Job satisfaction and short-term sickness absence among Dutch workers

BACKGROUND: Sickness absence is a considerable economic and social problem. Short-term sickness absence is known to be associated with behavioural attitudes. The correlation between sickness absence and job satisfaction has been studied infrequently and with contradictory results. AIMS: This study investigated the correlation between short-term sickness absence and both global and specific job satisfaction. We defined short-term sickness absence as spells of up to 42 days. METHODS: A random sample of 898 Dutch workers from a variety of economic sectors and companies received a self-report questionnaire on their first day of sick leave. The questionnaire measured global and specific job satisfaction. In our regression analysis, we controlled for the confounding factors of age, gender, educational level, perceived workload, job autonomy and decision latitude. The duration of an absence spell was defined as the amount of calendar days between sick leave and return to work. RESULTS: Global job satisfaction did not correlate significantly with the duration of short-term sickness absence. While increasing physical job demands predicted longer absence, increasing job autonomy and educational level predicted shorter absence. Satisfaction with colleagues predicted longer duration absence. CONCLUSION: Global job satisfaction did not correlate with the duration of short-term absence spells, but specific satisfaction with colleagues was associated with longer sickness spells.     

Attitudes to job turnover among Finnish anaesthetists

Background Structural changes have led to higher workload andmore frequent conflicts among hospital staff, which in turnhas been shown to be associated with increased employee turnover. Aims To study the willingness of anaesthetists to change theiremployment and factors associated with it. Work-related, individualand family-related factors were investigated as potential influenceson such willingness. Method A postal questionnaire was sent to all working Finnishanaesthetists (N = 550). Results The response rate was 60%; 175 (53% of responders) weremen. Of the respondents, 31% were willing to consider changingto another physician's job and 43% to a profession other thanmedicine. The most important correlates for these views wereconflicts with superiors (odds ratio 6.1; 95% confidence interval2.1–17.7) and co-workers (4.2; 1.4–12.2), low jobcontrol (2.6; 1.4–4.9), a sense of organizational injustice(2.4; 1.3–4.6), stress (6.5; 2.6–16.3) and job dissatisfaction(4.6; 2.4–8.8). Conclusions The establishment of respect, trust and genuinedialogue between co-workers and superiors is needed to minimizethe risk of loss of members of this occupational group.     

Increased risk of asthma among Finnish construction workers

AIM: To determine the risk of asthma among 7891 Finnish construction workers in the Pirkanmaa Region of southern Finland. METHOD: Retrospective cohort study of hospital records of the Tampere University Hospital. A population of Pirkanmaa paper mill workers (n=2686) and the Pirkanmaa working age population (n=252,500) served as reference populations. RESULTS: There were 147 new cases of asthma among the construction workers in 1991-1995. The annual rate was 37 per 10,000 workers and the odds ratio was 2.1 [95% confidence interval (CI)=1.2-3.6] for the women and 1.8 (95% CI=1.5-2.2) for the men when compared with the general working age population. In general, the risk of asthma among the paper mill workers did not differ from the risk of asthma among the general working age population. The construction workers had an increased risk for asthma, although the number of reported cases of occupational asthma was lower for the construction workers than for the paper mill workers or for the working population. CONCLUSION: Construction work, especially dusty tasks, was associated with an elevated risk of asthma. Thus the effect of exposure to irritant agents may have a role in the development of asthma among construction workers. For the most part, these cases of asthma do not meet the criteria for occupational asthma because the specified causal agent can not be defined. The aetiologic agents and mechanisms of asthma in construction work should be clarified for preventive measures.     

