Effect of change in the psychosocial work environment on sickness absence:a seven year follow up of initially healthy employees

Study objective-To investigate the impact of changes in psychosocial work e nvironment on subsequent sickness absence. Design-Analysis of questionnaire and sickness absence data collected in thr ee time periods: 1990-1991, before the recession; 1993, worst slump during the recession: and 1993-1997, a period after changes. Setting-Raisio, a town in south western Finland, during and after a period of economic decline. Participants-530 municipal employees (138 men, 392 women) working during 19 90-1997 who had no medically certified sick leaves in 1991. Mean length of follow up was 6.7 years. Main results-After adjustment for the pre-recession levels, the changes in the job characteristics of the workers during the recession predicted their subsequent sick leaves. Lowered job control caused a 1.30 (95% CI = 1.19, 1.41) times higher risk of sick leave than an increase in job control, The corresponding figures in relation to decreased social support and increased job demands were 1.30 (95% CI 1.20, 1.41) and 1.10 (95% CI = 1.03, 1.17), respectively. In some cases there was an interaction with socioeconomic sta tus, changes in the job characteristics being stronger predictors of sick l eaves for employees with a high income than for the others. The highest ris ks of sick leave (ranging from 1.40 to 1.90) were associated with combined effects related to poor levels of and negative changes in job control, job demands and social support. Conclusion-Negative changes in psychosocial work environment have adverse e ffects on the health of employees. Those working in an unfavourable psychos ocial environment before changes are at greatest risk.