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Course Information. Departmental Faculty. Diversity Commitment. Finally, the model suggests that the experience of musculoskeletal symptoms themselves can influence stress at work. The workstyle model of job stress and musculoskeletal disorders Feuerstein, was proposed to explain the relationship among job stress, ergonomic exposure, and work-related upper extremity disorders illustrated in Figure 7.
This model posits the importance of workstyle, that is, how an individual performs work in response to work demands. Workstyle consists of cognitive, behavioral, and physiological components that are consistent with the frequently reported multicomponent stress response. The behavioral component represents the overt manifestations of movement, posture, and activity. These behaviors can interact with workplace exposure to ergonomic risk factors, potentially increasing the risk of musculoskeletal pain Macfarlane, Hunt, and Silman, The cognitive component refers to the worker's thoughts, feelings, appraisals, and evaluation of the success or failure of his or her responses to the work demands.
The physiological component represents the biological changes that accompany the behavioral and cognitive reactions; these changes include increased muscle tension, tendon force, catecholamine or cortisol release, and stress-induced changes in immune function Feuerstein, Huang, and Pransky, This continuous arousal or reactivity can then set the stage for the development of symptoms,.
High-risk workstyle has been shown to be associated with symptom severity, functional limitations, and work disability in individuals exposed to hand-intensive work Feuerstein et al. While these models have some components in common, each has a unique contribution, such as a focus on work systems, the integration of work demands and unpaid domestic workload, the labeling of or attributions for symptoms experienced in the process of work, and the potential impact of workstyle.
Also, each of these models hypothesizes a psycho-physiological substrate linking occupational stress to various health outcomes, in an effort to explain how job stress may affect work-related upper extremity disorders.
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The biological plausibility of a link between. As with generic stress and health models, the majority of models attempting to describe how exposure to job stress may exert its effects on the physiology of upper extremity disorders focus their attention on musculoskeletal and neuroendocine pathways.
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These pathways are common to each of the models discussed above. Increases in muscular activity have been associated with tasks involving greater psychological demands Melin and Lundberg, It has also been observed that muscle activation can be triggered by mental stress independent of physical effort Melin and Lundberg, Spectral changes in forearm EMG, increased forearm tremor, and increased musculoskeletal discomfort have been observed in response to stress Gomer et al. In the absence of a quantifiable increase in work demands, the perception of an increase in work demands is sufficient to increase forearm muscular tension during task performance Arndt, When exposure to psychological stressors co-occurs with physical stressors, levels of EMG, blood pressure, and self-reported stress tend to be greater than in response to either exposure alone Lundberg et al.
An individual's psychological style, or how he or she characteristically responds to a challenge, has been related to the degree of muscle coactivation during completion of a simple motor task. This finding suggests that muscle activation can vary depending on how one characteristically perceives his or her environment Glasscock et al.
Taken as a whole, these studies suggest that while a perception of work as demanding is sufficient to increase musculoskeletal activity, the addition of physical exposures and a certain style or personality can further increase this activity. It is possible that such recurrent or chronic forearm muscle tension, secondary to psychosocial stressors, places sustained loads on the tendons in the wrist and elbow. The fatiguing of low-level motor neurons in the upper trapezius and forearm, secondary to stress-induced muscle contraction, may also lead to musculoskeletal discomfort or injury via the fatiguing of small motor units Westgaard and Bjorklund, ; Waersted, Bjorklund, and Westgaard, ; Westgaard and de Luca, This discomfort or injury may encourage alternative muscle recruitment and exposure to increased biomechanical risks e.
Another potential pathway linking occupational stress to work-related upper extremity disorders may involve the biochemical consequences of the stress response, specifically the release of catecholamines and cortisol. Although serum levels of cortisol, epinephrine, and norepinephrine typically rise and fall throughout the day Melin et al.
On the other hand, cortisol appears to be generally related to negative aspects of the stress response, including negative emotions, the anticipation of negative consequences, and the perception of events as novel, uncontrollable, or unpredictable Brantley et al.
The psychosocial characteristics of the work environment, such as task repetitiveness and rigid work arrangements, also appear to affect circulating catecholamines. Lundberg et al. Melin et al. In this study, the pattern of heightened reactivity and delayed recovery was observed in female workers in contrast to males and the pattern was even more marked in female workers who had children at home.
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Luecken et al. These cortisol levels were not affected by marital status or social support. These studies suggest a potential interaction among gender, paid and unpaid work demands, and stress reactivity and recovery Melin et al. Chronic elicitation of the stress response, and the concomitant increases in catecholamine and cortisol release, could also directly affect the structure and function of muscles, tendons, and ligaments Johnson et al. In addition to the direct effect these substances can exert on soft tissues, norepinephrine release can, theoretically, affect behavior, result-.
This, in turn, could result in more rapid and forceful responses during work tasks, thereby potentially increasing exposure to biomechanical risks.