Relationship between job, lifestyle, age and occupational injuries

Background Physical job demands (PJD), age, disability and lifestylemay influence the risk of occupational injury. Aim To assess the relationships between PJD, lifestyle and injuryin workers of various ages. Methods A total of 2888 randomly selected workers from northeasternFrance, aged 15, completed a postal questionnaire. The PJD scorewas defined as the total number of the following reported jobdemands: using pneumatic tools, other vibrating hand tools,hammers, machine tools or vibrating platforms and exposure tomanual handling tasks, awkward postures, high pace of work,high physical workload, work at heights, work in adverse climatesor exposure to noise, cold or heat. Data were analysed usinglogistic regression. Results Nine per cent of subjects reported an injury duringthe previous 2 years. The PJD score was related to the injuryrate for workers aged 45: crude odds ratio (OR) 3.5 (95% confidenceinterval = 1.5–8.0) for PJD = 1, 5.0 (2.2–11.3)for PJD = 2–3 and 14.5 (6.5–32.2) for PJD 4, versusPJD = 0. Lower ORs were found for those aged <30 (1.4, 4.2and 9.9, respectively) and 30–44 (1.5, 4.4 and 6.5, respectively).The differences between age groups remained when controllingfor all factors studied. Obesity, smoking and musculoskeletaldisorders were associated with injury risk in workers aged 45(adjusted ORs 1.7–2.6). Smoking was also an injury riskfactor for workers aged <30. Conclusions PJD and lifestyle have a higher impact on injuryrates among older workers than among younger ones. Injury preventionshould address reducing PJD and improving relevant lifestylefactors, especially for older workers.     

Identifying workers at risk of sickness absence by questionnaire

BACKGROUND: Sickness absence is an important economic problem, because of high costs and lost productivity. Determining factors associated with increased risk of sickness absence may lead to the development of preventive measures. AIMS: To determine whether self-report questionnaires can identify those employees at risk of sickness absence METHODS: Prospective study of 238 healthy administrative workers. Participants completed a questionnaire proven to be valid and consistent. The questionnaire consisted of 116 items about health, work and working conditions. Sickness absence was followed-up for a period of 1 year. RESULTS: The questionnaires of 191 workers (80%) were suitable for analysis. The number of reported health complaints was significantly (P < 0.01) associated with sickness absence (OR 2.18; 95% CI 1.32-3.61). Concentration problems were correlated with more frequent absences, and both nervous complaints and coping problems with longer duration. Age (OR 0.96; 95% CI 0.93-0.99; P = 0.02) and job insecurity (OR 0.68; 95% CI 0.47-0.98; P = 0.04) were negatively associated with sickness absence. Psychosocial and physical work factors were not associated with sickness absence. CONCLUSIONS: Questionnaires on health and work can identify employees at future risk of sickness absence. Workers who report multiple health complaints, especially concentration problems, nervous complaints or coping problems, may be at increased risk of sickness absence.     

Activity, functional capacity and well-being in ageing Finnish workers

BACKGROUND: The ageing of the labour force and falling employment rates have forced policy makers in industrialized countries to find means of increasing the well-being of older workers and of lengthening their work careers. AIMS: To longitudinally study the relationship between activity and functional capacity and the well-being of ageing workers. METHODS: Follow-up study to that carried out by the Finnish Institute of Occupational Health in 1981-97 (n = 3817). Activity level was measured using various free-time activities, and functional capacity was measured through daily-life activities. The measure of well-being included items with both positive and negative affects. The associations between activity, functional capacity and well-being were analysed by general linear models with repeated measures. RESULTS: Activity level and functional capacity had a strong positive effect (the effects of one unit increase were 0.32 and 0.30, respectively) on well-being. They were also interdependent. The impact of activity level in maintaining well-being became 31% greater during the follow-up, whereas the effect of functional capacity diminished by 17%. CONCLUSION: The results of the study indicate that both involvement in activities and functional capacity have an important, partly compensatory role in maintaining the well-being of ageing workers.     

Low back pain and occupation among Irish health service workers

BACKGROUND: The health services sector has been identified as a high-risk work sector for low back pain (LBP) and related absenteeism. AIMS: To establish levels and predictors of LBP prevalence and associated sick leave among health service workers. To identify if levels of LBP or related absenteeism differ between occupational groups. METHODS: A postal survey using a standardized questionnaire and disproportionate random sampling of occupational groups was conducted at a single Dublin hospital. Overall hospital LBP prevalence and sickness absence were calculated using weighted analysis methods. Univariate analysis included the use of Chi-square, Fisher's exact and Mann-Whitney tests. Multivariate logistic regression techniques were used to explore for independent predictors of lifetime LBP prevalence and LBP-related sickness absence. RESULTS: An overall response rate of 62% (n = 246) was achieved. Lifetime, annual and point prevalence rates for the hospital employees were calculated at 46, 30 and 15.5%, respectively. No significant difference in prevalence was found between occupational groups but sick leave did differ with the highest level among general support and nursing staff. Multivariate analysis confirmed that occupation was an independent predictor for LBP-related sick leave (P < 0.05). CONCLUSIONS: LBP prevalence rates did not differ significantly between occupational groups but occupation was found to be an independent predictor of LBP-related sick leave. Involvement in manual handling did not predict either LBP or related sick leave.     

