Psychosocial work characteristics and sickness absence in Japanese employees

NIPSA: a new scale for measuring non-illness predictors of sickness absence

OBJECTIVES

We describe the development and initial validation of a new scale for measuring non-illness factors that are important in predicting occupational outcomes, called the NIPSA (non-illness predictors of sickness absence) scale.

METHODS

Forty-two questions were developed which covered a broad range of potential non-illness-related risk factors for sickness absence. 682 participants in the South East London Community Health study answered these questions and a range of questions regarding both short-term and long-term sickness absence. Factor analysis was conducted prior to examining the links between each identified factor and sickness absence outcomes.

RESULTS

Exploratory factor analysis using the oblique rotation method suggested the questionnaire should contain 26 questions and extracted four factors with eigenvalues greater than 1: perception of psychosocial work environment (factor 1), perceived vulnerability (factor 2), rest-focused attitude towards recovery (factor 3) and attitudes towards work (factor 4). Three of these factors (factors 1, 2 and 3) showed significant associations with long-term sickness absence measures (p<0.05), meaning a final questionnaire that included 20 questions with three subscales.

CONCLUSIONS

The NIPSA is a new tool that will hopefully allow clinicians to quickly assess for the presence of non-illness factors that may be important in predicting occupational outcomes and tailor treatments and interventions to address the barriers identified. To the best of our knowledge, this is the first time that a scale focused on transdiagnostic, non-illness-related predictors of sickness absence has been developed.

Decrease in Work Ability Index and sickness absence during the following year: a two-year follow-up study

PURPOSE

Using a 2-year follow-up design, we examined whether changes in work ability during 1 year predicted sickness absence in the following year.

METHODS

Workers (N = 1408) from the Japanese information technology sector each completed the Work Ability Index (WAI), the Brief Job Stress Questionnaire (BJSQ), and the General Health Questionnaire (GHQ) in 2011 and 2012. Absence data during 2013 was obtained from employees' computerized attendance records. We used psychological distress as evaluated by the GHQ; job stress and job support calculated using the BJSQ; and job title, sex, and age as potential confounding variables.

RESULTS

Thirty-five employees had at least one sickness absence lasting more than seven consecutive days in 2013. Forty-nine percent of sickness absences were due to mental illness, and the others were due to orthopedic disease (20%), cancer (9%), and other illnesses (23%). Decrease in WAI scores from 2011 to 2012 predicted sickness absence in 2013 (Odds ratio (OR) 1.19, 95% confidence interval (CI) 1.12-1.27). This association remained unaltered after adjusting for sex, age, job title, WAI score from the year before, job stress, job support, and GHQ score (OR 1.15, 95% CI 1.06-1.25). We analyzed this association separately by reason for absence: mental or other illness. WAI score decreases predicted sickness absence for both reasons (OR for mental illness 1.24, 95% CI 1.14-1.36; OR for other illnesses 1.14, 95% CI 1.04-1.24).

CONCLUSIONS

Decrease in work ability during the year predicts sickness absence in the following year while predictive power was weak.

How job demands affect absenteeism? The mediating role of work-family conflict and exhaustion

PURPOSE

To investigate how psychosocial factors (such as job demands and work-family conflict) produce absenteeism in the workplace, using the health impairment process of the job demands-resources model. According to this model, job demands lead to burnout (often measured with the emotional exhaustion component), which in turn could lead to outcomes (such as absenteeism). Work-family conflict (WFC) was also studied, because of contradictory results collected in the existing literature on absenteeism in the workplace, regarding the role of WFC in causing absenteeism.

METHODS

Data were collected on 245 workers using both subjective (questionnaire on psychological risk factors and work-related health) and objective data (sickness leave frequency records). To test the hypothesis that job demands and WFC contribute to absenteeism in the workplace, a subsequent mediation analysis was used, which analysed both (a) the subsequent mediation of WFC and emotional exhaustion and (b) the separate roles played by the mediators proposed (WFC and emotional exhaustion).

