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International Archives of Occupational and Environmental Health

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01-01-2009 | Original Article

Effort-reward imbalance, “locked in” at work, and long-term sick leave

Authors: Göran Fahlén, Hans Goine, Curt Edlund, Britt Arrelöv, Anders Knutsson, Richard Peter

Published in: International Archives of Occupational and Environmental Health | Issue 2/2009

Abstract

Objectives

The objective was to study the relationship between a situation characterized as being in a “locked-in” position (LIP) in occupation and/or place of work, Effort-reward imbalance (ERI), and long-term sick leave.

Methods

The study population derived from one section of a cross-sectional study SKA (sick-leave, culture and attitudes), and comprised all employees at the Swedish Social Insurance Agency responsible for management and compensation of illness in the working population. The analyses were performed for 2,951 women and 534 men who had complete data. Logistic regression was used to calculate odds ratio (OR) for ERI and sick-leave, the latter only for women.

Results

The results showed a strong association between LIP within the place of work and ERI (for women OR = 3.28 95% CI 2.65–4.07, and for men 2.74 1.75–4.30). Also LIP within occupation resulted in high ERI (for women OR = 1.96 1.57–2.41, and for men 1.92 1.22–3.03). In women, ERI (OR = 1.40 1.15–1.70) as well as LIP within place of work (1.88 1.50–2.36) and within occupation (1.48 1.12–1.86) were associated with sick leave. ERI showed a significant mediating effect between LIP and sick leave, within place of work and within occupation (Z value 2.20 and 2.88, respectively).

Conclusions

High ERI is associated with a situation characterized by being locked-in within an occupation or/and within a place of work. The results thereby support the theoretical model of Effort-reward imbalance. The results show that high ERI and being locked in are associated with long-term sick leave. ERI is a potential mediator of the association between being locked in and sick leave.

Alexanderson K, Norlund A (2004) Sickness absence - causes, consequences, and physicians’ sickness certification practice. A systematic literature review by the Swedish Council on Technology Assessment in Health Care. Chapter 12. Future need for research. Scand J Public Health 32(Suppl 63):256–258CrossRef

Alexanderson K, Leijon M, Åkerlind I, Rydh H, Bjurulf P (1994) Epidemiology of sickness absence in a Swedish county in 1985, 1986, 1987. A three year longitudinal study with focus on gender, age and occupation. Scand J Soc Med 22:27–34PubMed

Allebeck P, Mastekaasa A (2004a) Sickness absence—causes, consequences, and physicians’ sickness certification practice. A systematic literature review by the Swedish Council on Technology Assessment in Health Care. Chapter 3. Causes of sickness absence: research approaches and explanatory models. Scand J Public Health Suppl 32(Suppl 63):36–43CrossRef

Allebeck P, Mastekaasa A (2004b) Sickness absence—causes, consequences, and physicians’ sickness certification practice. A systematic literature review by the Swedish Council on Technology Assessment in Health Care. Chapter 5. Risk factors for sick-leave—general studies. Scand J Public Health 32(Suppl 63):49–108CrossRef

Aronsson G, Göransson S (1999) Permanent employment but not in the preferred occupation: psychological and medical aspects, research implications. J Occup Health Psychol 4:152–163PubMedCrossRef

Aronsson G, Dallner M, Gustafsson K (2000) Yrkes- och arbetsplatsinlåsning. En empirisk studie av omfattning och hälsokonsekvenser (‘Locked-in’ in occupation and workplace—An empirical study of dimension and health consequences’ in Swedish). In: Arbetslivsinstitutet (National Institute for Working Life), Stockholm

Baron R, Kenny D (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51:1173–1182PubMedCrossRef

Clogg CC, Petkova E, Haritou A (1995) Statistical methods for comparing regression coefficients between models. AJS 100:1261–1293CrossRef

Evans O, Steptoe A (2002) The contribution of gender-role orientation, work factors and home stressors to psychological well-being and sickness absence in male- and female-dominated occupational groups. Soc Sci Med 54:481–492PubMedCrossRef