Health complaints and sickness absence in Norway, 1996-2003

BACKGROUND: From 1996 to 2003, the total number of sickness absence days increased by 65% in Norway. AIM: To investigate if this could be explained by a corresponding increase in the prevalence of self-reported health complaints in the same period. METHODS: Representative samples of the Norwegian working population in 1996 (n = 838) and 2003 (n = 637) answered the subjective health complaints (SHC) questionnaire. The single items of the SHC questionnaire were matched with the corresponding sickness absence statistics from the National Insurance Administration in 1996 and 2003. RESULTS: The main finding was a poor concordance between the change in prevalence of health complaints and the change in the prevalence of sickness absence for diagnoses corresponding to these complaints. The prevalence of health complaints in Norway was high and relatively stable from 1996 to 2003. The only complaints that increased in prevalence during the period were allergy and severe asthma. Sickness absence for health complaints, however, showed a general increase. The diagnoses with the largest percentage increase in sickness absence were sleep problems, tiredness, anxiety and palpitation, although the absolute number of individuals with sickness absence for these complaints was small. CONCLUSIONS: The increased sickness absence in Norway from 1996 to 2003 cannot be explained by an increase in health complaints in the general population in the same period. The increase in sickness absence is most likely to be explained by multifactorial causes, such as changes in working life and health expectations.     

Long-term sickness absence - risk indicators among occupationally active residents of a Danish county

This study aims to identify risk factors and their prevalence in long-term sickness absence. The study is designed as a case-referent study which comprises 481 participants who have experienced a sickness absence lasting >10 weeks and a reference group of 1326 individuals in active employment. Multivariate analysis identified the following significant risk factors for men: (i) age >50 years [odds ratio (OR) = 2.4]; (ii) short period of education (OR = 2.3); (iii) unemployment within the last 3 years (OR = 1.7); (iv) heavy-duty work (OR = 2.1); (v) monotonous, repetitive work (OR = 1.7); (vi) lack of job satisfaction (OR = 2.1); and (vii) much back pain during the last 3 years (OR = 2.1). The following risk factors were identified for women: (i) leaving school without graduation (OR = 2.6); (ii) unemployment within the last 3 years (OR = 1.5); (iii) heavy-duty work (OR = 2.8); (iv) lack of influence on own job situation (OR = 2.1); and (v) much back pain within the last 3 years (OR = 1.8). It is concluded that the identification of working environment risk factors constitutes a case for improvement of the working environment which may be instrumental in reducing long-term sickness absence.     

Job demands, health perception and sickness absence

BACKGROUND: Investigation of the relations between job demands, health and sickness absence is required to design a strategy for the prevention of absence and disability. AIM: To study the relationships between (physical and psychological) job demands, health perception and sickness absence. METHODS: Prospective study of 414 male employees working in two organizations with low company absence levels. Job demands and health were examined using the Basic Occupational Health Questionnaire. Sickness absence was followed for 1 year thereafter. The number of days and episodes of absence were counted. RESULTS: The questionnaires of 247 workers (60%) were suitable for statistical analysis. Physical job demands (r = 0.41; P <0.01) and, to a lesser extent, psychological job demands (r = 0.16; P = 0.01) were related to the number of health complaints. Short (1-7 days) duration absence was neither related to job demands nor to the number of health complaints. Longer (>7 days) duration absence was positively related to psychological job demands and to the number of health complaints. CONCLUSIONS: Job demands, particularly physical demands, correlated with perceived health. Poor health predicted long-term sickness absence. Early recognition of poor health should be the basis of a strategy that prevents long-term sickness absence.     

Interaction of working conditions, job satisfaction, and sickness absences: evidence from a representative sample of employees

We study the predictors of sickness absences among 2800 Finnish workers responding to the cross-sectional Quality of Work Life Survey in 1997. The data contain detailed information on the prevalence of adverse working conditions at the workplace from a representative sample of wage and salary earners. We show by using recursive multivariate models that the prevalence of harms at the workplace is associated with job dissatisfaction and dissatisfaction with sickness absences. The policy lesson is that the improvement of working conditions should be an integral part of any scheme aimed at decreasing sickness absence.     

