Relationships of Occupational Hazards With Burnout: An Assessment of Measures and Models

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1 Journal of Occupational Health Psychology 1997, Vol. 2, No. 1,35-44 Copyright 1997 by the Educational Publishing Foundation /97/$3.00 Relationships of Occupational Hazards With Burnout: An Assessment of Measures and Models Michael P. Leiter and Lynn Robichaud Acadia University A survey of aircraft maintenance technicians with the Canadian Forces (N = 157) found support for a model of burnout and occupational risk assessment. The model depicted employees' assessment of occupational risk as a function of the prevalence and lethatoess of workplace hazards, as well as of the amount of control employees experience over their interactions with these hazards. A confirmatory factor analysis, in which LISREL analysis was used, supported an integrated model of risk perception and burnout. In this model, the employee's sense of control in managing occupational hazards was pivotal in both the experience of exhaustion and being at risk at work. Safety training contributed to perceived control and technicians' sense of effectiveness at work. The extension of the burnout construct beyond the human service domain was considered by using the Maslach Burnout Inventory General Survey (C. Maslach, S. E. Jackson, & M. P. Leiter, 1996). As organizations strive toward increasing the safety of work environments, psychological research is making more extensive contributions to safety research. S. Cox and Cox (1993) proposed that a thorough safety analysis goes beyond what they called safety software rules, regulations, and policies that are often defined by legislation. The Cox and Cox model includes consideration of people and their assessment of occupational risk. The assessment of risk is influenced by a variety of factors, including employees' training history, personality, work group norms, and aspects of organizational culture. A sense of control is an intrapersonal factor that contributes to employees' assessment of occupational risk and their use of relevant skills. Slovic, Fischoff, and Lichtenstein (1984) defined risk appraisal in terms of control, knowledge, and aversive outcomes. Following this work, S. Cox and Michael P. Leiter and Lynn Robichaud, Psychology Department, Acadia University, Wolfville, Nova Scotia, Canada. The research reported in this article was supported by a grant from the Social Sciences and Humanities Research Council of Canada. This research was developed from a symposium (Extending the Burnout Construct: Reflecting Changing Career Paths) presented at the American Psychological Association/National Institute for Occupational Safety and Health conference: Work, Stress, and Health '95: Creating a Healthier Workplace, September 1995, Washington, DC. Correspondence concerning this article should be addressed to Michael P. Leiter, Psychology Department, Acadia University, Wolfville, Nova Scotia, Canada BOP 1X0. Electronic mail may be sent via Internet to leiter@ace. acadiau.ca. Tail (1991) described risk perception as recognition of a hazard's capacity to harm and as estimation of the probability of incurring harm. Their work emphasized individual judgments of a hazard's significance and the acceptability of a situation's riskiness. This work can be summarized into a three-component model of risk assessment (Leiter & Cox, 1992). The first component of the model of risk assessment is the estimate of a hazard's lethalness or the amount of harm a hazard may be expected to inflict. Acute workplace hazards range from events that can lead to irritating bumps or scrapes to those that can kill an individual worker or a large group of people. The second model component is prevalence, or estimates of the frequency of injury from a given hazard. Estimates of prevalence are subject to cognitive biases (Lichtenstein, Slovic, Fischoff, Layman, & Coombs, 1978), producing overestimates of low-frequency events and underestimates of high-frequency events. Prevalence and lethalness are largely independent factors, both of which make a distinct contribution to workers' sense of vulnerability. The third component of the model is control. The more control individuals experience themselves to have over their interactions with workplace hazards, the less they feel vulnerable. The relationship of control with the other two predictors in the model reflects the primary and secondary appraisal processes of the transactional model of stress (T. Cox, 1978; Lazarus & Folkman, 1984) in that prevalence and lethalness are assessments of the environment's capacity for inflicting harm, whereas control summarizes assessments of the individuals' capacity to cope 35

