Guidelines on Psychosocial Risk Assessment and Management at the Workplace 2024 PDF

MINISTRY OF HUMAN RESOURCES DEPARTMENT OF OCCUPATIONAL SAFETY AND HEALTH GUIDELINES ON PSYCHOSOCIAL RISK ASSESSMENT AND MANAGEMENT AT THE WORKPLACE (PRisMA) 2024  Guidelines on Psychosocial Risk Assessment and Management at the Workplace (PRisMA) 2024...

MINISTRY OF HUMAN RESOURCES DEPARTMENT OF OCCUPATIONAL SAFETY AND HEALTH GUIDELINES ON PSYCHOSOCIAL RISK ASSESSMENT AND MANAGEMENT AT THE WORKPLACE (PRisMA) 2024  Guidelines on Psychosocial Risk Assessment and Management at the Workplace (PRisMA) 2024 Copyright All Rights Reserved. Department of Occupational Safety and Health 2024 All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical including photocopying, recording, or any information storage and retrieval system without written permission from the Director General of Occupational Safety and Health. ISBN PUBLISHED BY THE DEPARTMENT OF OCCUPATIONAL SAFETY AND HEALTH Level 1, 3, 4 & 5 Block Setia Perkasa 4, Setia Perkasa Complex,Federal Government Administrative Centre, 62530 Federal Territory of Putrajaya  01 Preface Psychosocial risk at the workplace refers to the potential for psychological and social factors to cause harm to employees’ mental and physical health. These risks arise from the way work is designed, organised and managed, as well as from the social context in which work occurs. The purpose of the Guidelines on Psychosocial Risk Assessment and Management in the Workplace 2024 is to provide employers with guidance on the screening and assessment of psychosocial risks as well as actions to control and minimise these risks in the workplace. All employers, whether in the public or private sector, have a responsibility to uphold employees’ rights by creating work environments that prevent excessive stress and mental health risks, protect and promote employees’ mental health and well-being, and support individuals in fully and effectively participating in the workforce, free from stigma, discrimination, or abuse. Safe, healthy and inclusive workplaces not only enhance mental and physical health but also likely reduce absenteeism and presenteeism, improve work performance and productivity, boost staff morale and motivation, and minimise conflict between colleagues. PRisMA provides recommendations on interventions to better prevent, protect, promote providing work environment and support the mental health of employees. It that prevent excessive stress emphasizes the importance of organisational and mental health risks.. interventions, training for managers at all levels and employees as well as individual-focused interventions. All places of work are encouraged to adopt and implement PRisMA as an effective tool for ensuring safe, healthy and inclusive environments that foster and safeguard mental health. PRisMA will facilitate the identification and prevention of psychosocial hazards or risk factors and promote a healthy workforce. Ir. Mohd Hatta Bin Zakaria Director General, Department of Occupational Safety and Health II Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  02 Acknowledgments These guidelines have been prepared through the joint efforts of the Department of Occupational Safety and Health (DOSH), representatives from government agencies, institutions of higher learning and occupational safety and health professionals. DOSH would particularly like to thank the following organisations and distinguished individuals for their valuable contributions during the drafting of the guidelines. Technical Commitee No. Name Organisations 1. Dr. Ahmad Fitri Bin Abdullah Hair Department of Occupational Safety and Health 2. Dr. Rajinderjit Singh Hullon Department of Occupational Safety and Health 3. Dr. Ahmad Faiz Azhari Noor Department of Occupational Safety and Health 4. Dr. Mohd Fizal Izwan Abd Kadir Department of Occupational Safety and Health 5. Dr. Santhanamohan Nagesperam Department of Occupational Safety and Health 6. Dr. Muhd Zafran Bin Shamsudin Department of Occupational Safety and Health National Centre of Excellence for Mental Health, 7. Dr. Nurashikin Binti Ibrahim Ministry of Health Malaysia National Centre of Excellence for Mental Health, 8. Dr. Nur Sakinah Binti Ahmad Ministry of Health Malaysia 9. Prof. Madya Dr. Hanizah Binti Mohd Yusoff Universiti Kebangsaan Malaysia 10. Prof. Madya Dr. Irniza Binti Rasdi Universiti Putra Malaysia 11. Dr. Mohd Faiz Bin Md Tahir International Islamic University Malaysia (IIUM) 12. Dr. Nik Khairol Reza Bin Md Yazin Ministry of Health Malaysia Academy of Occupational & Environmental Medicine, 13. Prof. Dr. Victor Hoe Chee Wai Abdullah Malaysia (AOEMM) & Universiti Malaya Academy of Occupational & Environmental Medicine, 14. Dr. Anza Binti Elias Malaysia (AOEMM) 15. Dr. Zulkifli M. Yunus PETRONAS 16. Dr. Ahmad Syarifuddin Bin Ramlan PERKESO National Institute of Occupational Safety and Health 17. Dr. Muhamad Ariff Muhamad Noordin (NIOSH) 18. Dr. Mohamad Ghazali Bin Masuri Universiti Teknologi MARA Prof. Madya Ts. Dr. Mohd Shukri Bin Mohd. 19. Universiti Teknologi MARA Aris 20. Ts. Dr. Ismaniza Binti Ismail Universiti Teknologi MARA 21. Prof. Madya. Dr. Khairil Anuar Bin Md. Isa Universiti Teknologi MARA Acknowledgments III  03 Table of contents 01 02 Preface Acknowledgments II III 03 Table of Contents IV 04 List of Abbreviations VI 05 List of Figures & Tables VII 06 Terminology & Definitions VIII 07 Mental Health at the Workplace 01 07.1 : Introduction of Psychosocial Health 02 07.2 : Mental Health Conditions 03 07.3 : Psychosocial Risk at the Workplace 04 07.4 : Job Demand-Control-Support Model 04 08 Legislations & Standards 06 08.1 : Occupational Safety and Health Act 1994 07 08.2 : ISO 45003:2021 Occupational Health and Safety Management 07 09 Scope & Objectives 08 09.1 : Scope & Objectives 09 09.2 : Employer’s Roles and Responsibilities 09 09.3 : Employee’s Roles and Responsibilities 09 09.4 : Psychosocial Trained Person (PTP) 10 09.5 : PRisMA Tools 10 IV Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024 10 Assessment and Management Strategies 12 10.1 : PRisMA Process 13 10.2 : PRisMA Approach 13 10.3 : Application 15 11 Case Study 24 11.1 : Case Study 1 25 11.2 : Case Study 2 31 11.3 : Case Study 3 33 11.4 : Case Study 4 34 12 References 35 13 Appendices 36 Appendix 1 : Likelihood of Environment & Occupational Exposure Scale towards Psychosocial Risk at the Workplace (LEO26) 36 Appendix 2 : Employer Practice Checklist (EPC23) 38 Appendix 3 : PRisMA Reporting Form 40 Appendix 4 : Psychosocial Risk Management Plan of Actions (PRiMA) Table 41 Appendix 5 : RICoV and Risk Status Table 43 Appendix 6 : LEO26 Cumulative Percentage and Risk Indicator Table 43 Appendix 7 : Malaysia Standard Industrial Classification (MSIC) Codes 44 14 List of Contributors 45 Table