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Health problems and stress in Information Technology and Business Process

Outsourcing employees

Article  in  Journal of Pharmacy And Bioallied Sciences · April 2015

DOI: 10.4103/0975-7406.155764

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Medical Science - Research Article
Health problems and stress in Information
Technology and Business Process
Outsourcing employees
V. Padma, N. N. Anand, S. M. G. Swaminatha Gurukul,
S. M. A. Syed Mohammed Javid, Arun Prasad, S. Arun

Department of General ABSTRACT

Medicine, Sree Balaji
Medical College, Bharath
University, Chrompet,
Chennai, Tamil Nadu,
India.
Address for correspondence:
Dr. V. Padma,
E-mail: padmaramesh86@
yahoo.com
Received : 31-10-14
Review completed : 31-10-14
Accepted : 09-11-14
Stress is high in software profession because of their nature of work, target, achievements, night shift,
over work load. 1. To study the demographic profile of the employees. 2. To access the level of job stress
and quality of life of the respondents. 3. To study in detail the health problems of the employees. All
employees working in IT and BPO industry for more than two years were included into the study. A detailed
questionnaire of around 1000 IT and BPO employees including their personal details, stress score by Holmes
and Rahe to assess the level of stress and master health checkup profile were taken and the results were
analysed. Around 56% had musculoskeletal symptoms. 22% had newly diagnosed hypertension,10% had
diabetes, 36% had dyslipidemia, 54% had depression, anxiety and insomnia, 40% had obesity. The stress
score was higher in employees who developed diabetes, hypertension and depression. Early diagnosis
of stress induced health problems can be made out by stress scores, intense lifestyle modification, diet
advice along with psychological counselling would reduce the incidence of health problems in IT sector
and improve the quality of work force.
KEY WORDS: Business process outsourcing, health, information technology, stress

I nformation Technology (IT) industry in India has got

a tremendous boost due to globalization of Indian
economy and favorable government policies. IT and IT related
professionals are at a constant pressure to deliver services
efficiently and have to be cost effective.
Employees working in IT industry are prone to develop a lot of
health problems due to continuous physical and mental stress of
their work. Diseases are either induced, sustained or exacerbated
by stress. The common health problem due to stress are acid
peptic disease, alcoholism, asthma, diabetes, fatigue, tension
headache, hypertension, insomnia, irritable bowel syndrome,
psychoneurosis, sexual dysfunction and skin diseases such as
psoriasis, lichen planus, urticaria, pruritus, neurodermatitis
Access this article online
Quick Response Code:
Website:
www.jpbsonline.org
DOI:
10.4103/0975-7406.155764
How to cite this article: Padma V, Anand NN, Gurukul SS, Javid SS, Prasad A, Arun S. Health problems and stress in Information Technology and Business
Process Outsourcing employees. J Pharm Bioall Sci 2015;7:S9-13.
etc. Globalization and privatization have brought new work
relationships, job insecurity, insecurity regarding future working
conditions and rapid obsolescence of skills are causes of stress.
IT industry has become one of the fastest growing industries in
India. Strong demand over the past few years has placed India
among the fastest growing IT markets in Asia-Pacific region.
The reason for choosing particularly IT and ITES employees
is that the level of stress these employees face is comparatively
higher than other employees. Any kind of a job has targets, and
an employee becomes stressed when he or she is allotted with
unachievable targets and are unable to manage a given situation.
Thus, the main aim of this article is to bring to limelight the
level of stress with IT and ITES employees in Chennai.
Aim
1. To screen IT employees by a questionnaire that include details
of health illnesses, family history of illness, diet, lifestyle,
exercise and yoga activities and health checkup reports.
2. To assess the severity of stress using Holmes and Rahe Stress
Scale scoring which would measure stress with the number
of life change units and the final score would give a rough
estimate of how stress affects health of IT employees.

