Svärd Anna C, Kalima Mari-Liis, Halonen Jaana I, Mänty Minna, Kujanpää Tero, Roos Eira, Salmela Jatta, Lallukka Tea
Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Department of Public Health, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
Eur J Public Health. 2025 Jun 1;35(3):534-540. doi: 10.1093/eurpub/ckaf048.
This register-linked follow-up study examined whether psychological distress and demanding working conditions are jointly associated with short and long sickness absence (SA) periods among young and midlife Finnish public sector employees. We linked the Helsinki Health Study survey (response rate 51.5%, 80% women, ages 19-39 years in 2017) on psychological distress, physically and mentally strenuous work, and hours per day spent in physical work with the employer's SA register (n = 3609, mean follow-up of 2.1 years). We calculated rate ratios (RRs) and their 95% confidence intervals (CIs) for short (1-7 days) and long (8+ days) SA periods using negative binomial regression models. Additionally, we calculated the synergistic interaction between psychological distress and working conditions. Most (88%) participants had at least one short and 31% at least one long SA period. Participants with psychological distress and exposure to demanding working conditions had the highest RRs for long SA periods (physically strenuous work: RR: 2.27, CI: 1.87-2.77; mentally strenuous work: RR: 2.02, CI: 1.66-2.46; ≥3 h per day spent in physical work: RR: 2.41, CI: 1.94-2.99). The interactions for long SA were negative for physically demanding working conditions, but additive for mentally strenuous work. The associations were weaker for short SA periods. Adjusting for other covariates only slightly attenuated these associations. Psychological distress and demanding working conditions were jointly associated with short and long SA periods. Both individual- and workplace-related risk factors for SA need to be considered when planning preventive actions.
这项基于登记册的随访研究调查了心理困扰和苛刻的工作条件是否与芬兰公共部门年轻及中年员工的短期和长期病假缺勤期相关。我们将赫尔辛基健康研究调查（2017年的回复率为51.5%，80%为女性，年龄在19 - 39岁之间）中关于心理困扰、身心繁重工作以及每天从事体力工作的时长信息，与雇主的病假缺勤登记册（n = 3609，平均随访2.1年）进行了关联。我们使用负二项回归模型计算了短期（1 - 7天）和长期（8天及以上）病假缺勤期的率比（RRs）及其95%置信区间（CIs）。此外，我们还计算了心理困扰与工作条件之间的协同相互作用。大多数（88%）参与者至少有一次短期病假缺勤，31%至少有一次长期病假缺勤。存在心理困扰且面临苛刻工作条件的参与者，长期病假缺勤期的RRs最高（体力繁重工作：RR：2.27，CI：1.87 - 2.77；脑力繁重工作：RR：2.02，CI：1.66 - 2.46；每天从事体力工作≥3小时：RR：2.41，CI：1.94 - 2.99）。对于长期病假缺勤，体力要求苛刻的工作条件下的相互作用为负，但脑力繁重工作下为相加作用。短期病假缺勤期的关联较弱。调整其他协变量仅略微减弱了这些关联。心理困扰和苛刻的工作条件与短期和长期病假缺勤期均相关。在规划预防措施时，需要同时考虑与个人和工作场所相关的病假缺勤风险因素。
