Associations between physical and psychosocial work environment factors and sickness absence incidence depend on the lengths of the sickness absence episodes: A prospective study of 27 678 Danish employees

Objectives This study examined if the association between work environment factors and sickness absence (SA) depended on the inclusion or exclusion of short-term SA episodes. Methods We linked the € Work Environment and Health in Denmark' survey with the € Danish Register of Work Absences' (n=27 678). Using covariate adjusted Cox regression, we examined the associations between work environment factors and SA by changing the cut-off points for the length of the SA episodes, for example, episodes ≥1 day, ≥6 days and ≥21 days. We examined three physical work environment factors: € Back bend or twisted', € Lifting or carrying', € Wet hands' and three psychosocial work environment factors: € Poor influence', € Role conflicts' and € Bullying'. Results € Back bend or twisted' and € Lifting or carrying' had small significant HRs for SA episodes ≥1 day and large and highly significant HRs for SA episodes ≥6 days and ≥21 days. € Wet hands' had small significant HRs for SA episodes ≥1 day for both sexes and large and highly significant HR for ≥6 days for women. HRs of all three psychosocial factors were highly significant for SA episodes ≥1 day and ≥6 days for both sexes, and € Poor influence' and € Role conflicts' were significant for SA episodes ≥21 days for women. Conclusions The physical work factors had higher associations with SA when SA episodes of 1-5 days were excluded and focus was on SA episodes ≥6 days. The psychosocial work factors were strongly associated with SA both with and without SA episodes of 1-5 days included in the analyses.