Understanding the link between psychosocial work stressors and
work-related musculoskeletal complaints
Erin M. Eatough, Jason D. Way, Chu-Hsiang Chang
May 2012, Pages 554–563
Objective
The goal of the current study is to
test a stress-based model that links psychosocial work stressors, strain, and
WRMSD symptoms.
Summary
It is well established that
psychosocial work stressors relate to employees’ work-related musculoskeletal
disorder (WRMSD) symptoms. Work-related musculoskeletal disorders (WRMSDs)
affect tendons, tendons sheaths, muscles, nerves, bursae, and blood vessels in
the body. Every year, more than 70 million physician office visits can be
attributed to WRMSD-related complaints the economic burden resulting from
symptoms related to WRMSDs (including costs associated with workers’
compensation, lost wages, and productivity) at $50 billion annually.
Work-related musculoskeletal problems therefore represent a significant threat
to employees’ health and wellbeing across a wide range of industries and
occupations although multiple theoretical models (e.g., Bonger et al., 1993;
Faucett, 2005; Sauter and Swanson, 1996) exist in speculating the mechanisms
underlying the associations between psychological factors and WRMSDs, research
remains inconsistent in supporting hypotheses generated by different models
(e.g., Swanson and Sauter, 2006; Wademan and Kjellberg,2007). These conflicting
research findings may be partly due to the lack of precision in the definition
and measurement of the psychosocial aspects of jobs.We will first introduce the
occupational stress model and explain how psychosocial work stressors are
related to musculoskeletal complaints through psychological strain Specific
hypotheses based on the model will be presented. Results from structural
equation modeling will be used test the proposed hypotheses.
Existing literature supports that
these psychosocial work stressors have significant relationships to employee
strain responses (e.g., Jackson and Schuler, 1985; Spector and Jex, 1998). For
example, empirical studies have demonstrated that role conflict, job control
and leadership are associated with strain (e.g., Jex and Beehr, 1991; Siu et
al., 2004; Spector, 1986; Spector and Jex, 1998). Role conflict has been shown
to relate to employee strain responses (e.g., Jacksonand Schuler, 1985; Spector
and Jex,1998). Similarly, control has been shown to relate to strain (Spector
and Jex,1998). Effective leadership. one proposed model by Sauter and Swanson
(1996), an ecological model of musculo- skeletal disorders, is based on the
notion that both physical and psychological factors in the work environment
contribute to the experience of WRMSDs. While there are many possible
mediating mechanisms between strain and WRMSDs as described above, we did not
test them directly in the current study. Rather, the current study will test a
theoretical model that links stressors to work-based musculoskeletal complaints via psychological strain
Hypothesis1. (a) There will be a
positive relationship between role conflict and work-related musculoskeletal
complaints and (b) this relationship will be mediated by psychological strain.
Hypothesis2. (a) There will be a negative relationship between job control and
work-related musculoskeletal complaints and (b) this relationship will be
mediated by psychological strain.
Hypothesis3.
(a) There will be a negative relationship between safety-specific leadership and
work related musculoskeletal complaints and (b) this relationship will be mediated by
psychological strain
Methods: Data were obtained from 277
full-time employees. The majority of the participants were females (79%) and
Caucasian (69%), or African American (10%). The average age of the participants
was 24 years old (SD ¼ 6.6). Participants had an average tenure of 3 years (SD
¼ 3.5) in their present job and worked a minimum of 20 h per week.
