Work stress and musculoskeletal disorder etiology: The relative roles of psychosocial and physical risk factors

The intense battles preceding the recent promulgation of OSHA's Ergonomics Program Standard serve as a case study demonstrating the growing understanding that MSD causation, development, and exacerbation are the result of the combined contribution of (and possibly interaction between) a wide range of biomechanical and psychosocial stressors. The best designed studies, those that adequately measure both biomechanical and psychosocial exposures, strongly support this hypothesis. Work stress is one of the results of this stressor combination and is part of the physiological pathway to MSDs and a wide range of other occupational diseases. Prevention efforts geared to a single or single class of exposure may be only partly effective, ineffective, or even counter productive. The most effective control strategies are rooted in on-going, participatory ergonomics programs, incorporating a joint labor/management ergonomic team; this blueprint for intervention necessarily addresses the roots of both physical and psychosocial work stress experienced by workers.