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A Comparison of Job Stress Models

Associations With Employee Well-Being, Absenteeism, Presenteeism, and Resulting Costs

Schmidt, Burkhard PhD; Schneider, Michael MD; Seeger, Philipp MSc; van Vianen, Annelies PhD; Loerbroks, Adrian PhD; Herr, Raphael M. PhD

Journal of Occupational and Environmental Medicine: July 2019 - Volume 61 - Issue 7 - p 535–544
doi: 10.1097/JOM.0000000000001582

Objective: This study investigates the associations between Effort–Reward–Imbalance (ERI), Overcommitment (OC), Job–Demand–Control (JDC), and Organizational Injustice (OIJ) with employee well-being, absenteeism, and presenteeism, as well as the costs incurred.

Methods: Cross-sectional data from 1440 German pharmaceutical company employees assessing job stress, employee well-being, absenteeism, and presenteeism were used. Linear regression and interval regression analyses assessed separate and independent associations and sample-specific costs were estimated.

Results: All four stressors were related to employee well-being, presenteeism, and absenteeism when analyzed separately. OIJ showed the strongest independent association with absenteeism (coef. = 0.89; P < 0.01), whereas OC was most strongly independently associated with lower well-being (coef. = −0.44; P < 0.01) and higher presenteeism (coef. = 0.28; P < 0.01). Absenteeism costs per employee/year were higher than presenteeism costs.

Conclusions: Occupational health interventions reducing job stress will have strong potential for productivity raise and lower costs.

Department for Business, Work & Organizational Psychology, Applied University Fresenius, Heidelberg, Germany (Dr Schmidt); Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (Seeger and Dr Herr); Department of Work and Organizational Psychology, University of Amsterdam, Amsterdam, The Netherlands (Dr van Vianen); Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany (Dr Loerbroks); Department of Occupational Health, Boehringer Ingelheim, Ingelheim, Germany (Dr Schneider).

Address correspondence to: Burkhard Schmidt, PhD, Applied University Fresenius, Sickingenstr. 63, 69129 Heidelberg, Germany (

Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

BS and MS are first authors and equally contributed to this work.

This study was funded by a grant from Boehringer-Ingelheim GmbH.

Schmidt, Seeger, Herr, van Vianen, Loerbroks, and Schneider have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research

Copyright © 2019 by the American College of Occupational and Environmental Medicine