Release of neurotransmitters may also play a role in the exacerbation of muscle pain. It has been observed that serotonin, which is released in response to stress Stratakis, Gold, and Chrousos, , potentiates the effects of endogenous pain mediators, such as bradykinin Babenko et al. The infusion of both serotonin and bradykinin into the tibialis anterior muscle in humans has been associated with elevated pain intensity and prolonged pain in response to mechanical stimulation.
This preliminary evidence suggests that exposure to stress could exert a nociceptor sensitization effect on muscle. In addition to the peripheral effect of stress on pain, data exist to support a direct role of the central nervous system Fields and Basbaum, This may help explain how psychological processes, such as attention and emotion, influence pain and pain tolerance.
In addition, the peripheral vasoconstriction induced by circulating catecholamines could further inhibit blood flow to a potentially compromised nerve in the case of carpal tunnel syndrome. It has also been shown that exposure to stress exerts an inhibitory effect on inflammatory or immune responses Chrousos and Gold, Glucocorticoids cortisol decrease the production of cytokines and other mediators of inflammation and inhibit the effects of these agents on target tissues.
It is possible that the repeated elicitation of the stress response does not allow for the pain-sensitive tissues to recover following mechanical insult. Although the exact mechanism of injury differs from most work-related upper extremity disorders, it has recently been demonstrated that recovery from an oral puncture wound is significantly delayed following exposure to stress Marucha, Kiecolt-Glaser, and Favagehi, As indicated earlier, the potential pathways described above are speculative and represent a series of hypotheses that require rigorous scientific scrutiny.
A critical element in validating these models is the determination of the time course between job stressor exposure, physiological changes, and symptom expression. Given the role that job stress plays in work-related symptoms in both the back and upper extremities, it is critical to identify the biobehavioral pathways underlying this effect, in order to understand how job stress can result in the symptom expressions characteristic of these disorders and in order to develop effective prevention and management strategies.
The models reviewed need to be carefully tested using both laboratory and workplace studies. Several distinct work-related psychosocial factors have been identified conceptually and can be measured reliably. They are associated with work-related low back pain and, less consistently, with work-related upper extremity disorders. The extent to which these variables interact with physical stressors remains to be determined. Also in terms of intervention, it is currently unclear what impact reducing physical stressors may have on psychological distress. The models of job stress presented in this chapter provide an important conceptual link between work-related psychosocial factors and work-related musculoskeletal disorders.
They share many core features, providing additional face validity. These features include an association between stressful workplace conditions and a set of physiological responses, which, in turn, are associated with musculoskeletal disorders. These models need to be further validated. While the precise biological mechanisms through which these physiological responses to stress lead to musculoskeletal disorders have not been fully elucidated, work to date suggests that musculoskeletal, neuroendocrine, and immunological pathways may be prominent.
Further work in this area is needed to better define these biologic mechanisms. In addition, the knowledge currently available on psychosocial stress should be incorporated into interventions to ameliorate work-related musculoskeletal disorders. Every year workers' low-back, hand, and arm problems lead to time away from jobs and reduce the nation's economic productivity.
sighpress.de/cms/includes/single/bild-online-partnersuche.php The connection of these problems to workplace activities-from carrying boxes to lifting patients to pounding computer keyboards-is the subject of major disagreements among workers, employers, advocacy groups, and researchers. Musculoskeletal Disorders and the Workplace examines the scientific basis for connecting musculoskeletal disorders with the workplace, considering people, job tasks, and work environments.
A multidisciplinary panel draws conclusions about the likelihood of causal links and the effectiveness of various intervention strategies. The panel also offers recommendations for what actions can be considered on the basis of current information and for closing information gaps. This book presents the latest information on the prevalence, incidence, and costs of musculoskeletal disorders and identifies factors that influence injury reporting.
It reviews the broad scope of evidence: epidemiological studies of physical and psychosocial variables, basic biology, biomechanics, and physical and behavioral responses to stress. Given the magnitude of the problem-approximately 1 million people miss some work each year-and the current trends in workplace practices, this volume will be a must for advocates for workplace health, policy makers, employers, employees, medical professionals, engineers, lawyers, and labor officials. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.
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Do you enjoy reading reports from the Academies online for free? Sign up for email notifications and we'll let you know about new publications in your areas of interest when they're released. Get This Book. Visit NAP. Looking for other ways to read this? No thanks. Suggested Citation: "Occupational Stress. Page 7 Occupational Stress A s indicated in the review of the epidemiologic literature in Chapter 4 , a number of workplace psychosocial factors can affect work-related back and upper extremity disorders. Page Share Cite. Page ders, are speculative.
From Sauter and Swanson Reprinted with permission. Page continuous adaptation by the worker. Page chronic low back pain have baseline EMG activity similar to normal controls and show no consistent pattern of accentuated activity different from that of controls. Upper Extremity Disorders Models Linking Occupational Stress to Work-Related Musculoskeletal Disorders In contrast to the back literature, over the past decade a number of work-specific models have been proposed to help explain how stress at. Page work could affect upper extremity disorders.
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