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Original research
Work environment risk factors for the duration of all cause and diagnose-specific sickness absence among healthcare workers in Sweden: a prospective study
  1. Constanze Leineweber1,
  2. Staffan Marklund2,
  3. Klas Gustafsson2,
  4. Magnus Helgesson2
  1. 1 Stress Research Institute, Stockholm University, Stockholm, Sweden
  2. 2 Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Magnus Helgesson, Clinical Neuroscience, Karolinska Institutet, Stockholm 17177, Sweden; magnus.helgesson{at}


Objectives Increasing sickness absence (SA) has been reported among healthcare workers in Sweden. Our aim was to analyse the impact of work environment factors on short-term and long-term SA based on musculoskeletal and psychiatric diagnoses among healthcare workers.

Methods The study sample consisted of healthcare workers (n=12 452) drawn from representative samples of workers aged 16 to 64, who participated in the Swedish Work Environment Surveys (SWES) between 1993 and 2013. The outcomes were either short-term (≤28 days) or long-term (>104 days) SA between 1994 and 2016. HRs and 95% CIs were calculated for the impact of physical and psychosocial working conditions on risk of subsequent short-term or long-term SA for 3 years after participation in SWES.

Results Heavy physical work and strenuous work postures showed elevated HRs for short-term and long-term SA compared with those without these work exposures. Similarly, high job demands and low job control each increased the risk for both short-term and long-term SA compared with employees with low job demands and high job control. Low job support increased the risk for short-term SA compared with those with high job support. Working conditions were strongly related to short-term SA due to musculoskeletal diagnoses but not to short-term SA due to psychiatric diagnoses. None of the work characteristics, except strenuous postures, elevated the risk for long-term SA due to psychiatric diagnosis compared with employees without these characteristics.

Conclusions Ergonomic improvements and stress reduction among healthcare workers are likely to reduce the prevalence of SA foremost due to musculoskeletal diagnoses.

  • epidemiology
  • mental health
  • public health
  • sickness absence

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  • Contributors All authors made substantial contributions to the conception and design of the study. MH did the analyses in collaboration with KG. CL and SM drafted the manuscript, and all authors critically revised drafts of the manuscript on several occasions. All of the authors approved the final manuscript.

  • Funding The study was funded by AFA Insurance, Sweden, grant number 170114.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The regional ethical board in Stockholm approved this study (Dnr. 2018/223-31/5) and waived the requirement that informed consent from the research subjects should be collected. The Swedish law on Research Ethics states that the use of register data which has been given without consent and contains sensitive information (eg, regarding health conditions) must get approval from a Regional Research Ethics Committee. This applied to our SA data. Participation in the Work Environment survey was based on informed content. The approval must be sought for research use of personal information also where anonymisation has taken place after the data linkage.

  • 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. The data of this study are available from Statistics Sweden. The data is not publicly available but can be used if ethical permission is received.