Purpose To determine which work arrangements, physical working conditions, and psychosocial working conditions are important risk factors for sickness absence. Methods Survey data on working ...conditions collected among the employees of the City of Helsinki during 2000 to 2002 (N = 6503, response rate 67%) were linked to the employer's sickness absence records for the subsequent 3 years. First occurrences of short-term (1−3 days), intermediate (4−14 days), and long-term (15 days or more) sickness absence episodes were examined by the use of proportional hazards models with Bayesian model averaging. Results Working overtime decreased the risk of short-term sickness absence by 19%. Heavy physical work load and hazardous exposures were consistently associated with increased sickness absence episodes of all lengths. The risk of intermediate and long-term absence episodes was increased by 24% to 28% per one standard deviation increase in physical work load. Low job control in women and job dissatisfaction in men increased the risk of sickness absence episodes of all lengths. Conclusions Heavy physical work load and hazardous exposures had the strongest associations with sickness absence. Furthermore, low job control in women and job dissatisfaction in men were consistently associated with increased risk of sickness absence. Systematic differences in risk factors for absence episodes of different lengths were not found.
Purpose We sought to examine the importance of childhood circumstances, adult socioeconomic status, and material circumstances to physical and mental functioning among middle-aged women and men. ...Methods The data were collected among the employees of the City of Helsinki by mailed questionnaires from 2000 to 2002 (7148 women and 1799 men, response rate 67%). Three latent variables covering childhood circumstances, adult socioeconomic status, and material circumstances were constructed from 10 observed socioeconomic indicators. Direct and indirect effects of the latent variables on physical and mental functioning, measured by the SF-36 component summaries, were examined using structural equation modelling. Results Childhood circumstances were not directly associated with either physical or mental functioning but had some effect through socioeconomic status. Low socioeconomic status was associated with poor physical functioning, but mental functioning was poorer among those in higher positions. Material circumstances were associated with physical and especially with mental functioning. Conclusions Low socioeconomic status and material circumstances are both important for physical functioning. However, mental functioning does not necessarily follow a similar socioeconomic pattern and the results are heavily influenced by how socioeconomic position is measured.
