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Effect of employee worktime control on health: a prospective cohort study
  1. L Ala-Mursula1,
  2. J Vahtera2,
  3. J Pentti2,
  4. M Kivimäki2
  1. 1Development and Service Centre of Occupational Health, City of Oulu, Finland; Department of Public Health Science and General Practice, University of Oulu, Finland
  2. 2Finnish Institute of Occupational Health, Finland
  1. Correspondence to:
 Dr L Ala-Mursula
 Researcher, Development and Service Centre of Occupational Health, PO Box 36, FIN-90015 City of Oulu, Finland;


Aims: To investigate the health effects of employee worktime control.

Methods: Prospective cohort study among 4218 permanent full time municipal employees linking questionnaire data from 1997 and 2000 with sickness absence records from 1997 and 2001. Worktime control was considered high for the highest tertile in both 1997 and 2000, low for the lowest tertile for both years, and intermediate for all other combinations. Self rated health status, psychological distress, and medically certified periods of sickness absence were used as the health outcomes. Adjustments were made for age, baseline health status, occupational status, marital status, dependent children, and behavioural health risks.

Results: In the follow up, women with a low level of worktime control had a 1.9 times (95% CI 1.4 to 2.5) higher odds ratio for poor self rated health, a 1.4 times (95% CI 1.1 to 1.8) higher odds ratio for psychological distress, and a 1.5 times (95% CI 1.3 to 1.7) higher risk of medically certified sickness absences than women with a high level of worktime control. The health effects of worktime control were particularly evident among women with families. Among men, worktime control was not associated with self rated health or distress, but it predicted sickness absences in two subgroups: those with dependent children and those with manual occupations.

Conclusions: A low level of worktime control increases the risk of future health problems. The risk is highest among women, especially those with families, and among manual workers. The results suggest that worktime control can help workers integrate their work and private lives successfully.

  • working times
  • autonomy
  • gender
  • sickness absence
  • self rated health

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  • Conflicts of interest: none