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Effects of job strain on fatigue: cross-sectional and prospective views of the job content questionnaire and effort–reward imbalance in the GAZEL cohort
  1. Grace Sembajwe1,2,3,
  2. Morten Wahrendorf4,
  3. Johannes Siegrist4,
  4. Remi Sitta3,5,
  5. Marie Zins3,5,
  6. Marcel Goldberg3,5,
  7. Lisa Berkman1,6
  1. 1Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, USA
  2. 2Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
  3. 3INSERM U1018, Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France
  4. 4Institut für Medizinische Soziologie, Heinrich Heine-Universität Düsseldorf, Postfach, Düsseldorf, Germany
  5. 5Versailles-Saint Quentin University, France
  6. 6Harvard Center for Population and Development Studies, Bow Street, Cambridge, Massachusetts 02138
  1. Correspondence to Grace Sembajwe, Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA 02115, USA; grace_sembajwe{at}


Objectives The objectives this study were (1) to investigate correlations between measures of psychosocial workplace stress as measured in separate years by the Job Content Questionnaire (JCQ) and Effort–Reward Imbalance (ERI) scales; (2) to establish a valid measure of psychosocial job stress with its components (by identifying the individual and interactive associations of job stress components) and (3) to use the component measures to assess the risk of psychosocial strain at work on fatigue.

Methods The JCQ and ERI from the annual survey of the GAZEL cohort established in 1989 initially with 20 624 respondents were used to investigate the associations of workplace stress on mental and physical fatigue in two separate years (1998 and 2006). First, the JCQ measures from separate years (1997 and 1999) were combined to create a measure for the same year as ERI (1998). The new measure was validated for internal and external consistency. Using logistic regression, the subcomponents of stress (upper tertiles of psychological demands, physical demands, decision latitude, social support, effort, reward, ERI and overcommitment) were tested for associations with the highest reporting of mental and physical fatigue.

Results By combining JCQ responses from 1997 to 1999, we were able to increase the amount of information available on psychosocial factors in 1998. Psychometric properties of the workplace stress scales also showed expected factor loadings. Workplace psychosocial factors had greater associations with fatigue among men than women. Although psychosocial factors became less predictive of fatigue at 8 years of follow-up, associations between fatigue and psychosocial components (overcommitment, social support and rewards) remained significant.

Conclusions These analyses continue to validate the various subcomponents scales of workplace stress as measured by the JCQ and effort–reward imbalance model in GAZEL. They also highlight the importance of psychosocial work factors in the experience of overall fatigue even after an 8-year follow-up.

  • Decision latitude
  • psychological demands
  • overcommitment
  • mental
  • physical
  • occupational health practice
  • stress
  • fatigue
  • gender
  • longitudinal studies

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  • Funding This study was supported by ANR and AFSSET Workage grants, and National Institute on Aging grant #5U01AG027669-06 /3U01AG027669-05S1 for support of LB during this period. Other Funders: National Institutes of Health; l'Agence Nationale de la Recherche (ANR) and AFSSET, France. The GAZEL cohort is funded by grants from EDF-GDF (Electricité de France-Gaz de France) in association with INSERM (Institut National de la Santé de de la Recherche Médicale).

  • Competing interests None of the authors have an affiliation with an organisation that, to their knowledge, has a direct interest, particularly a financial interest, in the subject matter or materials described.

  • Ethics approval This study was conducted with the approval of the Harvard School of Public Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.