2 36 LEITER AND ROBICHAUD with those demands (Ferguson, Cox, Farnsworth, Irving, & Leiter, 1994). The similarity of this model of occupational risk with the transactional model of stress raises questions of the relationship of control with the other predictors. Stress research has depicted coping resources, especially social support, as having a moderating effect on the relationship of stressors with experienced stress (Blau, 1981; House & Wells, 1978; Leiter, 1990). However, this relationship is not found consistently. In some circumstances, social support appears to have an additive effect. Extensive research on the moderating versus the additive role of social support has been inconclusive (Etzion, 1984), with both models continuing to guide research. The complexity of the constructs stress and social support and the variety of the measures contribute to the mixed results of this research. The assessment of risk is subject to errors from the use of inaccurate information and faulty processing of that information (Kahneman & Tversky, 1973). To some extent, processing errors arise from the perceived riskiness of a situation and from the cognitive effects of experienced stress that interfere with the capacity to make an accurate assessment of the situation (T. Cox, 1987). Biased processing may also arise from context or work group factors, such as the extent to which one can exert control in various settings (Ferguson et al., 1994), or workgroup social environments (T. Cox & Leiter, 1992). These variations provide a context for a comprehensive model of risk assessment. The way in which safety issues are processed contributes to the safety culture of an organization. Especially important in employees' assessment of the safety culture is their assessment of management's commitment to safety. In a study of 20 factories (Zohar, 1980), the importance of safety training within an organization, the status of safety personnel, and the effects of safe job performance on promotion were considered important indicators of the actual value given to safe working practices in an organization. This study validated employees' ratings of safety climate with independent ratings from external assessors. The subsequent work on safety climate (Dedobbeleer & Beland, 1991; DeJoy, 1994) has further confirmed that employees use social cues within the organization in their assessment of occupational risks. Burnout has primarily been studied in regard to Lethalness Prevalence Training Withdrawal Burnout Figure 1. Proposed model that hypothesizes perceived risk as a function of the perceived prevalence of hazards in the workplace, the potential of these hazards to harm, and the control employees believe that they have over their contact with these hazards.

3 SPECIAL SECTION: RISK AND BURNOUT MODEL 37 human service providers (Maslach, 1993). The primary measure of the construct, the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1986), provides an operational definition of burnout in terms of the demands of human service work. The burnout construct has been extended to a much wider range of occupations in the development of a measure, the Maslach Burnout Inventory General Survey (MBI- GS; Maslach, Jackson, & Leiter, 1996), that defines burnout in terms of exhaustion, cynicism, and decreased professional efficacy. This measure is consistent with the MBI perspective on burnout, but it gives a central role to a person's engagement in work rather than the emotional demands and rewards of service provision (Leiter & Schaufeli, 1996). This is the first study of burnout with aircraft technicians. Burnout is an appropriate measure for this study because the work of this population requires a high degree of individual responsibility for meeting exacting standards of performance. Inadequate work performance may have severe consequences for the safety of maintenance crews and for the people using the aircraft. In this study we integrated a model of occupational risk perception with a model of burnout. There have been no investigations to date on the relationship of burnout to occupational risks, although the two factors clearly have implications for one another. Demands associated with being under risk may increase staff members' susceptibility to exhaustion. Furthermore, burnout itself is an occupational risk encountered by staff members. As indicated in Figure 1, the model hypothesizes perceived risk as a function of the perceived prevalence of hazards in the workplace, the potential of these hazards to harm, and the control employees believe that they have over their contact with the hazards. These three psychological components are supplemented by two aspects of the workplace: the strictness with which the employee and coworkers adhere to safety procedures and the physical condition of the workplace (safety conditions). In turn, training is expected to be related to strictness and control in that the immediate impact of training is expected to enhance