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.     

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.     

Reducing work related psychological ill health and sickness absence: a systematic literature review

A literature review revealed the following: key work factors associated with psychological ill health and sickness absence in staff were long hours worked, work overload and pressure, and the effects of these on personal lives; lack of control over work; lack of participation in decision making; poor social support; and unclear management and work role. There was some evidence that sickness absence was associated with poor management style. Successful interventions that improved psychological health and levels of sickness absence used training and organisational approaches to increase participation in decision making and problem solving, increase support and feedback, and improve communication. It is concluded that many of the work related variables associated with high levels of psychological ill health are potentially amenable to change. This is shown in intervention studies that have successfully improved psychological health and reduced 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.     

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   

Sickness absence in relation to psychosocial work factors among daytime workers in an electric equipment manufacturing company

Associations between psychosocial work factors and sickness absence were investigated in a cross-sectional study of 833 daytime workers. Participants completed a questionnaire regarding psychosocial work factors using the US National Institute for Occupational Safety and Health Generic Job Stress Questionnaire (job control, quantitative workload, cognitive demands, variance in workload, intragroup conflict, intergroup conflict, supervisor support, coworker support, family support, job satisfaction and depressive symptoms) and the number of days of sickness absence within the previous year. Multivariate analyses of covariance with age and occupation as covariates (MANCOVA) were used to test the relationships between psychosocial work factors and sickness absence stratified by sex. In men, the age-adjusted MANCOVA showed that, quantitative workload was highest in the 0.5-4.5 d of sickness absence group (p<0.001). However, the levels of stress reactions (job satisfaction and depressive symptoms) in this group were almost identical to the levels recorded in the no sickness absence group. In contrast, low levels of job control (p<0.01), supervisor support (p<0.05), and job satisfaction (p<0.01) and higher symptoms of depression (p<0.001) were associated with 5 d or more sickness absence. In women, only high job satisfaction was associated with 5 d or more sickness absence (p<0.10). This study suggests that appropriate use of sickness absence at times of being exposed to high quantitative workload may help male workers to recover from stressful situations.     

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.     

Psychosocial factors and work related sickness absence among permanent and non-permanent employees

STUDY OBJECTIVE: To examine the association between psychosocial work factors and work related sickness absence among permanent and non-permanent employees by sex. DESIGN: A cross sectional survey conducted in 2000 of a representative sample of the European Union total active population, aged 15 years and older. The independent variables were psychological job demands and job control as measures of psychosocial work environment, and work related sickness absence as the main outcome. Poisson regression models were used to compute sickness absence days' rate ratios. SETTING: 15 countries of the European Union. PARTICIPANTS: A sample of permanent (n = 12 875) and non-permanent (n = 1203) workers from the Third European Survey on Working Conditions. RESULTS: High psychological job demands, low job control, and high strain and passive work were associated with higher work related sickness absence. The risks were more pronounced in non-permanent compared with permanent employees and men compared with women. CONCLUSIONS: This work extends previous research on employment contracts and sickness absence, suggesting different effects depending on psychosocial working conditions and sex.     

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.     

Job stress, sickness absence and sickness presenteeism in Nordic elderly care

AIMS: Nordic elderly care has been restructured to obtain more efficiency. Among workers caring for the elderly, levels of perceived job stress could vary, due to understaffing and resource scarcity. This study examines how sickness absence and sickness presenteeism are associated with perceived job stress. METHODS: Data were obtained by posting questionnaires to lower-level care staff in Sweden (n=483), Denmark (n=704), Finland (n=597), and Norway (n=663). Self-reports about job stress (four items), sickness absence and sickness presenteeism were analysed by cross-tabulations and logistic regression. RESULTS: Each item of job stress was associated with sickness absence and sickness presenteeism in the samples from all four countries. With low levels of job stress, levels of reported sickness absence and sickness presenteeism were relatively moderate. With increasing levels of job stress, the level of sickness presenteeism rose more sharply than that of sickness absence. CONCLUSIONS: The results can be interpreted in the light of features inherent in care work. Owing to professional norms and moral obligations, care workers could lower their thresholds for taking sick leave when care organizations are understaffed, because absences will be particularly critical for care recipients in such circumstances. Thus, while increasing job stress tends to be accompanied both by more sickness absence and by more sickness presenteeism, sickness presenteeism rises particularly in cases of high levels of job stress. Owing to cross-sectional data and self-reported information, conclusions are tentative.     

