Psychosocial working conditions and future sick leave and disability pension trajectories in Sweden

Abstract

Abstract Background Psychosocial working conditions such as job demands and job control have been found to be associated with employee health and well-being, but studies on the associations with sickness absence (SA) and disability pension (DP) are scarce. We examined 11-year SA/DP trajectories and the association between psychosocial working conditions and subsequent SA/DP trajectories in the Swedish workforce. Methods Using a prospective cohort study with microdata we explored SA/DP trajectories among female and male employees, respectively, aged 30-53 years in 2001 in Sweden (1,076,042 women; 1,102,721 men). Group-based trajectory analysis was used to model annual mean SA/DP net days trajectories in 2002-2012. Based on a Swedish Job Exposure Matrix (JEM), individuals were assigned an age-, sex- and occupation-specific mean score for demands and control, respectively. Mean scores were categorized into tertiles and categorised into 3x3 combinations of exposure categories. Using multinomial regression we predicted trajectory group memberships for the JEM. Results The highest rate of women were in occupations with low demands and control (24.8%), while the highest rate of men (22.9%) was in occupations with high demands and control. We found three SA/DP trajectories for women (low, medium, high increasing) and two for men (low, high increasing). In fully adjusted models, those in occupations with low demands and low control were at higher risk of belonging to the high increasing SA/DP trajectory compared to those in occupations with high job demands and control in both women (OR 3.86; 95% CI: 3.75-3.97) and men (OR 3.0; 2.99-3.16). Conclusions Low job demands and low job control were associated with more high increasing future SA/DP trajectories compared to high job demands and job control in both women and men. Key messages In Sweden, women are more often in occupations characterized by low job demands and low job control and men are more often in occupations with high job demands and high job control. Occupations with low job demands and low job control were associated with more adverse SA/SP trajectories compared to occupations with high job demands and high job control in both women and men.