Dose-response relation between perceived physical exertion during healthcare work and risk of         long-term sickness absence.
OBJECTIVE
An imbalance between physical work demands and physical capacity of the worker may be a risk         factor for poor health. Perceived physical exertion provides information about the individual perception of the work         demands relative to the capacity to perform the work. This study estimates the risk for long-term sickness absence         (LTSA) from perceived physical exertion among healthcare workers.


METHODS
This prospective cohort study comprises 8592         Danish healthcare workers who responded to a baseline questionnaire in 2004-2005 and subsequently were followed         for one year in the Danish Register for Evaluation of Marginalization (DREAM), a national register of social transfer         payments. Using Cox regression hazard ratio (HR) analysis, controlled for age, gender, body mass index (BMI), smoking,         tenure, leisure-time physical activity, psychosocial working conditions, and LTSA during one year prior to baseline, we         modeled risk estimates of moderate and strenuous (reference: light) perceived physical exertion during healthcare work         for onset of LTSA (receiving sickness absence compensation for ≥8 consecutive weeks) during 1-year follow-up.


RESULTS
At baseline, 35.1%, 39.4%, and 25.5% of the healthcare workers experienced, respectively, light, moderate, and         strenuous physical exertion during healthcare work. During follow-up, the 12-month prevalence of LTSA was 4.6%, 6.4%,         and 8.9%, respectively, in these three exertion groups. A dose-response pattern between physical exertion and the         risk for LTSA was found (trend test P<0.0001). In the multi-adjusted model, the risk for LTSA was 1.31 [95%         confidence interval (95% CI) 1.04-1.64] for healthcare workers reporting moderate physical exertion and 1.57 (95%         CI 1.23-2.01) for those reporting strenuous physical exertion, referencing those reporting light physical         exertion during healthcare work.


CONCLUSIONS
Moderate and strenuous perceived physical exertion during healthcare work         increases - in a dose-response manner - the risk for LTSA. The possible preventive effect of         balancing work demands with the capacity of the worker, to thereby avoid excessive physical exertion, should be tested         in randomized controlled trials.
National Research Centre for the Working Environment, Copenhagen Ø, Denmark. lla@nrcwe.dk
Lars L
LL
Andersen
Thomas
T
Clausen
Roger
R
Persson
Andreas
A
Holtermann
D000328:Adult; D003718:Denmark; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D016016:Proportional Hazards Models; D018582:Sick Leave