participants' sense of control and the salience of safety procedures. The lower section of Figure 1 displays the burnout model in which exhaustion predicts cynicism which in turn leads to diminished professional efficacy. This model follows that of Leiter and Maslach (1988) by including the path from cynicism to efficacy in contrast to later models with a mixed sequential and parallel development of burnout that- exclude this path. It was included in light of the improvements of the cynicism measure of the MBI-GS over the MBI's depersonalization scale and the absence of organizational environment measures that mediate the relationship of exhaustion and efficacy (Leiter, 1993). The model indicates three paths from safety constructs to burnout: Training is hypothesized to have a path to efficacy, whereas control and risk have paths to exhaustion. Both exhaustion and efficacy have paths to withdrawal. Participants Method Participants were 157 of 193 members (81%) of the Canadian Forces who were based at a major air base for the Atlantic coast of Canada. The base supports a variety of aircraft engaged in military and military rescue missions in this area. The participants were full-time members of the Canadian Forces assigned to a full range of maintenance duties associated with aircraft on the base. The sample was predominantly male (147) with a few female (10) participants. The average age was years, ranging from 23 to 49. They had been in the Canadian Forces an average of years, with a minimum of 4 years and a maximum of 31 years. Most were of the rank of Corporal (102) or Master Corporal (41), with other ranks including Private (1), Sergeant (9), Warrant Officer (1), and Master Warrant Officer (2). Nearly one third of the sample had changed their job or section assignment over the past 6 months because of the normal rotation of assignments in the military. Measures: Safety Questionnaire Perceptions of safety issues were assessed with a questionnaire developed for this study that followed the general structure of a questionnaire developed for a study of microbiological hazards in health care (Leiter & Smiley, 1995). The specific content for the questionnaire was developed in consultation with the safety officer for the base and other personnel familiar with the work setting. These interviews defined eight areas of risk: (a) flammable atmospheres, (b) electric shocks, (c) hazardous chemicals, (d) high pressure fluid and air systems, (e) lifting heavy objects, (f) interaction with the aircraft when the engines are on, (g) interaction with the aircraft when the engines are off, and (h) contact (bumps, cuts, etc.) with aircraft components. The questionnaire presented a series of questions regarding these risk areas interspersed with general questions about safety procedures and training. Questions pertaining to distinct aspects of the model measured the constructs in this study. Participants responded to each question on a 7-point scale for each of the eight hazard areas. Lethalness. "Typically, how great an injury would an accident involving one of the following hazards usually produce?" Responses ranged from 1 (minor) to 7 (potentially fatal). Prevalence. "How often do you think accidents at work occur at 14 Wing involving the following hazards?" Responses ranged from 1 (never) to 7 (daily).

4 38 LEITER AND ROBICHAUD Control. "To what extent do you feel you have control over experiencing a work related accident with the following potential work hazards?" Responses ranged from 1 (never) to 7 (always). Risk. "To what extent do you feel at risk of injury to these potential hazards?" Responses ranged from 1 (not at risk at all) to 7 (could not be more at risk). Relative risk. To provide a second perspective on experienced risk, we had participants indicate the extent to which they felt at risk in relation to various comparison groups, including the general public, other civilian and other military personnel in their line of work, and people doing similar work in civilian settings. They rated this risk on 7-point scales ranging from 1 (much less likely) to 7 (much more likely). Strictness. Strictness in adhering to safety procedures was measured by three items developed for the study, for example: "To what extent do you strictly follow safe working procedures?" On a 5-point scale responses ranged from 1 (never) to 5 (always). Other items assessed the strictness of coworkers' adherence to safety procedures. Training. Participants indicated for each of the eight hazards the amount of training they had received on a 4-point scale with responses ranging from 1 (none) to 4 (extensive training). Safety conditions. Safety conditions were assessed with a 7-point scale with responses ranging from 1 (could not be worse) to 4 (good) to 7 (could not be better). Participants rated the work space, equipment, temperature