The first occurrence.
I am afraid of all my sorrows, I know that You will not hold me innocent. Job 9:28
(In the Scripture Picture: The LORD heals the brokenhearted, and binds up their wounds.)
The primitive root.
Strong’s H6094, atstsebeth, an abstract concept meaning, “sorrow, pain, or injury;” from Strong’s 6087 עצב atsab, a primitive root meaning, “to labor, to be in pain, to be vexed, to worry.” The 3-letter root is ayin + tsadey + bet.
ayin ע = the eye, thus to see, watch, look, know, understand
tsadey צ = trail, thus a man concealed, journey, chase, hunt
bet ב = house, thus house, household, family, in, within
The story: Looking ahead (ayin) at a lifelong journey (tsadey) to maintain the house and family (bet). The sense I am getting, in its association to pain from grief or heavy toil, is of endless work: a job that is never completed. Housework, cooking, laundry, home repairs, raising crops, tending livestock, going to a job: it is the same work over and over again constantly repeating, which continues until the man and the woman return to the dust from which they were taken.
An alternate meaning of atsab according to Gesenius’ Hebrew Lexicon, is “to worry or be vexed,” and I think that is a very common side effect of the responsibility men and women have in caring for their family.