MP120111AH2_029-1I am Tom Cox: I am both an organizational and a health psychologist of some experience broadly specialising in occupational and public health issues relating to the sustainability and the quality of working life. I was awarded the CBE in 2000 for my contribution to occupational health. This award was largely related to my role in the development of the Management Standards approach to work-related stress and psychosocial risks to employee health.  My main focus at present is on cancer survivorship and work participation and, not unrelated, issues relating to post-traumatic stress. I have other second-level research interests, however, including sexual and reproductive health which goes back many years.

I have held Chairs at three universities. I have just retired from Birkbeck University of London where I held the Chair of Occupational Health, Psychology & Management and was the Founding Director of the Centre for Sustainable Working Life (CSWL) in the School of Business, Economics & Informatics. In this role, I also established a Professional Doctorate in Occupational Health, Psychology & Management and was Programme Director until my retirement.

I am heavily involved in the METIS Collaboration as its Co Director. METIS is hosted at the University of Aberdeen by the Academic Urology Unit in the Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition. I hold an Honorary Chair in Occupational Health, specialising in long term conditions and working life, at that University. I also hold an Emeritus Chair in Organizational Psychology at the University of Nottingham, my Alma Mater, in the Division of Psychiatry & Applied Psychology, School of Medicine.

My professional activities and those of my wife, Professor Sue Cox OBE, are managed through COX Advisory in which we are equal partners.

images-2Hopefully, I am and will remain a productive researcher. I have had about 19126 citations of my more substantive publications (so far) with a h-index of 68 and an i10-index of 195 (Google Scholar). Since the early years of my partial retirement in 2015, I have managed 7691 citations, an h-index of 45 and an i10-index of 116 (Google Scholar). My most cited publication (1087 citations) appears to be: Research on Work-related Stress by T Cox, A Griffiths, and E Rial-González (2000) for the European Agency for Safety & Health at Work (EU OSHA).

This is my personal and research blog. At present, the Blog shares news of my current research and related interests, my professional activities, and related news. It also copies in some of my various Twitter accounts which are currently under review along with some RSS feeds in my areas of interest. You can soon read my comments on past and present political and historical events at:

The blog has achieved over 26,923 hits. Recently, the top 3 countries, by hits, have been the USA, China (with Hong Kong), and the UK with hits from Austria, Canada, Poland, Brazil, Italy, Australia, Ireland, Germany and Sweden. The blog also seems to have some appeal in some smaller countries such as Latvia, the UAE, Cyprus, Iceland, Serbia and Croatia!

Contact email:

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Getting the Message Right: Covid-19 Safety

There are always checks and balances to be discussed and decided in relation to shaping health-related behaviours; including those between individual rights and ownership of such behaviours and awareness and acknowledgement of contextual influences. The fight against the current Covid-19 pandemic is not immune to such considerations. The UK government and NHS have chosen to focus their messages on the individual’s behaviour and to strongly encourage the wearing of face masks, regular hand washing and 2 metre social distancing (face, hands and distance). This message has been made clearly and strongly reinforced.

However, in a sense, only employing this focus on the individual’s behaviour risks diverting attention away from people understanding the risks inherent in the different situations that they encounter in their everyday lives. In turn, this could also result in a sense of invulnerability. As we know from many different areas of safety-concern, avoidance of high risk situations is essential and this may not be achieved with sole reliance on the current UK face, hands and distance message.

Professor Jonathan Van-Tam (below) has offered an important addition to the current UK guidance on Covid-19 safety. Drawing on Far Eastern experience, he also recommends that people adopt an approach that draws attention to avoiding high-risk situations characterised by the Three Cs. These Three Cs are:

Closed spaces: The advice is that one cannot assume that large rooms are safe or that small rooms are unsafe. Instead, their ventilation is the important consideration.
Crowded places: The advice is to avoid crowded spaces and always, where ever you are, make room for other people – two metres or more.
Close contact settings – The advice is to avoid conversations or similar in close contact settings: the virus can be spread through the droplets created by speech.

Prof Van-Tam has said that as well as the Three Cs, people need to be aware of two further risk factors: their duration of exposure (D) to contact with other people, and the volume of noise (V) generated by the people to whom or with whom one is exposed (talking, shouting and singing).