level, and lighting. Other Measures Maslach Burnout Inventory General Survey (MBI-GS). The MBI-GS (Schaufeli, Leiter, Maslach, & Jackson, 1996) is a 16-item measure of burnout that extends the construct from human service providers to a wide range of occupations. Participants rated each item on a frequency scale from 0 (never) to 6 (every day). The scale was developed with populations in Holland, Finland, and Canada in the respective languages of these countries (Maslach et al., 1996). Schaufeli, Leiter, and Kalimo (1995) provided evidence for the reliability and validity of the scale. Leiter and Schaufeli (1996) demonstrated evidence of the measure's continuity with the burnout construct as developed among human service providers. Withdrawal. Two items measured withdrawal. One item measured turnover intention as the frequency with which participants thought about leaving their section, the base, or the armed forces over the past year. This was rated from 0 (never) to 5 (always). A second item asked "How do you rate the general morale amongst the staff?" Responses ranged from 1 (extremely low) to 3 (moderate) to 5 (extremely high). A low score on this item was interpreted as indicating withdrawal from the social environment of the workplace. Procedure Two formats for distribution of questionnaires were followed because of the circumstances within the work setting. One group completed the questionnaires outside of work hours, returning the questionnaires to a locked box at the work setting a few days after distribution of the Si f CO 00 g q; t-a c 2.2 St 6 1 a- "S e g O ^a 2 ^> blel >,ans, Standard Di p2 5S ^H 0 ON OO f ^0 u-i rr m cs a Q CO S«5 Variable # * * # * * # vi ^o en c^ o ^^ o o o ^- I I I I * * # # # * * fnt"-m00 1^W")lCNQ^O CSfN- C^OP'-'O' r r ' r r ' ' r * * irifn 'cn^nr-mm O^O^CN-^-HO 1 1 # * * * O vt t** oo 2 -^ v"> r r ' ' r * i i O ^^ ""^ O O i 1 * # o o ^ oo o T-< en ^H CN p p p p 1 * * * ON ^O oo I -H fs CS r r * *# OO \G -H IT) r r * 1? I S (Nr--oooooommr^ oor^t^oor-onoooor-m en ^" m o "* ^" vi oo ^^ v> o\ oimo^onofnooocnpr < t i H i i o> I"* 1 O ^" ON fn O osmrsr^s^spo^ fs irj-^httoow-i-hincscn >* rt O jp M C 0 - g- 13., "3 -jg Iileig 3 g> 1 l i ^ l wucccrti-jfl-cjf-^sw^ ^tsfnti-m^oc^ooono' 1 i s o ^u > ^ te. N = 157. dicates correlation t <.05. **p <.01 : **

5 SPECIAL SECTION: RISK AND BURNOUT MODEL 39 Table 2 Descriptive Statistics for Items in the Analysis Item Lethalness 1 Lethalness 2 Lethalness 3 Prevalence 1 Prevalence 2 Prevalence 3 Riskl Risk 2 Risk 3 Safety Conditions 1 Safety Conditions 2 Safety Conditions 3 Control 1 Control 2 Control 3 Training 1 Training 2 Trainings Strictness 1 Strictness 2 Strictness 3 Exhaustion 1 Exhaustion 2 Exhaustion 3 Cynicism 1 Cynicism 2 Cynicism 3 Professional Efficacy 1 Professional Efficacy 2 Professional Efficacy 3 Turnover intention Morale M SD Skew Kurtosis questionnaires. From this group, 45 of the 70 potential participants completed the survey for a response rate of 64%. The other group (n = 107) completed the questionnaire during working hours in an auditorium. Although they were given permission to withdraw from the study both verbally and in writing on the questionnaire, participation rate was 100%. Results Table 1 displays the item means, standard deviations, reliability coefficients, and correlations among the measures in the study. The variables in this analysis were based on all of the items in each scale, unlike the LISREL causal model analysis in which three items from each measure were selected. Overall, the pattern of correlations was consistent with expectations. This sample scored relatively low on exhaustion and at average levels of cynicism and professional efficacy compared with health care workers (Leiter & Schaufeli, 1996). This model was examined in a LISREL (Joreskog & Sorbom, 1989) confirmatory factor analysis that included the relationships specified among the constructs as indicated in Figure 1. For the purposes of the analysis three items were selected as indicators of each construct, except for withdrawal for which only two indicators were available. Table 2 displays descriptive statistics on the items used in the analysis. All items have acceptable distributions. All 11 latent variables were defined as endogenous variables in order to consider all relationships among items in the factor analysis and the structural equation. Thirteen of the 496 off-diagonal theta delta were freed to account for correlations among errors within scales. The delta 2 goodness-of-fit index (GFI; Bollen, 1989) was used to assess the quality of the models. This index is independent of sample size and is appropriate for models that have both structural and confirmatory factor analysis components (Gerbing & Anderson, 1993; Mulaik et al., 1989). It is computed in relation to a null model that specifies no relationships among the measures.

