Workplace levels of psychosocial factors as prospective predictors of registered sickness absence

OBJECTIVE: We sought to investigate whether workplace levels of psychosocial work environment factors predict individual sickness absence. METHODS: Data were collected in a prospective study in 52 Danish workplaces in three organizations: municipal care, technical services, and a pharmaceutical company. Psychosocial factors were aggregated as workplace means. We used multilevel Poisson regression models with psychosocial factors as predictors and individual level sickness absence from absence registries as outcome. RESULTS: High workplace levels of decision authority predicted low sickness absence in the technical services (rate ratio = 0.66, 95% confidence interval = 0.51-0.86) and high workplace levels of skill discretion predicted low sickness absence in the pharmaceutical company (rate ratio = 0.74, 95% confidence interval = 0.62-0.88) after control for relevant confounders. Workplaces in municipal care did not differ with respect to the psychosocial factors. CONCLUSIONS: Psychosocial factors at the workplace level may be important predictors of sickness absence.     

Multilevel analysis of individual and contextual factors as predictors of return to work

OBJECTIVE: The objective of this study was to examine if individual and contextual levels of work environment factors predict return to work (RTW). METHODS: Baseline data from 52 workplaces was linked to a national absence register. Four hundred twenty-eight persons with more than 2 weeks of sickness absence during a 2-year period were identified. Follow up was 1 year to examine three RTW outcomes. Multilevel logistic and Poisson regression models were used. RESULTS: At the individual level, significant associations were found between one psychosocial and four physical factors and RTW within 4 weeks. Two physical factors predicted RTW within 1 year. Two psychosocial and two physical factors significantly prolonged duration of sickness absence. No significant contextual level risk factors were found. CONCLUSION: At the individual level, both the psychosocial and physical work environment factors are important independent predictors of RTW.     

Psychosocial work environment exposures as risk factors for long-term sickness absence among Danish employees: results from DWECS/DREAM

OBJECTIVE: This study examines effects of psychosocial risk factors on long-term sickness absence, and investigates possible interactions between psychosocial and physical work environment risk factors. METHODS: A total of 5,357 employees were interviewed in 2000 regarding work environment and followed up during the proceeding 1.5 years regarding onset of long-term sickness absence. RESULTS: Long-term sickness absence among female employees was associated with role conflict, low reward, and poor management quality. Demands for hiding emotions and high emotional demands predicted long-term sickness absence among men. No significant interactions between psychosocial and physical exposures were found for female or male employees. CONCLUSIONS: The study suggests a potential for reducing long-term sickness absence through interventions targeted toward reducing role conflict, and improving reward and management quality among female employees, and through reducing emotional demands and demands for hiding emotions among male employees.     

Different risk factors for musculoskeletal complaints and musculoskeletal sickness absence

OBJECTIVES: The aim of this study was to investigate whether individual, work-related physical and psychosocial risk factors involved in the occurrence of musculoskeletal complaints also determine musculoskeletal sickness absence. METHODS: This cross-sectional study used a self-administered questionnaire to collect data on individual and work-related risk factors and the occurrence of musculoskeletal complaints and musculoskeletal sickness absence among 373 employees of laundry-works and dry-cleaning establishments (response rate 87%). Logistic regression models were used to determine associations between risk factors and the occurrence of musculoskeletal complaints and sickness absence due to these complaints. RESULTS: Both work-related physical and psychosocial factors showed strong associations with low-back pain and upper-extremity complaints. Work-related physical factors did not influence sickness absence, whereas psychosocial factors showed some associations with sickness absence. Sickness absence was associated with The Netherlands as the country of birth [odds ratio (OR) 0.3, 95% confidence interval (95% CI) 0.2-0.6], and female workers had an episode of sickness absence due to low-back pain less often (OR 0.5, 95% CI 0.3-0.9), but more often due to upper-extremity complaints (OR 2.2, 95% CI 1.14.5). CONCLUSIONS: Work-related physical and psychosocial factors largely determine the occurrence of low-back pain and upper-extremity complaints, whereas individual factors predominantly determine whether persons with these musculoskeletal complaints take sick leave.     

