Occupational burnout and medically certified sickness absence: a population-based study of Finnish employees

OBJECTIVE: Occupational burnout is a common problem in working populations, but its association with sickness absence is poorly understood. The contribution of occupational burnout to medically certified sickness absence was examined in a population-based sample of employees. METHODS: A representative sample of 3151 Finnish employees aged 30-60 years participated in a comprehensive health study in 2000-2001, including an assessment of physician-diagnosed physical illnesses and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders based on the Composite International Diagnostic Interview. Burnout was measured with the Maslach Burnout Inventory-General Survey. Sickness absences longer than 9 days in 2000-2001 were extracted from a register of the Social Insurance Institution of Finland. RESULTS: The occurrence of medically certified sickness absence was more prevalent among employees with burnout than among those without burnout. After adjusting for sociodemographic factors and mental and physical disorders, the odds ratio of sickness absence for severe burnout was 6.9 [95% confidence interval (95% CI)=2.7-17.8] for men and 2.1 (95% CI=1.1-4.0) for women. Among employees with mental or physical disorders, severe burnout was associated with a 7.7-fold risk of sickness absence among men and with a 2.6-fold risk among women. The duration of absence was related to burnout among men with absences, for whom severe burnout accounted for 52 excess sickness absence days during the 2-year period after adjusting for sociodemographic factors, mental disorders, and physical illnesses. CONCLUSIONS: Severe burnout is associated with a substantial excess risk of medically certified sickness absence among both men and women. This association is independent of prevalent mental disorders and physical illnesses.