Perceived stress and sickness absence: A prospective study of 17,795 employees in Denmark

Background
The aims of the study were to examine 1) the prospective association between perceived stress and sickness absence, 2) if the association differed by sex, and 3) if the association was stronger when only long-term sickness absence (⩾31 days) instead of all episodes of sickness absence (⩾1 day) was included in the analyses.
Methods
We followed respondents from the ‘Work Environment and Health in Denmark’ 2014-survey for up to 18 months in the ‘Register of Work Absences’ from Statistics Denmark. Perceived stress was measured by a single question: “In the last 2 weeks, how often have you felt stressed?” We used Cox-regression with repeated events, adjusted for age, occupational sector, education, and previous sickness absence.
Results
The hazard ratio (HR) for “Often/Always” stress compared to “Seldom/Never” stress was statistically significant among both men (HR=1.25 [1.13-1.38]) and women (HR=1.43 [1.34-1.51]) when all episodes off sickness absence was included in the analyses. The HR was statistically significant among women (HR=2.26[1.89-2.70]), but not men (HR=1.22 [0.86-1.73]), when the analyses were restricted to long-term sickness absence. The difference between men and women in the association of stress with sickness absence was statistically significant.
Conclusions
The prospective association of perceived stress with risk of sickness absence was stronger among women than men. For women only, the association between perceived stress and long-term sickness absence was stronger than the association between perceived stress and all episodes of sickness absence.