of contents V  04 List of Abbreviations DOSH Department of Occupational Safety and Health EPC23 Employer Practice Checklist ILO International Labour Organisation JC Job Control JS Job Support Likelihood of Environment & Occupational Exposure Scale towards LEO26 Psychosocial Risk in the Workplace MOH Ministry of Health Malaysia OSH Occupational Safety and Health PRiMA Psychosocial Risk Management Plan of Actions PRisMA Psychosocial Risk Assessment and Management in the Workplace PTP Psychosocial Trained Person RICoV Risk Indicator Cut-off Value WD Work Demand WHO World Health Organisation VI Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  05 List of Figures & Tables Figure 1 : The Job-Demand-Control-Support (JDCS) Model (Karasek & Theorell (1990) 05 Figure 2 : Flowchart of PRisMA Process 14 Table 1 : Individual Score Obtained According to LEO26 Components 15 Table 2 : Individual Risk Status Based on Individual Score and RICoV Value 16 Table 3 : Total Individuals in Work Unit with High-risk Status 16 Table 4 : Percentage of Employees within an Organisational with High-risk Status 16 Table 5 : Final Organisational Psychosocial Risk Status 17 Table 6 : Employer Practice Checklist (EPC23) 18 Table 7 : Risk Management based on LEO26 Components and EPC23 19 Table 8 : Specific Risk Management for Job Control (JC) Based on LEO26 Components and the Corresponding Items on EPC23 19 Table 9 : Specific Risk Management for Work Demand (WD) Based on LEO26 Components and the Corresponding Items on EPC23 20 Table 10 : Specific Risk Management for Job Support (JS) Based on LEO26 Components and the Corresponding Items on EPC23 20 Table 11 : PRiMA Table 22 Table 12 : Individual Score Obtained According to LEO26 Components 25 Table 13 : Individual Risk Status Based on Individual Score and RICoV Value 26 Table 14 : Total Individual In Work Unit with High-risk Status 26 Table 15 : Total Percentage of Organisational Score with High-risk Status 26 Table 16 : Final Overall Organisational Psychosocial Risk Status 27 Table 17 : Risk Management based on LEO26 Components and EPC23 27 Table 18 : Specific High Risk Organisational Psychosocial Risk Status (JC) 28 Table 19 : Specific Risk Management based on LEO26 Components and EPC23 (JC) 28 Table 20 : Case study: Psychosocial Risk Management Plan of Actions (PRiMA) Table 31 Table 21 : Case Study 2 – Result Summary Example – Booking Unit 32 Table 22 : Case Study 2 – Result Summary Example – Digital Unit 32 Table 23 : Case Study 2 – Result Summary Example – Distribution Unit 33  List of Figures & Tables VII  06 Terminology & Definitions Any person who has entered into a contract of service with an Employee employer. Any person who has entered into a contract of service to employ Employer any other person as an employee. The degree to which employees have autonomy, decision-making Job Control authority and control over their work tasks and environment. Physical, psychological, social or organisational aspects of a job that require sustained physical or psychological efforts and are Job Demand therefore associated with certain physiological and psychological costs. Interpersonal and organisational assistance and resources avail- Job Support able to employees within their work environment. The environment, conditions or circumstances in which work is Work Context performed. The physical, cognitive and emotional requirements of a job or Work Demand task that individuals are expected to fulfil. A division, section, area or other relevant clusters or groups within Work Unit a workplace. Working Positive and healthy supports, includes and engages employees, Environment enhancing their well-being, productivity and satisfaction. Amount of work that individuals are expected to complete within a Workload specific period. VIII Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024 07 Mental Health at the Workplace 07.1 : Introduction of Psychosocial Health 07.2 : Mental Health Conditions 07.3 : Psychosocial Risk at the Workplace 07.4 : Job Demand-Control-Support Model  Mental Health at the Workplace 01  07 Mental Health at the Workplace 07.1 Introduction of Psychosocial Health The term ‘psychosocial health’ encompasses mental, emotional, social and spiritual aspects of well-being. It involves the interaction between psychological and social factors in the workplace (ILO, 2009a). Relationship between Mental Health and Psychosocial Health Mental health is defined as a state of well-being in which individuals realise their own potential, can cope with the normal stresses of life, work productively and contribute to their community (WHO, 2021). It also affects how individuals think, feel, act and interact with others and their environment. Psychosocial health integrates mental health with broader social and environmental factors, highlighting the interconnectedness between an individual’s psychological well-being and their social context. Promoting psychosocial health in the workplace involves creating supportive policies, fostering a positive organisational culture and providing resources that enhance resilience and well- being (ILO, 2009b). 07.1.2 Relationship between Stress, Anxiety and Depression Stress is a physical, emotional and mental response to demands or pressure from external or internal changes that exceed individual capabilities. Sources of stress can also be contributed by social factors such as socioeconomic, socio-environmental and cultural aspects. Stress is not necessarily negative; everyone experiences stress to some degree which can be: 01 02 Positive stressors Negative Stressors (eustress) (distress) A beneficial form of stress Refer to the harmful effects of that can motivate individuals, stress that can lead to physical, enhance performance and emotional and mental health contribute to overall well-being. problems such as work-related, Examples include an upcoming financial and relationship stress. wedding, the holidays or starting a new job. 02 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  Work-related stress is influenced by work organisation, work design and employee relations that occur when job demands are inappropriate or exceed individual’s capabilities. Chronic stress may contribute to the development of burnout, anxiety and depression. Burnout is a psychological syndrome that emerges as a prolonged response to chronic interpersonal stressors. While it often occurs in work environment, it can also affect other areas of life. Burnout is specifically related to work stressors and is characterised by exhaustion, cynicism and reduced professional efficacy. Anxiety is a natural reaction to stress and can be beneficial in certain situations. It helps us stay alert and focused, motivates us to act, and can improve performance. However, when anxiety becomes excessive, persistent and interferes with daily life, it may develop into an anxiety disorder, which is considered a mental health condition. Depression is a common mental disorder characterised by persistent sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite and poor concentration lasting more than two weeks. Depression can affect anyone, impairing their ability to function and enjoy life. It can be triggered by stressful life events, chronic illness or genetic vulnerability. Additionally, depression can increase sensitivity to stressors and heighten anxiety. 