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. 2014 Apr 22;9(4):e96025.
doi: 10.1371/journal.pone.0096025. eCollection 2014.

Job strain, health and sickness absence: results from the Hordaland Health Study

Min-Jung Wang  1 , Arnstein Mykletun  2 , Ellen Ihlen Møyner  3 , Simon Øverland  3 , Max Henderson  4 , Stephen Stansfeld  5 , Matthew Hotopf  4 , Samuel B Harvey  6
Affiliations

Job strain, health and sickness absence: results from the Hordaland Health Study

Min-Jung Wang et al. PLoS One. .

Abstract

Objectives: While it is generally accepted that high job strain is associated with adverse occupational outcomes, the nature of this relationship and the causal pathways involved are not well elucidated. We aimed to assess the association between job strain and long-term sickness absence (LTSA), and investigate whether any associations could be explained by validated health measures.

Methods: Data from participants (n = 7346) of the Hordaland Health Study (HUSK), aged 40-47 at baseline, were analyzed using multivariate Cox regression to evaluate the association between job strain and LTSA over one year. Further analyses examined whether mental and physical health mediated any association between job strain and sickness absence.

Results: A positive association was found between job strain and risk of a LTSA episode, even controlling for confounding factors (HR = 1.64 (1.36-1.98); high job strain exposure accounted for a small proportion of LTSA episodes (population attributable risk 0.068). Further adjustments for physical health and mental health individually attenuated, but could not fully explain the association. In the fully adjusted model, the association between high job strain and LTSA remained significant (HR = 1.30 (1.07-1.59)).

Conclusion: High job strain increases the risk of LTSA. While our results suggest that one in 15 cases of LTSA could be avoided if high job strain were eliminated, we also provide evidence against simplistic causal models. The impact of job strain on future LTSA could not be fully explained by impaired health at baseline, which suggests that factors besides ill health are important in explaining the link between job strain and sickness absence.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Unadjusted risk of participants having an episode of long term sickness absence (LTSA) by job demand.
Figure 2
Figure 2. Unadjusted risk of participants having an episode of long term sickness absence (LTSA) by job control.
Figure 3
Figure 3. Unadjusted risk of participants having an episode of long term sickness absence (LTSA) by job strain.
See this image and copyright information in PMC

References

    1. Henderson M, Glozier N, Holland Elliott K (2005) Long term sickness absence. BMJ 330: 802–803. - PMC - PubMed
    1. Health and Safety Executive (2012) Stress and Psychological Disorders. London: Health and Safety Executive.
    1. Wainwright D, Calnan M (2002) Work stress. The making of a modern epidemic. Buckingham: Open University Press.
    1. Karasek RA (1979) Job Demands, Job Decision Latitude, and Mental Strain - Implications for Job Redesign. Administrative Science Quarterly 24: 285–308.
    1. Kuper H, Marmot M (2003) Job strain, job demands, decision latitude, and risk of coronary heart disease within the Whitehall II study. J Epidemiol Community Health 57: 147–153. - PMC - PubMed

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