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.     

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.     

Healthy workplace indicators: costing reasons for sickness absence within the UK National Health Service

Sandwell Healthcare NHS Trust has been developing a tool for monitoring the reasons and costs of long-term sick leave (> 7 days). The data obtained from this process has been used to modify the type of occupational health and safety services provided for the Trust. Adoption of more standardized tools of this nature throughout the National Health Service (NHS) would help trusts to compare, and where appropriate enhance, the services provided by occupational health. Musculo-skeletal and mental health problems, account for the greatest costs arising from long-term sickness absence. It may therefore be prudent for NHS employers and their occupational health services to target their efforts on these particular problems.     

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.     

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.     

A longitudinal study of changes in interactional justice and subsequent short-term sickness absence among municipal employees

Objectives:Level of perceived interactional justice has been shown to be associated with sickness absence, but less is known about the effects of changes in interactional justice. It is also unknown to what extent unmeasured, time-invariant differences contribute to the association. We investigated the association between interactional justice changes and subsequent short-term (1–3 days) sickness absences over a 12-year follow-up using between- and within-individual modeling among ageing municipal employees.Methods:The data was derived from Helsinki Health Study cohort with baseline survey in 2000–2002 (N=8960, response rate 67%) and follow-up surveys in 2007 and 2012 (response rates 79% and 83%, respectively). At baseline, participants were 40–60-year-old employees of the City of Helsinki, Finland. Sickness absences from the employer’s registry were linked with the responses (78%). The analytic sample was 2109 and 2070 individuals for between-individual and 4433 individuals and 8425 observations for within-individual associations.Results:Negative change in interactional justice was associated with an increased risk of short-term sickness absence in between-individual models after adjusting for age and gender. Adjustment for sickness absence history attenuated the association. In within-individual models, a negative change in perceived interactional justice was associated with an increased risk of short-term sickness absence spells [incidence rate ratios (IRR) 1.05 (95% confidence interval 1.01–1.09)]. This association was robust to adjustments for gender, age, health behaviors and sickness absence history.Conclusions:Paying attention to management principles – especially managerial behavior and treatment of employees to avoid the deterioration of the level of interactional justice – may provide a way of reducing self-certified short-term sickness absence spells.     

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.     

The connection between age,job control and sickness absences among Finnish food workers

METHODS: The relationship between sickness absence and job control among industrial food workers of different ages (n = 114) was studied. RESULTS: The number of absence spells, particularly short absence spells, was higher among younger workers, as expected. Using multivariate analysis, low job control was associated with an increased number of all absence spells (P < 0.02). CONCLUSIONS: Job control may be an important factor in determining sickness absence among industrial workers.     

Prognostic factors for respiratory sickness absence and return to work among blue collar workers and office personnel

OBJECTIVES—To analyze factors that determine the occurrence of sickness absence due to respiratory disorders and the time it takes to return to work.
METHODS—A longitudinal study with 2 year follow up was conducted among 326 male blue collar and white collar workers. The survey started with an interview on respiratory complaints and spirometry. Sixty six (21%) workers were lost to follow up. Complete data on sickness absence among 251 workers during the follow up were collected from absence records and self reports. Regression analysis based on a proportional hazards model was applied to identify risk factors for the occurrence and duration of sickness absence due to respiratory disorders.
RESULTS—During the follow up 35% workers attributed at least one period of sickness absence to respiratory complaints, which accounted for 14.2% of all days lost. A history of chronic obstructive pulmonary disease (COPD) did not predict sickness absence for COPD; the same was true for chronic non-specific lung disease (CNSLD). Complaints about asthma contributed significantly to absence due to asthma (relative risk (RR) 3.96; 95% confidence interval (95% CI) 1.99 to 7.90). Job title was a significant predictor of sickness absence due to respiratory complaints. Decrease in forced vital capacity (FVC, <80% of the reference value) was also a significant predictor of absence due to asthma (RR 4.03; 95% CI 1.41 to 11.54) and of respiratory absence (RR 2.49; 95% CI 1.07 to 5.79). Absence with respiratory complaints was not associated with age, height, body mass index, or smoking. Duration of employment was a weak almost significant predictor against respiratory absenteeism (RR 0.94; 95% CI 0.91 to 0.97). Return to work after respiratory absence was worse for blue collar workers than office personnel (RR 5.74; 95% CI 1.90 to 17.4 for welders, and RR 6.43; 95% CI 2.08 to 19.85 for metal workers).
CONCLUSIONS—Asthmatic complaints in the 12 months before the study were associated with sickness absence for these complaints during the follow up. An abnormal level of FVC also influenced respiratory absenteeism. Blue collar workers had more often and more prolonged absences due to respiratory disorders than white collar workers. Workers with absence due to respiratory complaints were at higher risk of subsequent sickness absence in the next year.


Keywords: respiratory complaints; sickness absence; return to work     

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.     