Psychosocial work factors and long sickness absence in Europe

Abstract

Background: Studies exploring a wide range of psychosocial work factors separately and together in association with long sickness absence are still lacking.

Objectives: The objective of this study was to explore the associations between psychosocial work factors measured following a comprehensive instrument (Copenhagen psychosocial questionnaire, COPSOQ) and long sickness absence (>7 days/year) in European employees of 34 countries. An additional objective was to study the differences in these associations according to gender and countries.

Methods: The study population consisted of 16?120 male and 16?588 female employees from the 2010 European working conditions survey. Twenty-five psychosocial work factors were explored. Statistical analysis was performed using multilevel logistic regression models and interaction testing.

Results: When studied together in the same model, factors related to job demands (quantitative demands and demands for hiding emotions), possibilities for development, social relationships (role conflicts, quality of leadership, social support, and sense of community), workplace violence (physical violence, bullying, and discrimination), shift work, and job promotion were associated with long sickness absence. Almost no difference was observed according to gender and country.

Conclusions: Comprehensive prevention policies oriented to psychosocial work factors may be useful to prevent long sickness absence at European level.     

Psychosocial work factors and long sickness absence in Europe

Background:

Studies exploring a wide range of psychosocial work factors separately and together in association with long sickness absence are still lacking.

Objectives:

The objective of this study was to explore the associations between psychosocial work factors measured following a comprehensive instrument (Copenhagen psychosocial questionnaire, COPSOQ) and long sickness absence (>7 days/year) in European employees of 34 countries. An additional objective was to study the differences in these associations according to gender and countries.

Methods:

The study population consisted of 16 120 male and 16 588 female employees from the 2010 European working conditions survey. Twenty-five psychosocial work factors were explored. Statistical analysis was performed using multilevel logistic regression models and interaction testing.

Results:

When studied together in the same model, factors related to job demands (quantitative demands and demands for hiding emotions), possibilities for development, social relationships (role conflicts, quality of leadership, social support, and sense of community), workplace violence (physical violence, bullying, and discrimination), shift work, and job promotion were associated with long sickness absence. Almost no difference was observed according to gender and country.

Conclusions:

Comprehensive prevention policies oriented to psychosocial work factors may be useful to prevent long sickness absence at European level.     

High physical and psychosocial load at work and sickness absence due to neck pain

OBJECTIVES: This study investigates the relationship between physical and psychosocial load at work and sickness absence due to neck pain. METHODS: A prospective cohort study with a follow-up period of 3 years (1994-1998) was performed among a working population. At the beginning of the study, physical load at work was quantified by means of video recordings. Work-related psychosocial variables were measured by means of the Job Content Questionnaire. The frequency of sickness absence due to neck pain with a minimal duration of 3 days was assessed on the basis of company registrations during the follow-up period. Altogether 758 workers were included in the analyses. Possible confounding by individual characteristics, physical load, and psychosocial load was studied. RESULTS: Work-related neck flexion and neck rotation, low decision authority, and medium skill discretion showed statistically significant increased risks for sickness absence due to neck pain (adjusted rate ratios ranging from 1.6 to 4.2). High quantitative job demands, low skill discretion, and low job security showed nonsignificant increased risks for sickness absence due to neck pain (adjusted rate ratios of 2.0, 1.6 and 1.7, respectively). Work-related sitting, conflicting job demands, supervisor support, and co-worker support did not increase sickness absence due to neck pain. CONCLUSION: Work-related neck flexion, neck rotation, low decision authority, and medium skill discretion are risk factors for sickness absence due to neck pain. There are indications that high job demands, low skill discretion, and low job security are also risk factors for sickness absence due to neck pain.     