Professor Van-Tam’s enhanced advice is both timely and required and, hopefully, will help people to assess the Covid-19 risk to themselves and to others from exposure to everyday situations. Using this enhanced approach is to be strongly recommended.


Professor Jonathan Van-Tam MBE is a British specialist in virus epidemiology and transmission, antiviral drugs and vaccinology, and pandemic preparedness. In October 2017 he took up the role of Deputy Chief Medical Officer for England.

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Continuing Research in Retirement

It is now nearly two months since I left Birkbeck University of London (BBK) having formally retired from the University of Nottingham some 10 years earlier. My commitment has always been to real world health-related research and that is where my academic heart will always remain albeit now with time and space for a more relaxed and thoughtful approach with greater freedom.

Over the two months since leaving BBK, I have been building a new platform for my research greatly helped by the re-instatement of my Honorary Chair in Occupational Health specialising in long term conditions and working life at the University of Aberdeen and my continuing collaboration with colleagues there (see post below). This research will find expression over the coming months in, among other things, the further development and launch of our METIS website which is focused on cancer survivorship, health and work participation.

This interest in cancer survivorship will also continue with my input as an External Advisor to two postgraduate projects at BBK as part of its Professional Doctorate in Occupational Health, Psychology & Management (PDP). These concern the advice and information on work participation made available to those diagnosed with head and neck cancers and the loneliness that can be experienced by cancer survivors.

There is also the possibility of further developing work in this general area with colleagues in the Social Justice Studio (UK) and, separately, with those in the University of Peking.

At the same time, I am committed to developing our existing research on post traumatic stress with colleagues in the University of Peking and also, separately, with those in Brazil (University of Minas Gerais and the Regional Fire & Emergency Service) and at BBK.

There are, of course, interesting cross-overs between these two over-arching research interests which are and which will continue to be explored as well as revisiting related issues of sexual and reproductive health. In terms of my interests in long term conditions, I am also a member of the Trial Steering Committee for the MS-Proactive Programme which involves a consortium of University Hospitals nationally as well as BBK.

Together, our various teams hope to raise new research funding and also continue to publish. Over the period during which I managed my leaving of BBK, several publications have been achieved and, undoubtedly, others will follow (see below).

Recent Publications

Teoh, K., Lima, EP Vasconcelos, A. G., Nascimento, E., & Cox, T. (2019) Trauma and work factors as predictors of firefighters’ psychiatric distress. Occupational Medicine, 69, 598-603. 

Teoh, K., Hassard, J., & Cox, T. (Accepted) Doctors’ working conditions, wellbeing and trust quality of care: A multilevel analysis. Safety Science.

Vasconcelos, A.G., Lima, E.P., Teoh, K., Nascimento, E., MacLennan S., & Cox, T.  (Accepted) Work-related factors in the aetiology of symptoms of post-traumatic stress among First Responders: The Brazilian Firefighters Longitudinal Health Study (FLoHS). Brazilian Public Health Reports (ISSN 1678-4464)

MacLennan, S., Eatough, V., & Cox, T. (Accepted) An interpretative phenomenological analysis of the meaning of work to women living with breast cancer. Chronic Illness

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Honorary Chair: Aberdeen

Since leaving Birkbeck University of London, I am proud to have been awarded an Honorary Chair in Occupational Health specialising in long term conditions and working life in the School of Medicine at the University of Aberdeen. This is effectively a renewal of my previous Honorary post there which I let lapse on taking up my position at Birkbeck. I now have a strong academic platform on which to take my research in cancer survivorship and working life forward in collaboration with Dr Sara MacLennan and her colleagues.

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Leaving the Building: Valedictory Lecture

After nearly 10 years, I am leaving Birkbeck University of London on 2nd October 2020. I will be giving an online Valedictory Lecture on Thursday 1st October – 10.30 to 11.15 on Teams: Looking Forward Looking Back Again.

All are welcome to sign in as I prepare to “leave the building. This is the Teams’ link to my Valedictory Lecture:

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The New Normal

The New Normal: For Better Or For Worse?

images-2The world around us is changing. A “new normal” is emerging driven by the coronavirus pandemic. For most people, many of the changes that they are forced to deal with are challenging and bring little joy now or in prospect. In many ways and for many people, the “new normal” is something to fear. A few are fortunate in that much of what is happening now, and will likely happen in the future, will be somewhat less challenging for them. However, some of the things that will help define the ‘new normal’ will be the sensible and necessary. Things that have been discussed for several years but somehow the times and system were never right for them to be implemented. Arguably, in the UK, the way that our National Health System functions, at the local (primary care) level, provides one such example.

