Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2013 Apr 19;8(4):e61830. doi: 10.1371/journal.pone.0061830. Print 2013.
Research has shown that individuals reporting a low level of adjustment latitude, defined as having few possibilities to temporarily adjust work demands to illness, have a higher risk of sick leave. To what extent lack of adjustment latitude influences the individual when making the decision to take sick leave is unknown. We hypothesize that ill individuals are more likely to take sick leave on days when they experience a lack of adjustment latitude at work than on days with access to adjustment latitude.
A case-crossover design was applied to 546 sick-leave spells, extracted from a cohort of 1 430 employees at six Swedish workplaces, with a 3-12 month follow-up of all new sick-leave spells. Exposure to lack of adjustment latitude on the first sick-leave day was compared with exposure during several types of control periods sampled from the previous two months for the same individual.
Only 35% of the respondents reported variations in access to adjustment latitude, and 19% reported a constant lack of adjustment latitude during the two weeks prior to the sick-leave spell. Among those that did report variation, the risk of sick leave was lower on days with lack of adjustment latitude, than on days with access (Odds Ratio 0.36, 95% Confidence Interval 0.25-0.52).
This is the first study to show the influence of adjustment latitude on the decision to take sick leave. Among those with variations in exposure, lack of adjustment latitude was a deterrent of sick leave, which is contrary to the à priori hypothesis. These results indicate that adjustment latitude may not only capture long-lasting effects of a flexible working environment, but also temporary possibilities to adjust work to being absent. Further studies are needed to disentangle the causal mechanisms of adjustment latitude on sick-leave.
研究表明，报告调整幅度较低（即暂时调整工作需求以应对疾病的可能性较小）的个体请病假的风险更高。个人在决定请病假时，缺乏调整幅度在多大程度上影响他们的决策尚不清楚。我们假设，感到不适的个体在工作中缺乏调整幅度的日子里比在有调整幅度的日子里更有可能请病假。
本项病例交叉设计应用于从六个瑞典工作场所的 1430 名员工队列中提取的 546 个病假案例，对所有新的病假案例进行了 3-12 个月的随访。将第一个病假日的缺乏调整幅度的暴露情况与同一个体前两个月的几种对照期内的暴露情况进行了比较。
只有 35%的受访者报告了调整幅度的变化，19%的受访者在病假前两周报告了持续缺乏调整幅度。在那些确实报告了变化的人群中，与有调整幅度的日子相比，缺乏调整幅度的日子请病假的风险较低（比值比 0.36，95%置信区间 0.25-0.52）。
这是第一项研究表明调整幅度对请病假决策的影响的研究。在那些有暴露度变化的人群中，缺乏调整幅度会阻止请病假，这与先验假设相反。这些结果表明，调整幅度不仅可以捕捉灵活工作环境的长期影响，还可以临时调整工作以应对缺勤。需要进一步研究来阐明调整幅度对病假的因果机制。
