Job strain and informal caregiving as predictors of long-term sickness absence: A longitudinal
                    multi-cohort study

Mortensen, Jørgen Birk; Dich, Nadya; Lange, Theis; Alexanderson, Kristina; Goldberg, Marcel; Head, Jenny; Kivimäki, Mika; Madsen, Ida E. H.; Rugulies, Reiner; Vahtera, Jussi; Zins, Marie; Rod, Naja Hulvej

doi:10.5271/sjweh.3587

Cited by 37 publications

(51 citation statements)

References 59 publications

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“…For these comprehensive prediction models, it has been shown that the risk of long-term sickness absence in identified, high-risk workers can successfully be reduced (18,19). Mortensen et al's study (6) reinforces the importance of including factors outside health, work and workability when considering the prediction of long-term sickness. And this in turn might lead to further optimization and broader implementation of preventive programs to reduce long-term sickness absence and as such contribute to a healthy and productive workforce.…”

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confidence: 94%

“…Although contextual factors have been considerably less-well studied, they can nevertheless provide crucial information on the actions needed to increase the participation of older workers in working life and prevent work disability (15,20). To conclude, the study of Mortensen et al (6) can be regarded as an essential step in the unravelling of the complex pathway towards the improved functioning of workers and the prevention of long-term sickness absence and eventually also work disability.…”

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confidence: 99%

“…So a spectrum of legal and cultural differences might add to the possible explanations for the noticeable divergence in the reported associations between the different cohorts included in the Mortensen et al study (6). Moreover, the flexibility of working time and provisions to enable or support caregiving (as facilitated by the employer through legislation or labor agreements) can differ extensively between employers, trades, sectors, and countries, and, as such, might have an additional modifying impact on the association between caregiving, job strain and long-term sickness absence, which necessitates the development of more elaborate sickness absence models.…”

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confidence: 99%

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Addressing long-term sickness absence: moving beyond disease, illness and work-related factors for effective prevention

Amelsvoort

Jansen

Kant³

2016

Scand J Work Environ Health

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Addressing long-term sickness absence: moving beyond disease, illness and work-related factors for effective preventionAlthough only a relatively small percentage of workers report sick for longer than a few days or weeks, it should be noted that long-term sickness absence constitutes the major part of the already substantial costs of sickness absence for companies and society (1). Moreover, long-term absence from work has been associated with a further detrimental impact on the mental health and wellbeing of the workers involved (2). These adverse effects, on top of the diminished social contacts with colleagues and coworkers and related alienation from work, often result in a return-to-work (RTW) barrier that grows as the duration since reporting sick from work increases. Moreover, the tendency of human beings to try to stick to the existing circumstances in uncertain situations (3), such as persisting sickness behavior, might further hamper the RTW process. Taken together, all these factors can lead to a downward spiral of deteriorating health and increased difficulties with reintegrating back into work. And as such, the process of longterm sickness absence can lead to permanent work disability. So its prevention should be an important component of occupational health policy, not only to reduce sickness-absence-related costs but also to improve workers' health and eventually avoid work disability.Establishing evidence-based models that depict the process leading up to long-term sickness is a logical and important step in establishing and improving preventive strategies. Most of the formulated current sickness absence models have a strong focus on health (4, 5) but other factors -often work-related or addressing social protection -have also been included. The large, multinational study by Mortensen et al (6) in this issue of the Scandinavian Journal of Work, Environment and Health contributes to the Literature as it considers the relevance of a factor outside the domain of work and health, namely informal caregiving (ie, unpaid assistance with the daily activities of sick, disabled, or elderly relatives), as a predictor of longterm sickness absence. The authors report that informal caregiving was associated with a higher risk of sickness absence among women [hazard ratio (HR) 1.13, 95% CI 1.04-1.23]. Mortensen et al opted for the inclusion of their underlying theoretical causal model in the form of a directed acyclic graph (DAG), a graphical representation of the assumed causal associations introduced by Robins (7). A DAG not only provides relevant and graphically illustrated information on the underlying theoretical model, but it also guides the statistical analyses and selection of potential confounders, as well as possibly preventing the reporting of spurious associations due the inclusion of colliding factors. A stimulating and helpful discussion for further use of the DAG, and its associated collider bias, can be found in the work of Glymour et al (8), for example. As presented by Mortensen et al (6), the...

