi rms and ‘may constitute an unacceptable risk’ (p. 71). Clearly, more research is needed to reconcile some of the claims in this area. Allied to this OHS-related literature is the literature on the health promotion initiatives in SMEs. For example, Sorensen et al. (2005) examined the extent to which a cancer prevention intervention improved health-related behavior of employees in small manufacturing businesses. There was a signifi cant interaction between the intervention and control groups for vitamin use as well as in physical activity, but only when poverty status was statistically controlled. Patterson, Bennett and Wiitala (2005) conducted an intervention study of small businesses in high-risk industries, and examined the eff ectiveness of two intervention programs aimed at helping workers improve their positive relaxation and unwinding behaviors and reduce their negative unwinding behaviors (e.g. consum- ing alcohol and drugs). Their four-hour team awareness training, which involved activities aimed at fostering communication, helping behaviors, and peer referral skills, increased the use of positive unwinding behaviors. Their tailored program, involving a needs assessment of each business, discussion, videos, lectures and goal setting, had a small eff ect on positive unwinding behaviors, but only when background factors were controlled. It also was associated with decreased use of over-the-counter drugs

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for women (Patterson et al., 2005). In their review of health promotion initiatives, Eakin and Weir (1995) concluded that implementation of these initiatives in small organizations is fragmented, and there is a great need to integrate both occupational and lifestyle issues into a more holistic model. This conclusion can be applied to the whole area of health and safety. What types of health and safety initiatives are off ered in SMEs? Wilson et al. (1999) found that the most common health programs in American organizations with 15 to 99 employees were those pertaining to OHS, prevention of back injury, and CPR training. Interestingly, the rate of health insurance coverage was only slightly higher in large organizations compared to SMEs (Wilson et al., 1999). However, Wilson et al. (1999) argued that because the majority of small businesses have fewer than 15 employees, their study does not provide any insight into these types of workplaces. Similarly, other surveys have indicated that employees in small fi rms are still less likely to be insured (Kaiser Family Foundation and the Health Research and Educational Trust, 2010) In a study of Japanese small-scale enterprises, 90 percent of enterprises under 50 employees conducted health examinations of their employees, but only 17 percent of them off ered exercise programs, and even fewer off ered information on smoking, health guidance, and nutritional education (12 percent, 11 percent, and 6 percent, respectively; Muto et al., 1999). Most of the large organizations (95 percent) conducted health examinations as well. However, in contrast to small enterprises, most large organizations also off ered exercise programs (80 percent) and health guidance (64 percent). Whereas only 0.7 percent of small enterprises off ered any mental health programs, 20 percent of larger organizations off ered these types of programs (Muto et al., 1999).

A Culture of Support, Respect and Fairness

Regardless of the size of the organization, healthy workplace practices must be consistent with organizational values in order to be eff ective (e.g. Fitz-enz, 1993; Grawitch et al., 2006). For example, providing healthy workplace initiatives without both the explicit and implicit support for them is not eff ective (Grawitch et al., 2006). We may expect this issue to be even more critical in smaller organizations in which the organization’s values (i.e. the ‘owner’s’ values) may be more apparent, and the perceived negative ramifi cations of deviating from these values may be more tangible. That is, the impact of leadership factors, in terms of style and values, may have a greater, or more immediate, eff ect on employees of smaller versus larger organizations, simply in terms of logistics: it is easier to

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communicate when you have a smaller workforce and a smaller span of control. Based on the assumption that accumulating valued components makes a workplace a desirable and healthy place to work, Szamosi (2006) examined the organizational factors in SMEs that were valued by a sample of 55 university students. Several factors relating to a supportive and respect- ful culture (i.e. empowerment and respect, concern for employee welfare and supportive management) were among the most valued components in SMEs (Szamosi, 2006). As noted by Meggeneder (2007), ‘in a small company, the whole company culture, including the management styles, is dominated by the owner’, and thus the owner’s management style can ‘determine the chances of successfully introducing workplace health promotion’ (p. 101). That is, unlike large organizations in which initiatives can be introduced even without complete management support, the success of any approach rests solely on the head of the SME (Meggeneder, 2007). In SMEs, however, there is a greater likelihood that the employer and employees are often engaged in the same (or similar) tasks and have similar working conditions (Meggeneder, 2007). Therefore, leaders of SMEs may have a greater understanding of the work, and greater empathy for the employees doing the work, and may be more willing to ensure positive working conditions. Similarly, having a more personalized work relationship, as is evident in small businesses, such that an employee is ‘treated as a person’ (Eakin and MacEachen, 1998, p. 901) can be benefi cial in creating a healthy environment.

Interpersonal Relationships

Tied closely to the aspect of a supportive culture is the quality of interpersonal relationships. Positive relationships with colleagues, as well as with employers, may be even more important in small businesses, in which the small numbers and proximity of working relationships may amplify the positive and negative outcomes. That is, we may expect one of two eff ects: on the one hand, because of the lower degree of polarization between the interests of the employer and the employees, employers may have a greater interest in and insight into the needs of the employees, and thus enable the implementation and success of healthy workplaces (Eakin and MacEachen, 1998). On the other hand, more interpersonal confl ict may arise in a small business because of the increased familiarity and increased interaction time, both of which may create increased workplace tension, and a less healthy workplace. Luckily for small businesses, some research has indicated that the trend

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is towards positive eff ects: for example, over 60 percent of employees in small Canadian fi rms reported they completely trusted their employer, in contrast to about 30 percent of employees in large businesses (and only 20 percent in public sector organizations; Goldfarb Consultants, 1999). Over 60 percent of these employees in small businesses also indicated they were very satisfi ed with the relationships among employees; over 50 percent were very satisfi ed with the manager–employee relationship; and over 40 percent were very satisfi ed with the quality of decision making. Conversely, only about 50 percent of employees in large organizations were satisfi ed with the relationships among employees; approximately 30 percent were very satisfi ed with the manager–employee relationship; and less than 20 percent were very satisfi ed with the quality of decision making (Goldfarb Consultants, 1999). Obviously, developing high quality relationships is much more complex than simply a function of the number of employees in a business. The business culture and interpersonal style of the leader will have a substantial impact on the degree to which social interactions are positive. Eff ective communication is an essential aspect of high-quality relationships at work. Typically, as size increases, so does the formality of communication, the number of communication channels, and the greater hierarchical structure of communication. Meggeneder (2007) argued that communication channels in SMEs should be good, because SMEs have a fl atter organizational structure that ‘enables participation, the essential requirement for [workplace health promotion]’ (p. 101). Given this fl at structure, better communication, the fact that employees may have high levels of autonomy (Meggeneder, 2007), and the role that communication is theorized to play in healthy workplaces, these aspects of SMEs may impact not only the need for various communication strategies, but the overall eff ectiveness of the initiatives. In fact, Randell et al. (2010) found that smaller organizations tended to rate themselves as having more positive communication than did larger organizations. This fl atter structure also allows for more direct interaction and feedback for employees: although SMEs may use more informal means of recognition, this type of recognition tends to be as eff ective as more formal initiatives.