RESULTS

Job demands affect absenteeism through the subsequent mediation of WFC and emotional exhaustion. In addition, emotional exhaustion mediates the relationship between job demands and absenteeism, while WFC does not.

CONCLUSION

In conclusion, subsequent mediation highlights the role of emotional exhaustion in causing absenteeism; in fact, when emotional exhaustion is included in the analysis, job demands are associated with higher levels of absenteeism. The results of this study suggest that without the concurrent contribution of emotional exhaustion, WFC does not influence absenteeism in the workplace. Our findings are useful for organizations that aim to reduce absenteeism.

Risk factors of recurrent sickness absence due to depression: a two-year cohort study among Japanese employees

PURPOSE

Depression has a high recurrence rate among employees. There have been few studies investigating risk factors for recurrent sickness absence due to depression after return to work (RTW). The objective of this study was to identify potential risk factors.

METHODS

Subjects were 540 full-time employees at the biggest telecommunication company in Japan who returned to work from April 2002 to March 2008 after their first leave of absence due to depression. The Cox proportional hazard model was employed to find risk factors for recurrent sickness absence by analyzing variables including demographic, work-related and work environmental factors.

RESULTS

Of 540 study subjects, 200 employees (37.0 %) experienced recurrent sickness absence due to depression after RTW within the follow-up period. Higher organizational job demand evaluated by the Brief Job Stress Questionnaire (BJSQ) was found to be a risk factor (OR 1.46, 95 % CI 1.01-2.10) for recurrent sickness absence due to depression adjusted for confounding factors.

CONCLUSIONS

High organizational job demand (evaluated by BJSQ) is a risk factor for recurrent sickness absence due to depression after RTW.

Health inequalities in Japan: the role of material, psychosocial, social relational and behavioural factors

The extent that risk factors, identified in Western countries, account for health inequalities in Japan remains unclear. We analysed a nationally representative sample (Comprehensive Survey of Living Conditions surveyed in 2001 (n = 40,243)). The cross-sectional association between self-rated fair or poor health and household income and a theory-based occupational social class was summarised using the relative index of inequality [RII]. The percentage attenuation in RII accounted for by candidate contributory factors - material, psychosocial, social relational and behavioural - was computed. The results showed that the RII for household income based on self-rated fair or poor health was reduced after including the four candidate contributory factors in the model by 20% (95% CI 2.1, 43.6) and 44% (95% CI 18.2, 92.5) in men and women, respectively. The RII for the Japanese Socioeconomic Classification [J-SEC] was reduced, not significantly, by 22% (95% CI -6.3, 100.0) in men in the corresponding model, while J-SEC was not associated with self-rated health in women. Material factors produced the most consistent and strong attenuation in RII for both socioeconomic indicators, while the contributions attributable to behaviour alone were modest. Social relational factors consistently attenuated the RII for both socioeconomic indicators in men whereas they did not make an independent contribution in women. The influence of perceived stress was inconsistent and depended on the socioeconomic indicator used. In summary, social inequalities in self-rated fair or poor health were reduced to a degree by the factors included. The results indicate that the levelling of health across the socioeconomic hierarchy needs to consider a wide range of factors, including material and psychosocial factors, in addition to the behavioural factors upon which the current public health policies in Japan focus. The analyses in this study need to be replicated using a longitudinal study design to confirm the roles of different factors in health inequalities.

Is absence related to work stress? A repeated cross-sectional study on a special police force

BACKGROUND

Sickness absence due to illness is considered an indicator of work-related stress. Police work is a very stressful job. Sickness absence and sick leave are frequent among policemen.

METHODS

We tested whether stress variables were predictors of absenteeism in a police unit specifically assigned to the maintenance of law and order.

RESULTS

Control, Reward, and Support were negatively related to frequency of absence and short-term absence. Demand and Effort were positively related to total lost days. Absence recorded in the previous year was the best predictor of absenteeism. We also found a positive, albeit weak association between absence in the previous year and subsequent work-related stress.

CONCLUSIONS

Stress variables are associated with sickness absence, although the association is weak. Both short-term and prolonged sickness absence should be regarded as a warning sign for subsequent sickness absence and distress.