Psychosocial work characteristics and sickness absence in Japanese employees

Objectives: This study was undertaken to examine the association between sickness absence in Japanese employees and job demand/control and occupational class as psychosocial work characteristics. Methods: The study was cross-sectional in design with data collected from 20,464 male and 3,617 female employees, whose mean age was 40.9 years (SD ± 9.1 years) and 36.9 years (SD ± 10.8 years), respectively. The participants were asked to write the total number of sick leaves they had taken during the past year, and a comparison was made between the group with more than 6 days of sickness absence and the group with 0–6 days as a reference group. Job demands, job control, and worksite support from supervisors and colleagues were analyzed by the Job Content Questionnaire, and likewise by the Generic Job Stress Questionnaire of the National Institute for Occupational Safety and Health. Results: Both low job control and low support at the worksite were associated with a high frequency of sickness absence. But there was no clear relationship between job demands and sickness absence. The lowest sickness absence rate was found in male managers and the highest in male and female laborers. Conclusion: This is the first report of a large-scale survey of Japanese employees to show a high frequency of sickness absence associated with increased work stress and a socioeconomically low occupational class.     

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.

     

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.     

Perceived job security and sickness absence: a study on moral hazard

A moral hazard problem was investigated by analysing the individual behaviour of female and male employees with regard to utilisation of sickness insurance in connection with perceived job security. It was hypothesised that employees with a higher perceived job security take more frequent sickness absence. Perceived higher job security is indicated by three variables, namely a permanent job contract, no unemployment history, and native ethnicity. The effect of perceived job security is expected to be stronger on short-term than on long-term sickness absence, since a medical certificate is required for the latter. Public health survey data from Stockholm County, Sweden, covering the year 2002 was used. Using logistic regression analyses separately for short- and long-term sickness absence and for females and males, we found that short-term sickness absence is more strongly influenced by perceived job security than long-term sickness absence. We observe indications of moral hazard in both female and male employees. However, the three indicators of perceived job security have a different influence on females and males.

Health problems and psychosocial work environment as predictors of long term sickness absence in employees who visited the occupational physician and/or general practitioner in relation to work: a prospective study

Aims: To determine whether psychosocial work environment and indicators of health problems are prospectively related to incident long term sickness absence in employees who visited the occupational physician (OP) and/or general practitioner (GP) in relation to work.

Methods: The baseline measurement (May 1998) of the Maastricht Cohort Study, a prospective cohort study among 45 companies and organisations, was used to select employees at work who indicated having visited the OP and/or GP in relation to work. Self report questionnaires were used to measure indicators of health problems (presence of at least one long term disease, likeliness of having a mental illness, fatigue) and psychosocial work environment (job demands, decision latitude, social support, job satisfaction) as predictors of subsequent sickness absence. Sickness absence data regarding total numbers of sickness absence days were obtained from the companies and occupational health services during an 18 month period (between 1 July 1998 and 31 December 1999). Complete data were available from 1271 employees.

Results: After adjustment for demographics and the other predictors, presence of at least one long term disease (OR 2.36; 95% CI 1.29 to 4.29) and lower level of decision latitude (OR 1.69; 95% CI 1.22 to 2.38) were the strongest predictors for sickness absence of at least one month. A higher likelihood of having a mental illness, a higher level of fatigue, a lower level of social support at work, and low job satisfaction were also significant predictors for long term sickness absence, but their effect was less strong.

Conclusion: In detecting employees at work but at risk for long term sickness absence, OPs and GPs should take into account not only influence of the psychosocial work environment in general and level of decision latitude in particular, but also influence of indicators of health problems, especially in the form of long term diseases.