6 40 LEITER AND ROBICHAUD Table 3 Model Contrasts Variable df GFI Delta 2 Revised model Proposed model Orthogonal model Null model ** 633** 886** 2,322** Note. For x 2, N = 157. GFI = goodness-of-fit index. **p< Difference 274** 253** The confirmatory factor analysis found all items to load significantly on their respective factors; the modification indices did not indicate any crossloadings that were essential for the model. The proposed model fit the data fairly well, with a Delta 2 of.90, x 2 (445, N= 157) = 633, GFI =.80 (see Table 3). As indicated in Figure 2, 11 of the 15 hypothesized paths met the t > 2.00 criterion for significance. Two of the paths that did not attain significance were those linking the risk constructs with the burnout model (risk to exhaustion and training to efficacy). Examination of the modification indices suggested that the relationship of training with other risk factors and with efficacy was indirect, mediated through strictness. The LISREL output suggested a path from exhaustion to strictness as well. Figure 3 displays the revised model with these modifications, replacing the direct path from training to efficacy with a path from training to strictness and a path from strictness to efficacy. The revised model also added a path from strictness to safety conditions. The path from strictness to risk, which fell short of significance in the proposed model, met the t > 2.00 criterion in the revised model. As indicated in Table 3, this model provided a slightly better fit with the data, x 2 (446, N = 157) = 612, GFI =.81. Figure 3 displays the structural relationships in the revised model. Figure 4 Lethalness Prevalence Safety Conditions _r*-rlsk Withdrawal Burnout Figure 2. Test results of the proposed model.

7 SPECIAL SECTION: RISK AND BURNOUT MODEL 41 Lethalness Prevalence Training.22? Strictness Withdrawal 1.23 U Burnout Figure 3. Modifications to the proposed model are shown in this revised model. This model replaced the direct path from training to efficacy with a path from training to strictness and a path from strictness to efficacy. The revised model also added a path from strictness to safety conditions. displays the factor loadings for this model. (The model was too complex to display the factor loadings in the context of the structural model.) Discussion This analysis provided confirmation for many aspects of an integrated model of risk perception and burnout. Consistent with expectations, a sense of control associated with safety education was related to both a diminished sense of being at risk and reduced burnout. The analysis suggested the relationship of training to both of these constructs to be more complex than originally anticipated. In addition to the study's confirmation of central aspects of the structural model, it provided confirmation of the factor structure of a measure of risk perception. Implications of these findings for further research and occupational safety training are discussed below. The construct linking employees' experience of burnout and perception of risk at work is training. Maintenance workers who had received more training reported a stronger sense of control over workplace hazards and stricter adherence to safety policies by themselves and their colleagues. Strictness mediated the predicted relationship of training with safety conditions: Training was associated with a safer work environment to the extent that it had an impact on adherence to strict safety procedures. In turn, both greater control and perceptions of a safer work environment were associated with decreased feelings of risk from workplace hazards. The relationship of risk assessment with burnout was more complex than expected. In the first place, perceived risk was not associated with emotional exhaustion: Neither the zero-order correlation nor the predicted path coefficient approached statistical significance. This finding is inconsistent with other research on risk and burnout (Whelan, 1995). Further research is needed to determine the extent to which this outcome resulted from specific qualities of the measure or the study site. The analysis did confirm the predicted relationship of control with exhaustion, consistent with the proposition that gaining control over demanding or threatening aspects of the workplace reduces experienced work demands. The