Measures: Demographic
variables, physical job demands, Safety-specific leadership, Autonomy/control,
Role conflict, Anger, anxiety, and depression, Frustration, Musculoskeletal
complaints
Data Analysis: For the exogenous
variables (i.e., role conflict, control, and safety leadership), scale items
were used as indicators for the latent
Factors: For psychological
strain, the scale scores of anger, anxiety, depression, and frustration were
used as indicators. The structural equation model was tested using the TCALIS
procedure in SAS 9.2 (Statistical Analysis Software) using maximum likelihood
estimation
Discussion: purpose of the current study was to
understand the link between psychosocial work stressors, strain, and the
musculoskeletal symptoms in a stress processed-based model. By cleanly
separating stressors from strains, relying on improved measures, and using
sophisticated methodology to test the theoretical model, the current work provides a
significant added value to the current literature in this area. Our methodology
included mediation analyses using structural equation modeling while ensuring
common method variance alone was not responsible for construct covariance. Our results suggested that high levels
of various psychosocial work stressors (namely low safety leadership, low job
control, and high role conflict) were associated with increased strain. Strain,
in turn, was related to higher levels of WRMSD symptoms of the wrist/hand,
shoulders, and lower back. These results were consistent when controlling for
the physical demands of the job. The fact that self-reports of physical demands
were not related to any of the physical symptom reports suggests that it may
not be any physical demands of the job causing the symptoms, but rather the
psychological work stressors and their resulting emotional strain. Furthermore, evidence of a partial mediation
by strain between control and both wrist/hand symptoms and shoulder symptoms
was found as well as a partial mediation between safety leadership and
wrist/hand symptoms. These partial mediation effects suggest that there may be
additional explanations regarding the mechanisms linking control and safety
leadership to WRMSD symptoms. The results of the SEM model demonstrate that
psychosocial stressors in the work environment can have meaningful links to
employee health on both psychological and physical levels.
Results: reports the means, standard
deviations, internal consistencies, and correlations among the focal variables.
Each psychosocial work stressor was significantly related to at least one of
the WRMSD symptoms. Consistent with our hypotheses, safety leadership was
significantly related to wrist/hand (r ¼ _.14) and lower back symptoms (r
¼_.13), and role conflict was significantly related to lower back symptoms (r ¼
.16), thus providing partial support for Hypotheses 1a and 3a. Interestingly, control
had positive, significant relationships with shoulder (r ¼.14) and wrist/hand
symptoms (r ¼ .12), which was opposite from our expectation. Thus, Hypothesis
2a was not supported.
1 Model testing, 2 model parameters
estimates.
Theoretical and
practical implications: Role conflict, job control and safety-specific
leadership all had significant path coefficients to strain. In line with
previous literature, role conflict was associated with increased levels of
psychological strain. This supports the notion that inconsistent demands from
multiple sources (i.e., multiple supervisors) can have a significant impact on
employee psychological well-being. Furthermore, in line with previous work, job
control was significantly related to strain such that lower levels of control
were associated with higher levels of strain (Karasek, 1979). Finally,
safety-specific leadership had a significant association with strain. This
finding underscores a lack of safety-specific leadership as an occupational
stressor that may elicit psychological distress in employees. Further, strain
fully mediated the association of role conflict with WRMSD symptoms, suggesting
that the psychological states arising from role conflict are related to
increases in WRMSD complaints. Our results suggest that low levels of role
conflict may be associated with reduced levels of strain which in turn leads to
fewer WRMSD complaints. This is in line Sauter and Swanson’s (1996) ecological
model of musculoskeletal disorders, suggesting that psychosocial work stressors
contribute to higher reports of WRMSDs through their effects on psychological
strain. This finding is also consistent with previous work demonstrating strain
as an important precursor of musculoskeletal symptoms (Lim and Carayon, 1993)
and emphasizes the role of psychological distress in understanding how role
conflict in one’s job may contribute to poorer physical health.
Conclusion: This study
demonstrates that high levels of psychosocial work stressors (high role
conflict, low job control, and low safety-specific leadership) are associated
with increased employee strain. Strain, in turn, related to higher levels of
WRMSD
symptoms of the wrist/hand, shoulders and
lower back. Partial mediation of some relationships was also found suggesting
other explanations for the relationships are plausible. This work supports the
notion that the psychosocial components of the work environment have important
links to employee health, as assessed by WRMSDs. To maintain a healthy and
productive workplace, organizations should work to reduce psychosocial work
stressors which could result in high levels of strain and in turn, physical
complaints in employees.
