Associations between physical and psychosocial work environment factors and sickness absence incidence depend on the lengths of the sickness absence episodes: a prospective study of 27 678 Danish employees

Abstract
Objectives
This study examined if the association between work environment factors and sickness absence (SA) depended on the inclusion or exclusion of short-term SA episodes.
Methods
We linked the ‘Work Environment and Health in Denmark’-survey with the ‘Danish Register of Work Absences’ (N= 27,678). Using covariate adjusted Cox-regression, we examined the associations between work environment factors and SA by changing the cut-off points for the length of the SA episodes, e.g. episodes ≥1 day, ≥6 days, and ≥21 days. We examined three physical work environment factors; ‘Back bend or twisted’, ‘Lifting or carrying’, ‘Wet hands’, and three psychosocial work environment factors; ‘Poor influence’, ‘Role conflicts’, and ‘Bullying’.
Results
‘Back bend or twisted’ and ‘Lifting or carrying’ had small significant hazard ratios (HRs) for SA episodes ≥1 day and large and highly significant HRs for SA episodes ≥6 days and ≥21 days. ‘Wet hands’ had small significant HRs for SA episodes ≥1 day for both sexes and large and highly significant HR for ≥6 days for women. HRs of all three psychosocial factors were highly significant for SA episodes ≥1 day and ≥6 days for both sexes, and ‘Poor influence’ and ‘Role conflicts’ were significant for SA episodes ≥21 days for women.
Conclusions
The physical work factors had higher associations with SA when SA episodes of 1-5 days were excluded and focus was on SA episodes ≥6 days. The psychosocial work factors were strongly associated with SA both with and without SA episodes of 1-5 days included in the analyses.