07.2 Mental Health Conditions Employees may experience mental health conditions such as anxiety disorders, depressive disorders, bipolar disorder and schizophrenia. With appropriate treatment and intervention, With appropriate treatment individuals with mental health conditions can continue to work productively. A safe workplace with a supportive psychosocial and intervention, individuals environment enables these individuals to functionn optimally. with mental health Treating mental health conditions and promoting psychosocial conditions can continue to support often lead to increased productivity in the workplace. By work productively. understanding and addressing these aspects, a healthier, more productive workplace can be created, ultimately benefiting both employees and the organisation.  Mental Health at the Workplace 03  07.3 Psychosocial Risk in the Workplace Psychosocial risk is the combination of the likelihood of occurrence of exposure to work-related hazard(s) of a psychosocial nature and the severity of injury or ill health that can be caused by these hazards (ISO 45003: 2021). Examples of psychosocial hazards are: 1. Workload: Excessive workload or unrealistic deadlines. 2. Work Context: Poor communication, conflicts or lack of social support. 3. Work Content: Monotonous or repetitive tasks. 4. Job Control: Lack of autonomy or decision-making authority. 5. Role Clarity: Unclear job roles or responsibilities. 6. Organisational Culture: Bullying, harassment or discrimination. 7. Work-life Balance: Inflexible work schedules or long working hours. 8. Career Development: Limited opportunities for growth or advancement. Impact on Employees: Impact on Organisations: Psychosocial risks can lead Organisations may experience to increased stress, burnout, decreased productivity, anxiety, depression and reduced increased absenteeism and job satisfaction. They may also presenteeism, higher turnover contribute to physical health rates and reputational damage issues such as cardiovascular if psychosocial risks are not problems. effectively managed. managing stress 07.4 Job Demand-Control-Support Model by identifying The Job-Demand-Control-Support (JDCS) Model provides insights into situations managing stress by identifying situations and individual characteristics that are and individual crucial during stressful times. The model shown in Figure 1 explains how job characteristics characteristics affect employees’ psychological well-being. It illustrates how that are crucial job demands, such as heavy workloads, role ambiguity, and job-related strain, during stressful can cause stress for employees. However, the model suggests that individuals times. can manage these stressors by utilising job skills that provide them with autonomy and control over their work (Karasek & Theorell, 1990). Specifically, it demonstrates that high job demands increase stress levels among employees. 04 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  Low Strain Active High Job Job Job Control Passive High Strain Low Job Job Low High Job Demands Figure 1: The Job-Demand-Control-Support (JDCS) Model (Karasek & Theorell (1990) ©Copyright R. Karasek JCQ Center Global ApS. All rights reserved.www.jcqcenter.com However, employees can decrease this stress by gaining greater job control and developing strong relationships with their colleagues and supervisors. The JDCS model is effective when an employee applies the following principles Karasek & Theorell (1990), Treiber & Davis (2011): Gain control over Gain support from Gain support from Increase the the job. the supervisor. your colleagues. psychosocial well-being. Mental Health at the Workplace 05  08 Legislations & Standards 08.1 : Occupational Safety and Health Act 1994 08.2 : ISO 45003:2021 Occupational Health and Safety Management 06 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  08 Legislations & Standards 08.1 Occupational Safety and Health Act 1994 Coverage of Act: 01 This Act shall apply to all places of work throughout Malaysia, including public services and statutory authorities, except for the work specified in the First Schedule of the Act. Duty to Conduct Risk Assessment: 02 Section 18B of the Act stipulates that every employer, self-employed person or principal shall carry out a risk assessment in relation to the safety and health risks posed to any person who may be affected by their undertaking at the workplace. If the risk assessment indicates that risk control is required to eliminate or reduce the safety and health risk, the employer, self-employed person or principal shall implement such control. Penalty: 03 Section 19 of the Act stipulates that any person who contravenes the provisions of Section 18B shall be guilty of an offence and liable to a fine not exceeding five hundred thousand ringgit. No Action Against Person Carrying Out Occupational Health Service: 04 Section 28A of the Act shows the seriousness and protection by DOSH to any person who runs occupational health services. The section stipulates that no employer shall take any action against any person carrying out occupational health services and this may include PRisMA programme in the workplace. If the risk assessment indicates that risk control is required to eliminate or reduce the safety and health risk, the employer, self-employed person or principal shall implement such control 08.2 ISO 45003:2021 Occupational Health and Safety Management ISO 45003:2021 provides guidelines within the framework of ISO 45001 for managing psychosocial risks in occupational health and safety management systems. It emphasizes the prevention of injuries and the promotion of employee’s well-being by addressing psychosocial hazards stemming from organisational factors, social dynamics and various aspects of the work environment. These risks impact psychological health and safety as well as overall workplace well-being, with significant implications for both organisations and society at large.  