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J Occup Environ Med. 2001 Dec;43(12):1081-8.

Associations between workload and diseases rarely occurring in sickness absence data.

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National Federation of Company Health Insurance Funds (BKK-Bundesverband), German Federation of Statutory Accident Insurance Institutions for the Industrial Sector (HVBG), Kronprinzenstrasse 6, D-45128, Essen, Germany.


This study provides rate ratios for sickness absence in relation to workload, which was accessed by means of a job exposure matrix. Emphasis is given to diseases that are seldom studied by sickness absence data either because the incidence is low or because medical treatment is not supplemented by rest from work. A total of 42,508 employees from the metal processing and retail trade were followed for 3 years. Sick leave related to hypertension, ischemic heart diseases, ulcer, neurotic disorders, or work accidents was most frequent in employees exposed to physical demands and low control. In contrast, an inverse relation was observed for psychological demands, for which rate ratios decreased with increasing exposure. This finding might be an expression of work commitment or pressure to attend rather than of coping behavior, because both hard and soft diagnoses were considered.

[Indexed for MEDLINE]

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