Frequency Of Sickness Absence Research Articles

Measuring and Assessing Sick Absence from Work: a European Cross‑sectional Study

This study analyses sickness absence in selected European countries. We suggested and applied three sick‑leave measures: global sickness absence rate, frequency rate, and absolute crude absence rate. To calculate the rates, open access data from Eurostat, the OECD, and the WHO were used. On the one hand, assessing sickness absence is a challenge in spite of accessible numbers of people and days of absence in public and employer registers. Simultaneously, a detailed understanding of sickness benefits and sick‑pay schemes is needed to elucidate cross‑country differences in sick‑leave rates. The long‑term dynamic trajectory (1970–2020) and regional differentiation effects on absenteeism among countries were considered. Using correlation coefficients and one‑way analysis of variance, a robustness check was performed, and the limitations of the proposed approach to measuring absenteeism were presented. The results evidence that the aforementioned indices present a unique and valid approximation to evaluate and monitor the state of sick absence and inequality in national policies.

Changing patterns of sickness absence among healthcare workers in England during the COVID-19 pandemic.

BackgroundPatterns of sickness absence shed useful light on disease occurrence and illness-related behaviours in working populations.MethodsWe analysed prospectively collected, pseudonymized data on 959 356 employees who were continuously employed by National Health Service trusts in England from 1 January 2019 to 31 July 2020, comparing the frequency of new sickness absence in 2020 with that at corresponding times in 2019.ResultsAfter exclusion of episodes directly related to COVID-19, the overall incidence of sickness absence during the initial 10 weeks of the pandemic (March–May 2020) was more than 20% lower than in corresponding weeks of 2019. Trends for specific categories of illness varied substantially, with a fall by 24% for cancer, but an increase for mental illness. A doubling of new absences for pregnancy-related disorders during May–July of 2020 was limited to women with earlier COVID-19 sickness absence.ConclusionsVarious factors will have contributed to the large and divergent changes that were observed. The findings reinforce concerns regarding delays in diagnosis and treatment of cancers and support a need to plan for a large backlog of treatment for many other diseases. Further research should explore the rise in absence for pregnancy-related disorders among women with earlier COVID-19 sickness absence.

Risks of COVID-19 by occupation in NHS workers in England

ObjectiveTo quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020–31 July 2020) of the pandemic in England.MethodsWe used pseudonymised data on 902 813 individuals...

Cardiorespiratory Fitness and Device-Measured Sedentary Behaviour are Associated with Sickness Absence in Office Workers.

Physical activity reduces the risk of several noncommunicable diseases, and a number of studies have found self-reported physical activity to be associated with sickness absence. The aim of this study was to examine if cardiorespiratory fitness, device-measured physical activity, and sedentary behaviour were associated with sickness absence among office workers. Participants were recruited from two Swedish companies. Data on sickness absence (frequency and duration) and covariates were collected via questionnaires. Physical activity pattern was assessed using ActiGraph and activPAL, and fitness was estimated from submaximal cycle ergometry. The sample consisted of 159 office workers (67% women, aged 43 ± 8 years). Higher cardiorespiratory fitness was significantly associated with a lower odds ratio (OR) for both sickness absence duration (OR = 0.92, 95% confidence interval (CI) 0.87–0.96) and frequency (OR = 0.93, 95% CI 0.90–0.97). Sedentary time was positively associated with higher odds of sickness absence frequency (OR = 1.03, 95% CI 0.99–1.08). No associations were found for physical activity at any intensity level and sickness absence. Higher sickness absence was found among office workers with low cardiorespiratory fitness and more daily time spent sedentary. In contrast to reports using self-reported physical activity, device-measured physical activity was not associated with sickness absence.

Effect of an eHealth Intervention to Reduce Sickness Absence Frequency Among Employees With Frequent Sickness Absence: Randomized Controlled Trial.

