83-698).
Specialists in occupational and environmental medicine have noted that a large number of illnesses and injuries can be attributed to the workplace, and many of these problems go undiagnosed or improperly treated because most physicians are not versed in this area of medicine. Stress is only one of the causes of such problems, and it can be brought about by environmental elements such as excessive noise. Stress is referred to as one of several psychosocial factors associated with upper-extremity disorders (Deitchman 1691-1692).
Stress that manifests itself in the workplace need not begin in the workplace, and a number of studies have tried to find the relationship between a stressful home environment and the work environment. Leiter and Durup report on a recent longitudinal study of hospital-based health care professionals that examined psychological states as a function of demands and resources in the workplace and at home. The study was conducted over a three-month period, and evidence was found of spillover relationships from the work to home environment, and to a lesser extent, from the home environment to work. The authors used a structural equation model focused on change and included only relationships that enhanced the prediction of each measure beyond its inherent consistency across the study interval. The study also considered relationships across the work and home domains in the context of relationships within each domain, so that spillover relationships were always considered in addition to domain-specific relationships. It was found that health care workers had a sense of professional efficacy with the most wide-ranging relationships, with links within the work domain, the home domain, and the boundary be
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