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The attribution of work environment in explaining gender differences in long-term sickness absence: results from the prospective DREAM study
  1. Merete Labriola1,
  2. Kari Anne Holte2,
  3. Karl Bang Christensen3,
  4. Helene Feveile4,5,
  5. Kristina Alexanderson6,
  6. Thomas Lund1
  1. 1Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital Herning, Herning, Denmark
  2. 2Department of Social Science and Business Development, International Research Institute of Stavanger, Stavanger, Norway
  3. 3Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
  4. 4National Research Centre for the Working Environment, Copenhagen, Denmark
  5. 5Statistics Denmark, Copenhagen, Denmark
  6. 6Department of Clinical Neuroscience, Karolinska Institute, University of Stockholm, Stockholm, Sweden
  1. Correspondence to Merete Labriola, Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital Herning, Herning 7400, Denmark; meretelabriola{at}


Objectives To identify differences in risk of long-term sickness absence between female and male employees in Denmark and to examine to what extent differences could be explained by work environment factors.

Methods A cohort of 5026 employees (49.1% women, mean age 40.4 years; 50.9% men, mean age 40.2 years) was interviewed in 2000 regarding gender, age, family status, socio-economic position and psychosocial and physical work environment factors. The participants were followed for 18 months in order to assess their incidence of long-term sickness absence exceeding 8 consecutive weeks.

Results 298 workers (5.9%) received sickness absence compensation for 8 weeks or more. Women had an excess risk of 37% compared to men, when adjusting for age, family status and socio-economic position. Physical work environment exposures could not explain this difference, whereas differences in psychosocial work environment exposures explained 32% of the differences in risk of long-term sickness absence between men and women, causing the effect of gender to become statistically insignificant. The combined effect of physical and psychosocial factors was similar, explaining 30% of the gender difference.

Conclusion Differences in psychosocial work environments in terms of emotional demands, reward at work, management quality and role conflicts, explained roughly 30% of women's excess long-term sickness absence risk. Assuming women and men had identical working conditions would leave the larger part of the gender difference in long-term sickness absence from work unexplained.

  • Register data
  • sickness absence
  • men
  • women
  • work environment
  • epidemiology
  • gender
  • longitudinal studies
  • sickness absence
  • international occupational health

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.