Samantha R. Lacey, B.A., University of Connecticut; Hannah L. Austin, B.S., University of Connecticut; Ethan W. Gossett, B.S., University of Connecticut; Janet Barnes-Farrell, Ph.D., University of Connecticut; Jennifer L. Garza, Sc.D., UConn Health; Martin G. Cherniack, M.D., M.P.H., UConn Health

Purpose/Objectives
Extending the fear-avoidance (FA) model, this work seeks to examine pain as an explanatory mechanism for the hypothesized relationship between physical job demands and turnover intentions.

Background
Physical job demands, work tasks requiring sustained physical effort, can have significant physiological and psychological costs (i.e., work incapacity, decreased performance and job satisfaction, burnout, absenteeism, workplace injuries) [1,2,3,4]. When physical job demands are high, they can serve as workplace stressors, which can also contribute to increased instances of pain [4]. Pain is increasingly recognized as one of the most common and costly health conditions in the U.S., costing anywhere between $560 and $635 billion annually [5]. Even more striking, it has been determined that more than half of this cost can be attributed to declines in work effectiveness/productivity (i.e., impaired work ability, increased absences, premature exit from the workforce) [6,7,8]. Given that the relationship between physical job demands and pain has been established, and that each has been shown to independently relate to similar work-related outcomes, our research hypothesizes that these variables may in fact work together in some way to affect downstream work factors.

One work-related factor that has yet to receive the attention it deserves in both of these literatures is turnover: one of the most well-known and costly outcomes to organizations [9,10]. Following the tenets of the fear avoidance (FA) model, we conceptualize turnover as an avoidance response to a painful activity, such as physical job demands, and view this response as a result of the fear conditioning inherent to the aversive nature of pain [11]. In this way, our research looks to explore pain as an explanatory mechanism for the relationship between physical job demands and turnover, such that as physical job demands increase, so do the associated experiences of pain, which may increase a worker’s likelihood of turning over.

Methods
In order to test the hypothesized mediation model, we used data from wave four of a multi-wave data collection investigating work capacity and aging. Participants (n = 360) recruited from five manufacturing organizations in the northeastern U.S. completed surveys that included measures of: physical job demands (antecedent), pain (mediator), and intention to turnover (outcome). Physical job demands were evaluated using a four-item measure from the Job Content Questionnaire [12]. Pain was measured with a two-item self-report measure that assessed both pain intensity and functional interference; two important facets in the accurate assessment of pain [13]. Given the constraints of this archival dataset, we were unable to directly assess turnover; however, we were able to assess participants’ intention to turnover (ITO) using an adapted two-item measure that evaluates thoughts about quitting and looking for a new job [14]. Although it has its limitations, ITO is generally viewed as the strongest single predictor of turnover [15]. Our model was tested using the SPSS PROCESS macro (model 4) with bias-corrected bootstrapping to estimate direct and indirect effects [16]. Age, gender, and whether a person was employed in an hourly or salaried position were included as covariates.

Findings
The results indicated that all paths in the model were significant: high physical job demands were significantly related to increased perceptions of pain [𝛽 = .257, SE = .07, BootCI (.1171, .3958)]; high perceptions of pain [𝛽 = .169, SE = .058, BootCI (.0545, .2832)] and high physical job demands [𝛽 = .304, SE = .079, BootCI (.1487, .4596)] were significantly related to higher intentions to turnover. The relationship between physical job demands and ITO was partially mediated by perceptions of pain, such that the relationship between physical job demands and ITO was exacerbated [𝛽 = .043, SE = .02, BootCI (.0098, .0886)].

Discussion
Although previous work has linked physical job demands and pain, the literature on both variables has been sparse when it comes to observing their potential relationships with a costly work-related outcome, turnover. The results of this study suggest that both physical job demands and pain can directly impact a person’s ITO. Taking this one step further, and consistent with the FA model used to conceptualize this analysis, we found that pain partially mediated the relationship between physical job demands and ITO.

Conclusions
Our novel findings suggest that people may go as far as intending to quit their job in response to stimuli that they perceive to be painful, such as physical job demands. Given the cross-sectional and industry-specific (manufacturing) nature of this study, future research should aim to examine these relationships over time and across other industries in which physical job demands are high. Further, although ITO is a strong predictor of actual turnover, this work could be strengthened by the inclusion of more objective turnover data. Lastly, special attention should be paid by researchers and organizations alike to uncover ways to reduce the pain that employees experience as a result of physical job demands.

Tags: Empirical study, Hazardous Work Environments and Safety, High Risk Jobs; Vulnerable/At-Risk Populations, Job and Task Design, Job Attitudes; Turnover; and Retention, Manufacturing, Organization- and Job-Level Environments and Practices, Organizational Practices, Psychological and Biological Effects of Job Stress, Safety Climate; Safety Management; and Training, Secondary or archival analysis, Workplace Injuries and Illnesses, Workplace Stress; Outcomes; and Recovery