Employee Involvement and Development

Based on data from their student sample, being able to be involved in the organization was among the top organizational factors that were valued in SMEs (Szamosi, 2006). Pohlmann and Dulipovici (2004) found that 34 percent of Canadian business owners in their study looked towards employee suggestions for developing workplace practices, and 16 percent

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indicated they had formal consultations with their employees to help develop practices. Similarly, because employees in small businesses may, out of necessity, be involved in multiple aspects of the business (e.g. marketing, administration), there is great potential for these types of organizations to provide positive learning and development opportunities. In fact, almost 80 percent of employees in Canadian small businesses indicated that they were very or somewhat satisfi ed with their training opportunities, and over 90 percent were very or somewhat satisfi ed with their level and range of responsibilities (Goldfarb Consultants, 1999). However, the same small environment that promotes learning multiple tasks and roles, also may restrict or preclude promotions and growth due to the lack of opportunities for upward advancement.

Work Content and Characteristics

A core part of the Kelloway and Day (2005a) model is the quality of work and job characteristics. Although work content in small businesses may not diff er from larger ones in the same industry, several characteristics of the job and work may diff er based on organizational size. For example, Meggeneder (2007) argued that employees in SMEs may have high autonomy. Because autonomy has been associated with positive outcomes (e.g. a increased sense of mastery; Parker and Sprigg, 1999), SMEs may have a natural advantage in creating this aspect of a healthy workplace. By defi nition, smaller organizations have fewer economic and personnel resources to put towards developing and maintaining healthy workplace initiatives. Meggeneder (2007) noted that time and fi nancial resources are barriers to workplace health promotion activities. Although this lack of resources may seem to be a barrier for SMEs to implement healthy workplace practices, there are many initiatives and organizational changes that are cheap, easy to implement and eff ective. As noted by Kevin Kelloway in his address to delegates at the Nova Scotia Psychologically Healthy Workplace Conference, it costs nothing to treat people with respect. Therefore, although SMEs may have fewer expensive and formal initiatives, they may be equally able (or even more able) to ‘implement’ informal policies and practices. However, even though smaller businesses may have access to fewer resources, the employees may have more control over the resources they do have. Moreover, compared to larger organizations, smaller organizations tend to rate themselves as providing employees with more control over their work (Randell et al., 2010). Both of these job control factors have been associated with positive worker outcomes (e.g. Day and Jreige, 2002; Dwyer and Ganster, 1991; Randell et al., 2010). Employees in SMEs

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may also experience issues pertaining to role confl ict, overload and fl exibility. Because of their relevance to work–life balance, these job characteristics are presented in the section below.

Work–Life Balance

A central key to managing work and life commitments is having a degree of autonomy and control over work activities and having fl exibility at work. In terms of SMEs, we may expect one of two eff ects: SMEs may have greater fl exibility because of the lack of formal policies, allowing employees to better integrate their work and non-work activities and responsibilities. Conversely, we may expect that, because of the smaller size of the organization and the criticality of each individual employee, SMEs may allow less fl exibility (and perhaps discourage time off ) because of the impact that absences and variations in scheduling can have on business performance. That is, SMEs, especially very small businesses, ‘may have more fl exibility than larger ones in providing diff erent options to their employees, but they may also be more rigid due to the size and demands of their operation’ (Pohlmann and Dulipovici, 2004, p. 4). In a survey of 10 699 business owners in Canada, about 40 percent indicated that owning a business allowed them to balance their personal and work activities more easily (Pohlmann and Dulipovici, 2004). Moreover, they indicated that they off ered many fl exibility-related initiatives to their employees: 74 percent of them off ered time off to deal with personal issues, 57 percent off ered fl exible work schedules, and 46 percent off ered fl exibility for child-related issues. Similarly, a little less than half of them off ered time off or compensation for working extra hours. Finally, 21 percent off ered a reduction in work time and 15 percent off ered their employees the opportunity to work a compressed work week (Pohlmann and Dulipovici, 2004). Interestingly, much of the fl exibility off ered in small businesses is not formalized, but off ered as needed on a case-by-case basis (Pohlmann and Dulipovici, 2004). Therefore, the boundary between work and non-work may become blurred in smaller, more fl exible businesses. This permeability may be even greater in family-run businesses, where there may be little or no distinction between work and home activities.

FAMILY BUSINESSES: A SPECIAL CASE OF SMALL AND MEDIUM SIZES ENTERPRISES

Family-run businesses can be defi ned in terms of a business where both the owner and at least one other family member work, and in which the

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family owner aims to pass the business on to their family members (Ward, 1987). Family businesses make up a large proportion of all businesses (Shanker and Astrachan, 1996).These businesses may experience unique problems, benefi ts, and challenges (Beehr et al., 1997), many of which are related to healthy workplace components. Beehr et al. (1997) argued that family businesses may be susceptible to inter-role confl ict (i.e. confl icting demands from diff erent life roles). Consequently, work–life balance may be more diffi cult to achieve for members in family businesses because work may infl uence non-work roles (Beehr et al., 1997). It is more diffi cult to disentangle the work and family domains, and there is great pressure to succeed at the business. If people are spending both their work and home time together, confl ict may arise or be exacerbated, as it may not be possible to avoid the other family members even while at work (Beehr et al., 1997). Interestingly, Beehr et al. (1997) argued that time-based confl ict in family businesses may not be as much of an issue as in larger, non-family businesses because there are diff erent expectations for work and there is more understanding and fl exibility in both roles. That is, balance may be better in family-run businesses because of the fl uidity of the boundaries, thus allowing workers to have greater fl exibility during normal working hours. It may be easier to develop healthy workplaces in family businesses, because members are more dedicated to the organization, and realize that the fundamental aspects of communication and respect are integral to healthy people and to a productive organization.

