The Effort-reward Imbalance Model: Experience in Japanese Working Population: Akizumi TSUTSUMI, et al. Okayama University Graduate School of Medicine and Dentistry-The validity of Siegrist's effort-reward imbalance model was examined in Japanese workers: 105 dental technicians, 902 employees of production companies, and 2,827 selected from staff of hospitals. After controlling for possible confounders, levels of the two stress measures, 'effort-reward imbalance' and lovercommitment', were similar for both genders. The effort-reward imbalance was most prevalent in the 2530 age employees and then decreased with age, but the level of overcommitment increased with age. Those with lower educational attainment and others who reported working long hours were more often exposed to effort-reward imbalance and those in the private sector reported higher overcommitment levels than their respective counterparts. Hospital staff (predominantly nurses) had almost twice as high a level of effort-reward imbalance as production workers. A review of empirical studies confirmed validity of the criterion with respect to a self-reported health outcome and the responsiveness of the measures to organizational changes. Nevertheless, the low prevalence of an effort-reward imbalance (originally formulated by Siegrist's group on European samples) in Japanese employees seemed to reduce the statistical power of these tests. A subsequent change in exposure prevalence by defining the top quintile of the distribution of the logarithmic-transformed effort-reward ratio resulted in an improvement in the statistical fit. The Japanese evidence indicates promising applicability Of the effort-reward imbalance model, particularly if statistical approaches that measure the model's core notion are extended, and recommendation of repeated measures for exposure. Cross-cultural research on occupational stress is instructive in terms of health science.