Low level of adjustment latitude--a risk factor for sickness absence.
BACKGROUND
The prerequisite for obtaining sickness benefit is reduced work ability for medical reasons in combination with work demands which cannot be adjusted accordingly. The aim of this study was to investigate if low levels of adjustment latitude, defined as the possibility to temporarily adjust work demands in case of ill health, influence sickness absence.


METHODS
A prospective cohort study of 1420 employees (47% participation, aged 19-68; 56% women) was conducted at six Swedish workplaces. Exposure to two general and nine specific types of adjustment latitude was ascertained at baseline. Outcome was defined as the first new employer-reported sick-leave spell during a follow-up of 3-12 months. Hazard ratios (HR) of sick leave, with 95% confidence intervals (CI), were estimated by Cox proportional hazards regression.


RESULTS
The incidence of sickness absence was 2.85/1000 person-days. The self-reported reasons for sick leave were mainly minor complaints such as colds, influenzas and headaches. Employees lacking adjustment latitude had an adjusted HR of sickness absence of 1.51 (95% CI 1.08-2.11). Among specific adjustment latitude types, those not having the possibility to work from home generated an HR of 1.86 (95% CI 1.31-2.64). The effects of lack of adjustment latitude were similar for men and women but seemed to vary between different occupations.


CONCLUSIONS
A low level of adjustment latitude at work is a risk factor for sickness absence.
Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Stockholm, Sweden. hanna.hultin@ki.se
Hanna
H
Hultin
Johan
J
Hallqvist
Kristina
K
Alexanderson
Gun
G
Johansson
Christina
C
Lindholm
Ingvar
I
Lundberg
Jette
J
Möller
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010561:Personnel Staffing and Scheduling; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D013548:Sweden