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Long hours in paid and domestic work and subsequent sickness absence: does control over daily working hours matter?
  1. L Ala-Mursula1,
  2. J Vahtera2,
  3. A Kouvonen3,
  4. A Väänänen2,
  5. A Linna2,
  6. J Pentti2,
  7. M Kivimäki2,3
  1. 1Centre of Occupational Health, Oulu, Finland; Department of Public Health Science and General Practice, University of Oulu, Finland
  2. 2Centre of Expertise in Work Organizations, Finnish Institute of Occupational Health, Helsinki, Finland
  3. 3Department of Psychology, University of Helsinki, Finland
  1. Correspondence to:
 Dr L Ala-Mursula
 Centre of Occupational Health, PO Box 36, FIN-90015 City of Oulu, Finland; Leena.Ala-Mursula{at}


Objectives: To explore the associations of working hours (paid, domestic, commuting, and total) with sickness absence, and to examine whether these associations vary according to the level of employee control over daily working hours.

Methods: Prospective cohort study among 25 703 full-time public sector employees in 10 towns in Finland. A survey of working hours and control over working hours was carried out in 2000–01. The survey responses were linked with register data on the number of self-certified (⩽3 days) and medically certified (>3 days) sickness absences until the end of 2003. Poisson regression analyses with generalised estimating equations were used to take into account the fact that the employees were nested within work units. Adjustments were made for work and family characteristics and health behaviour. The mean follow-up period was 28.1 (SD 8.1) months.

Results: Long domestic and total working hours were associated with higher rates of medically certified sickness absences among both genders. In contrast, long paid working hours were associated with lower rates of subsequent self-certified sickness absences. Long commuting hours were related to increased rates of sickness absence of both types. Low control over daily working hours predicted medically certified sickness absences for both the women and men and self-certified absences for the men. In combinations, high control over working hours reduced the adverse associations of long domestic and total working hours with medically certified absences.

Conclusions: Employee control over daily working hours may protect health and help workers successfully combine a full-time job with the demands of domestic work.

  • working times
  • autonomy
  • flexitime
  • commuting hours
  • longitudinal cohort study

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  • Published Online First 25 May 2006

  • Funding: This study was supported by the Academy of Finland (project 105195, grant 106645), the Finnish Work Environment Fund (projects 101190 and 103432), and the participating towns. The sponsors of the study had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

  • Competing interests: none