Risk factors for musculoskeletal disorders among nursing personnel in Greek hospitals

OBJECTIVES: To investigate the relationships between physical, psychosocial, and individual characteristics and different endpoints of musculoskeletal complaints of the lower back, neck and shoulders. METHODS: In this cross-sectional study a questionnaire survey was carried out among 351 nursing personnel (response 84%) in six general hospitals in Athens, Greece. A questionnaire was used on physical and psychosocial workload, need for recovery, perceived general health and (1) the occurrence of musculoskeletal complaints in the past 12 months, (2) chronic complaints during at least 3 months, and (3) complaints which led to sickness absence. In logistic regression analysis odds ratios (ORs) were estimated for all relevant risk factors. RESULTS: Self-reported factors of physical load were associated with the occurrence of back pain (OR=1.85), neck pain (OR=1.88), and shoulder pain (OR=1.87) but these factors were not associated with chronic complaints and musculoskeletal sickness absence. Physical load showed a trend with the number of musculoskeletal complaints with ORs of 2.47 and 4.13 for two and three musculoskeletal complaints, respectively. No consistent influence of psychosocial factors on complaints, chronicity, or sickness absence was observed. A perceived moderate general health was also a risk factor, and strongest associations were observed for sickness absence due to back pain (OR=2.03), neck pain (OR=8.31), and shoulder pain (OR=6.84). CONCLUSIONS: The handling of physical loads among nurses seems to put them at risk for the occurrence of musculoskeletal disorders. The development of these complaints into chronic complaints and associated sickness absence is strongly determined by perceived general health and almost not associated with work-related physical and psychosocial risk factors. When the influence of work-related risk factors on musculoskeletal health is being investigated, the general health status of individual workers should be taken into account.     

Evaluating different measures of sickness absence with respect to work characteristics

AIMS: Four different measures of sickness absence were related to psychosocial and physical work characteristics in workplaces with high, intermediate, and low sickness absence. The relationships between work characteristics and sickness absence were hypothesized to differ depending the sickness absence measure used. METHODS: Questionnaire data on physical work environment, physical load, support, influence at work, and worry were collected from 1,726 employees at 48 dental clinics in Stockholm, Sweden and were related to registry-based sickness absence obtained at the workplace level. The sickness absence measures included: (1) frequency, (2) one-day absence, (3) overall duration, and (4) duration between 2 and 21 days. RESULTS: For frequency, significant differences were found for all work characteristics, with poor work characteristics being associated with a high frequency of sickness absence. Considering duration between 2 and 21 days, there were significant differences in support, influence at work and physical work environment; for one-day absence, support, influence at work and physical load differed significantly. Conversely, there were no significant differences for the overall duration measure. CONCLUSIONS: The results show that frequency of sickness absence is most consistently related to work characteristics, that short-time sickness absences have more inconsistent relationships and that relationship with overall duration is lacking. This highlights the need for further differentiation between different sickness absence measures, the behavioral patterns associated with different types of absences and the implication of such processes for prevention and intervention.     

Importance of psychosocial work factors on general health outcomes in the national French SUMER survey

AIM: To examine the associations between psychosocial work factors and general health outcomes, taking into account other occupational risk factors, within the national French working population. METHODS: The study was based on a large national sample of 24 486 women and men of the French working population who filled in a self-administered questionnaire in 2003 (response rate: 96.5%). Psychosocial work exposures included psychological demands, decision latitude, social support, workplace bullying and violence from the public. The three health indicators studied were self-reported health, long sickness absence (>8 days of absence) and work injury. Adjustment was made for covariates: age, occupation, work status, working hours, time schedules, physical, ergonomic, biological and chemical exposures. Men and women were studied separately. RESULTS: Low levels of decision latitude, and of social support, and high psychological demands were found to be risk factors for poor self-reported health and long sickness absence. High demands were also found to be associated with work injury. Workplace bullying and/or violence from the public also increased the risk of poor health, long sickness absence and work injury. CONCLUSION: Psychosocial work factors were found to be strong risk factors for health outcomes; the results were unchanged after adjustment for other occupational risk factors. Preventive efforts should be intensified towards reducing these psychosocial work exposures.     

