The contribution of physical working conditions to sickness absence of varying length among employees with and without common mental disorders

Joint contributions of psychological distress and demanding working conditions to short and long sickness absence among young and early midlife municipal employees

This register-linked follow-up study examined whether psychological distress and demanding working conditions are jointly associated with short and long sickness absence (SA) periods among young and midlife Finnish public sector employees. We linked the Helsinki Health Study survey (response rate 51.5%, 80% women, ages 19-39 years in 2017) on psychological distress, physically and mentally strenuous work, and hours per day spent in physical work with the employer's SA register (n = 3609, mean follow-up of 2.1 years). We calculated rate ratios (RRs) and their 95% confidence intervals (CIs) for short (1-7 days) and long (8+ days) SA periods using negative binomial regression models. Additionally, we calculated the synergistic interaction between psychological distress and working conditions. Most (88%) participants had at least one short and 31% at least one long SA period. Participants with psychological distress and exposure to demanding working conditions had the highest RRs for long SA periods (physically strenuous work: RR: 2.27, CI: 1.87-2.77; mentally strenuous work: RR: 2.02, CI: 1.66-2.46; ≥3 h per day spent in physical work: RR: 2.41, CI: 1.94-2.99). The interactions for long SA were negative for physically demanding working conditions, but additive for mentally strenuous work. The associations were weaker for short SA periods. Adjusting for other covariates only slightly attenuated these associations. Psychological distress and demanding working conditions were jointly associated with short and long SA periods. Both individual- and workplace-related risk factors for SA need to be considered when planning preventive actions.

Are changes in perceived physical workload and strenuousness of work among partial disability pensioners associated with full disability pension?

AIMS

The aim of this study was to examine the changes in pensioners' perceived physical workload and the physical strenuousness of work before and after transition to partial disability pension (pDP), and whether these changes were associated with subsequent transition to full disability pension (fDP).

METHODS

We used survey data on physical workload and the physical strenuousness of work and covariates from the Helsinki Health Study, an occupational cohort measured in four phases: 2000-2002, 2007, 2012 and 2017. These data were prospectively linked to the Finnish Centre for Pensions' register data on pDP and fDP up to 2021 for those who had provided informed consent for such linkage (mean follow-up of 3 years). We included those who responded to the study surveys both before and after pDP (n = 235). Changes after transition to pDP in the physical strenuousness of work and in a constructed physical workload summary scale were analysed using log-binomial regression.

RESULTS

After transition to pDP, physical workload decreased among 20% of the participants, remained constantly low among 44% and constantly high among 36%. The changes in the physical strenuousness of work were similar. Thirty per cent (n = 70) of pDPs transitioned to fDP during the follow-up. The changes in physical workload or the physical strenuousness of work were not associated with transition to fDP.

CONCLUSIONS

Despite the transition to pDP and thus part-time work, perceived physical workload and the physical strenuousness of work remained stable, and were not reflected in transition to fDP. More research on larger samples is warranted.

Work-Related Psychosocial Risk and Protective Factors Influencing Workplace Sickness Absence: A Systematic Literature Review

PURPOSE

Employee sickness absence (SA) is a significant issue facing organizations and individuals worldwide, leading to multiple negative consequences, such as increased costs, early retirement, decreased productivity, and reduced quality of work. Therefore, within the occupational health and safety (OHS) framework, it is crucial to explore the factors that help workforces stay at work sustainably. This study investigates the role of work-related psychosocial factors (WRPFs) as predictors of SA and suggests proactive measures to prevent its occurrence.

METHODS

A systematic literature review was conducted within the Job Demands-Resources Model framework. Following the PRISMA Checklist, 1087 articles from PsycINFO, Medline, and Web of Science databases were screened, and 30 longitudinal studies were included.

RESULTS

The findings describe SA as a multifaceted phenomenon influenced by risk (e.g., poor quality leadership, bullying, and violence) and protective WRPFs (e.g., developmental opportunities and social support). These factors, spanning contextual, content-related, and relational dimensions, collectively influence workers' SA over time.

CONCLUSIONS

These insights provide valuable guidance for researchers and OHS stakeholders, supporting the development of research and interventions aimed at preventing SA. This research contributes important knowledge to the field, paving the way for more targeted strategies that address the organizational causes of SA and promote healthier, more productive work environments.

Comprehensive evaluation of the impact of workplace exposures on physician-certified sick leave in the general working population

BACKGROUND

Our objective was to quantify the prospective associations between work factors across chemical, physical, mechanical, and psychosocial domains and the onset of medically certified sick leave.

METHODS

Eligible respondents were interviewed in 2009, 2013, or 2016 and were registered in the national sick leave register with an employee relationship lasting more than 50 working days during the year of the survey interviews and the following year (n = 15,294 observations). To focus on the onset of high-level sick leave (HLSL; >16 days a year), we excluded individuals with HLSL during the survey year (baseline). We then used mixed-effect logistic regression models to assess prospective associations between self-reported work conditions and the occurrence of doctor-certified HLSL in the following year.

RESULTS

The average occurrence of HLSL was 13.1%. After adjusting for sex, age, level of education, chronic health problems, and smoking, we observed an exposure-response relationship between cumulative exposure to work factors within all domains and the occurrence of HLSL. When evaluating the impact of combined exposures, predicted odds ratios (OR) for employees exposed to 1, 2, and 3 or more work factors within all domains were 1.60 (95%CI 1.32 - 1.94), 2.56 (95%CI 1.73 - 3.74) and 4.09 (95%CI 2.28 - 7.25), compared to those not exposed.

CONCLUSIONS

The results support the notion that exposure to multiple work factors in various domains, including psychosocial, mechanical, chemical, and physical work conditions, is associated with an increased risk of high-level sick leave. Employers and occupational health professionals should consider the joint impact of these domains when designing interventions.

