A global and systematic review of the available evidence examining the cost of work-related stress would yield important insights into the magnitude and nature of this social phenomenon. The objective of this systematic review was to collate, extract, review, and synthesize economic evaluations of the cost of work-related stress to society.

A research protocol was developed outlining the search strategy. Included cost-ofillness (COI) studies estimated the cost of work-related stress at a societal level, and were published in English, French or German. Searches were carried out in ingentaconnect, EBSCO, JSTOR, Science Direct, Web of Knowledge, Google and Google scholar. Included studies were assessed against ten COI quality assessment criteria.

Fifteen COI studies met the inclusion criteria and were reviewed. These originated from Australia, Canada, Denmark, France, Sweden, Switzerland, the United Kingdom, the United States, and the EU-15. At a national and pan-European level, the total estimated cost of work-related stress in 2014 was observed to be considerable and ranged substantially from US$221.13 million to $187 billion. Productivity related losses were observed to proportionally contribute the majority of the total cost of work-related stress (between 70 to 90%), with healthcare and medical costs constituting the remaining 10% to 30%.

The evidence reviewed here suggests a sizeable financial burden imposed by work-related stress on society. The observed range of cost estimates across studies was understood to be attributable to variations in definitions of work-related stress; the number and type of costs estimated; and, in how production loss was estimated. It is postulated that the cost estimates identified by this review are likely conservative due to narrow definitions of work-related stress (WRS) and the exclusion of diverse range of cost components.