Casino employees are often vulnerable to a range of physical and emotional problems. Employees who work in casinos are expected to always treat customers with respect, smiles and dignity. Shelly Field, who counts "100 Best Careers in Casinos and Casino Hotels" among the 20 books she has written, said the 24-hour go-go atmosphere found in casinos piles stress on workers. "In the casino business you always have to be `on,' and that adds to stress. Having to smile and be customer-service oriented on a constant basis becomes stressful in some instances," said Field. The primary goal is to keep customers in the casino happy in spite of their attitude or behavior. Customers may often be intoxicated or angry over gambling losses. Employees are expected to tolerate rude and often insulting behavior. This can lead to stress, depression, hypertension, heart disease and anger. Since anger is a secondary emotion it is almost always preceded by frustration, stress or some other intense emotion.

Unrecognized and/or untreated workplace stress and anger can lead to an increase in sick day usage, accidents, interpersonal conflicts and poor morale. The resulting frustration experienced by the employee can trigger an angry outburst or employee burnout. According to an article published in CasinoDealers.net. Stress is extremely problematic among casino workers: 75% of casino workers identified stress as a significant cause of job dissatisfaction.50% of surveyed casino workers reported