Self-reported or register-based? A comparison of sickness absence data among 8110 public and private employees in Denmark:A comparison of sickness absence data among 8110 public and private employees in Denmark

Objectives The study aim was to examine (i) non-response bias between responders and non-responders, and (ii) whether the association between self-reported sickness absence (SA) and register-based SA differed by gender, age, sector, or physically demanding work. Methods The responses of 8110 participants to a question on self-reported SA in the past 12 months in the Work Environment and Health in Denmark Survey (2014) was linked to 12 months of SA data from the Danish Register of Work Absence. We used logistic regression for the non-response analysis and Poisson regression to examine associations. Results Responders had on average 0.5 days less SA per year than non-responders. Public employees had a higher response rate than private employees (approximately five percentage points), women had a higher rate than men (approximately nine percentage points), and older employees a higher rate than younger employees (approximately nine percentage points in ten years). Self-reported SA correlated highly with register-based SA (Spearman's rank correlation=0.76). In general, responders with few SA days (30) over-reported their SA. Women under-reported significantly more than men (average difference one day); older employees under-reported significantly more than younger employees (difference between age groups 18-29 and 60-64 was 1.7 days). Differences between sectors or levels of physically demanding work were non-significant. Conclusions Self-reported SA data may be influenced by non-response bias, and different accuracy in different demographic groups. When available, the use of register-based SA data is recommended

Expected Labor Market Affiliation:A New Method Illustrated by Estimating the Impact of Perceived Stress on Time in Work, Sickness Absence and Unemployment of 37,605 Danish Employees

As detailed data on labor market affiliation become more accessible, new approaches are needed to address the complex patterns of labor market affiliation. We introduce the expected labor market affiliation (ELMA) method by estimating the time-restricted impact of perceived stress on labor market affiliation in a large sample of Danish employees. Data from two national surveys were linked with a national register. A multi-state proportional hazards model was used to calculate ELMA estimates, i.e., the number of days in work, sickness absence, and unemployment during a 4-year follow-up period, stratified by gender and age. Among employees reporting frequent work-related stress, the expected number of working days decreased with age, ranging from 103 days lost among older women to 37 days lost among younger and middle-aged men. Young and middle-aged women reporting frequent work- and personal life-related stress lost 62 and 81 working days, respectively, and had more days of sickness absence (34 days and 42 days). In conclusion, we showed that perceived stress affects the labor market affiliation. The ELMA estimates provide a detailed understanding of the impact of perceived stress on labor market affiliation over time, and may inform policy and practice towards a more healthy and sustainable working life

Associations between the workplace-effort in psychosocial risk management and the employee-rating of the psychosocial work environment - A multilevel study of 7565 employees in 1013 workplaces

Aims: This study examined the association between the workplace-effort in psychosocial risk management and later employee-rating of the psychosocial work environment. Method: The study is based on data from two questionnaire surveys – one including 1013 workplaces and one including 7565 employees from these workplaces. The association was analyzed using multi-level linear regression. The association for five different trade-groups and for five different psychosocial work environment domains was examined. Results: Limited but statistically significant better employee-ratings of the psychosocial work environment in the respective domains were observed among Danish workplaces that prioritized “development possibilities for employees,” “recognition of employees,” “employees influence on own work tasks,” good “communication at the workplace,” and “help to prevent work overload.” Conclusion: Danish workplaces with a high effort in psychosocial risk management in the preceding year had a small but significantly more positive rating of the psychosocial work environment by the employees. However, future studies are needed to establish the causality of the associations. </jats:p

Impact of depressive symptoms on worklife expectancy:a longitudinal study on Danish employees

Objective Depressive symptoms are associated with sickness absence, work disability and unemployment, but little is known about worklife expectancy (WLE). This study investigates the impact of depressive symptoms on the WLE of a large sample of Danish employees. Methods We used occupational health survey data of 11 967 Danish employees from 2010 and linked them with register data on salary and transfer payments from 2010 to 2015. Depressive symptoms were self-reported using the Major Depression Inventory. We used multistate data and a life table approach with Cox proportional hazard modelling to estimate the WLE of employees, expressed by time in work, unemployment and sickness absence. Separate analyses were conducted for sex and employees with a voluntary early retirement pension scheme. Using age as time axis, we used inverse probability weights to account for differences in educational level, sector, body mass index, smoking habits and loss of employment during sickness absence. Results The WLE of employees reporting depressive symptoms was shorter compared with those not reporting depressive symptoms; that is, the expected time in unemployment and sickness absence was longer, while the expected time in work was shorter. The shorter WLE was most pronounced in women; for example, a 40-year-old woman with depressive symptoms can expect 3.3 years less in work, 0.8 years more in unemployment and 0.7 years more in sickness absence. Employees with a voluntary early retirement pension scheme showed an even lower WLE. Conclusions Our study showed a meaningful impact of depressive symptoms on the WLE of Danish employees using a multistate framework

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

The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence

Background The 'physical activity paradox' advocates that leisure physical activity (PA) promotes health while high occupational PA impairs health. However, this paradox can be explained by methodological limitations of the previous studies-self-reported PA measures, insufficient adjustment for socioeconomic confounding or not addressing the compositional nature of PA. Therefore, this study investigated if we still observe the PA paradox in relation to long-term sick absence (LTSA) after adjusting for the abovementioned limitations. Methods Time spent on moderate-to-vigorous physical activity (MVPA) and remaining physical behaviors (sedentary behavior, standing, light PA and time in bed) at work and in leisure was measured for 929 workers using thigh accelerometry and expressed as isometric log-ratios (ilrs). LTSA was register-based first event of >= 6 consecutive weeks of sickness absence during 4-year follow-up. The association betweenilrsand LTSA was analyzed using a Cox proportional hazards model adjusted for remaining physical behaviors and potential confounders, then separately adjusting for and stratifying by education and type of work. Results During the follow-up, 21% of the workers experienced LTSA. In leisure, more relative MVPA time was negatively associated with LTSA (20% lower risk with 20 min more MVPA,p = 0.02). At work, more relative MVPA time was positively associated with LTSA (15% higher risk with 20 min more MVPA,p = 0.02). Results remained unchanged when further adjusted for or stratified by education and type of work. Conclusion These findings provide further support to the 'PA paradox'