Until the pandemic and lockdown, appointments with a doctor or nurse were usually made by telephone or by a visit to the surgery. Such appointments were often for a week or so later and entailed a wait in the surgery in the presence of others who were also unwell. Much of the short consultation that followed was based on questions and answers and often resulted in the writing of a prescription. The prescription was then taken to the local pharmacist who dealt with it usually within three days. It was collected and taken home. As a result of the pandemic most of this protracted process, by necessity, has been replaced by telephone appointments and consultations, prescriptions passed directly to the local pharmacist, and in many cases delivered to the person’s door. The increased use of the internet may streamline the process further and further increase either or both of the number of consultations on offer and the length of consultations. Undoubtedly, these changes will reduce the risk to patients, doctors, nurses and other primary care staff.

In terms of research, the pandemic has forced a number of important changes in focus and in methods, and in the translation of findings into both policy and practices. At the same time, the mood of politics has moved dramatically from the ‘do not trust experts’ message of the Brexit debate to “ we are led by science and by scientific advice’ of the war against Covid-19.


In terms of the nitty-gritty of research, real world issues have taken centre stage and with this move the concept of ‘fit for purpose’ methods has gained traction with the necessary recognition that perfection might actually be Voltaire’s enemy of the good. That remains to be seen in context and with hindsight. The value placed on Big Data has grown as have the challenges and short comings of driving everything by data sets that are not disaggregated by context. Both are advances but in different ways. Finally, the speed with which research findings are put into play through changes in policy and practices has increased substantially. In doing so, it has highlighted that much of the ‘usual’ delay in implementation has been unnecessarily bureaucratic in nature.


It is interesting that some, well established and well-funded universities have benefitted from these developments and particularly in the health and life sciences and in medical and technological research. At the same time, partnerships, previously frowned upon, between universities, commercial research centres and manufacturing concerns have demonstrated their real value to the country.

All these things are for the good and hopefully will define the ‘new normal’ and make life better and safer in some respects at least.

As a final comment, retrenchment and austerity are not necessarily the answers to the current crisis and should not define the ‘new normality’ in the University sector. Innovation, investment and confidence also offer a way forward and it is the responsibility of senior leaders in those institutions to understand this and act bravely upon it. Many sadly are not up to this task and a Darwinian scenario of the ‘survival of the fittest’ will most probably and sadly define the future for their sector.

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Lockdown, Isolation & Wellbeing: Thoughts

As this post is written, some news sources report that London is facing an imminent lockdown, possibly before the weekend as PM Johnson prepares new measures to tackle the rapid spread of COV ID-19 in the UK. Lockdown is effectively some level of enforcement of the isolation of people. What does this challenge mean to those people? How can they cope?

UnknownA lockdown isolating people from their work, their social contacts and environments, and preventing them from travelling will mean different things and pose different challenges to different groups of people and to different individuals. This much is common sense. Therefore, there is no easy panacea to be offered. The platform for coping under these circumstances is each person thinking things through calmly, ignoring sensationalism and fake news, and planning ahead. There are a number of key things for people to think through and decide on.

First of all, one’s days need to have purpose, focus and structure. What can I use this time for? What things can I focus on to give that my use of that time some meaning? How am I going to organize my time to give a structure to my days? Different people will naturally have different answers to these questions. Possibly … I am going to use the time to do more things with my children, to get on top of things and have a good sort out, to learn more about cooking, to redo the garden, to learn something new, to read things that I have missed, to work from home etc … Obviously, deciding on a mixture of such things and then structuring one’s days around them should be good for most people.

Second, however one is locked down, there is a need to keep active. Many of the things that one might choose to focus on during this time probably include an active component if only walking around one’s home. Exercising at home is good no matter how little. If a garden is part of the plan, being outside is arguably better than being inside.

Third, there is a need to keep in the social loop somehow. Most have landlines or mobile phones, many have internet and email, and access to various forms of social media. Obviously, technology-based social interactions are not as good as being there with people and doing things but they do offer a platform for staying in touch. One can organise social time as an important and legitimate part of the plan.