BackgroundFrequent sickness absence—that is, 3 or more episodes of sickness absence in 1 year—is a problem for employers and employees. Many employees who have had frequent sickness absence in a prior year also have frequent sickness absence in subsequent years: 39% in the first follow-up year and 61% within 4 years. Moreover, 19% have long-term sickness absence (≥6 weeks) in the first follow-up year and 50% within 4 years. We developed an electronic health (eHealth) intervention, consisting of fully automated feedback and advice, to use either as a stand-alone tool (eHealth intervention–only) or combined with consultation with an occupational physician (eHealth intervention–occupational physician).ObjectiveThis study aimed to evaluate the effect of the eHealth intervention, with or without additional occupational physician consultation, to reduce sickness absence frequency for employees with frequent sickness absence, versus care as usual (CAU).MethodsThis study was a three-armed randomized controlled trial. Employees with frequent sickness absence received invitational letters, which were distributed by their employers. The primary outcome measure was the number of register-based sickness absence episodes 12 months after completing the baseline questionnaire. Secondary outcome measures were register-based total sickness absence days and self-assessed burnout, engagement, and work ability. In a process evaluation 3 months after baseline, we examined adherence to the intervention and additional actions such as general practitioner and occupational physician visit, communication with the manager, and lifestyle change.ResultsA total of 82 participants were included in the analyses, 21 in the eHealth intervention–only group, 31 in the eHealth intervention–occupational physician group, and 30 in the CAU group. We found no significant difference in sickness absence frequency between the groups at 1-year follow-up. Sickness absence frequency decreased in the eHealth intervention–only group from 3 (interquartile range, IQR 3-4) to 1 episode (IQR 0.3-2.8), in the eHealth intervention–occupational physician group from 4 (IQR 3-5) to 3 episodes (IQR 1-4), and in the CAU group from 3 (IQR 3-4) to 2 episodes (IQR 1-3). For secondary outcomes, we found no significant differences between the intervention groups and the control group. The process evaluation showed that only 3 participants from the eHealth intervention–occupational physician group visited the occupational physician on invitation.ConclusionsAmong employees with frequent sickness absence, we found no effect from the eHealth intervention as a stand-alone tool in reducing sickness absence frequency, nor on total sickness absence days, burnout, engagement, or work ability. This might be due to low adherence to the intervention because of insufficient urgency to act. We cannot draw any conclusion on the effect of the eHealth intervention tool combined with an occupational physician consultation (eHealth intervention–occupational physician), due to very low adherence to the occupational physician consultation. An occupational physician consultation could increase a sense of urgency and lead to more focus and appropriate support. As this was the first effectiveness study among employees with frequent sickness absence, strategies to improve recruitment and adherence in occupational eHealth are included.Trial RegistrationNetherlands Trial Register NTR4316; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4316 (Archived by WebCite at http://www.webcitation.org/713DHhOFU).

Sickness absenteeism of Healthcare Workers in a Teaching Hospital

Background: Absence from work for health reasons is known as “sickness absenteeism”. Frequent sick leave is a major concern to any organization, especially hospitals. Objective: This study analyzed the extent and causes of sickness absenteeism in a teaching hospital and evaluated its corelation with demographic and occupational factors. Methods: In a cross-sectional study, data was extracted from computerized records regarding sickness absenteeism of healthcare workers (HCWs) in the Occupational Health Department of a teaching hospital in Tehran. Studied variables included demographic characteristics, occupational factors, and causes of sickness absenteeism. The sickness absence rate (SAR) and absence frequency rate (AFR) in the study period were calculated. Chi-square and Mann-Whitney tests were used for the comparison of categorical and quantitative variables, respectively. Results: In the current study, SAR and AFR were 0.011 and 0.68, respectively. Job type was the only factor that had a significant correlation with sickness absenteeism. The major disease-causing sicknesses were flu (21%) and musculoskeletal disorders (18.9%). Conclusion: A significant relationship was found between the nursing group and sickness absence episodes. Flu, musculoskeletal disorders, and infectious diseases were the most frequent causes of sickness absence. Based on these findings, it can be concluded that factors such as availability of the flu vaccine and providing principles of personal protection and infection control can reduce sickness absence due to infectious disease.

Predictors of short- and long-term sickness absence in female post office workers in Poland.

