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Perceived and content-related emotional demands at work and risk of long-term sickness absence in the Danish workforce: a cohort study of 26 410 Danish employees
  1. Elisabeth Framke1,
  2. Jeppe Karl Sørensen1,
  3. Mads Nordentoft1,
  4. Nina Føns Johnsen1,
  5. Anne Helene Garde1,2,
  6. Jacob Pedersen1,
  7. Ida E H Madsen1,
  8. Reiner Rugulies1,2,3
  1. 1 National Research Centre for the Working Environment, Copenhagen, Denmark
  2. 2 Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  3. 3 Department of Psychology, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Dr Elisabeth Framke, National Research Centre for the Working Environment, Copenhagen, Denmark; elf{at}


Objectives This study aimed to examine whether high emotional demands at work predict long-term sickness absence (LTSA) in the Danish workforce and whether associations differ by perceived and content-related emotional demands.

Methods We included 26 410 individuals from the Work Environment and Health in Denmark Study, a nationwide sample of the Danish workforce. Emotional demands at work were measured with two items: one assessing perceived emotional demands (asking how often respondents were emotionally affected by work) and one assessing content-related emotional demands (frequency of contact with individuals in difficult situations). LTSA was register based and defined as spells of ≥6 weeks. Respondents with LTSA during 2 years before baseline were excluded. Follow-up was 52 weeks. Using Cox regression, we estimated risk of LTSA per one-unit increase in emotional demands rated on a five-point scale.

Results During 22 466 person-years, we identified 1002 LTSA cases. Both perceived (HR 1.20, 95% CI 1.12 to 1.28) and content-related emotional demands (HR 1.07, 95% CI 1.01 to 1.13) predicted risk of LTSA after adjustment for confounders. Further adjustment for baseline depressive symptoms substantially attenuated associations for perceived (HR 1.08, 95% CI 1.01 to 1.16) but not content-related emotional demands (HR 1.05, 95% CI 1.00 to 1.11). Individuals working in occupations with above-average values of both exposures had an increased risk of LTSA (HR 1.32, 95% CI 1.14 to 1.52) compared with individuals in all other job groups.

Conclusions Perceived and content-related emotional demands at work predicted LTSA, also after adjustment for baseline depressive symptoms, supporting the interpretation that high emotional demands may be hazardous to employee’s health.

  • emotional demands
  • perceived
  • content-related
  • workplace
  • sickness absence

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  • Correction notice This article has been corrected since it published Online First.

  • Contributors EF, JKS, IEHM and RR contributed to the conception of the study, and all authors contributed to the interpretation of data. JKS and EF conducted the data analysis. EF drafted the manuscript, and all authors critically revised it and approved the final version.

  • Funding This study was funded by the Danish Work Environment Research Fund (grant numbers 27-2017-03 and 10-2016-02).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The National Committee on Health Research Ethics. The study was approved by The Danish Data Protection Agency through the joint notification of the National Research Centre for the Working Environment (no. 2015-57-0074). All data are stored in a protected server environment hosted by Statistics Denmark.

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

  • Data availability statement Data may be obtained from a third party and are not publicly available.

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