HEALTHY WORKPLACES AS A COMPETITIVE ADVANTAGE IN SMALL AND MEDIUM SIZED ENTERPRISES

It has been argued that promoting and sustaining a healthy workplace would result not only in positive attitudes of current employees, but also a favorable reputation among customers and potential applicants. This competitive advantage may be even more important for SMEs, who may not be able to compete in off ering other fi nancial benefi ts available in larger organizations. In as much as applicants are ‘seeking equivalent values and satisfaction outcomes from SMEs . . . [and seeking] very caring, environmentally concerned, and sensitive SMEs’ (Szamosi, 2006, p. 654), it could be argued that having a healthy workplace would be a competitive advantage in the recruitment of new employees in SMEs. In fact, in a telephone poll of 1003 Canadian employees and business owners, 44 percent of employees working in small businesses were very satisfi ed with their

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jobs, compared to 38 percent in medium sized businesses, and 40 percent in large businesses (Goldfarb Consultants, 1999). Employees working in small businesses were most satisfi ed with the fl exibility off ered, the quality of the relationships among employees and with managers, their level of service and product quality, and work ethic and hours. Conversely, employees in large businesses were most satisfi ed with their benefi ts, time off , and service and product quality. Similarly to small business employees, employees in large businesses were satisfi ed with relationships with their colleagues, but satisfaction with the quality of communication and relationships with managers was very low on their list (Goldfarb Consultants, 1999). The fact that small businesses are not able to provide employees with more tangible benefi ts was refl ected in the satisfaction results: employees were less satisfi ed with their salary, benefi ts, job security and personal growth opportunities. Interestingly, employees in medium sized businesses were most satisfi ed with the fl exibility of the workplace to address their personal needs (although to a lesser degree than employees in small businesses), but they rated relationships and communication with managers as being much lower (Goldfarb Consultants, 1999). These results emphasize the fact that not only do SMEs diff er from large enterprises, there are diff erences between small and medium sized businesses, which should be examined more closely.

DISCUSSION

The concept of a healthy workplace must encompass more than a simple absence of ill health and accidents, but must also include work factors that foster positive employee outcomes (e.g. engagement; attitudinal and behavioral outcomes) and positive organizational outcomes (e.g. fi nancial performance). This concept follows recent defi nitions of worker health, which, as Kelloway and Day (2005a) argued, ‘must go beyond the simple absence of disorders, and must include features such as competence, mastery, autonomy, independence, aspiration, and self-esteem’ (p. 227). Future research must examine the joint impact of both positive and negative practices. Moreover, the organizational context is fundamental to future workplace health research (Grawitch et al., 2006). The organizational factors (such as structure and size) may have important ramifi cations for the eff ectiveness of such initiatives. However, despite calls to include these organizational context variables into healthy workplace research, the body of literature examining healthy workplaces in SMEs is quite small.

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Does the knowledge we have accrued while examining healthy workplaces across organizational size translate well when dealing solely with SMEs? When applying Kelloway and Day’s (2005a) model of healthy workplace components to SMEs, several characteristics of SMEs were highlighted as important to healthy workplaces, in terms of either their benefi cial or detrimental impact to workplace health. For example, potential SME employees view having supportive leaders (and thus, a supportive culture) positively (Szamosi, 2006), and these types of leaders are integral to the success of any workplace health initiative (Grawitch et al., 2006). In fact, as concluded in a study of Canadian businesses, the ‘top fi ve most important factors that infl uence workplace satisfaction . . . have more to do with interpersonal relationships . . . atmosphere at the workplace . . . and sense of personal achievement’ than with the ‘amount of time off , benefi ts, work hours and salary’ (Goldfarb Consultants, 1999). Because of the fl at organizational structure of SMEs, communication has the opportunity to be more direct, relevant, and eff ective, not only enabling the successful implementation of healthy workplace activities, but also directly improving employee well-being. The quality of relationships, both with one’s supervisor and co-workers, may have a greater impact on employees in SMEs. That is, when interpersonal relationships are positive, employees may have an even higher degree of well-being; however, if interpersonal relationships are poor, because of the diffi culty in avoiding other workers or supervisors in a small business, the negative eff ects of these poor interactions on employee health and well-being may be exacerbated. Although there has been much written on OHS in SMEs, more quantitative work must be conducted to test many of the commonly held assumptions about SMEs and their access to OHS information and their potential safety hazards. One study challenged the assumption that SMEs have more health and safety problems, and found that two-thirds of the small process plants it surveyed reported they had suffi cient resources to deal with health and safety issues (Harms-Ringdahl et al., 2000). However, SMEs can’t be expected to keep up with all of the health and safety information (Harms-Ringdahl et al., 2000), and employees in small fi rms are still less likely to be insured (Kaiser Family Foundation and the Health Research and Educational Trust, 2010). Some work has been done in the area of health promotion in SMEs, demonstrating the eff ectiveness of some programs, but there has not been any systematic evaluation of such programs across SMEs. About one third of SMEs tend to involve their employees in decision making (Pohlmann and Dulipovici, 2004), and this practice is viewed as a valued feature in SMEs (Szamosi, 2006). SMEs may be able to provide

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their employees with greater autonomy and control over specifi c aspects of their job; both of these work characteristics have been shown to have a positive impact on employee health and well-being. Finally, perhaps some of the greatest benefi ts (and competitive advantages) of SMEs lie in their ability to be fl exible and accommodate individual employees. SMEs tend to off er many fl exibility-related initiatives to their employees (Pohlmann and Dulipovici, 2004), and employees in small businesses tend to be very satisfi ed with the fl exibility off ered (Goldfarb Consultants, 1999). Overall, more research is needed to identify and integrate all of these fundamental components of healthy workplaces, as well as to examine the eff ectiveness of related healthy workplace programs.