8 42 LEITER AND ROBICHAUD _^..71* Lethall: Fire Lethalness *..82 Lethal3: Chemical ^^..71* Prevl:Fire Prevalence *.71 Prev2: Shock ~~ fc-.85 PrevS: Chemical JT.83* Riskl: Fire Risk +.77 Risk2: Shock "---*..72 RiskS: Chemical ^_» - 74 * Controll: Fire Control +*.77 Control2: Shock ' -k-.79 ControlS: Chemical +-.59* Conditionsl: Space Safety Conditions Conditions2: Equipment ^r;! ConditionsS: Temperature +..71* Trainingl: Fire Training * 79 TraininK2: Shock ^^ - /is L Tr aining3: Chemical. T- - 8 Strictl:Self Strictness -*. ^-83 Strict2: Coworkers ^~-*-.69 StrictS: Pace V -73* EX1: Drained Exhaustion *.92 EX2: Tired ~~" *.41 EX3: Strain _»..93* CY"l: Less Interest Cynicism """»..91 CY2:Unenthused '~" k-.44 CY3: Not Bothered J ^_^JV.81* PE1: Involved Efficacy fr..61 PE2: Calmly "~~~~*-.38 PE3: Confident Withdrawal ^.66* Turnover Intention ^ ' * Morale Figure 4. Confirmatory factor analysis is shown for the revised model. Asterisks indicate items that were used to fix scales. Prev = prevalence; EX = exhaustion; CY = cynicism; PE = professional efficacy. expected relationship of training with professional efficacy was mediated through strictness, suggesting that training is associated with enhanced efficacy only to the extent to which employees implement new skills and attitudes in their day-to-day work. Both the nature of the organization and the occupation of participants likely contributed to the influential role of training in the model. For aircraft technicians in a military organization, participation in training is extensive and readily available. It is also generally mandated. Every participant in the study reported some training involvement in the past 2 years, with some participating in extensive courses. The directed approach to training in the military leaves less room for personal inclination and job involvement to influence participation rates. However, the path from exhaustion to strictness suggests that the workers' physical and mental state may influence the extent to which training has an impact on behavior at work. Further, longitudinal studies with interventions are necessary to explore the causal relationships suggested by the revised model. The indirect path from exhaustion to professional efficacy through strictness supplements the predicted path through cynicism. The relationship among the three burnout scales is consistent with that proposed by Leiter and Maslach (1988) for burnout among human service professionals. Consistent with that

9 SPECIAL SECTION: RISK AND BURNOUT MODEL 43 model, this study proposed that burnout begins with exhaustion in response to aspects of the organizational environment, especially in the balance of demands and resources for doing the work. Workers develop cynical, distant relationships with their work in response to excessive demands. A cynical attitude in turn decreases the extent to which workers feel effective through their work. Leiter (1993) suggested that aspects of work environments related to both exhaustion and personal accomplishment explained their relationship more accurately than a direct or indirect path between them. The finding in this study of two indirect paths from exhaustion to professional efficacy may derive from the way in which the MBI-GS defines the constructs. As well, it may be a function of the distribution of the cynicism scale. This quality of the cynicism scale permits a more thorough assessment of its relationships with other aspects of the person and of the organizational environment. Extensive longitudinal research with the MBI-GS in a variety of settings is needed to determine the relationships among the three elements of burnout. The confirmatory factor analysis provided strong support for the risk perception survey developed for this study. The measure provided independent assessments of the lethalness, prevalence, and riskiness of various hazards, as well as the extent to which participants experienced control over each of the identified workplace hazards. The format of the scale permits researchers to adapt it to specific situations by identifying hazards of concern for that worksetting. Further, the scale provided distinct assessments of the strictness with which participants and their coworkers adhered to safety requirements in their work and the safety conditions inherent in the physical work environment. The structure of the scale facilitates clear feedback to workers and management through its focus on specific aspects of the work environment that pertain to safety. This research suggests a powerful association of occupational training with both employees' perception of workplace risks and their relationship with their work. Within this organization there is every indication that the training provided worked, in that those receiving what they considered to be adequate training reported greater control and more appropriate behavior at work. The risk perception survey developed in our study provides a practical means of assessing the safety climate of an organization in a manner that is responsive to its specific concerns. 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