Preventing sick leave during pregnancy

In September 2004, a national health promotion campaign was launched to encourage women to remain longer in work during pregnancy. The aim is to reduce levels of sick leave by facilitating women, doctors and employers in coming together to adjust working conditions appropriately.

Between 30% and 50% of all pregnant women in Denmark report absence due to illness in the course of their pregnancy, according to estimates (532Kb pdf; in Danish) from the Danish Ministry of Employment. A health promotion campaign ‘Pregnant and working’ has been launched in an effort to reduce these levels. The campaign was initiated by six of the Danish Sector Working Environment Councils (Branchearbejdsmiljøråd , BAR), and is aimed primarily at pregnant women, doctors and employers.

A website has been set up to provide information for each target group on relevant regulations and opportunities for preventing absence during pregnancy. For instance, there are details of entitlements, descriptions of what is defined as normal physical complications, and how to adjust working conditions to accommodate the specific needs of pregnant women. The employer can read about work-environment law and relevant workplace policies. GPs are updated on medical issues in relation to pregnancy and working conditions. In addition, the site contains sector specific information on exposures and risks in different sectors.

Action measures to improve working conditions

The ‘Pregnant and working’ campaign recommends that employers initiate early action measures to encourage pregnant employees to remain longer in the workplace. At a general level, employers are advised to implement suitable solutions such as adjusting work arrangements, organising work and working time differently, transferring employees to other tasks, or agreeing on a part-time work schedule.

The specific proposals to improve working conditions for pregnant women include:

• formulating and implementing relevant policies at the workplace;

• offering flexible working time;

• facilitating more breaks if necessary;

• adjusting work organisation to set out suitable tasks;

• offering partial sick leave if necessary.

As working conditions vary between sectors, the campaign emphasises that some measures could be more relevant than others, depending on particular exposures and risks at the workplace. For this reason, the Danish Sector Working Environment Councils have prepared more in-depth information and guidance targeted at different sectors, and made them available on the campaign website.

Improving working conditions reduces sick leave

The issues addressed by the campaign are highly relevant. Study results (265Kb PDF; in Danish) from several clinics of occupational medicine (Arbejdsmedicinske klinikker) indicate that the lack of relevant information among employers, GPs and pregnant employees, contributes significantly to high levels of absenteeism. Study results suggest that informing the parties on good practices and adjustments can reduce the numbers of those taking sick leave.

In particular, a greater knowledge of how to adjust working conditions has been underlined as an important measure in preventing sick leave. A study from the Clinic of Occupational Medicine in Århus shows that sick leave among pregnant women can be reduced by up to 40%, simply by adjusting working conditions. According to the study, the highest reductions are achievable by changing:

• long working hours;

• long periods of standing during work;

• working at a high speed;

• low job control;

• carrying heavy loads;

• painful or tiring work positions;

• lack of support and understanding from management.

Different approaches according to sector

The importance of this health promotion campaign is also confirmed by other study results. The Clinic of Occupational Medicine in Odense and Herning has published a report (222Kb pdf; in Danish) investigating the level of sick leave among pregnant women in certain sectors. The report is based on data from 51,000 women in the Danish National Birth Cohort (DNBC) during the period 1998-2003. Further information on the study can be downloaded from the DNBC website.

According to this study, there are significant sector-related differences in the levels of absence. Women working in sectors with a lot of manual work report absent more often. The study reveals that only a few women were transferred to other tasks at the workplace, despite the fact that such action can reduce sick leave further. Overall, the report supports the point that health promotion must be approached differently in relation to each sector.