CONCLUDING REMARKS

When examined individually, there has been relatively consistent evidence that many of the components of healthy workplaces are associated with better employee health and organizational functioning. The few studies that have examined more comprehensive healthy workplace models provide some preliminary support that initiatives may have a positive eff ect not only on individual employees, but also on organizational functioning. However, the literature dealing with these types of healthy workplace models is somewhat sparse, especially when considered in the context of SMEs. Two main premises have emerged pertaining to healthy workplace components in SMEs. First, initiatives that have been identifi ed as being ‘eff ective’ in larger organizations may not be feasible in SMEs in terms of cost, time or scope, and they may have limited applicability or relevance to employees in SMEs. Second, SMEs may experience unique demands, challenges and resources, which would infl uence their need for, and usage and eff ectiveness of, specifi c healthy workplace initiatives. Although this eff ect on healthy workplace initiatives has been assumed to be negative (e.g. due to a lack of resources), it is important to recognize that SMEs are in an enviable position to provide to their employees many healthy workplace supports and opportunities (e.g. fl exibility, control) that are not feasible in larger organizations. Thus, there is a need for a more systematic examination of the workplace factors that infl uence both employee health and organizational productivity in all sizes of organizations. The combination of the lack of research on comprehensive models of healthy workplaces, the general lack of attention given to SMEs, the economic importance of SMEs, and the premise that SMEs have unique needs and environments suggests that the area of healthy workplaces in SMEs is ripe for future research.

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absence costs 82–84, 90, 93, 114, 131, Barling, J. 20, 48, 49, 60, 62, 63, 129, 167 131, 132, 135, 141, 147–148, absenteeism 82–83, 90, 107, 122, 159–160, 167 131–132, 167, 177 Baum, J. 118, 120 see also absence costs; absenteeism Beehr, T.A. 178 reduction; presenteeism Berdahl, J.L. 130, 131, 132 absenteeism reduction 86, 93, 94, 97, Black, C. 81, 82, 87 100, 102, 166 ‘black sheep eff ect’ 146 accidents and injuries 7–8, 13, 14, 15, Bowes-Sperry, L. 138, 139, 145 16–17, 26, 69, 167, 171 Bradley, D.E. 90, 119, 120 see also fatalities; incident Brough, P. 108, 109, 110–111, 112, 113, investigation; incident 114, 116 reporting; physical assaults; Brun, J.-P. 9, 14, 15, 16, 17, 18, serious injuries 171–172 achievement 90, 119, 120, 165, 180 Bureau of Labor Statistics (BLS) age 56, 71 (USA) 26, 54, 70, 75 aggression 49 bureaucratic organizational culture see also workplace aggression 33, 34 agricultural sector 17–18, 69, business case, health and stress 70–71 management in SMEs 82–84, 86, see also farm stressors; suicide 87, 94, 97, 98, 102 and suicide attempts in the bystander intervention, sexual agricultural sector harassment 138–140, 144–147 Ahmed, G.M. 73–74 bystanders to sexual harassment American Psychological Association 135 (APA) 162 animal handling injuries/livestock Cal OSHA framework, workplace issues 69, 72 violence 53, 54 anxiety 73, 74, 93, 111, 112, calculative organizational culture 34, 131 35 Asia 13–14, 16–17, 29–30, 31, 106, Canada 173 accidents and injuries in the assertive target coping, sexual construction industry 7 harassment 137 health and safety legislation and Australia 58, 70, 72, 116 regulations 1 authoritarianism, in family business healthy workplaces 175–176, 177, culture 141 178–179, 180 avoidance-denial target coping, sexual micro-businesses and small harassment 137, 143 companies 2, 169 awareness 14, 19, 87, 88, 95, 96, 97–98, non-fatal workplace injuries 26 99, 102 organizational factors in high versus

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low accident companies 10, 30, competitive advantage of healthy 31 workplaces for SMEs 178–179, safety climate 13 181 sexual harassment legislation 133 compressed work weeks 115, 122, 177 workplace violence and workplace Confederation of British Industry violence interventions 52–53, (CBI) 82–83, 86, 90, 93, 94, 96, 54, 58 100 see also small construction construction industry 7–8, 16–17 companies’ safety management see also small construction study companies’ safety management cash handling policies 59 study Castillo, D.N. 54, 57 Cooper, C.L. 81, 85, 119, 129, 160, 167 Certifi cate of Recognition (COR) 36, corporate social responsibility 164 37, 43 Cortina, L.M. 130, 131, 135, 137 Champoux, D. 9, 14, 15, 16, 17, 18, cost–benefi t analysis 87, 116 171–172 see also absence costs; employee Chartered Institute of Personnel benefi ts; family benefi ts; Development (CIPD) (UK) 82, fi nancial costs; litigation and 97, 100, 102 legal costs; organizational chemical hazards 8, 69, 71, 73–74, benefi ts; suicide costs 172 counselling 84, 86, 98 Chen, P.Y. 73, 75 Crime Prevention Through Chew, D.C.E. 28, 29–30, 31, 41 Environmental Design (CPTED) children, responsibility for 110, 111, 57–60, 61 177 criminal activity 53, 54, 57 chronic organophosphate-induced customer satisfaction 161, 162, 163, neuropsychiatric disorder 164, 178 (COPIND) 73–74 customers, as workplace violence Chuang, Y. 88–89 sources 49, 53, 54 Clarke, S. 9, 11, 12, 15, 16, 18, 19, 21 Clarke, S.D. 96–97 Davies, D.R. 73–74 Cleveland, R.J. 28, 29, 31, 32, 41 Day, A.L. 161, 163–165, 166, 168, 170, clients, as workplace violence sources 176, 179, 180 49, 53, 54, 57, 60–63 dependents, responsibility for 110–111, co-worker safety 13 112, 115, 122, 177 co-workers 21, 49, 53, 54, 57, 62, 73, depression 71, 72, 73, 74, 75, 111, 131, 162, 167 167 cognitive behavioural skills training 84, depression reduction 119, 120 88, 100 Desroches, F.J. 57, 58, 59 communication 11, 29, 85, 175, 178, Dewe, P.J. 81, 84–85, 167 179 diversity policies 114, 116–117 see also health communication; Drach-Zahavy, A. 162 information and Dulipovici, A. 175–176, 177, 180, 181 communications technologies; informed culture; safety Eakin, J.M. 2, 171, 173, 174 communication; safety economic climate and recession 9, 90, communication defi cits; safety 92–94, 97 information; safety information elderly dependent relatives, defi cits responsibility for 110, 122 communities 71, 75, 164 emotional contagion 90, 112

