Melchior Maria, Krieger Nancy, Kawachi Ichiro, Berkman Lisa F, Niedhammer Isabelle, Goldberg Marcel
National Institute of Health and Medical Research, Saint-Maurice, France.
Am J Public Health. 2005 Jul;95(7):1206-12. doi: 10.2105/AJPH.2004.048835. Epub 2005 Jun 2.
To estimate the contribution of stress-related and physical work factors to occupational class disparities in sickness absence from work.
Our sample consisted of 8847 men and 2886 women participating in the French GAZEL cohort study. Occupational class and medically certified sickness absence data (1995-2001) were obtained from the participants' employer. Work characteristics (physical and stress-related) were self-reported. We calculated rate ratios with Poisson regression models; fractions of sickness absence attributable to work factors were estimated with the Miettinen formula.
Sickness absence was distributed along an occupational gradient. Work characteristics accounted for 19% (women) and 21% (men) of all absences. Physical work conditions accounted for 42% and 13% of absences for musculoskeletal reasons, and work stress accounted for 48% and 40% of psychiatric absences. Overall, about 20% of the occupational class gradient in sickness absence could have been associated with deleterious work conditions.
Work conditions contribute to sickness absence, particularly among manual workers and clerks. Policies that decrease ergonomic constraints and work stress also could reduce the burden of ill health and sickness absence among the lowest strata of working populations.
评估与压力相关的工作因素和体力工作因素对因病缺勤职业阶层差异的影响。
我们的样本包括参与法国GAZEL队列研究的8847名男性和2886名女性。职业阶层和经医学认证的因病缺勤数据（1995 - 2001年）来自参与者的雇主。工作特征（体力和与压力相关的）通过自我报告获得。我们使用泊松回归模型计算率比；使用米耶蒂宁公式估计因病缺勤可归因于工作因素的比例。
因病缺勤呈现职业梯度分布。工作特征占所有缺勤的19%（女性）和21%（男性）。体力工作条件占肌肉骨骼疾病缺勤的42%和13%，工作压力占精神疾病缺勤的48%和40%。总体而言，因病缺勤职业阶层梯度中约20%可能与有害的工作条件有关。
工作条件导致因病缺勤，尤其是在体力劳动者和职员中。减少人体工程学限制和工作压力的政策也可以减轻劳动人口最低阶层的健康不良负担和因病缺勤情况。
