Changes in Working Conditions and Subsequent Sickness Absence

By Saastamoinen, Peppiina; Laaksonen, Mikko et al. | Scandinavian Journal of Work, Environment & Health, January 1, 2014 | Go to article overview

Changes in Working Conditions and Subsequent Sickness Absence


Saastamoinen, Peppiina, Laaksonen, Mikko, Lahelma, Eero, Lallukka, Tea, Pietiläinen, Olli, Rahkonen, Ossi, Scandinavian Journal of Work, Environment & Health


Saastamoinen P, Laaksonen M, Lahelma E, Lallukka T, Pietiläinen O, Rahkonen O. Changes in working conditions and subsequent sickness absence. Scand J Work Environ Health. 2014;40(1):82-88 doi:10.5271/sjweh.3379

Objectives The aim of the study was to examine the associations of changes in exposure to physical and psy- chosocial working conditions on subsequent sickness absence among ageing municipal employees of the City of Helsinki, Finland.

Methods Changes in exposure to working conditions were assessed between baseline (2000-2002) and follow- up (2007) surveys. Register-based sickness absence information was linked to the survey data (N=3739) and followed-up from the return of the questionnaire in 2007 to the end of 2010. The study included six measures of physical and two measures of psychosocial working conditions. Negative binomial regression analysis was used to assess the associations and adjust for covariates.

Results Favorable changes in physical working conditions lowered the risk for sickness absence whereas adverse changes increased the risk. Adverse changes in psychosocial working conditions only slightly increased the risk for sickness absence whereas favorable changes were unassociated with sickness absence.

Conclusions Changes in exposure to physical working conditions in particular are associated with subsequent sickness absence. Preventing an increase in exposure to both psychosocial and physical working conditions and promoting a decrease in exposure to physical working conditions likely helps reduce the risk of sickness absence.

Key terms epidemiology; Finland; physical working condition; psychosocial working condition; sick leave.

Health, individual characteristics, functional capacity, and working conditions are key factors affecting sickness absence (1). Previous research has shown that physical working conditions, such as repetitive monotonous work, lifting, or working mainly standing or squatting (2-4), and psychosocial working conditions, such as low job control, are associated with sickness absence (2, 4-8). However, the majority of previous studies have measured working conditions at a single time point. Less is known about how changes over time in the exposure to working conditions affect subsequent sickness absence.

Only a few previous studies have focused on the effects of changes in working conditions on subsequent sickness absence. The effect of adverse changes in expo- sure to job demands, job control, social support, and physical demands on sickness absence was studied among 530 municipal employees of a small Finnish town dur- ing and after economic recession (9). Adverse changes were associated with increased risk of medically certified sickness absence spells. A similar study was conducted among 3817 British civil servants (10), but favorable changes in exposure to psychosocial working conditions were included in addition to adverse changes. Adverse changes in exposure to job demands and job control were associated with sickness absence spells of ?7 days, but favorable changes were not.

In addition to these two prospective cohort studies, the association of changes in exposure to psychosocial and physical working conditions with preceding changes in sickness absence was studied among 679 Finnish food industry employees (11). Adverse changes in exposure to work postures, team spirit, and reactivity were associ- ated with an increase in sickness absence days.

Previous studies on the effects of changes in exposure to working conditions on sickness absence have focused primarily on psychosocial working conditions and often examined adverse changes only. Both definition and the assessment of changes have varied between the stud- ies. In the Finnish municipal sector study, the scores of physical work factors were first standardized and +0.5 standard deviation was used to detect change (9). In the British study, the scores of changes in psychosocial work factors were calculated as a percentage of the total scores and >10 points change in either direction was defined as a decrease or increase. …

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