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empathy 146, 174 employee safety training defi cits 14, employee behaviour, workplace 16–17 violence interventions 58, 59–60, employee services 113 62–3 employee training defi cits 88 employee behavioural standards employees 11–12, 13, 14, 21, 88–90, policies 61–62 110 employee benefi ts 83, 86, 107, 113–114, enjoyment, workaholics 109–110 122 entrepreneurs 110, 111, 117–121 employee commitment to safety 13–14 equipment and machinery hazards 15, employee development 114, 163, 164, 29, 69 165, 166, 175–176 equity 114 employee disengagement 83, 112 European Union 2, 106, 169–170 employee engagement 17, 83, 100, 108, 112, 164, 166, 168, 179 Fabiano, B. 7–8 employee goals 161–162 failure see health and safety failure; employee involvement in health and organizational failure; risk of safety issues organizational failure high versus low accident companies fairness 147, 162, 173–174 30, 31 family benefi ts 107, 122, 164 low injury rates in SMEs 10 family business culture 140–147 safety climate 13, 16 family businesses 69, 71, 72–73, 75, 89, safety cultural change 17, 19 177–178 small construction companies’ safety ‘family’ loyalty, in SMEs 144–147 management study 33, 39–40, family-related stress 89, 93, 111–112 41–42, 45 family role performance 107, 112 stress management in SMEs 94, 95, family roles see fathers; mothers; non- 100, 101 parents; parents; responsibility for employee involvement in dependents organizational decision making family satisfaction 112 162, 163, 164, 165, 166, 175–176, farm stressors 69, 72–73, 75–76 180–181 farms see agricultural sector; farm employee job autonomy stressors healthy workplaces 162, 165, 167, fatalities 1, 43, 69 175, 176, 177, 179, 181 see also homicide; suicide limitations in SMEs 141 fathers 111, 115 stress management 85 female employees 55–56, 110–111, 112, employee job control 87, 89, 98, 100, 116–117 164, 165, 176–177, 181 female entrepreneurs 110, 111, 118 employee job control defi cits 141, 161 female sexual harassment perpetrators employee non-involvement in health 131 and safety issues 15 female sexual harassment victims 131, employee outcomes 131, 135, 137, 137 142–143, 161–162, 163, 164, female suicide rate 70, 71 166–168, 179 fi nancial costs 82–84, 87, 93–94, 98, employee recognition 165, 166, 175 116, 122, 167 employee responsibility 2 fi nancial resource insecurity 1, 8–9, 27, employee safety behaviour 11, 13, 16, 72, 89, 90, 92–94, 118 17, 21 fi nancial resources 118 employee safety training 14, 16, 29, 30, Fitzgerald, L.F. 130–131, 132, 134, 135, 31, 33, 40, 59–60, 62–63 143

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fl exibility 19, 57, 109, 120, 141, 177, healthy workplaces 160, 161, 162, 178, 179, 181 163, 165, 171–173, 180 fl exible working high versus low accident companies entrepreneurs 120, 121 29 well being and stress management large companies 7 85, 86, 98, 99, 101 safety climate 11, 12, 15–16, 22 work–life balance 109, 114–115, 117, safety culture 17–21 122, 177, 178, 181 suicide and depression in the Flin, R. 12, 14, 15, 16, 42 agricultural sector 74–76 Flitcroft, C. 9, 15, 16, 18, 19 work–life balance 112, 113–117, 118, food services sector 53, 54, 56 121–122 formal safety practices 12 workplace violence 57–63 Francis, L. 14–15, 52 see also health communication; frustration 54, 61 health promotion; incident investigation; incident gender 55–56, 70, 71, 131, 135, 137 reporting; risk assessment; see also female employees; female safety audits and inspections; entrepreneurs; gender safety communication; harassment; gender inequality safety evaluation; safety gender harassment 130 information; safety training; gender inequality 116–117 sexual harassment policies and generative organizational culture sanctions; stress management; 33–34, 35 written health and safety Germany 106, 120–121, 172 policies Goldfarb Consultants 175, 176, 179, health and safety legislation and 180, 181 regulations 1, 27, 83, 94–96, ‘good jobs’ 98 98–99, 114, 115, 116, 171–172 Grawitch, M.J. 164–165, 166, 173, 179, health and safety personnel defi cits 9, 180 27 Greenhaus, J.H. 107, 111, 121 health and safety responsibilities 9 Guterman, N.B. 55, 56 health care sector 53, 54, 55, 56, 60, 61, 62–63, 162 Handy, J. 142 health communication 99, 101 Harms-Ringdahl, L. 169, 172, 180 health promotion 99, 160, 162, 170, Haslam, C. 82, 83, 86, 87, 96 172–173, 176, 180 Hasle, P. 8, 17, 19, 27 healthy lifestyles 160, 161, 165 hazard assessment 29, 31, 33 healthy workplaces health 83–84, 97, 98, 100, 101–102 competitive advantage in SMEs see also health promotion; ill-health; 178–179 physical health; psycho-social components in SMEs 170–177 health and well-being defi nitions 160–162 Health and Safety Executive (HSE) discussion 179–181 (UK) 94–96, 98–99, 101, 159, family businesses 177–178 167 impacts 166–168 health and safety failure 35, 36, 41, models 162–165 133, 136 Hendricks, S.A. 57, 58, 59 health and safety interventions, hierarchical supervisory style 30 practices and policies high accident companies 10, 28–32, 41 business case 82–84, 86, 87, 94, 97, high-hazard sectors 7–8, 16–17, 98, 102 172–173

