title: Work factors and occupational class disparities in sickness absence: findings from the GAZEL cohort study.
abstract: OBJECTIVE
  To estimate the contribution of stress-related and physical work factors to occupational class disparities in sickness absence from work.
  
  
  METHODS
  Our sample consisted of 8847 men and 2886 women participating in the French GAZEL cohort study. Occupational class and medically certified sickness absence data (1995-2001) were obtained from the participants' employer. Work characteristics (physical and stress-related) were self-reported. We calculated rate ratios with Poisson regression models; fractions of sickness absence attributable to work factors were estimated with the Miettinen formula.
  
  
  RESULTS
  Sickness absence was distributed along an occupational gradient. Work characteristics accounted for 19% (women) and 21% (men) of all absences. Physical work conditions accounted for 42% and 13% of absences for musculoskeletal reasons, and work stress accounted for 48% and 40% of psychiatric absences. Overall, about 20% of the occupational class gradient in sickness absence could have been associated with deleterious work conditions.
  
  
  CONCLUSIONS
  Work conditions contribute to sickness absence, particularly among manual workers and clerks. Policies that decrease ergonomic constraints and work stress also could reduce the burden of ill health and sickness absence among the lowest strata of working populations.
authors.affiliation: National Institute of Health and Medical Research, Saint-Maurice, France. maria.melchior@st-maurice.inserm.fr
authors.forename: Maria
authors.initials: M
authors.lastname: Melchior
authors.forename: Nancy
authors.initials: N
authors.lastname: Krieger
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.forename: Lisa F
authors.initials: LF
authors.lastname: Berkman
authors.forename: Isabelle
authors.initials: I
authors.lastname: Niedhammer
authors.forename: Marcel
authors.initials: M
authors.lastname: Goldberg
mesh_terms: D000041:Absenteeism; D000328:Adult; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000209:etiology*; D009784:Occupational Diseases / Q000209:etiology* / Q000523:psychology; D009790:Occupations / Q000145:classification*; D016012:Poisson Distribution; D017678:Sex Distribution; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology; D016526:Workload