     

Psychosocial work environment and registered absence from work: estimating the etiologic fraction

BACKGROUND: Evidence is growing that an adverse psychosocial work environment increases sickness absence, but little is known on the magnitude of this problem or the impact of specific factors. METHODS: Psychological demands, decision authority, skill discretion, social support from colleagues or supervisor, predictability, and meaning of work were assessed with questionnaires at baseline and sickness absence was followed-up in employers' registers for 1,919 respondents (response rate 75.2%, 68% women, mainly low-skilled jobs) from 52 Danish workplaces during a 2-year period. Etiologic fractions (EFs) were calculated with the most favorable quartiles as reference. RESULTS: In the fully adjusted model, the following EFs were found: decision authority: 12%; social support from supervisors: 8%; psychological demands: 6%; and predictability: 5%. In total, the seven psychosocial factors explained 29% of all sick-leave days. CONCLUSIONS: The results suggest that improving the psychosocial work environment among the less favorable 75% may prevent substantial amounts of absence.     

From insecure to secure employment: changes in work, health, health related behaviours, and sickness absence

Aims: To determine whether change in employment status (from fixed term to permanent employment) is followed by changes in work, health, health related behaviours, and sickness absence.

Methods: Prospective cohort study with four year follow up. Data from 4851 (710 male, 4141 female) hospital employees having a fixed term or permanent job contract on entry to the study were collected at baseline and follow up.

Results: At baseline, compared to permanent employees, fixed term employees reported lower levels of workload, job security, and job satisfaction. They also reported greater work ability. All fixed term employees had a lower rate of medically certified sickness absence at baseline. Baseline rate ratios for those who remained fixed term were 0.64 (95% CI 0.55 to 0.75), and were 0.50 (95% CI 0.34 to 0.75) for those who later became permanent. Continuous fixed term employment was not associated with changes in the outcome measures. Change from fixed term to permanent employment was followed by an increase in job security, enduring job satisfaction, and increased medically certified sickness absence (compared to permanent workers rate ratio 0.96 (95% CI 0.80 to 1.16)). Other indicators of work, health, and health related behaviours remained unchanged.

Conclusion: Receiving a permanent job contract after fixed term employment is associated with favourable changes in job security and job satisfaction. The corresponding increase in sickness absence might be due to a reduction in presenteeism and the wearing off of health related selection.

     

Sickness absence due to influenza

In addition to its recognized health effects, influenza has socio-economic consequences, most notably sickness absence and associated work disruption. It may account for 10-12% of all sickness absence from work. Data on the impact of influenza on work are limited. Most research has assessed the impact of an intervention, usually influenza immunization. Within the available literature, there are five randomized controlled trials in the workplace that have assessed the effectiveness of influenza immunization as an intervention: two in the general working population and three in the health sector. If the benefit desired is a reduction in sickness absence as a cost-effective measure, the likely outcome is a modest gain in years when incidence of influenza is increased in the community. There are some distinctive factors in the health care industry: health care workers may exhibit different absence behaviour, they may be more exposed to infection at work and they may pose a risk as a source of nosocomial infection. From the occupational health perspective, how do we best inform employers currently? The cost-effectiveness case has not been absolutely proven. More research appears necessary, including assessment of those factors that influence uptake of influenza immunization. In the interim, a targeted approach to certain job categories may be the way forward.     

Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: Background,design and conceptual model of FINALE

Background  

A mismatch between individual physical capacities and physical work demands enhance the risk for musculoskeletal disorders, poor work ability and sickness absence, termed physical deterioration. However, effective intervention strategies for preventing physical deterioration in job groups with high physical demands remains to be established. This paper describes the background, design and conceptual model of the FINALE programme, a framework for health promoting interventions at 4 Danish job groups (i.e. cleaners, health-care workers, construction workers and industrial workers) characterized by high physical work demands, musculoskeletal disorders, poor work ability and sickness absence.