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see also agricultural sector; healthy workplaces 162, 163, construction industry; off shore 174–175, 179, 180 oil industry safety cultural change 19, 20, 21 high risk of workplace violence sectors stress in SMEs 88, 89–90, 91, 92 53, 54–55, 56, 57 whistle-blowing in SMEs, eff ects of see also health care sector; home care 145–147 sector; public services sector; workplace violence reduction in retail sector; security sector small businesses 57 hindering organizational culture intimate partner violence 55, 143 113 Italy 7–8, 172 Holliday, R. 140, 141–142 home care sector 55, 60, 62 Jamal, M. 90 homicide 53, 54, 56, 57 Japan 106, 173 human resource department and policy job autonomy see employee job defi cits 2, 136–137, 139, 171 autonomy; owner-manager job human resource policies 9–10, autonomy and control 116–117, 136 job control see employee job control; see also health and safety employee job control defi cits; interventions, practices and owner-manager job autonomy and policies control; perceived job control human rights legislation 133 job dissatisfaction 112, 120, 131, 137 Hurrell, J.J. 55, 56 job insecurity 72, 92–93 job satisfaction 90, 108, 112, 113, 119, ill-health 82–84, 92, 109, 159, 167 120–121, 168, 178–179, 180 see also absenteeism; accidents Johnson, D. 83, 86, 89, 91, 92, 98 and injuries; fatalities; health; physical ill-health; psycho-social Kath, L.M. 13, 135 ill-health; stress Kelloway, E.K. 14–15, 20–21, 48, 49, incident investigation 30, 31, 33, 39–40, 52, 54, 55, 62, 129, 161, 163–165, 41–42, 45 166, 167, 168, 170, 176, 179, 180 incident reporting 7–8, 15, 18, 28, 31, Kirkwood, J. 110, 111 41, 42, 61–62 Kompier, M.A.J. 84–85 incident under-reporting 8, 60 informal culture 27, 116–117 Lamontagne, A.D. 84, 85, 86 informal human resource policies 9–10, large companies 116–117, 136 accidents and injuries 7–8 informal management style 9 fi nancial costs of ill-health 82–83 informal safety practices 12, 15, 16, healthy workplaces 170, 171, 173, 27, 176 176, 179 informal social networks 141–142, resources 118 143 safety climate 13–14, 16 information and communications safety practices 7 technologies 19, 58, 91, 109 stress management 86, 88 informed culture 18–19 work–life balance policies 115, 116, injuries see accidents and injuries; 118 fatalities; non-fatal injuries; leadership 10, 14–15, 20–21, 163–164, physical assaults; serious injuries 168, 173–174, 180 interpersonal confl ict 15, 174, 180 leadership training 20–21, 148 interpersonal relationships LeBlanc, M.M. 49, 54, 55, 58, 143 blurred boundaries in SMEs 142 Leseleuc, S. 52–53, 54

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Levin, P.F. 56, 61, 62 mental health problems see anxiety; litigation and legal costs 82, 83, depression; psycho-social ill- 131–132, 133 health; stress long working hours 69, 90, 93, Miceli, M.P. 109, 144, 145 108–111, 120, 121 micro businesses 1–2, 106, 169 low accident companies 10, 28–32, 41 middle managers 11–12, 100 Lupton, B. 116–117, 134 monitoring, stress management in Luria, G. 11–12 SMEs 99, 100 morale 83, 94, 97, 100, 112 MacEachen, E. 1, 3, 27, 171, 174 morality 83, 98, 99, 144–147 Malamut, A.B. 137, 147, 148, 242–243 Morrow, S.L. 13 male employees 55–56 mothers 110–111, 112, 115 male sexual harassment perpetrators Mullen, J.E. 14, 20–21 131, 135 multiple roles 2, 9, 89, 91, 107, 176 male sexual harassment victims 131 male suicide rate 70, 71 National Institute for Occupational Malik, F. 114, 115, 122 Safety and Health (NIOSH) Management Standards (HSE, UK) (USA) 1, 28–29, 31, 32, 54, 57, 61, 95–96, 101 62, 69, 75, 159 manager commitment to health and National Quality Institute (NQI) safety 12, 13–15, 99 (Canada) 161–162 manager health and safety training 29, Near, J.P. 144, 145 31, 33, 40, 97, 98, 100 New Zealand 70, 106–107, 110, 111, manager involvement in safety 112, 116 inspections 28, 31, 33, 40, 42, 45 night/evening working 55, 58, 62 manager involvement in safety non-awareness of sexual harassment practices 29, 31 133 manager non-commitment to health non-fatal injuries 26, 69 and safety 10, 15 non-organizational members 49, 53, manager performance evaluation 33, 40 54, 57, 60–63, 112 manager responsibility for stress risk non-parents 115, 122 assessment 94–96 non-physical aggression 48, 49 manager support 13–14, 99 non-responsibility for accidents and manager support defi cits 87 injuries, of owner-managers 17 managers 118 non-work situations, sexual harassment see also middle managers; owner- 142–143 managers; senior managers; NorthWest Public Health Observatory supervisors; top management (NWPHO) 83, 86, 93, 94, 97, 99 commitment to health and Norway 14, 21 safety Nova Scotia Construction Safety Marchand, A. 28, 30, 31, 37 Association (NSCSA) 36–38, 39 Marmot, M. 94, 98 Nova Scotia Stress survey 52 Marques, J.M. 146 nurture sexual harassment theory 132 Martin, A. 84, 87, 88, 90, 92, 100 maternity leave 116 Occupational Safety and Health Maxwell, G. 114 Administration (OSHA) 54, 57, Mayhew, C. 3, 56, 57, 58, 59 58, 59, 60, 61, 62, 75 McVittie, D. 7 O’Driscoll, M.P. 109, 110, 111, 112, medium-sized companies 106, 169, 179 113, 114, 116 Meggeneder, O. 169, 171, 174, 175, 176 OECD 106, 107, 172

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Off erman, L.R. 137, 142–143, 147, defi nition 117 148, 161 health and safety responsibilities 9 off shore oil industry 14, 21 healthy workplaces 173, 174, 175, older employees 56, 71 177–179 O’Leary-Kelly, A.M. 138, 139, 143, 145 non-responsibility for accidents and organization-focused stress injuries 17 management 85–86, 97 stress 89–92, 93, 98, 100 organizational benefi ts 83, 86, 87, 98, stress management 94–95, 97, 98–99, 107, 121–122 100–101 organizational climate 162 work–life balance/imbalance 110, see also perceived safety climate; 117–121, 177 safety climate; sexual owner-managers non-commitment to harassment climate health and safety 2–3, 8–9 organizational culture 33–35, 85, 99, 100, 101, 113, 114, 116–117 Packham, C. 96 see also family business culture; paid parental leave 114, 116 informal culture; informed Parasuraman, S. 111, 118, 119, 120 culture; safety culture; parental leave 114, 116, 122 supportive organizational parents 110–111, 112, 115 culture part-time work 114, 115, 122, 177 organizational development initiatives participatory supervisory style 30 114 passive leadership style 14, 15, 20 organizational factors 10, 11–12, paternal leave 115 26–32, 41, 61–62, 132–134 pathological organizational culture 33, see also organizational climate; 34, 35 organizational culture; Patterson, C.R. 171, 172–173 organizational goals; pay reduction 92–93 organizational size; small Peek-Asa, C. 50, 54, 57, 58, 60 construction companies’ safety perceived job control 62, 122–123 management study perceived organizational tolerance organizational failure 34, 117, 120 of sexual harassment 135, 138, organizational goals 11, 14–15, 161, 139–140 162 perceived risk management 18 organizational outcomes 161, 162, 163, perceived safety climate 11, 12, 13, 14, 164, 167, 168, 179 15, 21 organizational performance 137, 161, person-centred stress management 162, 163, 164, 168, 181 84–85, 86, 97 organizational size 7–8, 15–16, 148, 176 personality traits, entrepreneurs versus see also large companies; medium- managers 118–119 sized companies; micro pesticides 69, 71, 73–74 businesses; small and medium- physical assaults 48, 49, 51, 52, 53, 55, sized enterprises (SMEs); small 56, 60 companies see also homicide; threats of physical organizational tolerance of sexual assaults; weapons harassment 135, 137 physical health 120–121, 160, 161, 163, organophosphate pesticides 73–74 164, 165 owner-manager job autonomy and physical ill-health 71, 72, 75, 111, 120, control 3, 90, 110, 120–121, 136 167, 171 owner-managers Pohlmann, C. 175–176, 177, 180, 181

