While research has demonstrated positive effects from health promotions at the worksite, experts advise those interested in launching such programs to proceed with caution. "Confidentiality is an issue," notes Ruth Behrens of the Washington Business Group on Health. "In the process of encouraging people to change their life style, you will probably uncover some poor life styles, and if you use that against people in the future, it will never work." "In some cases, companies might not need to provide fitness because employes are getting it on their own," says Jack Jones, chief industrial psychologist of the St. Paul's Companies, a property insurance firm that conducts corporate stress tests. "We recommend fitness programs for maybe one fifth of our clients.

"Our main recommendation is to deal with organizational and management stressors in high-risk stress groups. Number two is to teach employes what stress is and to understand that stress causes accidents and losses." Research psychologist Larry Murphy of the National Institute of Occupational Safety and Health warns against "treating the worker as a white rat."

"Management and labor see stress from their different camps . . . The camps have remained pretty isolated and narrow," notes Murphy, who is writing a book on worksite stress management programs. The programs can work, Murphy says, if they are presented as a benefit to the worker rather than a bottom-line gain for the company. "A big brother approach is a thing of the past -- 'Okay, boys and girls let's all talk about smoking,' " says General Health's Kathryn Kelly. "It only works for a very few companies. There are a lot of ways to change health behavior -- removing cigarette vending machines, putting happy face stickers on foods low in cholesterol, putting a scale in the bathroom. There doesn't have be this great big production, and still they can be wildly successful." "There are sociological issues here," notes Brandeis University sociologist Peter Conrad. "One could look at this and say, 'Isn't the company becoming more involved in leisure activity and everyday lives?' It's not just in health. Drug testing is another side of the coin.

"There is some sociological fuzzing of the lines between off time and work time. That may have some consequences we don't know about."