Occupational Medicine: State of the Art Reviews; Chapter 3: Stressors at the Workplace: Theoretical Models Authors: Lennart Levi, Mel Bartley, Michael Marmot, Tores Theorell, Robert Karasek, Johannes Siegrist, Richard Peter, Karen Belkic, Cedo Savic, Peter Schnall, Paul Landsbergis
Several theoretical models of workplace psychosocial stressors have been empirically validated, including the Demand-Control-Support (DCS) model and the Effort Reward Imbalance (ERI) model. The nature of these models –deeply rooted in social class relations–is explored in terms of their relationship to the organization of work. While gradations in degree of job strain (high demand, low control work) exist, the trend is for increasing demands with inadequate augmentation of control for more and more of the labor force. Demands are viewed in a broad context encompassing workload, time pressure, conflicts, requirements upon attentional resources, and the emotional dimensions of work-especially those involving threat avoidance–as well as long and unphysiologic work hours. In comparison to the DCS model with its emphasis on moment-to-moment control over the work process (i.e. decision latitude), the ERI model emphasizes macro-level rewards such as career opportunities, job security, esteem and income. The ERI model also integrates the exigencies and rewards of the job with the individual’s input and coping style. The insights provided by cognitive ergonomics and brain research complement the DCS and ERI models, and can be of practical use in efforts to humanize the labor process. The concept of total burden (risk) due to exposure to multiple occupational stressors is explored.