The aim of this study was to highlight major predictors of the frequency of sickness absence in a group of workers directly involved in customer service. The study was carried out on a random sample of 229 women employed as assistants and clerks in post offices. The survey was based on the Subjective Work, Health Status and Life Style Characteristics Questionnaire, and sickness absence data for the years 2004-2006. The negative binominal regression model of sickness absence risk revealed the following significant predictors of short-term absence spells (1-29 days): 1) marital status, sickness absence risk for single women was (rate ratio (RR)) = 1.56 (95% confidence interval (CI): 1.01-2.39) vs. married women; 2) post offices employing 7 workers had a rate ratio of sickness absence of 1.6 (95% CI: 1.04-2.42); 13-25 workers - RR = 2.03 (95% CI: 1.41-2.93); > 25 workers - RR = 1.82 (95% CI: 1.15-2.88) compared with an average number of 8-12 workers; 3) shift work, RR = 1.57 (95% CI: 1.14-2.14); 4) breaks from work - the risk of absence in the case of any breaks amounted to RR = 1.5 (95% CI: 1.07-2.07) in comparison with the statutory breaks; 5) self-rated health reported as moderate relative to good health, RR = 1.71 (95% CI: 1.26-2.32); and 6) occurrence of respiratory diseases resulted in the risk of RR = 1.51 (95% CI: 1.08-2.08). The Poisson regression model of long-term sickness absence spells (≥ 30 days) revealed the following significant predictors: 1) number of clients per shift: 51-100 clients, RR = 3.62 (95% CI: 1.07-22.6) compared with a lower number of clients; 2) self-rated health, assessed as moderate, RR = 1.97 (95% CI: 1.06-3.78) and 3) household chores performed for at least 4 h a day, RR = 0.4 (95% CI: 0.18-0.79). Association between sickness absence and workload as well as work organization indicates directions of corrective actions, which could reduce the scale of the problem.

Estimación de episodios de incapacidad temporal por contingencia común relacionados con un accidente de trabajo previo en Cataluña

To estimate the frequency of non-work sickness absence (ITcc) related to previous occupational injuries with (ATB) or without (ATSB) sick leave. Prospective longitudinal study. Workers with ATB or ATSB notified to the Occupational Accident Registry of Catalonia were selected in the last term of 2009. They were followed-up for six months after returning to work (ATB) or after the accident (ATSB), by sex and occupation. Official labor and health authority registries were used as information sources. An "injury-associated ITcc" was defined when the sick leave occurred in the following six months and within the same diagnosis group. The absolute and relative frequency were calculated according to time elapsed and its duration (cumulated days, measures of central trend and dispersion), by diagnosis group or affected body area, as compared to all of Catalonia. 2,9%of ATB (n=627) had an injury-associated ITcc, with differences by diagnosis, sex and occupation; this was also the case for 2,1% of ATSB (n=496).With the same diagnosis, duration of ITcc was longer among those who had an associated injury, and with respect to all of Catalonia. Some of the under-reporting of occupational pathology corresponds to episodes initially recognized as being work-related. Duration of sickness absence depends not only on diagnosis and clinical course, but also on criteria established by the entities managing the case. This could imply that more complicated injuries are referred to the national health system, resulting in personal, legal, healthcare and economic cost consequences for all involved stakeholders.

The Impact of Effort–Reward Imbalance and Learning Motivation on Teachers' Sickness Absence

The aim of this study was to analyse the impact of the effort-reward imbalance and learning motivation on sickness absence duration and sickness absence frequency among beginning teachers in Flanders (Belgium). A total of 603 teachers, who recently graduated, participated in this study. Effort-reward imbalance and learning motivation were assessed by means of self-administered questionnaires. Prospective data of registered sickness absence during 12 months follow-up were collected. Multivariate logistic regression analyses were performed. An imbalance between high efforts and low rewards (extrinsic hypothesis) was associated with longer sickness absence duration and more frequent absences. A low level of learning motivation (intrinsic hypothesis) was not associated with longer sickness absence duration but was significantly positively associated with sickness absence frequency. No significant results were obtained for the interaction hypothesis between imbalance and learning motivation. Further research is needed to deepen our understanding of the impact of psychosocial work conditions and personal resources on both sickness absence duration and frequency. Specifically, attention could be given to optimizing or reducing efforts spent at work, increasing rewards and stimulating learning motivation to influence sickness absence.

