[Psychosocial stress at work and disease risks : Scientific evidence and implications for practice]

Abstract

The modern working world makes a significant contribution to the development of diseases, which goes far beyond the field of traditional occupational diseases. Despite technological progress and successful medical healthcare, distinct widely disseminated psychosocial working conditions contribute to a remarkable burden of work-related diseases. By inducing chronic activation of psychobiological stress reactions, they promote the development of various physical and mental disorders. To identify "toxic" constellations within the complexity and variability of modern work environments, a theoretical model is required. It aims at delineating core critical elements at a level of generalization that enables their identification in a wide range of occupations. This article describes the leading theoretical work stress models in the international research and it demonstrates their contribution towards explaining elevated disease risks among employees. Research based on prospective epidemiologic cohort studies focused specifically on depressive disorders and coronary heart diseases. Two theoretical concepts received particular attention, the demand-control and the effort-reward imbalance models. Results derived from meta-analyses indicate increased relative risks of these disorders in the range of 35-80% among those exposed to these stressors compared to nonexposed groups. Finally, practical implications of this scientific evidence for worksite screening and health promoting activities are discussed.

Keywords: Coronary heart disease; Demand-control model; Depression; Effort-reward imbalance model; Health promotion.