Legislations & Standards 07  09 Scope & Objectives 09.1 : Scope & Objectives 09.2 : 09.3 : Employee’s Roles and Responsibilities 09.4 : Psychosocial Trained Person (PTP) 09.5 : PRisMA Tools 08 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  09 Scope and Objectives 09.1 Scope & Objectives: These guidelines are to be adopted by employers and employees as a guide for the assessment and management of psychosocial risks in the workplace. The guidelines do not cover non-work-related psychosocial risks. The scope of these guidelines includes: Providing organisational Applicability to places of work psychosocial risk assessment in Malaysia in accordance and management in the with the Occupational Safety workplace. and Health Act 1994. These guidelines aim to achieve the following objectives: 1 2 3 To provide guidance to To recommend actions To establish a standardised employers on screening for for employers to control format for recordkeeping psychosocial risks in the psychosocial risks in the and monitoring psychosocial workplace. workplace. health in the workplace. 09.2 Employer’s Roles and Responsibilities Employers shall conduct risk assessments as stipulated in the Act. They also should appoint Psychosocial Trained Person (PTP) to assist them to conduct PRisMA assessment. 09.3 Employee’s Roles and Responsibilities All employees must cooperate with the employer in all activities organised under PRisMA. They are also responsible for reporting any psychosocial issues in the workplace to the employer.  Scope and Objectives 09  09.4 Psychosocial Trained Person (PTP) Psychosocial Trained Persons (PTP) should undergo appropriate training. The appointed PTP should assist employers to conduct PRisMA based on the following processes: 1 2 3 Identifying psychosocial Assessing existing control Prioritising risk according hazards in the workplace measures to the findings 5 6 4 Reassessing the risks and Presenting the findings to the Managing the risks evaluating the effectiveness of employer and maintaining appropriately risk management records The processes are outlined in these guidelines. The PTPs must maintain the confidentiality of all information and perform their duties with integrity. 09.5 PRisMA Tools Several tools have been developed to achieve the objectives of PRisMA. They are: PRisMA PRisMA PRisMA Psychosocial Risk Employer Risk Psychosocial Assessment Tool Management Checklist Action Plan 10 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  09.5.1 PRisMA – Psychosocial Risk Assessment Tool The PRisMA Psychosocial Risk Assessment Tool is a 26-item (LEO26) screening tool guided by the International Labour Organisation (ILO) documents and aligned with ISO 45003:2021 Occupational Health and Safety Management – Psychological Health and Safety at Work – Guidelines for Managing Psychosocial Risks. LEO26 assesses the likelihood that an employee’s workplace environment and work activities impact their psychosocial health. It helps both employees and employers take appropriate actions. LEO26 has been validated and employs the cut-off value principle to determine risk levels (high or low) based on the obtained value. 09.5.2 PRisMA – Employer Risk Management Checklist The PRisMA Employer Risk Management checklist consists of 23 points (EPC23) that guide employers in taking necessary actions based on their LEO26 score. The total LEO26 score is individually matched with the 23 points on the checklist. The EPC23 checklist is only required when the LEO26 score falls into the high-risk category (refer to the PRisMA flowchart). Employers use the checklist as a guide for managing psychosocial risk at the workplace. The PTP will use the information in matching LEO26 and EPC23 for risk prioritisation. 09.5.3 PRisMA – Psychosocial Risk Management Action Plan The PRiMA table is a list of suggested actions for managing psychosocial risks in the workplace. This table contains seven themes arranged according to the LEO26 components: Job Control (JC), Work Demand (WD), and Job Support (JS). The PRiMA themes are as follows: Social Working Job Training and Support Environment Matching Education Transparency Control Workload and fairness  Scope & Objectives 11  Asessment and 10 Management Strategies 10.1 : PRisMA Process 10.2 : PRisMA Approach 10.3 : Application 12 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  10 Asessment and Management Strategies 10.1 PRisMA Process Figure 2 illustrates the PRISMA process, which consists of six components: 01 Identify Psychosocial Hazards using LEO26 02 Assess Existing Control Measures Using EPC23 PRisMA process 6 03 Prioritise Risk by Matching LEO26 and EPC2 04 Manage Risks According to Risk Prioritisation components 05 Reassess Risk 06 Recordkeeping 10.2 PRisMA Approach proactive PRisMA guides employers in screening and managing psychosocial risks in the workplace. A proactive approach is the most effective way to address workplace approach is the risks. This approach involves taking preemptive measures to identify, assess and most effective mitigate potential risks before they occur, rather than reacting to them afterward. way to address Employers can implement the following steps as part of this proactive approach: workplace risks.. a. Employee survey b. Job design review c. Risk mapping d. Policy review However, some employers may choose to respond to risks only after they have occurred. This reactive approach can be detrimental to both employers and employees. Indicators of a reactive approach include: 1. High absenteeism and/or presenteeism rates. 2. High turnover rate. 3. Complaints from others. 4. Reports or notifications of psychosocial-related cases requiring new assessments.  Asessment and Management Strategies 13  Start Low 1 Stage I Identify psychosocial Identify psychosocial hazards & characterise hazards & characterise Hazard risks using LEO26 risks using LEO26 Identification Step 1 - 7 High 2 Assess existing Stage II Assess existing control measuring using EPC23 control measuring Risk using EPC23 Assessment Step 8 & 9 3 Prioritise risks by matching LEO26 Prioritise risks by matching and EPC23 LEO26 and EPC23 Manage risks according to risk prioritisation 12 months Stage III 4 Manage risks according Risk 12 months to risk prioritisation Control Step 10 & 11 5 Reassess psychosocial High Reassess psychosocial hazards & characterise hazards & characterise risks risks using LEO26 using LEO26 Low 6 Record keeping Low 2 years/ when needed Record keeping Figure 2: Flowchart of PRisMA Process 14 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024 Properly selecting and implementing these approaches can enhance an employer’s future value and productivity. 10.3 Application PRisMA risk assessment is used to categorise the level of psychosocial risks at the work unit levels. All work units need to be assessed, including management units such as, top management and middle management units. The assessment starts with assessing the psychosocial risk of the employees using the LEO26. The data is then consolidated by work unit such as division, section, area or other relevant clusters or groups. Each work unit, requires a separate risk assessment report. The employer can take appropriate actions if, during the PRisMA process, cases are identified that require the attention of other professionals, such as doctors, counsellors, industrial psychologists, occupational therapists and others. 