title: Work-related gender differences in physician-certified sick leave: a prospective study of the general working population in Norway.
abstract: OBJECTIVE
  This study aimed to examine gender differences in physician-certified sick leave and the extent to which these differences can be explained by work-related psychosocial and mechanical risk factors.
  
  
  METHODS
  Randomly drawn from the general population in Norway, the cohort comprised working men and women aged 18-69 years (N=12 255, response rate at baseline = 60.9%). Eligible respondents were interviewed in 2009 and registered with an active employee relationship of ≥ 100 actual working days in 2009 and 2010 (N=3688 men and 3070 women). The study measured 11 work-related psychosocial factors and 11 mechanical exposures, and outcomes of interest were physician-certified general sick leave (GSL) >0 days and long-term sick leave (LTSL) ≥ 40 working days during 2010.
  
  
  RESULTS
  Women reported a significantly higher level of exposure to 9 of the 11 psychosocial factors evaluated. For mechanical factors, the reporting was mixed. After controlling for age, educational level, sick leave during 2009, housework, working hours and family status, a 1.7-fold risk for GSL and LTSL were found among women. In comparison with the initial model, adjusting for psychosocial factors reduced the excess risk by 21% and 27% for GSL and LTSL, respectively. The total effect of mechanical factors was negligible. Differences between occupations held by women and men explained an additional one-tenth of the excess risk for LTSL among women.
  
  
  CONCLUSIONS
  Work-related psychosocial factors contributed significantly to a higher level of GSL and LTSL among women. The most important factors were demands for hiding emotions, emotional demands, and effort-payment imbalance.
authors.affiliation: National Institute of Occupational Health, PO Box 8149 Dep, NO-0033 Oslo, Norway. tom.sterud@stami.no.
authors.forename: Tom
authors.initials: T
authors.lastname: Sterud
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D004651:Employment / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D016017:Odds Ratio; D011446:Prospective Studies; D036301:Qualitative Research; D012307:Risk Factors; D012737:Sex Factors; D018582:Sick Leave / Q000706:statistics & numerical data; D055815:Young Adult