attitude to work–life balance 113 positive emotions 112

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positive working culture 99, 100, 101 resource instability power perspective on sexual owner-manager non-commitment to harassment 132 health and safety 2, 9 power perspective on whistle-blowing small companies 118 145 SMEs 129, 171, 172, 176, 181 presenteeism 82, 83, 90, 93 stress management defi cits 87 preventative measures, safety climate work–life imbalance 114 14, 15, 16 workplace violence in small proactive organizational culture 34, businesses 57 35 see also fi nancial resource insecurity; production versus safety 11, 14–15 human resource department productivity 161 and policy defi cits productivity reduction 131, 137 resources 95–96, 97, 100, 101–102, 118, Prottas, D.J. 110, 111 172, 180 psycho-social health and well-being respect 161, 162, 163, 165, 173–174, business case for 82–84, 86, 87, 94, 176, 178 97, 98, 102 responsibility for accidents and entrepreneurs 118–121 injuries, attribution 17 healthy workplaces 161, 162, 163, responsibility for dependents 110–111, 164–165, 167–168, 170 112, 115, 122, 177 resources 101–102 responsibility for employees 90, 92, 93 work–life balance 107–108, 109, responsibility for stress risk assessment 111–112, 122 94–96 psycho-social ill-health responsibility of bystanders 139, 140, entrepreneurs 120 145 fi nancial costs in the UK 82 retail sector 54, 56, 58–59 owner-manager stress in SMEs retention 114, 116 92 rewards for safety eff orts 30, 31 sexual harassment 131, 142 risk acceptance 18 suicide in the agricultural sector 71, risk assessment 15, 16, 18–19, 94–96, 72, 73–74, 75 99, 100 unhealthy workplaces 161, 167 risk awareness 14, 19 psycho-social working conditions in risk factors 7, 8, 12, 16–17, 54–56, 57, SMEs 95, 96 71–74, 75–76, 171 psychological aggression 48, 49, 131 risk management 16–17, 18 public, members of 49, 53, 54 risk management defi cits 9–10 public services sector 53, 54, 55, 60 risk of organizational failure 90, 93 see also health care sector; home care robbery 53, 54, 57, 58, 59–60 sector; security sector Roberts, J.A. 90, 119, 120 role boundary blurring 141–143 race, suicide risk 71 role confl ict 15, 72, 88, 111, 167, 177, Ram, M. 140, 141–142 178 Randell, K. 166, 170, 175, 176 roles see family role performance; reactive organizational culture 34, 35 multiple roles; role boundary Reason, J.T. 11, 18, 19, 34–35 blurring; role confl ict; work role recruitment 114, 141–142, 143 performance relaxation techniques 84, 86, 98, 172–173 safety audits and inspections 28, 29, research defi cits, health and safety in 30 SMEs 3, 7, 148, 181 safety audits and inspections defi cits 27

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safety climate 11–17, 21 Scotland 114 see also perceived safety climate; security sector 54, 55, 60 sexual harassment climate self-concept 92 safety communication self-employed workers 110, 111 high versus low accident companies see also entrepreneurs; owner- 28, 29, 31 managers safety climate 13, 14, 15, 16 self-training 100 safety cultural change 19 Semmer, N.K. 84, 85, 86, 87, 88 small construction companies’ safety senior management commitment to management study 33, 40, 42, safety 11, 12, 14, 29, 147–148 44–45 senior management non-commitment safety communication defi cits 9, 171 to safety 11 safety culture 10–11, 17–21 senior managers 9, 10–12 safety evaluation 29, 30, 31 serious injuries 43 safety experience defi cits 8, 11 services 53, 54, 57 safety in small and medium sized see also employee services; food enterprises services sector; public services challenges: implications for the sector; retail sector; security safety climate 13–17 sector; taxi drivers obstacles and challenges 8–10 sexual assaults 53, 56 potential solutions: development of sexual coercion 131 safety culture 17–21 sexual harassment versus production 11, 14–15 defi nitions 130–131 safety culture and safety climate impacts 131, 135, 137, 142–143 10–13 incidence 131 safety information 19 recommendations 147–8 safety information defi cits 9, 11, 171, sexual harassment climate 134–140 172, 180 in SMEs 132–134, 135–140 safety interventions, practices and theories 132 policies see health and safety workforce composition of SMEs interventions, practices and 140–147 policies in workplace aggression defi nitions safety knowledge 17 49 safety knowledge defi cits 2, 8, 9, 11, 14, sexual harassment climate 134–140 27, 172 sexual harassment legislation 133 safety leadership 20–21 sexual harassment policies and safety maturity models 33–35 sanctions 133, 135, 137, 138, safety training 14, 16, 17, 27, 29, 30, 31 147–148 see also employee safety training; sexual harassment policy and sanction manager health and safety defi cits 133, 136–137, 138 training; safety training defi cits; sexual harassment reporting 137 Stress Management Training Shafai-Sahrai, Y. 28, 31 (SMT); supervisor safety shift-work 114, 115 training see also night/evening working safety training defi cits 9, 14, 16–17, short working hours 110–111 27 Simard, M. 28, 30, 31, 37, 41 Sauter, S.L. 85, 159, 161–162, 163, 164 small and medium-sized enterprises Schat, A. 48, 49, 50, 51, 52, 54, 56, 57, (SMEs) 87, 106–107, 134, 62, 167 168–170, 169 Schulte, P. 81, 83, 84, 87 see also medium-sized companies;