10.3.1 Stage I : Hazard Identification (Step 1-7) PRisMA hazard identification begins with comprehensive data collection from employees using LEO26. The LEO26 score guides the PTP in selecting appropriate actions for risk management activities. The following are the steps to determine the final organisational risk score: 1. Identify Psychosocial Hazards Step 1: Distribute LEO26 to All Employees at Targeted Work Units. The PTP and employer should make an early announcement to their employees about this programme. This is important to maximise the response rate from employees. Please refer to Appendix 1 & Appendix 7. Step 2: Collect LEO26 from All Respondents. The PTP and employer may need to decide the reasonable optimal time to achieve 100% or the highest possible response rate from the population. Step 3: LEO26 Individual Score. Identifying individual risk statuses (JC, WD, and JS) is an important step in determining the organisational psychosocial risk status. The PTP will calculate the individual scores and record them based on the LEO26 components. Score LEO26 Components Individual Score Range Job Control (JC) 11 – 55 Value 1 Q1+Q2+Q3+Q7+Q8+Q9+Q10+Q11+Q12+Q14+Q16 Work Demand (WD) 5 – 25 Value 2 Q4+Q5+Q6+Q25+Q26 Job Support (JS) 10 – 50 Value 3 Q13+Q15+Q17+Q18+Q19+Q20+Q21+Q22+Q23+Q24 Table 1: Individual Score Obtained According to LEO26 Components  Asessment and Management Strategies 15  Step 4: Individual With High-risk Status. Identify individual risk status by comparing individual score with the RICoV value (Table 2 - Refer Appendix 5 for more details). Individual LEO26 Components Score Range RICoV Risk Status Score Job Control (JC) 11 – 55 Value 1 ≥15.5 High Work Demand (WD) 5 – 25 Value 2 ≥7.5 High Job Support (JS) 10 – 50 Value 3 ≤38.5 High Table 2: Individual Risk Status Based on Individual Score and RICoV Value Step 5: Total Individual with High-risk Status by Work Unit Calculate the number of individuals from each work unit (separately) who have a high risk status (Table 3). Total Individuals with LEO26 Components RICoV Risk Status High-risk Status Job Control (JC) ≥15.5 High n Work Demand (WD) ≥7.5 High n Job Support (JS) ≤38.5 High n Table 3: Total Individuals in Work Unit with High-risk Status Step 6: Organisational Psychosocial Risk Score The percentage of employees with high-risk status compared to the total number of employees in each work unit is calculated (Table 4). Total Individuals with Organisational LEO26 Components Risk Status High-risk Status Score (%) Job Control (JC) High n n/N% Work Demand (WD) High n n/N% Job Support (JS) High n n/N% Table 4: Percentage of Employees within an Organisation with High-risk Status Step 7: Organisational Psychosocial Risk Status. The organisational risk score obtained in Step 6 is compared to the cumulative high risk percentage cut- off value of LEO 26 (Table 5 - Please refer to Appendix 6 for more details). 16 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  Organisational LEO26 Cumulative High Organisational LEO26 Components Score (%) Risk Percentage Cut-off Psychosocial Risk Status Job Control (JC) n/N% 50% and above High Work Demand (WD) n/N% 25% and above High Job Support (JS) n/N% 25% and above High Table 5: Final Organisational Psychosocial Risk Status 10.3.2 Stage II : Risk Assessment (Step 8 & 9) PRisMA risk assessment involves data analysis between LEO26 and EPC23 scores. The PTPs will analyse the data and assess any existing control measures using EPC23. The work unit representative is responsible for completing the checklist. The following are the steps to determine the risk according to priority: 2. Assess existing control measures using EPC23 Step 8: Assessment of Current Practice (where applicable) If any of the organisational risk statuses (JC, WD, or JS) is high, the PTP will proceed with assessing the current practice using EPC23. The EPC23 will be distributed to the work unit representative to be completed. The PTP is responsible for confirming all evidence that the employer affirms as “Yes” under EPC23. For “No” answers, proceed with the risk prioritisation process and refer to the PRiMA table. The psychosocial risks need to be re-evaluated after 12 months or as needed. Refer to Appendix 2 for the actual EPC document. Risk Kindly Refer to Yes/No Management Employer Practice Checklist 23 (EPC23) PRiMA Table for (√ / X) (1 – 23) ALL NO Answers Ensure the psychosocial risks of employees are 1 Social Support managed accordingly. Ensure transparency and fairness in complaint-handling Transparency and 2 procedures. Fairness 3 Ensure tasks are clearly defined. Job Matching 4 Ensure work hours are predictable and reasonable. Workload Provide appropriate lighting, equipment, air quality and 5 Working Environment noise levels in the workplace. Assign tasks according to the experience and 6 Job Matching competence of the employee. Strengthen motivation by emphasizing the positive and 7 Social Support useful aspects of work. Establish clear roles, and avoid role conflicts and 8 Job Matching ambiguity. 9 Provide job security as far as possible. Working Environment  Asessment and Management Strategies 17  Risk Kindly Refer to Yes/No Management Employer Practice Checklist 23 (EPC23) PRiMA Table for (√ / X) (1 – 23) ALL NO Answers Create an infrastructure where supervisors are 10 responsible for employees and maintain appropriate Control levels of communication. Ensure human resources and staffing levels are 11 Control sufficient. Take ergonomic factors into account to limit stress on 12 Working Environment employees. Ensure a good relationship between supervisors and 13 Social Support employees. 14 Ensure proper use of skills. Job Matching Encourage employees to discuss any conflicting Transparency and 15 demands between work and home. Fairness Provide information on psychosocial risks and work- Training and 16 related stress and how to prevent them. Education Match the job with the employee’s physical and 17 Job Matching psychological skills and abilities. Periodically assess the time requirements of a job and 18 Workload set a reasonable deadline/pace. Allow employees to express input on how their work is Transparency and 19 carried out. Fairness Provide adequate training to ensure employees’ skills Training and 20 align with their jobs. Education 21 Foster positive relationships between employees. Social Support Maintain a workplace free from physical and 22 Working Environment psychological violence. Provide psychosocial support for employees with mental 23 Social Support health conditions. Table 6: Employer Practice Checklist (EPC23) If none of the organisational risk status (JC, WD, and JS) is high, the PTP should reassess according to reactive criteria after two years or when needed. 