Effort–reward imbalance is associated with the frequency of sickness absence among female hospital nurses: A cross-sectional study

Background Most research on sickness absence among nurses has focused on long-term work disability. Absence from work due to short-term sickness, however, is more common and frequent short absences result in understaffing and increased workload of nursing teams. Objectives To investigate health and work factors in relation to the frequency of short-term sickness absence among nurses. Design A cross-sectional study linking self-reported health and work factors to the frequency of registered sickness absence episodes in the preceding 3 years. Settings A regional hospital in the Dutch province Friesland employing 1153 persons. Participants 459 female nurses working at least 3 years in the clinical wards ( n = 337) or the outpatient clinic ( n = 122) of the hospital. Methods Perceived general health, mental health, demand/control (DC) ratio, workplace social support, effort/reward (ER) ratio, and over-commitment (i.e. the inability to withdraw from work obligations) were assessed by a self-administered questionnaire. The associations between the questionnaire results and the registered number of sickness absence episodes were analysed by negative binomial regression analysis, distinguishing between short (1–7 days) and long (>7 days) sickness absence episodes and controlling for age, hours worked, and duration of employment. Results 328 (71%) female nurses completed their questionnaires and of these 291 were eligible for analysis. High frequent absentees perceived poorer health, had lower over-commitment scores, and reported higher ER-ratios than low frequent absentees. Esteem rewards were related to sickness absence whereas monetary rewards were not. Feeling respect from the supervisor was associated with fewer short sickness absence episodes and respect from co-workers was associated with fewer long sickness absence episodes. Conclusions Effort–reward imbalance was associated with frequent short sickness absence episodes among nurses. Work efforts and rewards ought to be potentially considered when managing nurses who are frequently absent from work as these factors can be dealt with by managers.

Measures of Work-Family Conflict Predict Sickness Absence From Work

To examine the relation between work-family conflict and sickness absence. The BELSTRESS III study comprised 2983 middle-aged workers. Strain-based work-home interference (WHI) and home-work interference (HWI) were assessed by means of self-administered questionnaires. Prospective data of registered sickness absence during 12-months follow-up were collected. Multiple logistic regression analysis was conducted. HWI was positively and significantly related to high sickness absence duration (at least 10 sick leave days) and high sickness absence frequency (at least 3 sick leave episodes) in men and women, also after adjustments were made for sociodemographic variables, health indicators, and environmental psychosocial factors. In multivariate analysis, no association between WHI and sickness absence was found. HWI was positively and significantly related to high sickness absence duration and frequency during 12-months follow-up in male and female workers.

Sickness absence frequency among women working in hospital care

Frequent short sickness absences result in understaffing and interfere with work processes. We need more knowledge about factors associated with this type of absence. To investigate associations between the frequency of previous sickness absence and self-reported perceptions of health and work. Cross-sectional study of female hospital care workers in which health, work characteristics and coping styles were assessed by questionnaire and linked to the number of sickness absence episodes recorded in the preceding 5 years using negative binomial regression analysis for counts distinguishing between short (1-7 days) and long (>7 days) episodes of absence after adjusting for age and duration of employment in December 2007 and hours worked between 2003 and 2007. Of 350 women employed for at least 5 years, 237 (68%) answered the questionnaire. The hours worked over the 5 year period [rate ratio (RR) = 1.2] and problem solving coping style score (RR = 1.1) were positively associated with the number of short sickness absence episodes. Age (RR = 0.8) and good general health (RR = 0.7) were inversely related to the number of both short and long episodes. Self-reported mental health and work characteristics were not shown to be related to the frequency of sickness absence. Hours worked, problem-solving coping style, age and general health showed associations with the frequency of previous sickness absence among women who had worked at least 5 years in health care. Future prospective studies on the frequency of sickness absence should consider the impact of these factors further.

Occupational rewards relate to sickness absence frequency but not duration

Work stress is an important problem that shifted sickness absence research to the psychosocial work environment at the expense of physical or chemical hazards. Most studies investigated the psychosocial work environment using the Demand-Control model. However, this model does not consider coping styles which are important in absenteeism. The Effort-Reward Imbalance model takes coping into account. Little is known about occupational rewards and their relationship with sickness absence. This study investigated the relations between occupational rewards and the frequency and duration of sickness absence among 366 workers. The data of 326 employees (89%) were suitable for statistical analysis. Rewards in terms of job esteem (OR = 0.64; 95% CI = 0.47-0.87) and job perspectives (OR = 0.59; 95% CI = 0.57-0.84) were negatively related to the absence frequency in men. Satisfaction with income (OR = 0.53; 95% CI = 0.35-0.81) was negatively related to the absence frequency in women. Occupational rewards were not associated with the mean duration of absence episodes. The associations we found warrant more attention for occupational rewards in sickness absence research.

