The Invisible Toxicity of Work: From an Early Observation to Four Decades of Research on Stress, Health, and Resilience

More than four decades ago, an informal observation among approximately 200 managers and other professionals who had survived a first myocardial infarction profoundly changed the direction of my professional life. During doctoral research at the University of Minnesota, I participated in data collection at the Mayo Clinic and was struck by the fact that more than 90% of those interviewed spontaneously attributed their cardiac event principally to their work. Participants with a previous history of cardiovascular disease had been excluded. Although this observation was neither a controlled epidemiological study nor evidence of causality, it generated a question that has remained central throughout my career: can work become a form of invisible toxicity capable of damaging both physical and mental health?This question led to more than four decades of research on stress, health, work, organizational culture, and resilience, including a research collaboration in Montreal with Hans Selye and multidisciplinary work with André Arsenault (Montreal Institute of Cardiology) and other colleagues. Since then, the scientific evidence linking psychosocial working conditions and cardiovascular disease has expanded substantially. Contemporary estimates indicate that work-related diseases and injuries account for millions of deaths globally, while long working hours alone have been associated with hundreds of thousands of deaths from ischemic heart disease and stroke. At the same time, depression and anxiety impose an enormous global burden on workers and economies.The central argument of this perspective is that the future of occupational health must move beyond treating stress after it becomes pathological. We need earlier diagnosis of chronic stress, greater attention to organizational sources of toxicity, and systematic redesign of work to enhance resilience and well-being.