Godin I, Kittel F (2004) Differential economic stability and psychosocial stress at work: associations with psychosomatic complaints and absenteeism. Soc Sci Med 58:1543–1553PubMedCrossRef

Hanebuth D, Meinel M, Fischer J (2006) Health-related quality of life, psychosocial work conditions, and absenteeism in an industrial sample of blue- and white-collar employees: a comparison of potential predictors. J Occup Environ Med 48:28–37PubMedCrossRef

Hensing G, Alexandersson K, Åkerlind I, Bjurulf P (1995) Sick-leave due to minor psychiatric morbidity: role of sex integration. Soc Psychiatry Psychiatr Epidemiol 30:39–43PubMedCrossRef

Karasek RA (1979) Job demands, job decision latitude, and mental strain: Implications for job redesign. Adm Sci Q 24:285–307CrossRef

Kuper H, Singh-Manoux A, Siegrist J, Marmont M (2002) When reciprocity fails: effort-reward imbalance in relation to coronary heart disease and health functioning whitin the Whitehall II study. Occup Environ Med 59:777–784PubMedCrossRef

Mastekaasa A (2005) Sickness absence in female- and male-dominated occupations and workplaces. Soc Sci Med 60:2261–2272PubMed

Palmer E (ed) (2006) Sjukförsäkring, kultur och attityder - fyra aktörers perspektiv (‘Social Insurance, culture and attitudes - perspective of four actors’ in Swedish). Försäkringskassan (Social Insurance Agency), Stockholm

Peter R, Siegrist J (1997) Chronic work stress, sickness absence, and hypertension in middle managers: general or specific sociological explanations? Soc Sci Med 45:1111–1120PubMedCrossRef

Peter R, Siegrist J (1999) Chronic psychosocial stress at work and cardiovascular disease: the role of effort-reward imbalance. Int J Law Psychiatry 22:441–449PubMedCrossRef

Schönpflug W, Batmann W (1989) The costs and benefits of coping. In: Fischer S, Reason J (eds) Handbook of stress, cognition and health. Wiley, Chichester, pp 699–714

Severens JL, Mulder J, Laheij RJ, Verbeek AL (2000) Precision and accuracy in measuring absence from work as a basis for calculating productivity costs in The Netherlands. Soc Sci Med 51:243–249PubMedCrossRef

Siegrist J (1996) Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol 1:27–41PubMedCrossRef

Siegrist J (2005) Social reciprocity and health: new scientific evidence and policy implications. Psychoneuroendocrinology 30:1033–1038PubMedCrossRef

Siegrist J, Starke D, Chandola T, Godin I, Niedhammer I, Peter R (2004) The measurement of effort-reward imbalance at work: European comparisons. Soc Sci Med 58:1483–1499PubMedCrossRef

Tsui A, Egan T, O’Reilly C (1992) Being different: relational demography and organizational attachment. Adm Sci Q 37:549–579CrossRef

Tsutsumi A, Kawakami N (2004) A review of empirical studies on the model of effort-reward imbalance at work: reducing occupational stress by implementing a new theory. Soc Sci Med 59:2335–2359PubMedCrossRef

van Vegchel N, de Jonge J, Bosma H, Schaufeli W (2005) Reviewing the effort-reward imbalance model: drawing up the balance of 45 empirical studies. Soc Sci Med 60:1117–1131PubMedCrossRef

VINNOVA (2007) DYNAMO Arbetsgivarringar för ökad rörlighet - En slututvärdering av projekt om arbetsgivarringar inom DYNAMO- programmet (‘Employer rings for increased mobility - a final evaluation of projects concerning employer rings within the DYNAMO programme’ in Swedish). In, vol 2008. VINNOVA - Verket för innovationssystem (Swedish Governmental Agemncuy for innovation systems)

Title: Effort-reward imbalance, “locked in” at work, and long-term sick leave
Authors: Göran Fahlén
Hans Goine
Curt Edlund
Britt Arrelöv
Anders Knutsson
Richard Peter
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: International Archives of Occupational and Environmental Health / Issue 2/2009
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-008-0321-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Effort-reward imbalance, “locked in” at work, and long-term sick leave

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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