Johannes Siegrist's effort-reward model has been tested in
a number of studies. In a 6.5 year prospective study of 416 male
German factory workers, status inconsistency (OR=4.4), job insecurity
(OR=3.4), work pressure (OR=3.4), and immersion (OR=4.5) independently
predict MI or sudden cardiac death (SCD) incidence after adjusting
for other behavioral and somatic risk factors (103). A combined
"effort-reward imbalance" variable is also a significant
predictor (OR=3.4) in a separate analysis. If subclinical CHD
is added to the case definition, the association with the combined
"effort-reward imbalance" variable increases (OR=6.2).
If stroke is added to the case definition, the association with
the combined variable also increases (OR=8.2) (Siegrist, 1996).
In a cross-sectional study of CVD risk factors among 179 male
German middle managers, a variable combining frequent interruptions
(effort) and forced job change (low reward) was strongly associated
(OR=6.8) with hypertension (Siegrist, 1996). In the factory worker
sample, a variable combining overtime work (effort) and fear of
job loss, job instability, and layoffs (low reward) was associated
(OR=3.3) with a comanifestation of hypertension and atherogenic
lipids (Siegrist, 1996).
Finally, among 190 healthy male blue-collar workers, those facing
high chronic occupational stress (cumulative workload, worsening
of job conditions, and high demand and low job security) exhibited
lower reactivity (lower maximal heart rate and blood pressure
elevations under challenge) as compared to workers with low levels
of stress, adjusting for age, hypertensive status, physiological
baseline level, cigarette smoking, test performance, and individual
style of coping (Siegrist and Klein, 1990).
References
Peter R, Siegrist J. Chronic work stress, sickness absence, and hypertension in middle-managers - general or specific sociological explanations? Soc Sci Med 1997;45:1111-20.
Siegrist J, Peter R, Cremer P, Seidel, D. Chronic work stress is associated with atheroeic lipids and elevated fibrinogen in middle-aged men. J Internal Medicine 1997;242:149-56.
Siegrist J, Klein D, Voigt KH. Linking sociological with physiological data: the model of effort-reward imbalance at work. Acta Physiol Scand 1997; special issue November.
Aust B, Peter R, Siegrist J. Stress management in bus drivers: a pilot study based on the model of effort-reward imbalance. Int J Stress Management 1997 (in press).
Peter R, Siegrist J. Threat to occupational status control and cardiovascular risk. Israel J of Med Sci 1996;32:179-84.
Siegrist J. Adverse health effects of high-effort/low-reward conditions. Journal of Occupational Health Psychology 1996;1:27-41.
Siegrist J, Klein D. Occupational stress and cardiovascular reactivity in blue-collar workers. Work & Stress 1990;4:295-304.