Fourth, there is a need to develop attitudes and emotional reactions to current events which are positive in some way. Explicit decisions to ‘get through it’ and to ‘stay calm and positive’ can be extremely important but need to be managed actively. Shun sensationalist and fake news and the words of doomsayers. Seek out the facts and question them with healthy skepticism. Get things into perspective. Glasses are best viewed as half full and, even in dire circumstances, there are little things that can be positive, good, or make one happy. Focus on such things.

Across all of this, your plan and your determined attitudes to the situation in-hand can give you a feeling of some control and this is often accompanied by a degree of relief from feeling powerless, worried or depressed.

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Coronavirus, Health & Working Life

UnknownCoronavirus, Health & Working Life: Thoughts

Without doubt, the challenge that faces us globally as a result of the rapid spread of the new coronavirus is one of the greatest of our generation. A report published by the COVID-19 Team at Imperial College London, which is advising the UK government on its coronavirus response, warns that the current threat to public health is the “most serious” from any respiratory virus since the Spanish Flu in 1918.

This challenge should not be under-estimated but, at the same time, it must be managed sensibly without panic and on the basis of our developing understanding of the nature of this particular beast, its behavior and its effects.

COVID-19 threatens our health and most particularly that of the older members of our societies with underlying health concerns of substance. Their very survival can be threatened, although not always, while those less at risk might manifest much less of a threat to health.

The effects of COVID-19 and the way in which it is being managed, however, go far beyond those of individual and public health and are impacting our ways of working, the nature of our work organisations and of our working lives. Many of these effects will most certainly be long lasting and, at this time, we stand on the edge of significant change in the world of work.

In terms of health service provision, COVID-19 has made clear that most existing health systems cannot easily cope with such large scale challenges to public health and for two particular reasons. The first is clearly the lack of funding sufficient to keep pushing medicine-in-practice ever forward in relation to both public and occupational health. The second is the commitment to what is too wide a spectrum of service provision. In particular, we strive and seemingly need to provide health services that cover minor ailments and injuries, ones that should primarily be the individual’s responsibility. The situation that we face in this respect is partly driven by a longstanding lack of appropriate health and social education at school level.

imagesIn terms of the world of work, we are using working at home largely supported by ICT and less travel and social interaction, as a strategy for slowing the spread of the virus. This may prove effective. However, at the same time, it greatly accelerates changes in working practices that have been growing over recent years. Once established, these will not be easily reversed and this will, in turn, change the nature of our work organisations. At the same time, these changes could offer a greener working life agenda. However, social isolation, even in relation to reducing the risk of infection, may in itself prove a long term health risk. Our knowledge of the effects of such isolation have been growing and in recommending it as a public health strategy – sensibly so at this time – we may be trading a medium term win (hopefully) against a longer term cost.

Finally, there is the question of the resilience of the world economic system in the face of the COVID-19 challenge and its management. Undoubtedly, the signs are that the world is in or fast approaching a global recession with all that follows from that. Looking back, the total collapse of the system has been forecast several times across recent generations and it is still here and functioning to be challenged yet again. Recession is one thing, total systems collapse is another. There is an argument that the economic system cannot totally fail. However, that does not mean that it will not live on the edge of chaos for some time to come.

In focusing our attention and our concerns and fears on managing the spread of COVID-19, we must not ignore the changes that it and the way we manage it are having on our health behavior and on work and our working lives. To do so, will leave us unprepared for the future however it is shaped by the current challenge.

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The Three Musketeers

scenic view of rocky mountains

Photo by Fabio Marciano on

A year or so back, I wrote a short piece in a book that the School of Business, Economics & Informatics, (Birkbeck University of London) put together to mark Professor Phillip Powell’s resignation from his post as its Dean. It was entitled ‘The Three Musketeers’ and briefly described how three of us (Professor Philip Dewe, Vice Master, Professor Phillip Powell, Dean, and me (Tom Cox)) came together to set ambitious plans for a new School-level research centre with a new professional doctorate. Their focus was (and remains) occupational health, psychology and management. Phillip Powell continued to guide and support this adventure after Philip Dewe had to leave Birkbeck for health reasons eventually going home to New Zealand. I concluded my piece by saying that there was then going to be just one Musketeer left (me). The breaking news now is that there will soon be no Musketeers left as I am also resigning from BBK with effect from 2nd October 2020. I leave after nearly 10 years of service having achieved the initial goals of the Three Musketeers.