Preschool children's sickness absenteeism from Norwegian regular and outdoor day care centres: A comparative study

To examine whether there are any differences in sickness absenteeism between children in outdoor day care centres and regular day care centres and also to investigate whether other variables predict sickness absenteeism. Data on sickness absence during a 4-week period together with several explanatory variables of 531 children in 32 regular and 37 outdoor day care centres were collected and included in the analysis. The data were analysed by generalized linear modelling. The overall frequency of sickness absence was 5.1%. There was no general significant difference between sickness absenteeism in regular and outdoor day care centres. Of the other possible explanatory variables only two were found to contribute significantly: age, with a negative relationship, and the interaction effect of a child with a chronic disease or disability going to an outdoor day care centre, with a positive relationship. The present study indicates that sickness absenteeism of a child without a chronic disease or disability is not affected by whether the child attends a regular or an outdoor day care centre. There seem to be no health benefits for children with chronic diseases or disabilities to attend outdoor day care centres--there is in fact evidence that sickness absence for those children is higher in outdoor centres.

Coping and sickness absence

ObjectivesThe aim of this study is to examine the role of coping styles in sickness absence. In line with findings that contrast the reactive–passive focused strategies, problem-solving strategies are generally associated with positive results in terms of well-being and overall health outcomes; our hypothesis is that such strategies are positively related to a low frequency of sickness absence and with short lengths (total number of days absent) and durations (mean duration per spell).MethodsUsing a prospective design, employees’ (N = 3,628) responses on a self-report coping inventory are used to predict future registered sickness absence (i.e. frequency, length, duration, and median time before the onset of a new sick leave period).Results and conclusionsIn accordance with our hypothesis, and after adjustment for potential confounders, employees with an active problem-solving coping strategy are less likely to drop out because of sickness absence in terms of frequency, length (longer than 14 days), and duration (more than 7 days) of sickness absence. This positive effect is observed in the case of seeking social support only for the duration of sickness absence and in the case of palliative reaction only for the length and frequency of absence. In contrast, an avoidant coping style, representing a reactive–passive strategy, increases the likelihood of frequent absences significantly, as well as the length and duration of sickness absence. Expression of emotions, representing another reactive–passive strategy, has no effect on future sickness absenteeism. The median time before the onset of a new episode of absenteeism is significantly extended for active problem-solving and reduced for avoidance and for a palliative response.The results of the present study support the notion that problem-solving coping and reactive–passive strategies are inextricably connected to frequency, duration, length and onset of sickness absence. Especially, active problem-solving decreases the chance of future sickness absence.

Impact of recurrent changes in the work environment on nurses’ psychological well‐being and sickness absence

This paper is a report of a study of how the occurrence and appraisal of recurrent changes in the work environment of hospital nurses affect psychological well-being (i.e. job satisfaction, eustress and distress) and absence through illness. Many researchers have demonstrated the impact of major organizational changes on employees' psychological well-being, but only a few have focused on the permanent consequences in work conditions. In a contemporary healthcare setting, an increased number of recurrent operational changes has become a normal characteristic of nurses' work environment. Specific work situations have frequently been associated with occupational stress, whereas employees' appraisal of recurrent changes as stressors and their relation to psychological well-being and health outcomes (i.e. sickness absence) have been dismissed. A cross-sectional questionnaire survey was conducted in 2003 with 2094 Registered Nurses in 10 general hospitals. Logistic regressions were used to investigate the impact on psychological well-being and prospectively measured rates of sickness absence (frequency and duration). The occurrence of changes in the work environment (in the past 6 months) had had a negative impact on staff psychological well-being. Nurses who had been confronted with changes scored statistically significantly higher for distress. Changes appraised as threatening were negatively related to job satisfaction and eustress, and positively related to distress and sickness absence (frequency and duration). Changes appraised as challenging were positively related to job satisfaction and eustress but had no impact on distress and sickness absence. Future research should take into consideration the impact of the occurrence and appraisal of recurrent changes in the work environment of healthcare employees (i.e. Registered Nurses) on psychological well-being and sickness absence. This should also be considered by managers when dealing with these nursing workforce issues.