3. Prioritise Risk by Matching LEO26 and EPC23 Risk management will be based on the total organisational risk score derived from LEO26. Analysis of LEO26 and EPC23 will provide appropriate recommendations for psychosocial risk management in the workplace. The implementation of the psychological risk management should be based on best practices and to ensure good occupational safety and health practices is adhered to at all times. When there is a conflict between the risk management measures and company’s policy and procedures, there should be a discussion between the PTP and employer to identify the most appropriate control measures. 18 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  Risk control actions are categorised into short-term (1-6 months) and long-term (12 months). Employers should regularly monitor employees’ psychosocial risks. In the process of monitoring psychosocial risk, employer’s must ensure the confidentiality of all employees’ information. Immediate assessments and support should be provided as necessary. Step 9: Risk Prioritisation For any Organisational Psychosocial risk status scores (JC, WD, JS) with a high-risk value (based on findings from Step 7), the PTP should match the LEO26 components and EPC23 responses for risk prioritisation. If there is a discrepancy between the LEO26 components and the EPC23 scores, priority in managing risk should be given to LEO26 components with high risk even when the corresponding EPC23 appears satisfactory (refer case study 2 for more details). It is important for the PTP to communicate this situation clearly to the employer. LEO26 Components Item Risk Management (1 – 23) Job Control (JC) Work Environment 1 Job Control (JC) Tools and Workspaces 5, 9, 12 Job Control (JC) Career Progress 14, 17, 20 Work Demand (WD) Balance Work and Daily Life 3, 15 Work Demand (WD) Working Hours 4, 11, 18 Job Support (JS) Role in the Organisation 6, 8, 19 Job Support (JS) Relationship between Colleagues 7, 13, 21 Job Support (JS) Organisational Culture 2, 10, 16, 22, 23 Table 7: Risk Management based on LEO26 Components and EPC23 With regard to the risk prioritisation, the PTP may choose and refer to the specific table as follows (depending on the risk status). LEO26 Components Item Risk Management (1 – 23) Job Control (JC) Work Environment 1 Job Control (JC) Tools and Workspaces 5, 9, 12 Job Control (JC) Career Progress 14, 17, 20 Table 8: Specific Risk Management for Job Control (JC) based on LEO26 Components and the Corresponding Items on EPC23  Asessment and Management Strategies 19  LEO26 Components Item Risk Management (1 – 23) Work Demand (WD) Balance Work and Daily Life 3, 15 Work Demand (WD) Working Hours 4, 11, 18 Table 9: Specific Risk Management for Work Demand (WD) based on LEO26 Components and the Corresponding Items on EPC23 LEO26 Components Item Risk Management (1 – 23) Job Support (JS) Role in the Organisation 6, 8, 19 Job Support (JS) Relationship Between Colleagues 7, 13, 21 Job Support (JS) Organisational Culture 2, 10, 16, 22, 23 Table 10: Specific Risk Management for Job Support (JS) Based on LEO26 Components and the Corresponding Items on EPC23 10.3.3 Stage III : PRisMA: Risk Control (Step 10 & 11) Psychosocial risk management involves implementing strategies and measures to prevent, mitigate or manage risks that can impact employees’ psychological and social well-being. It aims to create a supportive work environment that enhances mental health, job satisfaction and overall well-being. Further details on risk management will be discussed in the following section. 4. Manage Risks According to Risk Prioritisation Step 10: Risk Management Plan of Actions Once Step 9 is completed, appropriate management strategies can be proposed according to the PRiMA table (Table 11). The PTP will present the assessment results and outline the psychosocial risk management measures that need to be taken by the employer (JC, WD, and/or JS). This includes: Social Support Workload Control Job Matching Training and Education Working Environment Transparency and fairness The PTP may refer to the psychosocial risk management plan of actions (PRiMA) table to summarise their process. 20 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024 Circle all NO answer(s) of EPC23 Job Work Job Re- Control Demand Support Theme Action marks (JC) (WD) (JS) 1. To foster positive relationships between employees. 2. To maintain a workplace free from physical and psychological violence. 3. To ensure there is a good relationship between supervisors and employees. 4. To create an infrastructure where supervisors are responsible for employees and have an appropriate level of 7 communication. 5. To encourage employees to discuss any 13 Social conflicting demands between work and 1 Support home. 21 6. To strengthen motivation by emphasizing 23 positive and useful aspects of career. 7. To provide support on employees’ welfare to ease daily work components such as flexible working hours, child care centres, marriage and family counselling, money management and others. 8. To encourage participation in social activities such as family day, sports day, festive season celebration, etc. 1. To provide appropriate lighting, equipment, air quality and noise levels. 2. To avoid exposure to harmful agents. 5 3. Take ergonomic factors into account to Working limit stress on employees. 9 22 Environ- ment 4. To address incivility in the workplace – 12 internal and external. 5. To train employees to adapt to multiple working environments: physical, psychological, emotional, and social. 1. To ensure jobs match the employee’s physical and psychological skills and abilities. 14 6 Job 2. To assign tasks according to experience 3 Matching and competence. 17 8 3. To ensure proper use of skills. 4. To ensure employees’ roles and responsibilities are clearly defined.  Asessment and Management Strategies 21  Job Work Job Re- Control Demand Support Theme Action marks (JC) (WD) (JS) 1. To provide adequate training to ensure that skills and jobs are suitable for employ- ees. 2. To provide information on psychosocial risks and work-related stress and how to prevent them. 3. To conduct mental health awareness Training programmes such as emotional support, 20 16 and Edu- stress and anger management, and over- cation coming burnout at the workplace. 4. To introduce and provide proper job man- agement in the workplace. 5. To provide specific training such as psy- chosocial programmes, work-life balance workshops, resilience-building training. 