title: Do work-related factors contribute to differences in doctor-certified sick leave? A prospective study comparing women in health and social occupations with women in the general working population.
abstract: BACKGROUND
  Doctor -certified sick leave is prevalent in the health and social sector. We examined whether the higher risk of doctor-certified sick leave in women in health and social occupations compared to women in other occupations was explained by particular work-related psychosocial and mechanical risk factors.
  
  
  METHODS
  A randomly drawn cohort aged 18-69 years from the general population in Norway was surveyed in 2009 (n = 12,255, response at baseline = 60.9 %), and was followed up in the national registry of social transfer payments in 2010. Eligible respondents were women registered with an active employee relationship for ≥100 actual working days in 2009 and 2010 (n = 3032). Using this sample, we compared health and social workers (n = 661) with the general working population (n = 2371). The outcome of interest was long-term sick leave (LTSL) ≥21 working days during 2010. Eight psychosocial and eight mechanical factors were evaluated.
  
  
  RESULTS
  After adjusting for age, previous LTSL, education and working hours/week, women in health and social occupations had a higher risk for LTSL compared with women in the general working population (OR = 1.42, 95 % CI = 1.13-1.79; p = 0.003). After adjusting for psychosocial and mechanical factors, 70 % of the excess risk for LTSL was explained compared with the initial model. The main contributory factors to the increased risk were threats of violence and violence, emotional demands and awkward lifting.
  
  
  CONCLUSIONS
  Psychosocial and mechanical factors explained much of the excess risk for LTSL in women in health and social occupations compared with working women in general. Psychosocial risk factors were the most important contributors.
authors.affiliation: Department of Occupational Health Surveillance, National Institute of Occupational Health, PO Box 8149 Dep, N-0033, Oslo, Norway. Cecilie.Aagestad@stami.no.|Department of Behavioral Sciences, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, PO Box 1111, Blindern, 0317, Oslo, Norway. Cecilie.Aagestad@stami.no.
authors.forename: Cecilie
authors.initials: C
authors.lastname: Aagestad
authors.affiliation: Department of Behavioral Sciences, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, PO Box 1111, Blindern, 0317, Oslo, Norway. reidar.tyssen@medisn.uio.no.
authors.forename: Reidar
authors.initials: R
authors.lastname: Tyssen
authors.affiliation: Department of Occupational Health Surveillance, National Institute of Occupational Health, PO Box 8149 Dep, N-0033, Oslo, Norway. Tom.Sterud@stami.no.
authors.forename: Tom
authors.initials: T
authors.lastname: Sterud
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009664:Norway; D009790:Occupations / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D012947:Social Work / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014931:Women, Working / Q000706:statistics & numerical data*; D055815:Young Adult