Smoking and sickness absence among public health workers

BACKGROUND: As well as causing sickness and death, smoking has high socio-economic costs. The aim of this paper was to examine how closely smoking is associated with sickness absence among healthcare workers. SUBJECTS AND METHODS: Cases and controls were paired by age, gender and occupation among primary healthcare workers in Tenerife, Canary Islands, Spain. Cases were selected from workers that had been absent from work due to sickness for 1 or more days in an entire year, regardless of the cause. Controls were those workers who were not absent due to sickness over the same period. Tobacco consumption was verified by telephone poll. Matched pairs analysis was performed. RESULTS: Among the 292 cases, 40% were smokers, compared with 31% of controls [odds ratio (OR)=1.51, 95% confidence intervals (CI)=1.06-2.14]. The association between smoking and sickness absence was stronger in those aged 30-45 years (OR=1.60, 95%CI=1.04-2.44) and among nurses (OR=2.08, 95%CI=1.05-4.14). When the cause of sickness absence was a respiratory disease, no association was found with smoking. However, an association was found with back pain (OR=5, 95%CI=1.45-17.27). Duration of tobacco consumption was higher in cases (a) when only current smokers were considered (P=0.002), and (b) when including the smoking duration of former smokers (P=0.0004). CONCLUSIONS: Smoking is associated with a higher risk of sickness absence among healthcare workers, particularly due to back pain. This could be used as an incentive to persuade healthcare workers to stop smoking and re-inforce the non-smoking message given to their patients.     

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.     

Job satisfaction and turnover intent among hospital social workers in the United States

Feelings of job satisfaction and turnover intentions among social workers affect work quality for both social workers and the people for whom they provide services. Existing literature on job satisfaction among hospital social workers is limited, and is overly focused on issues of compensation. There is job satisfaction research with hospital nurses available for comparison. Other informative social work research on job satisfaction and turnover exists in mental health and generally, across settings. Research on turnover intent in social work is primarily from child welfare settings and may not generalize. The literature notes gaps and contradictions about predictors of job satisfaction and turnover intent. Using a large national dataset of hospital social workers, this research clarifies and fills gaps regarding hospital social workers, and explores how Herzberg’s theory of work can clarify the difference between sources of job dissatisfaction and job satisfaction. Findings include hospital social workers reporting high job satisfaction and that demographics do not contribute to the predictive models. The findings do support centralized social work departments and variety in the job functions of hospital social workers, and are consistent with the theoretical framework.     

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.     

Job satisfaction of health care staff employed at health centres in Turkey

The objective of the study was to identify job satisfaction levels and their causes among health care workers employed at public health centres. A survey was therefore carried out of health care workers in 21 health centres in Konya, Turkey. The Minnesota Satisfaction Questionnaire was used to investigate job satisfaction. The satisfaction score and proportion of those satisfied were determined according to demographic features. The percentage of satisfied health care workers was 60% and the satisfaction score was 3.8 +/- 0.5. Midwives had the lowest satisfaction scores. Working environment and income were the most important factors for dissatisfaction. There was no correlation between global satisfaction and other demographic variables. These results showed that the health care workers at public health centres in the province have low satisfaction scores. Improving working conditions and income may improve the overall quality of health care provision.     

Recurrence of sickness absence episodes certified by general practitioners in the UK

Background: Compared to other areas of sickness certification, recurrence of certified sickness absence has been relatively under-researched.

Objectives: This study aims to report the extent and patterns of recurrence and to identify factors associated with higher rates of recurrence.

Methods: Sickness certification (‘fit note’) data were collected from 68 general practices in eight regions of the UK for 12 months.

Results: Twenty percent of 31,453 patients in the study had a recurrent certified sickness episode, with over half of these having the second episode in the same diagnostic category as their first. Mental health problems accounted for over a half of all days certified in same-diagnosis recurrent episodes. Male gender, residing in an area of social deprivation, a longer episode of initial certified sickness absence, not having return to work (‘may be fit’) advice in the first episode, having a mental disorder or musculoskeletal (particularly back) problem were all independently associated with a higher incidence of recurrence.

Conclusion: Differential risk of recurrence needs to be considered when designing return-to-work interventions. Evaluation of effectiveness of interventions (particularly for sickness absentees with mental health problems) has to consider the sustainability of employment after a return to work.     

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.     

Job satisfaction among general practitioners: A systematic literature review

Objective: In recent years, the incidence of being overworked and burnt out has increased among general practitioners (GPs). One of the factors that influences the development of burnout is the job satisfaction that physicians experience. Therefore, we conducted a literature review to answer the question: what factors influence the job satisfaction experienced by GPs? Methods: We used two methods to retrieve citations. We searched four literature databases for citations from 1990 until July 2006, and we checked the reference lists of relevant articles. The inclusion criteria were: GPs had to be the subjects of the study, the study had to describe empirical research, the study had to focus on job satisfaction, and the number of subjects had to be greater than 30. Results: We found 24 relevant citations. Factors increasing job satisfaction which were mentioned more than twice were: diversity of work, relations and contact with colleagues, and being involved in teaching medical students. Factors decreasing job satisfaction were: low income, too many working hours, administrative burdens, heavy workload, lack of time, and lack of recognition.

Conclusion: Aspects of job satisfaction concerning the content of the profession seem to increase job satisfaction, and aspects concerning employment conditions seem to decrease job satisfaction.     

乡镇卫生院职工工作满意度及影响因素分析

目的：了解乡镇卫生院职工工作满意度,并分析其主要影响因素,为提高乡镇卫生院服务水平提供参考依据。方法：采用分层抽样的方法,抽取连云港市2个县,对其8家乡镇卫生院的234名医务人员进行问卷调查,并运用因子分析和Logistic回归分析筛选出主要影响因子以及社会学影响因素。结果：回收有效问卷215份,有效应答率为91.9%,总体满意得分为2.51分,影响职工工作满意度的主要因子依次为医院管理及人文制度、工作环境及工作报酬2个;影响职工工作满意度的社会学因素依次为文化程度、行政职务、专业职称。结论：乡镇卫生院应当从完善人文制度、加强基础设施、提高医务人员工资与待遇等方面增强自身的内涵建设,提高职工工作满意度。