title: Work-related psychosocial events as triggers of sick leave--results from a Swedish case-crossover study.
abstract: BACKGROUND
  Although illness is an important cause of sick leave, it has also been suggested that non-medical risk factors may influence this association. If such factors impact on the period of decision making, they should be considered as triggers. Yet, there is no empirical support available.The aim was to investigate whether recent exposure to work-related psychosocial events can trigger the decision to report sick when ill.
  
  
  METHODS
  A case-crossover design was applied to 546 sick-leave spells, extracted from a Swedish cohort of 1430 employees with a 3-12 month follow-up of new sick-leave spells. Exposure in a case period corresponding to an induction period of one or two days was compared with exposure during control periods sampled from workdays during a two-week period prior to sick leave for the same individual. This was done according to the matched-pair interval and the usual frequency approaches. Results are presented as odds ratios (OR) with 95% confidence intervals (CI).
  
  
  RESULTS
  Most sick-leave spells happened in relation to acute, minor illnesses that substantially reduced work ability. The risk of taking sick leave was increased when individuals had recently been exposed to problems in their relationship with a superior (OR 3.63; CI 1.44-9.14) or colleagues (OR 4.68; CI 1.43-15.29). Individuals were also more inclined to report sick on days when they expected a very stressful work situation than on a day when they were not under such stress (OR 2.27; CI 1.40-3.70).
  
  
  CONCLUSIONS
  Exposure to problems in workplace relationships or a stressful work situation seems to be able to trigger reporting sick. Psychosocial work-environmental factors appear to have a short-term effect on individuals when deciding to report sick.
authors.affiliation: Karolinska Institutet, Department of Public Health Sciences, Division of Public Health Epidemiology, Norrbacka 7thfloor, SE-171 76 Stockholm, Sweden. hanna.hultin@ki.se
authors.forename: Hanna
authors.initials: H
authors.lastname: Hultin
authors.forename: Johan
authors.initials: J
authors.lastname: Hallqvist
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
authors.forename: Gun
authors.initials: G
authors.lastname: Johansson
authors.forename: Christina
authors.initials: C
authors.lastname: Lindholm
authors.forename: Ingvar
authors.initials: I
authors.lastname: Lundberg
authors.forename: Jette
authors.initials: J
authors.lastname: Möller
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000523:psychology*; D013548:Sweden; D014937:Work / Q000523:psychology*