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Work-related psychosocial events as triggers of sickleave – results from a Swedish case-crossover study
Karolinska Institutet, Department of Public Health Sciences.
Karolinska Institutet, Department of Public Health Sciences.
Karolinska Institutet, Department of Clinical Neuroscience.
Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, Faculty of Health Sciences.
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2011 (English)In: BMC Public Health, ISSN 1471-2458, Vol. 11, no 175Article in journal (Refereed) Published
Abstract [en]


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.


A case-crossover design was applied to 546 sick-leave spells, extracted from a

Swedish cohort of 1 430 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).


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).


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.

Place, publisher, year, edition, pages
BMC , 2011. Vol. 11, no 175
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-66970DOI: 10.1186/1471-2458-11-175ISI: 000289285200001OAI: diva2:405721
Original Publication: Hanna Hultin, Johan Hallqvist, Kristina Alexandersson, Gun Johansson, Lindholm Christina, Ingvar Lundberg and Jette Möller, Work-related psychosocial events as triggers of sickleave – results from a Swedish case-crossover study, 2011, BMC Public Health, (11), 175. Licensee: BioMed Central Available from: 2011-03-23 Created: 2011-03-23 Last updated: 2011-05-09

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