title: Effort-reward imbalance, "locked in" at work, and long-term sick leave.
abstract: OBJECTIVE
  The objective was to study the relationship between a situation characterized as being in a "locked-in" position (LIP) in occupation and/or place of work, Effort-reward imbalance (ERI), and long-term sick leave.
  
  
  METHODS
  The study population derived from one section of a cross-sectional study SKA (sick-leave, culture and attitudes), and comprised all employees at the Swedish Social Insurance Agency responsible for management and compensation of illness in the working population. The analyses were performed for 2,951 women and 534 men who had complete data. Logistic regression was used to calculate odds ratio (OR) for ERI and sick-leave, the latter only for women.
  
  
  RESULTS
  The results showed a strong association between LIP within the place of work and ERI (for women OR = 3.28 95% CI 2.65-4.07, and for men 2.74 1.75-4.30). Also LIP within occupation resulted in high ERI (for women OR = 1.96 1.57-2.41, and for men 1.92 1.22-3.03). In women, ERI (OR = 1.40 1.15-1.70) as well as LIP within place of work (1.88 1.50-2.36) and within occupation (1.48 1.12-1.86) were associated with sick leave. ERI showed a significant mediating effect between LIP and sick leave, within place of work and within occupation (Z value 2.20 and 2.88, respectively).
  
  
  CONCLUSIONS
  High ERI is associated with a situation characterized by being locked-in within an occupation or/and within a place of work. The results thereby support the theoretical model of Effort-reward imbalance. The results show that high ERI and being locked in are associated with long-term sick leave. ERI is a potential mediator of the association between being locked in and sick leave.
authors.affiliation: Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden. goran.fahlen@miun.se
authors.forename: Göran
authors.initials: G
authors.lastname: Fahlén
authors.forename: Hans
authors.initials: H
authors.lastname: Goine
authors.forename: Curt
authors.initials: C
authors.lastname: Edlund
authors.forename: Britt
authors.initials: B
authors.lastname: Arrelöv
authors.forename: Anders
authors.initials: A
authors.lastname: Knutsson
authors.forename: Richard
authors.initials: R
authors.lastname: Peter
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D001290:Attitude; D002322:Career Mobility; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D004651:Employment / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D007588:Job Satisfaction; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology*; D009786:Occupational Health Services; D012201:Reward; D018582:Sick Leave / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D017132:Workplace / Q000523:psychology; D055815:Young Adult