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micro businesses; small consequences 71 companies incidence 70–71 small companies prevention 74–76 accidents and injuries 7–8 risk factors 69, 71–74, 75–76 defi nition 1–2, 27, 106, 169 suicide costs 71 healthy workplaces 170, 171–175, supervisor attitude to work–life 176–177, 178–179, 180 balance 113 informal culture 27 supervisor involvement in safety organizational factors associated inspections 30, 31, 33, 40, with safety 26–28 41 prevalence 106–107, 169 supervisor involvement in safety resource defi cits 118 practices 29–30, 31, 41 small workforce eff ects 107, 118, 139, supervisor performance evaluation 33, 140–147 40, 41 small construction companies’ safety supervisor safety training 29, 31, 33, management study 40, 41 diff erences between low and high supervisors 13, 55 accident companies 28–32 supervisory style 30 discussion 40–45 supportive organizational culture method 32–9 11, 113, 114, 116, 163–164, 165, results 39–40 167–168, 173–174, 180 unique factors associated with safety surveillance cameras 58, 61 in small companies 26–28 Sweden 17–18, 172 social identity theory 145–146 Swuste, P. 8, 9 social information processing theory, sexual harassment 138–139 Tackling Absence Management social services sectors see health care Toolkit 97, 100, 102 sector; home care sector; public target coping, sexual harassment services sector; security sector 137–138, 143 social support 18, 98, 100, 121 target hardening, Crime Prevention social support defi cits 9, 73, 88, 91, Through Environmental Design 92, 93 (CPTED) 59–60 societal outcomes 161, 163, 164 taxi drivers 54, 57–58, 59 Spain 15–16, 109, 170 Thompson, C.A. 110, 111 Stallones, L. 70, 71, 73, 75 threats of physical assaults 48, 49, Statistics Canada Victimization Study 50–51, 52, 53, 56, 59–60 52–53, 54 time demands/expenditure 2, 13, 14, Stave, C. 17–18 72, 107, 108–110, 167 stress 54, 92–94, 111–112, 118 time factors see time demands/ see also anxiety; depression; expenditure; timeframes, in family-related stress; stress workplace violence prevalence management; work-related estimation; waiting times; working stress hours stress management 84–88, 94–101, 117 timeframes, in workplace violence Stress Management Training (SMT) prevalence estimation 51 84–85, 88 Tootell, B. 110, 111 subcontracting 2–3 top management commitment to suicide 70, 71 health and safety 10, 14, 28 suicide and suicide attempts in the Trades Union Congress (TUC) (UK) agricultural sector 82, 89, 90, 94, 101

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training see cognitive behavioural verbal aggression 48, 56, 130 skills training; leadership training; visibility, Crime Prevention Through safety training; safety training Environmental Design (CPTED) defi cits; self-training; Stress 57–59, 61 Management Training (SMT) transformational leadership style 10, Wagar, T.H. 133 15, 20–21, 168 waiting areas 61 trust 19, 20, 122, 140–141, 144, 145, waiting times 61, 62–63 175 Walker, E. 110, 111, 117 turnover 86, 112, 116 Walters, D. 2, 8, 9 two-clerk provision 58 weapons 48, 50–51, 52, 53 Type I violence 53, 54, 57–60 Webster, S. 96 Type II violence 53, 54, 60–63 well-being see health; psycho-social Type III violence 53, 54 health and well-being; psychosocial ill-health uncertainty 90, 93, 97 Westman, M. 112 understaffi ng 88–89 Westrum, R. 33–34 unhealthy workplaces 159, 161, whistle-blowing 144–147 166–167, 171, 174, 180 Wilkinson, A. 10, 88, 129, 134, 136, United Kingdom 141 fi nancial costs of ill-health 82–83 Williams, J.H. 135 health and safety responsibilities in Wilson, M.G. 162, 170, 173 SMEs 9 withdrawal behaviours 112, 137, 143 health and well-being 81, 87 Woodhams, C. 116–117, 134 knowledge defi cits in SMEs 172 work content and characteristics 162, resource defi cits in SMEs 9 163, 164, 168, 181 safety management systems 15 work environment-focused stress SMEs 107, 170 management 85–86, 97 stress management 87, 94–96, 98–99, work–life balance 101–102 antecedents and consequences work–life balance policies 114, 115, 107–113 116–117 defi nitions 107 work-related stress 159, 167 enhancing work–life balance within United States SMEs 112, 113–117, 118, agricultural sector 69, 70–71 121–122 non-fatal and fatal workplace entrepreneurs 110, 111, 117–121 injuries 26, 69 healthy workplaces 162, 163, 164, organizational factors in high versus 165, 166, 177, 178, 181 low accident companies 28–29, perceived control 122–123 31, 32 stress management in SMEs 101 safety climate 13 work–life balance organizational SMEs 106, 107, 169 policies 112, 113–117, 118, 121–122 suicide 70–71 work–life imbalance work-related stress 159 agricultural sector 69, 72–73, 75 workplace violence 52, 54, 56, 60 antecedents and consequences unpaid parental leave 116 108–109, 110–112, 113 unwanted sexual attention 130–131 entrepreneurs 118–119, 120 human resource policies in SMEs Vainio, H. 81, 83, 84, 87 116–117 Vassie, L. 9, 14, 15 stress in SMEs 89, 90, 91, 92–93

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work overload 69, 72, 88–89, 90, 91, parental leave; part-time work; 93, 167 shift-work; short working hours work-related stress 15, 88–90, 92–94, workplace aggression 48–49, 167 111–112, 159, 167 workplace violence work role performance 107, 112–113, defi nitions 49, 50–51, 52 114 interventions 57–63 workaholics 109–110 prevalence 49–53, 60 workers see employees sources 53–57 Workers Compensation Board (WCB) workplace violence interventions 57–63 of Nova Skotia 36–37 written health and safety policies 15, working alone 55, 58–59, 60, 62 94, 98 working conditions 88–90, 95, 96 working hours 108–111, 114 young workers 56 see also compressed work weeks; fl exible working; long working Zacharatos, A. 10, 11 hours; night/evening working; Zohar, D. 11–12, 14

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