Evaluating different measures of sickness absence with respect to work characteristics

Four different measures of sickness absence were related to psychosocial and physical work characteristics in workplaces with high, intermediate, and low sickness absence. The relationships between work characteristics and sickness absence were hypothesized to differ depending the sickness absence measure used. Questionnaire data on physical work environment, physical load, support, influence at work, and worry were collected from 1,726 employees at 48 dental clinics in Stockholm, Sweden and were related to registry-based sickness absence obtained at the workplace level. The sickness absence measures included: (1) frequency, (2) one-day absence, (3) overall duration, and (4) duration between 2 and 21 days. For frequency, significant differences were found for all work characteristics, with poor work characteristics being associated with a high frequency of sickness absence. Considering duration between 2 and 21 days, there were significant differences in support, influence at work and physical work environment; for one-day absence, support, influence at work and physical load differed significantly. Conversely, there were no significant differences for the overall duration measure. The results show that frequency of sickness absence is most consistently related to work characteristics, that short-time sickness absences have more inconsistent relationships and that relationship with overall duration is lacking. This highlights the need for further differentiation between different sickness absence measures, the behavioral patterns associated with different types of absences and the implication of such processes for prevention and intervention.

Psychosocial work characteristics and sickness absence in Japanese employees

This study was undertaken to examine the association between sickness absence in Japanese employees and job demand/control and occupational class as psychosocial work characteristics. The study was cross-sectional in design with data collected from 20,464 male and 3,617 female employees, whose mean age was 40.9 years (SD +/- 9.1 years) and 36.9 years (SD +/- 10.8 years), respectively. The participants were asked to write the total number of sick leaves they had taken during the past year, and a comparison was made between the group with more than 6 days of sickness absence and the group with 0-6 days as a reference group. Job demands, job control, and worksite support from supervisors and colleagues were analyzed by the Job Content Questionnaire, and likewise by the Generic Job Stress Questionnaire of the National Institute for Occupational Safety and Health. Both low job control and low support at the worksite were associated with a high frequency of sickness absence. But there was no clear relationship between job demands and sickness absence. The lowest sickness absence rate was found in male managers and the highest in male and female laborers. This is the first report of a large-scale survey of Japanese employees to show a high frequency of sickness absence associated with increased work stress and a socioeconomically low occupational class.

Chapter 7. Sickness absence and psychiatric disorders

There is limited scientific evidence that women have a higher frequency and incidence of sickness absence due to psychiatric diagnoses. Because of conflicting findings, there is insufficient evidence on gender differences in the duration of sickness absence. Because of conflicting findings, there is also insufficient evidence on the association between age and sickness absence with psychiatric diagnoses. There is insufficient evidence on the association of sickness absence due to psychiatric diagnoses with work-related factors, factors related to family and social networks outside of the job, and psychosocial factors in childhood and adolescence since none of the individual factors were investigated in more than a single study. The results were conflicting (insufficient evidence) in five studies that investigated whether individuals with psychiatric disorders were at greater risk for sickness absence and disability pension, irrespective of the diagnosis on the sickness certificate. The four studies that used alcohol diagnoses to identify alcohol problems found increased sickness absence irrespective of the diagnosis on the certificate (expressed as more sick-leave days or an increased risk for prolonged sickness absence in individuals with alcohol problems). Furthermore, two of the studies found an increased risk for disability pension in women diagnosed with alcohol problems. There is insufficient evidence because of too few studies. The results are conflicting with regard to the association between high alcohol consumption and sickness absence, irrespective of the diagnosis on the certificate (insufficient evidence).

Occupational and social variation in subjective health complaints.

Occupational and social factors are thought to be important determinants of health inequality. The aim of this study was to examine the relationships between occupation, lifestyle and subjective health complaints (SHC). SHC and self-reported sickness absence were recorded in a cross-sectional study of 662 individuals aged between 16 and 67 from five occupational groups: blue-collar, school/education, health service, white-collar and service. Differences in SHC and sickness absence were investigated. A model of sociodemographic, lifestyle and work-related factors was tested to examine associations with SHC. Few differences in SHC and sickness absence were found when educational level, age and gender were controlled for. Female health service workers did, however, show significantly higher prevalence of pseudoneurological complaints compared with white-collar workers. Male blue-collar workers had significantly higher frequency of sickness absence than white-collar workers; otherwise, there were no significant differences in frequency and duration of sickness absence. The model explained very little of the variance of SHC (R(2)(adj) = 0.15) and occupational group was not significantly associated with health. Physical workload and sleep quality showed significant relationships with SHC for both genders. Education, however, was a significant factor for women only. The differences in health found between major occupational groups in this sample were mainly explained by gender differences. Sociodemographic, lifestyle and work-related factors explained little of the variance in SHC, suggesting that factors such as psychological demands, perceived job stress, coping and other psychological factors might be of stronger importance for SHC.