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confidence: 94%

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confidence: 99%

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confidence: 99%

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Addressing long-term sickness absence: moving beyond disease, illness and work-related factors for effective prevention

Amelsvoort

Jansen

Kant³

2016

Scand J Work Environ Health

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“…There were no interactions between sex and informal caregiving/psychosocial work factors and analyses are therefore presented combined for men and women. In sub analyses using data from SLOSH and Whitehall II we investigated the impact of weekly hours of caregiving (divided into no caregiving, 1-4 weekly hours of caregiving per week, and >4 hours of caregiving per week, the latter corresponding with caregiving at on average at least one hour each weekday) to determine potential doseeffects relations [7]. Sensitivity analyses were carried out to assess the robustness of results (Appendix E).…”

Section: Statistical Analysesmentioning

confidence: 99%

“…and we have recently shown that informal caregiving predicts long-term sickness absence in women [7].…”

Section: Introductionmentioning

confidence: 99%

Informal caregiving as a risk factor for type 2 diabetes in individuals with favourable and unfavourable psychosocial work environments: A longitudinal multi-cohort study

Mortensen

Clark

Lange

et al. 2018

Diabetes & Metabolism

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Aim: To examine whether informal caregiving is associated with increased risk of type 2 diabetes and whether job strain and social support at work modify this association. Research Methods: We pooled individual-participant data from three cohort studies (the French GAZEL cohort, the Swedish Longitudinal Occupational Survey of Health, and the British Whitehall II study), 21,243 individuals. Informal caregiving was defined as unpaid care for a closely related person. Job strain was assessed with the demand/control model and questions on coworker and supervisor support were combined in a measure of social support at work.Incident type 2 diabetes was ascertained using register-based, clinically assessed, and selfreported data. Results: 1,058 participants got type 2 diabetes during 10 years follow-up.Neither informal caregiving (OR=1.10, 95%CI:0.92-1.30) nor high job strain (OR=1.04, 95%CI:0.86-1.26) were associated with type 2 diabetes risk. Low social support at work was a risk factor for type 2 diabetes (OR=1.18, 95%CI:1.02-1.37). Individuals jointly exposed to informal caregiving and low social support at work were at higher risk of type 2 diabetes (OR=1.40, 95%CI:1.08-1.82) compared to individuals with no informal caregiving and high social support at work; test for interaction (multiplicative: p=0.04, additive: synergy index=10). Conclusion: Informal caregiving was not independently associated with risk of type 2 diabetes. However, low social support at work was a risk factor for type 2 diabetes and caregivers with low social support at work had an even higher risk of type 2 diabetes.

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Differences between men and women in their risk of work injury and disability: A systematic review

Biswas

Harbin

Irvin

et al. 2022

American J Industrial Med

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Background: Health responses associated with occupational exposures can vary between men and women.Aims: This study reviewed the work injury and disability risks associated with similar types of occupational exposures for men and women within and across occupations.Materials & Methods: A systematic review was undertaken of observational studies published between 2009 and 2019. Studies were required to empirically compare men and women for associations between occupational exposures and work injury or disability outcomes. Included studies were appraised for methodological quality and medium to high rated studies were compared for risk differences between men and women.Results: Of 14,006 records identified, 440 articles were assessed for methodological quality, and 33 medium to high rated studies were included and reviewed. Among all occupations, the association between physical exposures, job demands, noise, and repetitive tasks, and injury risk were stronger among men. The relationship between repetitive tasks and sickness absence was stronger among women. Most studies examining psychological exposures found no risk differences for men and women across occupations. Men were at higher injury risk in certain occupations in primary and secondary industry sectors involving physical exposures and some chemical/ biological exposures. Women were at higher injury risk for the physical demands and repetitive tasks of health care and aluminum production occupations. Conclusion:This review found that men and women can have different work injury and disability risks, both across and within the same occupations, for some physical exposures and to a lesser extent for some chemical and biological exposures. These differences might be a result of occupation-specific task differences.

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Job strain and informal caregiving as predictors of long-term sickness absence: A longitudinal multi-cohort study

Abstract: This study is the first to investigate the joint effects of job strain and informal caregiving on long-term sickness absence. The main finding was that informal caregiving responsibilities and/or high job strain predicted long-term sickness absence among women.

Cited by 37 publications

References 59 publications

Addressing long-term sickness absence: moving beyond disease, illness and work-related factors for effective prevention

Addressing long-term sickness absence: moving beyond disease, illness and work-related factors for effective prevention

Informal caregiving as a risk factor for type 2 diabetes in individuals with favourable and unfavourable psychosocial work environments: A longitudinal multi-cohort study

Differences between men and women in their risk of work injury and disability: A systematic review

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