Journal of Pharmacy and Bioallied Sciences April 2015 Vol 7 Supplement 1 S9 

 Padma, et al.: Health problems and stress in information technology and business process outsourcing employees

Material and Methods Life event Life change units

Change in health of family member 44
This is a cross-sectional study involving IT employees in Pregnancy 40
Chennai. Sexual difficulties 39
Gain a new family member 39
As there are no such studies available, I have done a pilot Business readjustment 39
Change in financial state 38
study with 30 IT employees and collected data from 1,000 Death of a close friend 37
IT employees. The study was started after getting Ethical Change to different line of work 36
Committee approval and getting consent from the employees Change in frequency of arguments 35
in IT industry. The employees enrolled voluntarily to the study Major mortgage 32
should be working for at least 2 years in the industry. A detailed Foreclosure of mortgage or loan 30
Change in responsibilities at work 29
questionnaire, including the health history, diet pattern, lifestyle Child leaving home 29
and stress score was given to them-Holmes, and Rahe stress Trouble with in‑laws 29
score scale. A complete master health checkup was done, and Outstanding personal achievement 28
the results were analyzed. Spouse starts or stops work 26
Beginning or end studies 26
Change in living conditions 25
Results Revision of personal habits 24
Trouble with boss 23
Around 56% had musculoskeletal symptoms. 22% had Change in working hours or conditions 20
newly diagnosed hypertension, 10% had diabetes, 36% had Change in residence 20
dyslipidemia, 54% had depression, anxiety and insomnia, 40% Change in schools 20
Change in recreation 19
had obesity [Figure 1]. Musculoskeletal symptoms included Change in religious activities 19
cervical and lumbar strain with or without disc disease, Change in social activities 18
polyarthralgia, and muscle spasm and heel pain. Minor mortgage or loan 17
Change in number of family reunions 15
The stress score was higher in employees who developed Change in eating habits 15
Vacation 13
diabetes, hypertension, dyslipidemia and obesity. Most of the Major festival 12
employees who were obese had a higher stress score. Of the Minor violation of law 11
metabolic disorders employees with higher stress score had
dyslipidemia, followed by hypertension and diabetes [Figure 2].
Among IT employees with health problems 67% were men and
33% were women [Figure 3].
Disease Stress score‑average Percentage
Diabetes 240 10
Hypertension 260 22 Discussion
Dyslipidemia 320 36
Musculoskeletal 130 56 Stress at work has been linked with coronary heart
Depression 180 54 disease and metabolic syndrome in retrospective and
Obesity 340 60 prospective studies.[1,2] The biological mechanisms remain
unclear.[3] The pathophysiological mechanisms involve direct
To measure stress according to the Holmes and Rahe Stress neuroendocrine effects and indirect effects mediated by
Scale, the number of “Life Change Units” that apply to events adverse health behaviors.[4-6] The metabolic syndrome is a
in the past year of an individual’s life are added and the final cluster of risk factors that increases the risk of heart disease
score will give a rough estimate of how stress affects health. and type 2 diabetes. [7] Characteristics of the metabolic
syndrome are abdominal obesity, atherogenic dyslipidemia
• Score of 300+: At risk of illness. (raised triglycerides, small low-density lipoprotein particles,
• Score of 150-299: Risk of illness is moderate (reduced by and low concentrations of high-density lipoprotein
30% from the above risk). cholesterol), high blood pressure (BP), insulin resistance
• Score <150: Only have slight risks of illness. (with or without glucose intolerance), and prothrombotic and
proinflammatory states. Studies have found a social gradient
Life event Life change units in work stress and the metabolic syndrome,[8,9] suggesting a
Death of a spouse 100 greater exposure to working stress among less advantaged
Divorce 73 social groups. Cross-sectional studies have linked work stress
Marital separation 65 with components of the syndrome,[10,11] but this association
Imprisonment 63 is not consistent.[4,12]
Death of a close family member 63
Personal injury or illness 53
Marriage 50 Technostress is the word used to explain the phenomenon of
Dismissal from work 47 stress arising due to the usage of computers. It is a modern
Marital reconciliation 45 disease of adaptation caused by the inability to cope with new
Retirement 45 computer technologies in a healthy manner.
 S10 Journal of Pharmacy and Bioallied Sciences April 2015 Vol 7 Supplement 1