6. To provide training that relates to employ- ees’ real duty. 1. To ensure tasks are clearly defined. 2. To provide clear roles, avoid role conflicts and ambiguity. 2 Transpar- 3. To provide job security as far as possible. 15 ency and 19 Fairness 4. To provide adequate wages for work per- formed. 5. To ensure transparency and fairness in complaint-handling procedures. 1. To ensure adequate resource levels. 2. To review current job process - rotate and rearrange if possible to improve produc- tivity. 3. To discuss with employees the opportunity to control the occupational activities and sub-activities according to employees’ performance. 11 10 Control 4. To provide opportunities for employees to manage their work, such as selection of location (home or office) and work pace. 5. Allow employees to express input on how their work is carried out. 6. To discuss with employees on how to be involved in decision -making (where appli- cable). 1. To continually assess time requirements 4 and set reasonable deadlines. Workload 2. To ensure that working hours are predict- 18 able and reasonable. Table 11: PRiMA Table Date of Assessment: Date of Re-assessment: Please refer to Appendix 4. 22 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024 Upon completing the assessment, the PTP should submit the report to the employer within 30 days. 5. Reassess Risk Step 11: Reassessment The PTP will conduct a re-evaluation based on the PRisMA work processes: If any of the components of LEO26 (JC, WD, JS) has a high-risk score, the PTP should re-evaluate after 12 months or when needed. If none of the components of LEO26 (JC, WD, JS) has a high-risk score, the PTP should reassess according to reactive criteria after two years or when needed. 6. Recordkeeping All records must be kept by the employer for audit purposes by DOSH and for the improvement process for at least seven (7) years or whichever is longer. The PTP must maintain confidentiality under the Personal Data Protection Act (PDPA) 2010. Limitation PRisMA is not a clinical diagnostic tool. It is used to identify workplace psychosocial risk factors or hazards. The screening data obtained, such as JC, WD, and JS, will provide guidance to employers and employees regarding psychosocial risks in the workplace. Factors outside of employment, such as non-work-related and personal factors, need to be assessed separately. Asessment and Management Strategies 23  11 Case Study 11.1 : Case Study 1 11.2 : Case Study 2 11.3 : Case Study 3 11.4 : Case Study 4 24 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  11 Case Study These guidelines will provide a basis for decision-making. The results can serve as a reference for any further actions. Below are examples of cases and actions that should be taken by the employer. 11.1 Case Study 1 EMAS Edar is a small packaging company that has 10 employees and one manager. EMAS Edar wants to take proactive steps to participate in the PRisMA programme. The PTP is recommended to refer to the step- by-step guide as follows: 1. Identify Psychosocial Hazards Example of risk indicator according to the established RICoV (based on 10 employees). Step 1: Distribute LEO26 to All Employees. Please refer to Appendix 1. Step 2: Collect LEO26 from All Respondents. Allow reasonable time for employees to return the assessment form. Step 3: LEO26 Individual Score. The PTP identifies the individual risk status (JC, WD, and JS) by calculating the individual scores obtained and recording them according to the LEO26 components. Score LEO26 Components Individual Score Obtained (N=10) Range 1 2 3 4 5 6 7 8 9 10 Job Control (JC) Q1+Q2+Q3+Q7+Q8+Q 11 – 55 16 18 18 30 30 46 55 14 13 12 9+Q10+Q11+Q12+Q1 4+Q16 Work Demand (WD) 5 – 25 6 5 5 5 5 6 6 8 8 6 Q4+Q5+Q6+Q25+Q26 Job Support (JS) Q13+Q15+Q17+Q18+ 10 – 50 40 39 39 40 40 50 49 50 50 37 Q19+Q20+Q21+Q22+ Q23+Q24 Table 12: Individual Score Obtained According to LEO26 Components  Case Study 25  Step 4: Individual with High-risk Status. The PTP identifies the individual risk status. Please refer to Appendix 5. Risk LEO26 Score Individual Score Obtained (N=10) RICoV Sta- Components Range tus 1 2 3 4 5 6 7 8 9 10 Job Control (JC) 11 – 55 16 18 18 30 30 46 55 14 13 12 ≥15.5 High Work Demand 5 – 25 6 5 5 5 5 6 6 8 8 6 ≥7.5 High (WD) Job Support 10 – 50 40 39 39 40 40 50 49 50 50 37 ≤38.5 High (JS) Table 13: Individual Risk Status Based on Individual Score and RICoV Value Step 5: Total Individual with High-risk Status. The PTP calculates the total individual for each work unit falls under the high-risk category. Total Individual LEO26 Components RICoV Risk Status with High-risk Status Job Control (JC) ≥15.5 High 7 Work Demand (WD) ≥7.5 High 2 Job Support (JS) ≤38.5 High 1 Table 14: Total Individual In Work Unit with High-risk Status Step 6: Organisational Psychosocial Risk Score. The PTP calculates the percentage value of all individuals with high-risk status. Total Individual Organisation- LEO26 Components Risk Status with High-risk al Score (%) Status Job Control (JC) High 7 70 Work Demand (WD) High 2 20 Job Support (JS) High 1 10 Table 15: Total Percentage of Organisational Score with High-risk Status Step 7: Organisational Psychosocial Risk Status. The PTP identifies the organisational risk status. Please refer to Appendix 6. 26 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  Organisational Organisational LEO26 Cumulative High Risk LEO26 Components Psychosocial Score (%) Percentage Cut-off Risk Status Job Control (JC) 70 50% and above High Work Demand (WD) 20 25% and above Low Job Support (JS) 10 25% and above Low Table 16: Final Overall Organisational Psychosocial Risk Status 2. Assess Existing Control Measures Using EPC23 Step 8: Assessment of Current Practice (where applicable). Since the JC component for organisational psychosocial risk status is high, the PTP will proceed with EPC23. The PTP will distribute the EPC23 to the EMAS Edar packaging work unit representative. The PTP is responsible for collecting all evidence that the employer affirms as “Yes” under EPC23. Please refer to Appendix 2. Step II PRisMA: Risk Management. Psychosocial risk management for EMAS Edar packaging. 3. Prioritise Risk by Matching LEO26 and EPC23 Step 9: Risk Prioritisation The PTP matches the LEO26 components and EPC23 responses for risk prioritisation. Risk Management LEO26 Components Item (1 – 23) Job Control (JC) Work Environment 1 Job Control (JC) Tools and Workspaces 5, 9, 12 Job Control (JC) Career Progress 14, 17, 20 Work Demand (WD) Balance Work and Daily Life 3, 15 Work Demand (WD) Working Hours 4, 11, 18 Job Support (JS) Role in the Organisation 6, 8, 19 Job Support (JS) Relationship Between Colleagues 7, 13, 21 Job Support (JS) Organisational Culture 2, 10, 16, 22, 23 Table 17: Risk Management based on LEO26 Components and EPC23 Since the EMAS Edar packaging organisational psychosocial risk status for JC is high, the plan of actions will be selected accordingly.  