title: Three job stress models and their relationship with musculoskeletal pain in blue- and white-collar workers.
abstract: OBJECTIVE
  Musculoskeletal pain has been found to co-occur with psychosocial job stress. However, different conceptualizations of job stress exist, each emphasizing different aspects of the work environment, and it is unknown which of these aspects show the strongest associations with musculoskeletal pain. Further, these associations may differ for white-collar vs. blue-collar job types, but this has not been tested. The present study examined the independent and combined contributions of Effort-RewardImbalance (ERI), Job-Demand-Control (JDC) and Organizational Justice (OJ) to musculoskeletal pain symptoms among white- and blue-collar workers.
  
  
  METHODS
  Participants of a cross-sectional study (n=1634) completed validated questionnaires measuring ERI, JDC, and OJ, and reported the frequency of pain during the previous year at four anatomical locations (lower back, neck or shoulder, arms and hands, and knees/feet). Pain reports were summarized into a single musculoskeletal symptom score (MSS). Analyses were stratified for white- and blue-collar workers.
  
  
  RESULTS
  Among white-collar workers, ERI and OJ were independently associated with MSS. In addition to these additive effects, significant 2-way and 3-way interactions indicated a synergistic effect of job stressors in relation to reported pain. In blue-collar workers, ERI and JDC independently associated with MSS, and a significant 3-way interaction was observed showing that the combination of job stressors exceeded an additive effect.
  
  
  CONCLUSIONS
  ERI influences pain symptoms in both occupational groups. OJ was independent significant predictor only among white-collar workers, whereas JDC had additive predictive utility exclusively among blue-collar workers. Simultaneous exposure to multiple job stress factors appeared to synergize pain symptom reporting.
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Raphael M
authors.initials: RM
authors.lastname: Herr
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: j.a.bosch@uva.nl.
authors.forename: Jos A
authors.initials: JA
authors.lastname: Bosch
authors.affiliation: Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Adrian
authors.initials: A
authors.lastname: Loerbroks
authors.affiliation: Department of Work and Organizational Psychology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Annelies E M
authors.initials: AE
authors.lastname: van Vianen
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Jarczok
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Fischer
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Work and Organizational Psychology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004651:Employment / Q000145:classification; D005260:Female; D006801:Humans; D008019:Life Style; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008959:Models, Neurological; D059352:Musculoskeletal Pain / Q000209:etiology* / Q000503:physiopathology*; D019547:Neck Pain / Q000209:etiology / Q000503:physiopathology; D009784:Occupational Diseases / Q000523:psychology*; D016273:Occupational Exposure / Q000009:adverse effects*; D005082:Physical Exertion; D012201:Reward; D020069:Shoulder Pain / Q000209:etiology / Q000503:physiopathology; D012935:Social Justice; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D017132:Workplace; D055815:Young Adult
keywords: Effort–reward imbalance; Job strain; Job-demand control; Musculoskeletal pain; Organizational justice; Work stress