Leisure time physical activity and sickness absenteeism; a prospective study

AIM: To establish whether workers with frequent leisure time physical activities are at higher or lower risk of sickness absence compared to inactive workers. METHOD: Self reported and company recorded sickness absence data were collected during 18 months of follow-up for 8902 workers. Frequency of leisure time physical activities was queried at baseline. RESULTS: Overall, we found that workers active in their leisure time twice or more each week reported significantly less sickness absence compared to inactive workers (14.8 versus 19.5 days/year), mainly due to a decrease in sick leave because of musculoskeletal disorders. CONCLUSION: Demotivating sports participation by making workers liable for workdays lost due to sporting injuries might be counter-productive in decreasing absenteeism and its related costs. Promoting worker participation in sport might lead to reduced absenteeism.     

Ethical issues among Finnish occupational physicians and nurses

A postal survey was conducted among 200 Finnish occupational physicians and nurses on their ethical values and problems. Both groups considered 'expertise' and 'confidentiality' as the most important core values of occupational health services (OHS) corresponding with newly published national ethical guidelines for occupational physicians and nurses in Finland. Nearly all respondents had encountered ethically problematic situations in their work, but ethical problems with gene testing in the near future were not considered likely to occur. Only 41% of the nurses and 36% of the physicians had received some training in the ethics of OHS, and 76% of all respondents never used available ethical guidelines. According to the results, even if ethics play a vital role in OHS, the ability to critically evaluate one's own performance seems quite limited. This creates a need for further training and more practicable national guidelines.     

The relationship between waist-to-hip ratio and occupational status and life-style factors among middle-aged male and female Japanese workers.

As a marker of body fat distribution and therefore level of obesity, the waist-to-hip ratio (W:H) is a good indicator of coronary heart disease risk status. The present study investigated the association between occupational status and life-style factors, and W:H of middle-aged Japanese male (n = 2,550) and female (n = 1,283) workers in a metal-products factory. A higher W:H was observed in the management level males as compared with the other male workers and we suggest this was promoted by the sedentary aspect of their work, as well as their higher levels of alcohol consumption and lower levels of leisure-time physical activity. In contrast, a higher W:H was recorded in female labourers, whose work was typically less sedentary as compared with female managers. Life-style factors included in the study were not related to this observation. We conclude that other unmeasured psychosocial factors may be important in promoting higher W:H in female labourers.     

The effect on attendance rates for sickness absence assessment of a revised employee information sheet

BACKGROUND: An increasingly high standard of ethical practice is expected of all doctors and in particular those not providing treatment services. AIMS: This case-control study investigated the effect on non-attendance rates for first sickness absence appointments of a new employee information sheet sent to staff from the two largest departments, education and social services, of a large UK local authority. METHOD: An information sheet detailing the ethical standards applying to a local authority occupational health service was developed and sent to all employees referred by their managers as part of the sickness absence management procedures, along with details of their appointment. RESULTS: A reduction of approximately 1/3 in the rate of non-attendance was noted in the intervention group, which was statistically significant for social services referrals. CONCLUSION: This approach may improve the efficiency and effectiveness of occupational health services, as well as helping to achieve the informed consent of employees undergoing occupational health assessment.     

The implementation of occupational health guidelines principles for reducing sickness absence due to musculoskeletal disorders

BACKGROUND: Occupational health guidelines recommend a biopsychosocial approach to manage sickness absence due to musculoskeletal disorders (MSDs), with a primary focus on early intervention through provision of a supportive network. AIMS: To investigate the implementation of a guidelines-based intervention (early contact of absentees; addressing psychosocial obstacles; offering temporary modified work; communicating among the players), and to determine whether this is effective for reducing return-to-work times and duration of future absence. METHODS: A non-randomized controlled trial was conducted within a UK company. Occupational health nurses at two experimental sites (1,435 workers) were trained to deliver the intervention to workers taking absence due to MSDs (low back and upper limb disorders), while usual care was delivered at three control sites (1,483 workers). Company-recorded absence data were collected over a 12-month follow-up period. RESULTS: The implementation of the experimental intervention was impeded by unforeseen organizational obstacles at one site (policies, procedures and individual approaches) which had a detrimental effect on uptake and delivery. At the site where the intervention was delivered per protocol, absence was significantly less compared with controls; 6.5 and 10.8 days, respectively. However, the duration of future absence was not significantly different (13.0 and 25.1 days, respectively). CONCLUSIONS: An early intervention addressing psychosocial obstacles to recovery can be effective for reducing absence due to MSDs. Successful implementation, where the key players are onside and organizational obstacles are overcome, is difficult to achieve.     

