Associations between working conditions, sickness absence and sickness presenteeism in Finland

Abstract Background Demanding working conditions are associated with sickness absence, but less is known about their association with sickness presenteeism. We examined the associations between demanding working conditions, sickness absence and sickness presenteeism days among young and midlife employees. Methods We prospectively linked the Helsinki Health Study survey (80% women, ages 19-39 years in 2017) on physical and mental strenuousness of work and hours per day spent in physical work with the employer's sickness absence register (n = 4,044). We used the Work Ability Score (WAS, current workability 0-10 compared to lifetime best), along with WAS-related discount factors to estimate the annual number of presenteeism days lost due to reduced workability. We calculated rate ratios (RRs) and 95% confidence intervals (CIs) for sickness absence and sickness presenteeism days using negative binomial regression. Results Participants had on average 12.1 sickness absence and 10.5 sickness presenteeism days during the follow-up year, and 44% had both. Physically strenuous work (RR: 1.32, CI: 1.24-1.42), mentally strenuous work (RR: 1.49, CI: 1.36-1.62) and ≥3 h/day spent in physical work (RR: 1.46, CI: 1.36-1.57) were associated with sickness absence days. Similar associations were found for sickness presenteeism days (physically strenuous work: RR: 1.23, CI: 1.15-1.32; mentally strenuous work: RR: 2.02, CI: 1.85-2.21; ≥3 h/day spent in physical work: RR: 1.14, CI: 1.06-1.23). Adjusting for education somewhat attenuated the associations for physical working conditions, but the association for mentally strenuous work remained strong. Further adjustment for marital status and health behavior had minor effects. Conclusions Working conditions were associated with both sickness absence and sickness presenteeism days, which were both common among the employees. Improving working conditions may help promote employee wellbeing and prevent both sickness absence and sickness presenteeism. Key messages • Young and midlife employees with demanding working conditions had increased rates of sickness absence and presenteeism days, and the association was strong especially for mentally strenuous work. • Improving working conditions, especially by reducing mental strain at work, should be considered when planning preventive actions to reduce sickness absence and sickness presenteeism.