 Padma, et al.: Health problems and stress in information technology and business process outsourcing employees
Figure 1: Percentage of health problems in IT and BPO employees
Figure 2: Health problems and stress scores in IT, BPO employees
Figure 3: Health problems and sex wise distribution
Transduction is the translation of emotional distress to
physiological change and then to a physical symptom. Complex
autoimmune, humoral and neuromuscular mechanisms mediate
this reaction, and may itself affect the environment by a social
response that may yield a positive or a negative response. Effects
of stress on mind and body are due to increased sympathetic
nervous system activity and increased secretion of adrenaline,
cortisol and other stress hormones.
Occupational (job, work or workplace) stress has become one of
the most serious health issues in the modern world (Lu et al.,
2003, 479), as it occurs in any job and is even more present than
decades ago. Namely, the world of work differs considerably from
Journal of Pharmacy and Bioallied Sciences April 2015 Vol 7 Supplement 1 S11 
the working environment of 30 years ago: longer hours at work
are not unusual, frequent changes in culture and structure are
often cited, as well as the loss of lifetime career paths (Cooper
and Locke, 2000 in Fotinatos-Ventouratos and Cooper 2005),
which all leads to greater presence and levels of stress.
Hans Selye was one of the founding fathers of stress research.
His view in 1956 was that “stress is not necessarily something
bad – it all depends on how you take it. The stress of exhilarating,
creative, successful work is beneficial, while that of failure,
humiliation or infection is detrimental.” Selye believed that the
biochemical effects of stress would be experienced irrespective
of whether the situation was positive or negative.
Job stress occurs in response to both workplace and employee
factors, but the characteristics of the workplace likely play the
primary role. “Job stress can be defined as the harmful physical
and emotional responses that occur when the requirements
of the job do not match the capabilities, resources or needs
of the worker. Job stress can lead to poor health and even
injury.” (Stress at work, United States National Institute of
Occupational Safety and Health, Cincinnati, 1999).
A Canadian graduate school study[13] suggested companies
should invest in IT specific employee assistance programs. Survey
conducted by Techweb Network Research on behalf of Op
Tier quantified how stressed managers are. This survey showed
the greatest cause of job stress were complexity of company IT
infrastructures and poorly defined goals. 264 women employees
were studied by Aziz to explore the level of stress. Resource
inadequacy role overload and personal inadequacy were the main
causes of stress. There was a difference between married and
unmarried women. Working in IT calls for a high degree of accuracy
over the long period of time, and a small lapse would be disastrous.
Studies have shown that employees with chronic work stress
(three or more exposures) were nearly twice as likely to develop
the metabolic syndrome[14] than those with no exposure to work
stress. Women with chronic work stress were over five times more
likely to have the metabolic syndrome. Greater exposure to job
stress over 14 years was linked to greater risk of the metabolic
syndrome, in a dose-response manner. The association was robust
to adjustment for occupational status and health behaviors.[15 ] It
is unclear whether the development of risk seen here is due in part
to the direct effects of chronic stress on insulin resistance, resting
BP, and lipoprotein metabolism, although this interpretation is
supported by Whitehall II and other studies.[3,5,16]
Stress and its types
We cannot have a stress-free life. Stress is, of course, essential
for every human being as it is considered as a boost that takes
an employee to the highest ladder in the organization. The
various types of stress is mentioned below:
Eustress is a type of short-term stress that provides immediate
strength. It is a positive stress that arises when motivation and
inspiration are needed.
 Padma, et al.: Health problems and stress in information technology and business process outsourcing employees
Distress, on the other hand, is a negative stress brought about
by constant readjustments and alternatives in a routine. Distress
creates feelings of discomfort and unfamiliarity.
Hyper stress occurs when an individual is pushed beyond
what he or she can handle. It results from being overloaded or
overworked.
Hypo stress occurs when an individual is bored or unchallenged.
People who experience hypo stress are often restless.
Stages of work stress
According to Pestonjee (1992) work stress progresses through