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Occupational Health Psychology: An Agenda

UnknownWe all want Occupational Health Psychology (OHP) to address relevant real world issues using methods that are fit for purpose. We want to see research, policy and practice intimately related. We want to make a difference. However, there are two important caveats that concern me with regards this otherwise exemplary vision.


First, not only should OHP address those issues that present themselves now but it must be concerned for and seek to address those that are currently emerging and those issues that we might anticipate in the short to longer terms. Obviously, this requires us to increase the importance of horizon scanning and also of preparedness in our discipline and to develop the scientific methodologies and management processes that might support them. Taken together these different things will lead us into new territories of research, conceptual and methodological, most will be situated beyond the boundaries of what is currently published in our esteemed journals. It will also lead to new forms of policy and practice. These are no bad things.

UnknownSecond, a forward-looking stance is not my only concern. There is another which is geopolitical and economic. We need to ensure our world-wide relevance and make clear our concern for all societies, peoples and forms of work. To these ends, we have to develop and practice a discipline that is relevant to the challenges and needs of under developed and developing countries and to countries outside of the Western geopolitical sphere. Achieving these things will again lead us into new  areas of research, policy and practice.

If OHP remains a discipline focused largely on the now and mainly that of Western/developed countries then it will have failed us all in the wider sense. This is especially clear when seen in the context of fast changing technologies and politics in a fast changing world economic community. The challenges are to keep OHP relevant for the future and as a real world discipline for all … if we want it to be more than just an another traditional academic subject.



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UPDATE: Publication Record



Here is a selection of my recent publications from the Centre for Sustainable Working Life, Birkbeck University of London. Together, they give a flavour of the Centre’s research programme. Of course, there are other publications from the Centre and these will be updated in due course.

Hassard, J., Teoh, K., & Cox, T (2018 Submitted) Estimating the cost of work-relatede violence: A systematic review of cost of illness studies. Safety Science (Accepted subject to minor revisions)

Teoh, Kevin, Hassard, J, and Cox, T. (2018 In press) A multilevel perspective on the interaction between job demands and resources impact on doctor wellbeing. Health Care Management Review.

Hassard, J., Teoh, K., Visockaite, G., Dewe, P., & Cox, T. (2018) The cost of work-related stress: a systematic review. Journal of Occupational Health Psychology, 23 (1), 1-17

Georgopoulou, S., Efraimidou, S., MacLennan, S. J., Ibrahim, F., & Cox, T. (2018) Social support and its relationship with health-related quality of life in patients with antiphospholipid (Hughes) syndrome. Modern Rheumatology, 55,(S1), i110

Samra, R., Cox, T., Gordon, A.L., Conroy,S., Lucassen, M., & Griffiths, A. (2017) Factors related to medical students’ and doctors’ attitudes towards older patients: A systematic review. Age and Ageing, 46: 911–919

Hassard, J., Teoh, K., Visockaite, G., Dewe, P., & Cox, T. (2018) The financial burden of workplace aggression: a systematic review of cost-of-illness studies.Work & Stress, 32 (1), 6- 32

Hassard, J.,  Teoh, K., & Cox, T (2017) Organizational uncertainty and stress among teachers in Hong Kong: work characteristics and organizational justice. Health Promotion

MacLennan, S., Cox, T., & Murdoch, S. (2016). Working together: Providing better information, advice and support on work engagement and cancer. European Journal of Surgical Oncology, 42(11), S221

Samra, R., Griffiths, A., Cox, T., Conroy, S., Gordon, A., & Gladman, J. R. (2015). Medical students’ and doctors’ attitudes towards older patients and their care in hospital settings: a conceptualisation. Age & Ageing, 44 (5), 776-783

Karanika-Murray, M., Bartholomew, K. J., Williams, G. A., & Cox, T. (2015). Leader-Member Exchange across two hierarchical levels of leadership: concurrent influences on work characteristics and employee psychological health. Work & Stress, 29 (1), 57-74

Georgopoulou, S., Efraimidou, S., MacLennan, S. J., Ibrahim, F., & Cox, T. (2015). Antiphospholipid (Hughes) syndrome: description of population and health-related quality of life (HRQoL) using the SF-36. Lupus, 24, (2), 174-179






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