Original Research
Occupational Health

Occupational Stress and Its Associated Factors Among Workers in Malaysia

Source: Malaysian Journal of Public Health Medicine — Occupational Health Research Series

Publisher: Malaysian Public Health Physicians’ Association

Last reviewed: March 2026

Background

Occupational stress has emerged as one of the most significant occupational health concerns globally, with substantial implications for individual well-being, organisational productivity, and healthcare systems. The World Health Organisation has identified work-related stress as a modern hazard that is particularly pronounced in rapidly developing economies where workforce demands are evolving rapidly. In Malaysia, where the labour market has undergone significant transformation alongside the country’s economic development, understanding the prevalence and determinants of occupational stress is essential for developing effective workplace health policies.

The Malaysian Journal of Public Health Medicine has published a substantial body of research examining occupational stress across diverse working populations in Malaysia. This article summarises the key findings and insights from this research programme, which collectively provides a comprehensive picture of workplace stress in the Malaysian context.

Prevalence of Occupational Stress in Malaysia

A systematic review of occupational stress prevalence among selected working populations in Malaysia, published in MJPHM in 2018, synthesised findings from multiple studies conducted across various occupational sectors. The review identified significant variation in stress prevalence across different job categories, reflecting the diverse nature of workplace stressors encountered in different professional settings.

In the healthcare sector, occupational stress has been particularly well documented. Research on the public health workforce in Terengganu, Malaysia, conducted across all eight District Health Offices and government health clinics, revealed that nurses experienced the highest percentage of occupational stress at 24.3%, followed by medical assistants at 18.3% and physicians at 16.0%. Public health assistants demonstrated the lowest rates of occupational stress among the groups studied.

Studies of nurses at tertiary referral hospitals have further characterised the stress-satisfaction-turnover nexus. Research at a Terengganu tertiary referral hospital involving nurses aged predominantly between 26 and 45 years (83.9% of the sample) found that occupational stress and job satisfaction were significant predictors of intent to leave, with these factors contributing 28.7% to the variance in turnover intention. The mean occupational stress score was 1.966 on a standardised scale, with a moderate relationship between stress, satisfaction, and intent to leave (R = 0.536, p = 0.001).

Predictors of Occupational Stress

The MJPHM literature has identified two broad categories of occupational stress predictors in the Malaysian workforce. Organisational factors include high job demand, poor workplace conditions, lack of organisational support, job insecurity, long working hours, burdens related to career development, and interpersonal conflicts. Individual or extra-organisational factors encompass gender, age, marital status, number of children, and the coping strategies employed by workers.

The Karasek demand-control-support model has been applied in several MJPHM studies to characterise job types and their associations with stress. Research using the Malay version of the Job Content Questionnaire found that different occupational groups exhibited distinct patterns: doctors were most likely to have active jobs (46.4%), medical assistants had the highest proportion of low-strain jobs (17.9%), and public health assistants predominantly had passive job types (44.7%).

Impact of COVID-19 on Occupational Stress

The COVID-19 pandemic intensified occupational stress across multiple sectors in Malaysia, as documented in several MJPHM publications. Healthcare workers, in particular, faced substantially elevated risks due to direct exposure to the virus, increased workloads, and the emotional toll of treating critically ill patients during successive waves of infection.

Research among laboratory healthcare workers in Central Peninsular Malaysia during the pandemic found a prevalence of probable generalised anxiety disorder of 20.7%. Factors significantly associated with anxiety included younger age (adjusted odds ratio: 3.23; 95% CI: 1.22–8.57) and excessive working hours. Similarly, studies among higher education employees found elevated rates of depression (26.5%), anxiety (36.2%), and stress (21.3%) during the pandemic period.

Intervention Strategies

The research published in MJPHM collectively points towards several evidence-based strategies for addressing occupational stress in Malaysia. Dual approaches involving both organisational-level and individual-level interventions are recommended. At the organisational level, this includes workload management, improved workplace conditions, enhanced supervisory support, clearer career development pathways, and conflict resolution mechanisms. At the individual level, stress management training, resilience building, and access to mental health support services are identified as important components.

The research also emphasises the importance of tailored interventions that address the specific stressors faced by different occupational groups, rather than generic one-size-fits-all programmes. For healthcare workers, strategies addressing staffing adequacy, shift scheduling, and emotional support are particularly relevant. For educators, interventions focusing on student behaviour management and workload reduction have been recommended.

Limitations of the Evidence Base

Most occupational stress studies published in MJPHM employ cross-sectional designs, which capture stress levels at single time points but cannot establish causal relationships or track changes over time. Self-report measures of stress may be subject to response biases. The preponderance of studies focused on healthcare workers and educators means that stress patterns in other important sectors—including manufacturing, agriculture, and the service industry—remain less well documented. Geographic concentration of studies in certain states limits generalisability to the national level.