A new theory-based social classification in Japan and its validation using historically collected information

Studies of health inequalities in Japan have increased since the millennium. However, there remains a lack of an accepted theory-based classification to measure occupation-related social position for Japan. This study attempts to derive such a classification based on the National Statistics Socio-economic Classification in the UK. Using routinely collected data from the nationally representative Comprehensive Survey of the Living Conditions of People on Health and Welfare, the Japanese Socioeconomic Classification was derived using two variables - occupational group and employment status. Validation analyses were conducted using household income, home ownership, self-rated good or poor health, and Kessler 6 psychological distress (n ≈ 36,000). After adjustment for age, marital status, and area (prefecture), one step lower social class was associated with mean 16% (p < 0.001) lower income, and a risk ratio of 0.93 (p < 0.001) for home ownership. The probability of good health showed a trend in men and women (risk ratio 0.94 and 0.93, respectively, for one step lower social class, p < 0.001). The trend for poor health was significant in women (odds ratio 1.12, p < 0.001) but not in men. Kessler 6 psychological distress showed significant trends in men (risk ratio 1.03, p = 0.044) and in women (1.05, p = 0.004). We propose the Japanese Socioeconomic Classification, derived from basic occupational and employment status information, as a meaningful, theory-based and standard classification system suitable for monitoring occupation-related health inequalities in Japan.

A prospective study of psychosocial work characteristics and long sick leave of Japanese male employees in multiple workplaces

The aim of this study was to identify psychosocial work characteristics associated with long sick leave in a large population of male Japanese employees in multiple workplaces. We examined various psychosocial work characteristics (job overload, job control, supervisor support, coworker support, support by family and friends, role ambiguity, role conflict, intragroup conflict and intergroup conflict) of employees in six factories at the base line. We then conducted a follow-up survey on the recorded long sick leaves of ≥ 30 continuous days taken by the employees due to any medical condition. We found 574 cases of long sick leave out of 15,531 subjects during an average 5.07-yr follow-up. The results showed that high supervisor support was significantly associated with a decrease in the hazard ratio (HR) of long sick leave after adjustment for several confounding factors (95%CI; 0.69-0.97). High role ambiguity also tended to increase HR, but without reaching significance (95%CI; 0.99-1.41). The results suggest that supervisor support in the workplace may be important to reduce long sick leave in Japanese male employees.

Age differences in the associations between sick leave and aspects of health, psychosocial workload and family life: a cross-sectional study

OBJECTIVES

To investigate differences in associations between sick leave and aspects of health, psychosocial workload, family life and work-family interference between four age groups (<36, 36-45, 46-55 and 55+ years).

DESIGN

A cross-sectional study; a questionnaire was sent to the home addresses of all employees of a university.

SETTING

A Dutch university.

PARTICIPANTS

1843 employees returned the questionnaire (net response: 49.1%). The age distribution was as follows: <36: 32%; 36-45: 26%; 46-55: 27% and 55+: 12%.

PRIMARY OUTCOMES

Frequent sick leave (FSL, ≥3 times in the past 12 months) and prolonged sick leave (PSL, >2 weeks in total in the past 12 months). Differences between the age groups in independent variables and outcomes were investigated. Logistic regression analysis was used to calculate associations between various variables and the sick leave outcomes. Interaction terms were included to detect differences between the age groups.

RESULTS

Age differences were found for many work- and family-related characteristics but not in the mean scores for health-related aspects. Presence of chronic disease was reported more frequently with increasing age. The 55+ age group had almost two times less chance of FSL, but 1.6 times more chance of PSL than the <36 age group. Age moderates the associations between career opportunities, partner's contribution in domestic tasks and sex, and FSL. Job security and pay, support from supervisor, challenging work and being breadwinner have different associations with PSL. However, life events in private lives and perceived health complaints are important in all age groups. FSL and PSL have some determinants in common, but there are differences between the outcomes as well.

CONCLUSIONS

Age should be treated as a variable of interest instead of a control variable. Employers and occupational physicians need to be aware that each phase in life has specific difficulties that can lead to FSL and PSL.

