Factors influencing sickness absence

In Denmark, it is believed that sickness absence costs the economy about DKK 32 billion (€4.3 billion) each year. A recent report published by the National Research Centre for the Working Environment concludes that factors such as sex, age, education, job and social status, as well as physical and psychosocial factors, all influence the level of sickness absence.

In 2003, the Danish government launched a national action plan which aimed to reduce the levels of sickness absence among workers. As part of this action plan, the government decided that more research was needed on the factors influencing sickness absence. Subsequently, in March 2007, the National Research Centre for the Working Environment (Nationale Forskningscenter for Arbejdsmiljø, NFA) published the report Results of a study on sickness absence 2003–2007 (in Danish, 1.4Mb PDF) which is the outcome of 17 studies on sickness absence. The data presented here are taken from these different studies (see also DK0401NU03 and DK0606019I).

Main results

The NFA study sought answers to two basic questions: the impact of the working environment on sickness absence and the factors that are strongly connected with such absence. The study reveals the following results:

• 20% of the workforce accounts for 80% of sickness absence;

• sickness absence is related to sex, age, education, job, social status and sector – that is, public or private sector;

• smoking and being overweight increase the risk of absence from work;

• sickness absence is related to burnout (DK0606019I), workers’ poor estimation of their health and mental health problems.

• sickness absence is interrelated with both the physical and psychosocial working environment.

Influence of age, education and job

The study shows that women run a 36% higher risk of experiencing long-term sickness absence – totalling more than eight weeks a year – than men. Workers in the 30–59 age category have a higher risk of long-term sickness absence than those aged 18–29 years and those aged 60 years or older.

The risk of long-term sickness absence declines gradually with the number of years that people have studied. For example, women with no education have a six times higher risk and uneducated men have a four times higher risk of long-term sickness absence than women and men with a master’s degree.

Employees in some job categories are more exposed to sickness absence than others. People working in day-care institutions, cleaning and kitchen assistants, healthcare personnel and unskilled workers have a significantly higher risk of long-term sickness absence than the average employee, whereas managers, academics and information technology (IT) professionals have a significantly lower risk of long-term sickness absence.

Figure 1: Risk of long-term sickness absence within different job categories (%)

Notes: Average = 100%. The proportions are approximate, as the exact numbers are not given in the study. The top four occupational groups (denoted in blue) have a statistically significant above-average risk of long-term sickness absence. The middle four groups (shown in purple) have an average level of risk, while the bottom three groups (highlighted in yellow) have a below-average risk.

Source: NFA, 2007

Risk of long-term sickness absence among different categories of workers (%)

Physical and psychosocial factors

The risk of long-term sickness absence increases for workers who are exposed to certain physical postures while carrying out their tasks. Figure 2 shows how much this risk increases when a worker is more exposed to certain working postures compared with the average for male and female employees. In particular, lifting, standing and walking while working increase the risk of long-term sickness absence among both sexes.

Figure 2: Physical factors increasing the risk of long-term sickness absence, by sex (%)

Note: The results are adjusted for age, education, smoking habits, being overweight, consumption of alcohol, family status, the number of children living at home, suffering from chronic disease, exercise and exposure to psychosocial working environment factors at the workplace.

Source: NFA, 2007

Physical factors causing an increased risk of long-term sickness absence, by sex (%)

Certain combinations of psychosocial and physical work factors increase the risk of sickness absence among women. Women who are exposed to psychosocial factors such as poor management, role conflicts or high emotional demands combined with heavy physical workloads have a higher risk of being absent from work on a long-term basis compared with women exposed only to heavy physical workloads.

Positive effect of training and personal development

Personal development and vocational training have positive effects on the levels of long-term sickness absence. The study found that employees with mental health problems or suffering from neck strain had a lower risk of long-term sickness absence if they worked in an enterprise prioritising personal development and vocational training than in an enterprise without such priorities.

Factors influencing return to work

Around 11%–12% of the Danish workforce are absent from work due to illness for more than two weeks a year. Among these workers, the average period of absence is 6.5 weeks. Factors that may influence the length of absence include: educational level, company size and whether a worker is employed in the public or private sector. Furthermore, older people and women are absent from work for longer than young people and men. Factors relating to the physical and psychosocial working environment such as emotional demands, job insecurity and working with one’s back twisted also influence the length of sickness absence. On the other hand, factors such as smoking, exercise and a person’s self-esteem before taking sick leave do not affect how soon a person returns to work. However, sickness absence may have a negative impact on a worker’s self-esteem. The study reveals that people who are absent from work have a significantly lower level of self-esteem than those who are working.

Mette Ballebye and Helle Ourø Nielsen, Oxford Research