The contribution of occupational factors to social inequalities in health: findings from the national French SUMER survey

Social inequalities in health have long been demonstrated, but the understanding of these inequalities remains unclear. Work and its related occupational factors may contribute to these inequalities. The objective of this study was to study the contribution of work factors using an integrated approach (including all types of exposures) to social inequalities in three health outcomes: poor self-reported health, long sickness absence, and work injury. Respondents were 14,241 men and 10,245 women drawn from a survey of the national French working population (response rate: 96.5%). Work factors included job characteristics, and occupational exposures of the physical, ergonomic, biological, chemical, and psychosocial work environment. All work factors were measured through expert evaluation by occupational physicians, except psychosocial work factors, which were self-reported. Strong social gradients were found for all work factors, except for psychological demands, workplace bullying, and aggression from the public. Marked social gradients were also observed for the health outcomes studied, blue collar workers being more likely to report poor self-reported health, long sickness absence, and work injury. The social differences in health were reduced strongly after adjustment for work factors (psychological demands excluded) by 24-58% according to sex and health outcomes. The strongest impacts were found for decision latitude, ergonomic, physical, and chemical exposures, as well as for work schedules. A detailed analysis allowed us to identify more precisely the contributing occupational factors. It suggests that concerted prevention of occupational risk factors would be useful not only to improve health at work, but also to reduce social inequalities in health.     

Structured Early Consultation with the Occupational Physician Reduces Sickness Absence Among Office Workers at High Risk for Long-Term Sickness Absence: a Randomized Controlled Trial

Objective To examine the efficacy of structured early consultation among employees at high risk for future long-term sickness absence, in the prevention and/or reduction of sickness absence. The focus of the experiment was the timing of the intervention, that is, treatment before sickness absence actually occurs. Methods In the current prospective randomized controlled trial (RCT), employees at high risk for long-term sickness absence were selected based on responses to a 34-item screening questionnaire including demographic, workplace, health and psychosocial factors associated with long-term sickness absence (>28 days). A total of 299 subjects at risk for future long-term sickness absence were randomized in an experimental group (n = 147) or in a control group (n = 152). Subjects in the experimental group received a structured early consult with their occupational physician (OP), in some cases followed by targeted intervention. The control group received care as usual. Sickness absence was assessed objectively through record linkage with the company registers on sickness absence over a 1 year follow-up period. Results Modified intention-to-treat analysis revealed substantial and statistically significant differences (p = 0.007) in total sickness absence duration over 1 year follow-up between the experimental (mean 18.98; SD 29.50) and control group (mean 31.13; SD 55.47). Per-protocol analysis additionally showed that the proportion of long-term sickness absence spells (>28 days) over 1 year follow-up was significantly (p = 0.048) lower in the experimental (9.1%) versus control group (18.3%). Conclusions Structured early consultation with the OP among employees at high risk for future long-term sickness absence is successful in reducing total sickness absence.     

Biomechanical and psychosocial risk factors for low back pain at work.

OBJECTIVES: This study determined whether the physical and psychosocial demands of work are associated with low back pain. METHODS: A case-control approach was used. Case subjects (n = 137) reported a new episode of low back pain to their employer, a large automobile manufacturing complex. Control subjects were randomly selected from the study base as cases accrued (n = 179) or were matched to cases by exact job (n = 65). Individual, clinical, and psychosocial variables were assessed by interview. Physical demands were assessed with direct workplace measurements of subjects at their usual jobs. The analysis used multiple logistic regression adjusted for individual characteristics. RESULTS: Self-reported risk factors included a physically demanding job, a poor workplace social environment, inconsistency between job and education level, better job satisfaction, and better coworker support. Low job control showed a borderline association. Physical-measure risk factors included peak lumbar shear force, peak load handled, and cumulative lumbar disc compression. Low body mass index and prior low back pain compensation claims were the only significant individual characteristics. CONCLUSIONS: This study identified specific physical and psychosocial demands of work as independent risk factors for low back pain.     