Prospective study of physical and psychosocial risk factors for sickness absence

AIM: To investigate the associations between psychosocial and physical work environment exposures and sickness absence from work taking into account health, health behaviour and employer characteristics known to affect sickness absence. METHODS: In 1995, a random sample of 5574 employees aged 18-64 years were interviewed. In 2000, 3792 of those still employed supplied data on days absent from work the year preceding the date of follow-up. Associations between risk factors at baseline and sickness absence at follow-up were studied. Logistic regression analyses were performed. RESULTS: Sickness absence was associated with working with arms lifted/hands twisted, extreme bending/stooping of the back/neck, repetitive monotonous work, low skill discretion, low decision authority, obesity, current and former smoking, poor self-rated health, female gender, increasing age and public employer. The aetiological fraction attributable to differences in work environment exposures was calculated to be 40%. CONCLUSION: The study suggests a potential for reducing sickness absence through multifactorial interventions towards smoking, obesity, physical and psychosocial work environment exposures. The study showed that differences in work environment exposures account for 40% of the cases of high sickness absence.     

Headache and blood pressure among triethylamine-exposed foundry workers

This study attempted to determine whether Cold box core makersexposed to triethylamine in foundries experienced headachesor had elevated blood pressure more often than workers withoutTEA exposure, as proposed by earlier reports. Forty-one coremakers in three foundries and 82 referents were interviewedaccording to a structured questionnaire, and their blood pressurewas measured. TEA exposure was determined from breathing-zonemeasurements. The 8-h time-weighted average TEA exposure variedbetween 0.3–60 mg/m³. The core makers did not report thatthey had the general symptoms of headaches more often than thereferents. However, they had mild weekly headaches more often(44% vs. 17%). The core makers also reported headaches moreoften during the workweeks (45% vs. 19%). It seems likely thatTEA exposure provokes mild headache among persons prone to sufferfrom vascular headaches. There was no difference in the occurrenceof severe headaches or in the duration of headaches betweenthe groups. The blood pressures were similar in both groups.     

Factors associated with premature departure from working life among ageing food industry employees

AIM: To find out how health status, work ability and job-related factors were associated with premature departure from working life in an 11 year follow-up period. METHODS: The study population was composed of 126 ageing food industry employees. Baseline data were derived from medical examinations and self-completed questionnaires in 1989. The follow-up data were collected in 2000. Data analyses were performed by independent samples t-tests and Mann-Whitney and chi(2) tests. RESULTS: Several chronic diseases, higher degree of work impairment due to diseases, long-term sickness absence, stress symptoms, low scores in work ability index, poor subjective work ability and physical work ability, and heavy physical workload seemed to be factors associated with early departure from working life among ageing food industry employees. CONCLUSION: Identification of these factors, prevention of sickness and promotion of work ability seem to be the most important tools to reduce premature exit from working life.     

Occupational fatalities among coal mine workers in Zonguldak, Turkey, 1994-2003

BACKGROUND: Fatal underground coal mine injuries are a worldwide problem. Zonguldak holds 95% of all Turkey's coal reserves. AIM: To investigate fatalities in the underground coal-mining industry in the Zonguldak province. METHODS: Retrospective study of fatal underground coal-mining accidents from 1994 to 2003 through evaluation of industry records. RESULTS: There were 164 deaths available for analysis. The median age was 36 years (range: 14-56 years). Eighty-one fatalities (49%) were due to subsidence, 33 (20%) were due to underground railway accidents and 18 (11%) were due to gas poisoning. Asphyxia was the most common cause of death (99, 60%). The majority of fatalities (144, 87%) occurred instantaneously at the scene of the incident. The remainder (20, 13%) occurred on the way to the hospital or in the emergency room or the intensive care unit. CONCLUSION: The underground coal-mining industry in Turkey requires strategies to improve safety and reduce the number of fatalities occurring. These strategies should focus on improved underground safety through engineering measures.