Case Study 27  LEO26 Cumulative LEO26 Organisational Organisational Score (%) High Risk Percentage Components Psychosocial Risk Status Cut-off Job Control (JC) 70 50% and above High Table 18: Specific High Risk Organisational Psychosocial Risk Status (JC) Since the EMAS Edar packaging organisational psychosocial risk status for JC is high, the plan of actions will be selected accordingly. 4. Manage Risks According to Risk Prioritisation Step 10: Risk Management Plan of Actions. The PTP presents the assessment results and outlines the psychosocial risk management measures that need to be taken by the employer. The selection for plan of actions will be focused on JC components only. Risk Management LEO26 Components Item (1 – 23) Job Control (JC) Work Environment 1 Job Control (JC) Tools and Workspaces 5, 9, 12 Job Control (JC) Career Progress 14, 17, 20 Table 19: Specific Risk Management based on LEO26 Components and EPC23 (JC) The PTP may refer to the psychosocial risk management plan of actions (PRiMA) table to summarise their plan of actions. Please refer to Appendix 4. Upon completing the assessment, the PTP must submit the report to the employer within 30 days. 5. Reassess Risk Step 11: Reassessment. The PTP will reassess the workplace based on the PRisMA work processes. 6. Recordkeeping All records must be kept by the employer for DOSH audit purposes and for the improvement process for at least seven (7) years or whichever is longer. The PTP must maintain confidentiality under the Personal Data Protection Act (PDPA) 2010. Please refer to Appendix 3. 28 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024  EMAS Edar Packaging Case Report Example Name of Department/unit : EMAS Edar Packaging Total number of Staff : 10 Number of Staff Assessed : 10 % Participation : 100 % WORKPLACE PSYCHOSOCIAL RISK REPORT LEO26 Cumulative Organisational LEO26 Com- Organisation- Circle all No an- High-Risk Psychosocial Risk LEO26 Items ponents al Score (%) swer(s) of EPC23** Percentage Status* Cut-Off Work environment  1, Job Control 70% 50% and above Low High Tools and workspaces 5, 9, 12 (JC) Career progress 14, 17, 20 Work Demand Balance work and daily life 3, 15, 20% 25% and above Low High (WD) Working hours 4, 11, 18 Role in the organisation 6, 8, 19 Job Support 10% 25% and above Low High Relationship between colleagues 7, 13, 21 (JS) Organisational culture 2, 10, 16, 22, 23 *Circle where is appropriate. **Refer to the PRiMA table (JC, JS & WD). Comment : The PTP as identified component 14 (No) that needs an immediate attention. Improvement action plans will be discussed with the management team. Name & PTP Reg. No. : Aris Masuri B. Ismail Isa: DOSH PTP-001/24 Signature : Aris Isa EMAS Edar Packaging Case Date : 7th July 2024 Report Example Official Stamp : Case Study 29 PRiMA Table Psychosocial Risk Management Plan of Actions (PRiMA) Matrix. Circle all No answer(s) of EPC23 Job Work Job Control Demand Support Theme Action Remarks (JC) (WD) (JS) 1. To foster positive relationships between employees. 2. To maintain a workplace free from physical and psychological violence. 3. To ensure there is a good relationship between supervisors and employees. 4. To create an infrastructure where supervisors are responsible for employees 7 and have an appropriate level of communication. 13 5. To encourage employees to discuss any Social 1 conflicting demands between work and Support 21 home. 6. To strengthen motivation by emphasizing 23 positive and useful aspects of career. 7. To provide support on employees’ welfare to ease daily work components such as flexible working hours, child care centres, marriage and family counselling, money management, and others. 8. To encourage participation in social activities such as family day, sports day, festive season celebration, etc. 1. To provide appropriate lighting, equipment, air quality, and noise levels. 5 2. To avoid exposure to harmful agents. 3. Take ergonomic factors into account to Working 9 limit stress on employees. 22 Environ- ment 4. To address incivility in the workplace – 12 internal and external. 5. To train employees to adapt to multiple working environments: physical, psychological, emotional, and social. 1. To ensure jobs match the employee’s 1. Job match- physical and psychological skills and ing analysis. abilities. 2. Job promo- 6 2. To assign tasks according to experience tion. 14 3 Job and competence. 3. Job match- 17 8 Matching ing analysis. 3. To ensure proper use of skills. 4. Written job 4. To ensure employees’ roles and scope and job review. EMAS Edar Packaging Case Report responsibilities are clearly defined. 5. Others... Example 30 Guidelines on Psychosocial Risk Assessment and Management at Workplace 2024 PRiMA Table Psychosocial Risk Management Plan of Actions (PRiMA) Matrix. Circle all No answer(s) of EPC23 Job Work Job Control Demand Support Theme Action Remarks (JC) (WD) (JS) 1. To ensure adequate resource levels. 2. To review current job process - rotate and rearrange if possible to improve productivity. 3. To discuss with employees the opportunity to control the occupational activities and sub-activities according to employees’ performance. 11 10 Control 4. To provide opportunities for employees to manage their work, such as selection of location (home or office) and work pace. 5. Allow employees to express input on how their work is carried out. 6. To discuss with employees on how to be involved in decision -making (where applicable). 4 1. To continually assess time requirements and set reasonable deadlins. 18 Workload 2. To ensure that working hours are predictable and reasonable. EMAS Edar Packaging Case Report Example Date of assessment: 7th June 2024 Date of Re-assessment: Table 20: Case study: Psychosocial Risk Management Plan of Actions (PRiMA) Table 11.2 Case Study 2 KGB Company is a multinational printing company in Kuala Lumpur. The company has a total of 500 employees in three work units: the booking unit (100 employees), the digital unit (200 employees), and the distribution unit (200 employees). In line with its responsibilities, the company has proactively enrolled in the PRisMA programme. Employers have conducted screenings for all employees at both premises.  Case Study 31 The PTP must follow the PRisMA process as above for each work units. LEO26 Organisa- Circle all LEO26 Organi- Cumulative tional Psy- No an- Compo- sational High-Risk LEO26 Items chosocial swer(s) of nents Score (%) Percentage Risk Status* EPC23** Cut-Off Work environment 1, Job Control 50% and 80% Low High Tools and workspaces 5, 9, 12 (JC) above Career progress 14, 17, 20 Work Balance work and daily 25% and 3, 15, Demand 20% Low High life