Effort-Reward Imbalance Is Associated With Salivary Immunoglobulin A and Cortisol Secretion in Disability Workers

Objective: This study attempted to determine the relationship of physiological indices of stress (ie, cortisol and salivary immunoglobulin A) to the effort-reward imbalance model (ERI). Methods: A sample of 98 direct-care disability workers completed the Work-Related Questions II-III and provided morning saliva samples on the same day of completion, which were subsequently analyzed for cortisol and salivary immunoglobulin A concentration levels. Results: Using structural equation modeling, the ERI successfully predicted potentially adverse physiological outcomes. The salivary immunoglobulin A scores were predicted more successfully by the ERI than the cortisol data. Conclusions: The present investigation suggests that the ERI may be useful in determining which aspects of work life are associated with ill health and as such may be useful in identifying meaningful intervention.