a series of five stages.
1. The honeymoon stage: Euphoric feeling if excitement,
enthusiasm, challenges and pride on getting a new job.
Dysfunctional processes include the depletion of energy
reserves in coping and adapting to the new environment.
2. The full throttle stage: Going full swing leads to a depletion
of resources. Other symptoms include dissatisfaction, sleep
disturbances, overeating, drinking or smoking.
3. The chronic symptom stage: Development of chronic
symptoms like physical illness, anger and depression.
4. The crisis stage: Persistence of symptoms leads to disease,
chronic backache, headache, high BP, insomnia, etc., would
develop.
5. Hitting the wall stage: No person can continue under strain
for too long and one may reach the end of one’s professional
career. Burnout stress syndrome takes over.
6. The opposite: Rust our stress syndrome occurs under extreme
hypo stress. This is likely to occur when the gap between one’
capabilities and environmental demands becomes too wide.
Biology of stress
Prolonged exposure to work stress may affect the autonomic
nervous system and neuroendocrine activity directly, contributing
to the development of the metabolic syndrome.
A case–control study showed that participants in the Whitehall
II study with the metabolic syndrome had raised cortisol and
normetanephrine output, and also had reduced variability in
heart rate.[5] Decrements in cardiac autonomic function have
been linked to the metabolic syndrome in other populations
and to low job control and social isolation among men in the
Whitehall II study.[6,17,18] Psychobiological studies have also
shown that heightened stress reactivity and impaired recovery
after stress, assessed by BP and inflammatory markers, predict
the 5 years progression of the metabolic syndrome.[18]
Chronic psychological stress may reduce biological resilience
and thus disturb homoeostasis. Altered adrenocortical function
can influence hepatic lipoprotein metabolism and insulin
sensitivity at target organs.[15,19]
Cortisol is an insulin antagonist, and cortisol output is increased
in the metabolic syndrome.[5]
 S12 Journal of Pharmacy and Bioallied Sciences April 2015 Vol 7 Supplement 1
Low concentrations of high density lipoprotein cholesterol and
glucose intolerance have been linked with high basal secretion
of cortisol.[20]
Stress at work is associated with coronary heart disease, but the
biological mechanisms underlying this association are unclear
Information Technology industry causes stress among employees
in many ways:
1. Software packages used as the operating system for
companies releases 3-4 updates in a year. The employee
has to learn about these updates each time. Otherwise they
would lag behind others causing pressure on the employee
and increased job risk if he fails to perform well.
2. Training program sanctioned by the company is not
employee oriented as each employ
3. Another form of stress is called technologist. People do not
communicate or interact with their colleagues as before.
This can cause alienated feelings among colleagues.
4. Employees working in IT industry need to work with a high
degree of accuracy over a long period. A small lapse can lead
to disastrous effect for the company. They need to have an
outlet to manage their stress.
Conclusion
The daily impact of IT on our lives continues unabated. As
innovations and computer capacities increase this influence
will continue to grow in the coming years at an increasing
rate. As technology advances, there is also increased stress that
is associated with it called as “technology stress.” IT is here
to stay. This brings extra pressure on people to adapt to new
advancements and update their knowledge in their field.
Annual stress scoring has to be done and a score above 300 needs
stress management program like yoga, meditation and other
destressing activities like aerobics, dance etc., would prevent or
reduce risk of disease due to stress in IT people which in turn
will produce a healthy community.
To manage stress these people need to play sport, have a hobby or
just have a good holiday. Stress score helps us to screen who would be
prone to stress related physical illness and people with a score more
than 300 are at risk of illness and care should be taken at the earliest
to relive their stress. Healthy employees mean better performance by
employee that in turn produce a healthy community. Annual stress
scoring has to be done, and employees are having a score more than
300 should be involved in active antistress management.
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Source of Support: Nil, Conflict of Interest: None declared.

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