Can individual health differences be explained by workplace characteristics?-A multilevel analysis

Research on work-related health has mainly focused on individual factors. The present study expands the focus by exploring the role of organizational characteristics of workplaces for different individual health outcomes. The aim of the study was to look at differences in relative effect of workplace variations on five health outcomes, and to explain those differences in health outcomes by organizational characteristics. The sample encompassed 90 workplaces in Sweden and about 4300 individuals employed within these workplaces. Measurement of the workplace characteristics was carried out independently of the measurement of the individual's working conditions and health. Organizational data were collected by interviews with local managers at participating workplaces, and individual data were obtained by means of a survey of the employees. The results showed that a significant proportion of the variance in sickness absence, work ability, general health, and musculoskeletal disorders was attributed to the workplace. Of eight tested organizational characteristics, customer adaptation, lean production, and performance control could explain some of this workplace variance. The results also showed that only one organizational effect remained significant when controlled for the individual confounder of age and gender. High customer adaptation is associated with higher sickness absence. This association is not mediated via differences in mental and physical job strain.     

High physical work load and low job satisfaction increase the risk of sickness absence due to low back pain: results of a prospective cohort study

Objective: To determine whether physical and psychosocial load at work influence sickness absence due to low back pain.

Methods: The research was a part of the study on musculoskeletal disorders, absenteeism, stress, and health (SMASH), a 3 year prospective cohort study on risk factors for musculoskeletal disorders. Workers from 21 companies located throughout The Netherlands participated in the part of this study on sickness absence due to low back pain. The study population consisted of 732 workers with no sickness absences of 3 days or longer due to low back pain in the 3 months before the baseline survey and complete data on the reasons for absences during the follow up period. The mean (range) period of follow up in this group was 37 (7–44) months. Physical load at work was assessed by analyses of video recordings. Baseline information on psychosocial work characteristics was obtained by a questionnaire. Data on sickness absence were collected from company records. The main outcome measure was the rate of sickness absences of 3 days or longer due to low back pain during the follow up period.

Results: After adjustment of the work related physical and psychosocial factors for each other and for other potential determinants, significant rate ratios ranging from 2.0 to 3.2 were found for trunk flexion, trunk rotation, lifting, and low job satisfaction. A dose-response relation was found for trunk flexion, but not for trunk rotation or lifting. Non-significant rate ratios of about 1.4 were found for low supervisor support and low coworker support. Quantitative job demands, conflicting demands, decision authority, and skill discretion showed no relation with sickness absence due to low back pain.

Conclusions: Flexion and rotation of the trunk, lifting, and low job satisfaction are risk factors for sickness absence due to low back pain. Some indications of a relation between low social support, either from supervisors or coworkers, and sickness absence due to low back pain are also present.

     

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.     

Health-related quality of life and sickness absence in community nursing home employees: randomized controlled trial of physical exercise

BACKGROUND: It is a common belief that physical exercise at the workplace decreases subjective health complaints and reduces sickness absence, but this is not supported by previous randomized studies. AIMS: To evaluate the effectiveness of physical exercise at the workplace. METHODS: One hundred and twenty-nine employees in a community-based nursing home for the elderly were randomized into physical exercise or control groups. A weekly exercise class consisting of light aerobic exercise, muscle strengthening and stretching was held for a 6-month period. The control group was told to continue their ordinary activity. The main outcome measures were aerobic fitness (UKK, walking test), health-related quality of life (COOP/WONCA) and sickness absence. Blinded assessments were carried out at baseline and following the 6-month intervention. Complete sickness absence data were collected from a community register for two comparable 7-month periods. RESULTS: The average number of exercise sessions was 12 (0-26). Self-reported physical activity increased in the intervention group compared with the control group (P < 0.01). Aerobic fitness improved in both groups (P < 0.01). Mean sickness absence increased from 6.8 to 15.6 days in the exercise group and from 10.4 to 14.5 in the control group. No differences between groups were found for aerobic fitness, health-related quality of life or sickness absence. CONCLUSION: The intervention neither improved health-related quality of life nor reduced sickness absence.     

