Sickness absence and psychosocial work conditions: a multilevel study.

BACKGROUND Psychosocial work conditions, particularly psychological job demands, are inconsistently associated with sickness absence rates. This might be the result of investigating the psychosocial work environment at the individual level, reflecting personal perceptions rather than actual demands. AIM To investigate associations between sickness absence and psychosocial work conditions at both the individual and the workplace level. METHODS A cross-sectional study of insurance company employees (n = 395) in four departments. Psychological job demands, job control and job support were investigated at the individual level using the self-completed Questionnaire on Experience and Assessment of Work. An external occupational psychologist interviewed the supervisor and a group of employees of each department, assessing job demands, job control, job support and psychological distress at the workplace level. These data were related to the number of short (1-7 days), medium (8-21 days) and long (>21 days) episodes of sickness absence in the period January 2001 to December 2002. RESULTS A total of 244 questionnaires (62%) were suitable for analysis. Quantitative job control scores at the individual level differed from qualitative data at the workplace level. Self-assessed job demands and control were unrelated to sickness absence. The rates of short and long episodes of absence were higher in the department with combined high demands and low control, assessed at the workplace level. CONCLUSIONS The associations between psychosocial work conditions and sickness absence depended on the level at which the former were assessed. More multilevel research is needed to disentangle the relations between psychosocial work conditions and sickness absence.