Perceived Working Conditions and Sickness Absence - A Four-year Follow-up in the Food Industry

OBJECTIVES

To analyze the association between changes in perceived physical and psychosocial working conditions and change of sickness absence days in younger and older (< 50 and ≥ 50 years) food industry employees.

METHODS

This was a follow up study of 679 employees, who completed working conditions survey questionnaires in 2005 and 2009 and for whom the requisite sickness absence data were available for the years 2004 and 2008.

RESULTS

Sickness absence increased and working conditions improved during follow-up. However, the change of increased sickness absence days were associated with the change of increased poor working postures and the change of deteriorated team spirit and reactivity (especially among < 50 years). No other changes in working conditions were associated with the changes in sickness absence.

CONCLUSION

Sickness absence is affected by many factors other than working conditions. Nevertheless, according to this study improving team spirit and reactivity and preventing poor working postures are important in decreasing sickness absence.

Occupational factors and sick leave in Australian employees

OBJECTIVES

To investigate occupational factors associated with sick leave over a 4-year period in Australian employees.

METHODS

Longitudinal data (self-report) from 2861 Australian full-time employees (69.4% male) were used. Occupational factors and relevant covariates were assessed at baseline with sick leave assessed yearly over a 4-year period. The data were analyzed using multinomial logistic regression models.

RESULTS

Job strain and longer commuting time were associated with long sick leave, whereas long work hours were inversely associated with long sick leave.

CONCLUSIONS

These results provide further evidence that certain aspects of work are associated with sick leave, whereas other work aspects such as long work hours are inversely associated with sick leave. Organizations need to understand and address these factors to improve the well-being of employees and increase workplace productivity.

Job strain among rubber-glove-factory workers in central Thailand

Job strain has become a major concern because of its potential impacts on worker well-being and performance. This cross-sectional study aimed to assess the prevalence of, and examine factors associated with, job strain among workers in a rubber-glove factory, in a central province of Thailand. A total of 200 workers aged 18-55 yr, who had worked at the factory for at least 6 months, completed the Job Content Questionnaire (JCQ) (Thai Version). Two of 5 scales in the JCQ were used to measure job strain, i.e.; job control and psychological job demand. The prevalence of job strain was 27.5%. Multiple logistic regression analysis indicated two variables significantly associated with job strain: low supervisor social support (adjusted OR=3.08; 95%CI: 1.38-6.91) and high job insecurity (adjusted OR=2.25; 95%CI: 1.04-4.88). Effective training for supervisors, to create good relationships among workers and supervisors, and ensuring steady and secure jobs for good employees, are necessary.

Sickness absence in relation to psychosocial work factors among daytime workers in an electric equipment manufacturing company

Associations between psychosocial work factors and sickness absence were investigated in a cross-sectional study of 833 daytime workers. Participants completed a questionnaire regarding psychosocial work factors using the US National Institute for Occupational Safety and Health Generic Job Stress Questionnaire (job control, quantitative workload, cognitive demands, variance in workload, intragroup conflict, intergroup conflict, supervisor support, coworker support, family support, job satisfaction and depressive symptoms) and the number of days of sickness absence within the previous year. Multivariate analyses of covariance with age and occupation as covariates (MANCOVA) were used to test the relationships between psychosocial work factors and sickness absence stratified by sex. In men, the age-adjusted MANCOVA showed that, quantitative workload was highest in the 0.5-4.5 d of sickness absence group (p<0.001). However, the levels of stress reactions (job satisfaction and depressive symptoms) in this group were almost identical to the levels recorded in the no sickness absence group. In contrast, low levels of job control (p<0.01), supervisor support (p<0.05), and job satisfaction (p<0.01) and higher symptoms of depression (p<0.001) were associated with 5 d or more sickness absence. In women, only high job satisfaction was associated with 5 d or more sickness absence (p<0.10). This study suggests that appropriate use of sickness absence at times of being exposed to high quantitative workload may help male workers to recover from stressful situations.