Influence of change in psychosocial work characteristics on sickness absence: The Whitehall II Study

OBJECTIVES: To study the influence of change in self perceived psychosocial work characteristics on subsequent rates of sickness absence. METHODS: Prospective cohort study of British civil service employees. Job control, job demands, and work social supports were measured in 1985/88 and in 1991/93. Analyses included 3817 British civil servants with sickness absence records at baseline (1985-89) and for two follow up periods, early (1994-95) and later follow up (1996-98). RESULTS: Change in work characteristics predicted subsequent incidence of long spells of sickness absence (>7 days) in the early follow up period after adjustment for covariates including baseline work characteristics, health status, and sickness absence. Adjusted rate ratios were 1.23 (95% CI 1.03 to 1.46) for decreased compared with stable decision latitude; 1.17 (95% CI 1.01 to 1.36) for increased compared with stable job demands and 0.79 (95% CI 0.67 to 0.93) for increased compared with stable work social support. These associations were also seen in a sub-sample who did not change employment grade. In the later follow up period, associations between work change and long spells of sickness absence were similar for decision latitude, less pronounced for job demands, and no longer apparent for social supports. Changes in work characteristics were not associated with subsequent short spells of sickness absence (相似文献   

Determinants of work absence following surgery for carpal tunnel syndrome

BACKGROUND: The objective was to identify factors across multiple domains associated with return to work in a community-based cohort of workers with carpal tunnel syndrome. METHODS: Workers scheduled for carpal tunnel release were recruited into this prospective study. Subjects completed questionnaires preoperatively and at 2, 6, and 12 months postoperatively. The questionnaires contained demographic, clinical, and psychosocial factors and physical and psychosocial workplace stressors. Predictors of work absence at 6 and 12 months were examined in bivariate and multivariate logistic regression analyses. RESULTS: Six months following surgery of 181 subjects, 29 (19%) were out of work. Twelve months postoperatively 33 subjects (22%) were out of work. In bivariate analyses, the factors associated with work absence at 6 months, at P < or = 0.01, included preoperative physical functional status, change in self-efficacy between preoperative assessment and 2 months, lower income, workers' compensation, representation by an attorney, work exposure to force and repetition, higher psychological job demands and lower control, lower social support by coworkers, lower job security and more supportive organizational policies and practices. The factors associated with work absence at 12 months in bivariate analyses included preoperative physical functional status, lower self-efficacy at 2 months, workers' compensation, and less supportive organizational policies and practices. Multivariate analyses documented a multidimensional model, with predictors from multiple domains. CONCLUSIONS: Clinical, demographic, economic, and workplace factors were associated with work absence. Strategies to reduce work absence following carpal tunnel release should address multiple dimensions of the worker and workplace.     

A one-item workability measure mediates work demands, individual resources and health in the prediction of sickness absence

Objectives

The study tested the hypothesis that a one-item workability measure represented an assessment of the fit between resources (the individuals’ physical and mental health and functioning) and workplace demands and that this resource/demand fit was a mediator in the prediction of sickness absence. We also estimated the relative importance of health and work environment for workability and sickness absence.

Methods

Baseline data were collected within a Danish work and health survey (3,214 men and 3,529 women) and followed up in a register of sickness absence. Probit regression analysis with workability as mediator was performed for a binary outcome of sickness absence. The predictors in the analysis were as follows: age, social class, physical health, mental health, number of diagnoses, ergonomic exposures, occupational noise, exposure to risks, social support from supervisor, job control and quantitative demands.

Results

High age, poor health and ergonomic exposures were associated with low workability and mediated by workability to sickness absence for both genders. Low social class and low quantitative demands were associated with low workability and mediated to sickness absence among men. The mediated part was from 11 to 63 % of the total effect for the significant predictors.

Conclusion

Workability mediated health, age, social class and ergonomic exposures in the prediction of sickness absence. The health predictors had the highest association with both workability and sickness absence; physical work environment was higher associated with the outcomes than psychosocial work environment. However, the explanatory value of the predictors for the variance in the model was low.