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BMC Public Health. 2014 Sep 29;14:1016. doi: 10.1186/1471-2458-14-1016.

Psychosocial and organizational risk factors for doctor-certified sick leave: a prospective study of female health and social workers in Norway.

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Department of Occupational Health Surveillance, National Institute of Occupational Health, PO BOX 8149 Dep, NO-0033 Oslo, Norway.



Doctor-certified sick leave differs substantially across sectors, and among health and social workers, in particular, there is an increased risk. Previous studies have shown that work environmental factors contribute to sick leave. Hence, the identification of specific organizational and psychosocial risk factors for long- term sick leave, taking into account potential confounding related to mechanical risk factors such as lifting and awkward body postures, will be of importance in the work of prevention.


A randomly drawn population sample of Norwegian residents was interviewed about working conditions in 2009 (n = 12,255; response rate 60.9%). Female health and social care workers (n = 925) were followed in a national registry for subsequent sickness absence during 2010. The outcome of interest was doctor-certified sick leave of 21 days or more (long-term sick leave). Eleven work-related psychosocial and organizational factors were evaluated.


In total, 186 persons (20.1%) were classified with subsequent long-term sick leave. After thoroughly adjusting for competing explanatory variables, the most consistent predictors for long-term sick leave were violence and threats of violence (OR = 1.67; 95% CI 1.14-2.45). The estimated population attributable risk for violence and threats of violence was 13%.


The present study among female health and social care workers revealed a substantial relationship between self-reported violence and threats of violence and subsequent long- term sick leave.

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