Prospective associations of psychosocial work factors with sickness absence spells and duration: Results from the French national working conditions survey

BACKGROUND

Some psychosocial work factors are associated with sickness absence, however little information is available on the associations of various psychosocial work factors and multiple exposures with sickness absence spells and duration, and gender differences.

METHODS

Data were from the French working conditions survey conducted on a nationally representative sample of the working population. The study sample included 17,437 employees (7292 men, 10,145 women) followed from 2013 to 2016 and/or from 2016 to 2019. Occupational exposures (20 psychosocial work factors, 4 working time/hours factors, 4 physical work exposures) were measured at the beginning of each follow-up period. Hurdle and multinomial models were used to study the associations with the number of days and spells of sickness absence.

RESULTS

Most of the psychosocial work factors predicted the risk of at least 1 day of sickness absence. Stronger associations were found among women than men for some factors. Psychosocial work factors were more likely to predict the number of spells than the number of days of sickness absence. Some physical work exposures predicted sickness absence spells and days, whereas shift work in women predicted the risk of at least 1 day of sickness absence. Dose-response associations were found between multiple psychosocial work exposures and sickness absence spells, and between multiple physical exposures and sickness absence spells and days.

CONCLUSION

Comprehensive prevention policies oriented toward the whole psychosocial and physical work environment should be useful to reduce sickness absence among men and women.

The Joint Contributions of Overweight/Obesity and Physical and Mental Working Conditions to Short and Long Sickness Absence among Young and Midlife Finnish Employees: A Register-Linked Follow-Up Study

INTRODUCTION

Overweight/obesity and strenuous working conditions are associated with work disability, but their joint contributions to sickness absence (SA) are unknown. We aimed to examine their joint contributions to SA periods of 1-7 and ≥8 days.

METHODS

Self-reported data on body mass index and working conditions, including perceived physically and mentally strenuous work and hours per day spent in heavy physical work, were linked to the employer's SA register for the City of Helsinki, Finland, employees (n = 4,323, women 78%) who were 19-39 years old at baseline. We calculated rate ratios (RRs) and 95% confidence intervals (CIs) for SA periods using negative binomial regression models among participants with healthy weight and overweight/obesity, with and without exposure to strenuous working conditions. The mean follow-up time was 2.1 years.

RESULTS

Participants with overweight/obesity and exposure to physically strenuous working conditions had the highest age- and gender-adjusted RRs for SA periods of both 1-7 and ≥8 days (physically strenuous work: RR: 1.38, CI: 1.25-1.52, and RR: 1.87, CI: 1.60-2.18, respectively; ≥3 h per day spent in physical work: RR: 1.40, CI: 1.26-1.55 and 2.04, CI: 1.73-2.40, respectively). The interaction between overweight/obesity and physically strenuous working conditions was additive for SA periods of 1-7 days and weakly synergistic for SA periods of ≥8 days. For mentally strenuous work, participants with overweight/obesity and exposure to mentally strenuous work had the highest age-adjusted RRs for SA periods of ≥8 days, and the interaction was additive.

CONCLUSION

The joint contributions of overweight/obesity and exposure to strenuous working conditions to SA should be considered when aiming to reduce employees' SA. Employers might benefit from providing employees adequate support for weight management and adherence to healthy lifestyles while improving employees' working conditions.

Working Conditions and Long-Term Sickness Absence Due to Mental Disorders: A Prospective Record Linkage Cohort Study Among 19- to 39-Year-Old Female Municipal Employees

OBJECTIVE

We examined associations between working conditions and long-term sickness absence due to mental disorders (LTSA-MD) among younger female public sector employees from different employment sectors.

METHODS

Survey data collected in 2017 (n = 3048) among 19- to 39-year-old female employees of the City of Helsinki, Finland, were used to examine job demands, job control, physical workload, computer work, and covariates. Register data on LTSA-MD were used over 1-year follow-up. Negative binomial regression models were applied.

RESULTS

Adverse psychosocial and physical working conditions were associated with higher LTSA-MD during the follow-up. Health and social care workers had the highest number of days of LTSA-MD.

CONCLUSION

Working conditions are important factors when aiming to prevent LTSA-MD among younger employees, in the health and social care sector in particular.

Physical working conditions and subsequent sickness absence: a record linkage follow-up study among 19-39-year-old municipal employees

Purpose

Physical work exposures are associated with sickness absence among older employees. We aimed to examine if they similarly contribute to all-cause sickness absence during early and mid-careers.

Methods

We used questionnaire data on physical work exposures linked to register data on sickness absence from 3542 municipal employees aged 19–39 years. Follow-up for the number of sickness absence days was 12 months. Exposures to physical workload, occupational environmental hazards, and sedentary work were divided into quartiles. In addition, duration of daily exposure to heavy work was included. Negative binomial regression models were used.

Results

Higher exposure to physical workload or hazardous exposures was associated with a higher number of sickness absence days. The age and gender adjusted rate ratios for sickness absence days among the participants whose exposure to physical workload was in the highest exposure quartile were 2.1 (95% CI 1.8‒2.5) compared with those whose exposure was in the lowest quartile. In addition, rate ratios for sickness absence days among participants who reported that they do heavy physical work 1.1‒2.0 h, 2.1‒4.0 h or over 4 h daily were 1.6 (1.3‒1.9), 1.5 (1.3‒1.8) and 1.7 (1.5‒2.1), respectively, compared with those who reported not doing physical work. Further adjustment for lifestyle factors or health characteristics attenuated the associations only slightly.

Conclusion

Exposure to physically demanding work is associated with a higher number of sickness absence days among municipal employees below 40 years of age. Physical working conditions should be considered when aiming to support later work ability.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01791-y.