Objective To evaluate the factors associated with long term absences from work due to mental and behavioural disorders, including the interactions of two theoretical models of occupational stress.
Methods A case control study was conducted among workers seeking social security benefits in São Paulo, Brazil. They were absent from work more than fifteen days due to medical conditions, confirmed by social security medical doctors. Cases were workers diagnosed with mental and behavioural disorders. Controls were patients with clinical disability due to other medical problems. Both groups, 160 cases and 225 controls, were randomly selected in an agency of Brazilian Social Security Institution. They were interviewed and answered a comprehensive questionnaire about sociodemographic data, habits and lyfestyle, occupational information, perception of work conditions and clinical history. Multiple logistic regressions were performed to evaluate the hierarchical association of independent variables with the outcome.
Results Mental and behavioural disorders were associated with females (OR 2.48, 95% CI 1.43- 4.30), self-reported skin colour as white (OR 2.16, 95% CI 1.30–3.59), higher school education (OR 2.07, 95% CI 1.15–3.71), high tobacco consumption (OR 5.10, 95% CI 1.55–16.80), high alcohol intake (OR 8.91, 95% CI 1.26–62.90), employed by a public company (OR 3.33, 95% CI 1.01–10.97), exposure to violence at work (OR 4.23, 95% CI 1.92–9.28), perception of high strain combined with low social support and effort-reward imbalance combined with high overcommitment at work (OR 5.70, 95% CI 2.67–12.18 ), and more than two clinical disorders in the past year (OR 2.66, 95% CI 1.59–4.43).
Conclusions There are variables in all hierarchical levels associated with long term sickness absence due to mental and behavioural disorders. Occupational stressors are strongly associated with these conditions. The public health policies must consider social security data to establish guidelines for health promotion in primary level, in order to minimise social and economic impacts.
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