Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Eur J Public Health. 2010 Dec;20(6):682-8. doi: 10.1093/eurpub/ckp240. Epub 2010 Feb 8.
The prerequisite for obtaining sickness benefit is reduced work ability for medical reasons in combination with work demands which cannot be adjusted accordingly. The aim of this study was to investigate if low levels of adjustment latitude, defined as the possibility to temporarily adjust work demands in case of ill health, influence sickness absence.
A prospective cohort study of 1420 employees (47% participation, aged 19-68; 56% women) was conducted at six Swedish workplaces. Exposure to two general and nine specific types of adjustment latitude was ascertained at baseline. Outcome was defined as the first new employer-reported sick-leave spell during a follow-up of 3-12 months. Hazard ratios (HR) of sick leave, with 95% confidence intervals (CI), were estimated by Cox proportional hazards regression.
The incidence of sickness absence was 2.85/1000 person-days. The self-reported reasons for sick leave were mainly minor complaints such as colds, influenzas and headaches. Employees lacking adjustment latitude had an adjusted HR of sickness absence of 1.51 (95% CI 1.08-2.11). Among specific adjustment latitude types, those not having the possibility to work from home generated an HR of 1.86 (95% CI 1.31-2.64). The effects of lack of adjustment latitude were similar for men and women but seemed to vary between different occupations.
A low level of adjustment latitude at work is a risk factor for sickness absence.
获得疾病津贴的前提是由于医疗原因导致工作能力下降，并且工作需求无法相应调整。本研究的目的是调查调整幅度较低（定义为在健康状况不佳时暂时调整工作需求的可能性）是否会影响病假。
在瑞典的六个工作场所进行了一项前瞻性队列研究，共纳入了 1420 名员工（参与率为 47%，年龄为 19-68 岁，女性占 56%）。在基线时确定了两种一般和九种特定类型的调整幅度。结果定义为在 3-12 个月的随访期间首次由雇主报告的新的病假。使用 Cox 比例风险回归估计了病假的风险比（HR）及其 95%置信区间（CI）。
病假的发病率为 2.85/1000 人天。请病假的自我报告的原因主要是轻微的疾病，如感冒、流感和头痛。缺乏调整幅度的员工的病假调整后 HR 为 1.51（95% CI 1.08-2.11）。在特定的调整幅度类型中，那些没有在家工作的可能性的员工的 HR 为 1.86（95% CI 1.31-2.64）。缺乏调整幅度的影响在男性和女性中相似，但似乎因不同职业而异。
工作中的调整幅度较低是病假的一个风险因素。
