GENDER DIFFERENCES AT THE WORKPLACE: SICKNESS ABSENCE AND PRODUCTIVITY LOSS AT WORK AND THEIR ASSOCIATION WITH HEALTH AND WORK-RELATED FACTORS

  • Prof. dr Bosiljka Đikanović Institute of Social Medicine, Faculty of Medicine, University of Belgrade; Centre – School of Public Health
  • Tessa A. Kouwenhoven-Pasmooij VitAll, Rotterdam, The Netherlands
  • Roderik A. Kraaijenhagen NIPED Research Foundation, Research & Development, Amsterdam, The Netherlands
  • Jeanine E. Roeters van Lennep Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
  • Alex Burdorf Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
  • Vladimir Vasilev VFV Clinic, Skopje, North Macedonia
  • Suzan J.W. Robroek Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
Keywords: gender differences, sickness absence, productivity loss at work, health, disease, psychosocial work-related factors

Abstract


Introduction: Differences in sickness absence and productivity loss at work between men and women are recognized but need to be better understood. 

Materials and methods: In a cross-sectional study, 10,407 employees from 37 companies in the Netherlands participated in a web-based health risk assessment, between 2010 and 2014. Self-reported short-term (<9 days) and long-term (10 or more days) sickness absences during the preceding 12 months were assessed. The questionnaire also asked about productivity loss at work, physical and psychosocial work-related factors, and health problems. Log-linear models were used to estimate prevalence ratios (PR), with 95% confidence intervals (CI). 

Results: Women, more often than men, experienced short-term and long-term sickness absence (PR 1.06, 95% CI 1.01 – 1.11, and PR 1.33, 95% CI 1.21 – 1.46, respectively) but were less likely to have productivity loss at work (more than 30%), (PR 0.90, 95% CI 0.81 – 0.99). In short-term sickness absence, gender differences were reduced by 20%, after controlling for psychosocial work-related factors, and by 60%, after controlling for health problems, separately. None of the factors mentioned above could explain a large productivity loss at work among men. 

Conclusions: Higher prevalence of sickness absence among women can partly be explained by psychosocial work-related factors and health problems. Further studies are needed to explore large productivity loss at work among men.

References

1. Zhang W, Bansback N, Anis AH. Measuring and valuing productivity loss due to poor health: A critical review. Soc Sci Med. 2011 Jan;72(2):185-92. doi: 10.1016/j.socscimed.2010.10.026. 

2. Helgesson M, Johansson B, Nordqvist T, Lundberg I, Vingård E. Sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income in native Swedes and immigrants. Eur J Public Health. 2015 Aug;25(4):688-92. doi: 10.1093/eurpub/cku250.   

3. Alavinia SM, van den Berg TI, van Duivenbooden C, Elders LA, Burdorf A. Impact of work-related factors, lifestyle, and work ability on sickness absence among Dutch construction workers. Scand J Work Environ Health. 2009 Oct;35(5):325-33. doi: 10.5271/sjweh.1340. 

4. Laaksonen M, Martikainen P, Rahkonen O, Lahelma E. Explanations for gender differences in sickness absence: evidence from middle-aged municipal employees from Finland. Occup Environ Med. 2008 May;65(5):325-30. doi: 10.1136/oem.2007.033910.  

5. Bekker MH, Rutte CG, van Rijswijk K. Sickness absence: A gender-focused review. Psychol Health Med. 2009 Aug;14(4):405-18. doi: 10.1080/13548500903012830.  

6. Mastekaasa A. The gender gap in sickness absence: long-term trends in eight European countries. Eur J Public Health. 2014 Aug;24(4):656-62. doi: 10.1093/eurpub/cku075.   

7. Hooftman WE, van Poppel MN, van der Beek AJ, Bongers PM, van Mechelen W. Gender differences in the relations between work-related physical and psychosocial risk factors and musculoskeletal complaints. Scand J Work Environ Health. 2004 Aug;30(4):261-78. doi: 10.5271/sjweh.794.   

8. de Smet P, Sans S, Dramaix M, Boulenguez C, de Backer G, Ferrario M, et al. Gender and regional differences in perceived job stress across Europe. Eur J Public Health. 2005 Oct;15(5):536-45. doi: 10.1093/eurpub/cki028.  

9. Hooftman WE, van der Beek AJ, Bongers PM, van Mechelen W. Gender differences in self-reported physical and psychosocial exposures in jobs with both female and male workers. J Occup Environ Med. 2005 Mar;47(3):244-52. doi: 10.1097/01.jom.0000150387.14885.6b. 

10. Campos-Serna J, Ronda-Pérez E, Artazcoz L, Moen BE, Benavides FG. Gender inequalities in occupational health related to the unequal distribution of working and employment conditions: a systematic review. Int J Equity Health. 2013 Aug 5;12:57. doi: 10.1186/1475-9276-12-57. 

11. Leijten FR, van den Heuvel SG, Ybema JF, Robroek SJ, Burdorf A. Do work factors modify the association between chronic health problems and sickness absence among older employees? Scand J Work Environ Health. 2013 Sep 1;39(5):477-85. doi: 10.5271/sjweh.3353.   

12. Janssens H, Clays E, De Clercq B, De Bacquer D, Braeckman L. The relation between presenteeism and different types of future sickness absence. J Occup Health. 2013;55(3):132-41. doi: 10.1539/joh.12-0164-oa. 

13. Robroek SJ, van den Berg TI, Plat JF, Burdorf A. The role of obesity and lifestyle behaviours in a productive workforce. Occup Environ Med. 2011 Feb;68(2):134-9. doi: 10.1136/oem.2010.055962.  

14. Robroek SJ, van Lenthe FJ, Burdorf A. The role of lifestyle, health, and work in educational inequalities in sick leave and productivity loss at work. Int Arch Occup Environ Health. 2013 Aug;86(6):619-27. doi: 10.1007/s00420-012-0793-1. 

15. Meerding WJ, IJzelenberg W, Koopmanschap MA, Severens JL, Burdorf A. Health problems lead to considerable productivity loss at work among workers with high physical load jobs. J Clin Epidemiol. 2005 May;58(5):517-23. doi: 10.1016/j.jclinepi.2004.06.016. 

16. Alavinia SM, Molenaar D, Burdorf A. Productivity loss in the workforce: associations with health, work demands, and individual characteristics. Am J Ind Med. 2009 Jan;52(1):49-56. doi: 10.1002/ajim.20648.  

17. Hafner M, van Stolk C, Saunders CL, Krapels J, Baruch B. Health, wellbeing and productivity in the workplace: A Britain's Healthiest Company summary report. Santa Monica, CA: RAND Corporation, 2015. [Internet]. Available from: https://www.rand.org/pubs/research_reports/RR1084.html >

18. Brouwer WB, Koopmanschap MA, Rutten FF. Productivity losses without absence: measurement validation and empirical evidence. Health Policy. 1999 Jul;48(1):13-27. doi: 10.1016/s0168-8510(99)00028-7.  

19. Strømholm T, Pape K, Ose SO, Krokstad S, Bjørngaard JH. Psychosocial working conditions and sickness absence in a general population: a cohort study of 21,834 workers in Norway (The HUNT Study). J Occup Environ Med. 2015 Apr;57(4):386-92. doi: 10.1097/JOM.0000000000000362.  

20. Leijten FR, de Wind A, van den Heuvel SG, Ybema JF, van der Beek AJ, Robroek SJ, et al. The influence of chronic health problems and work-related factors on loss of paid employment among older workers. J Epidemiol Community Health. 2015 Nov;69(11):1058-65. doi: 10.1136/jech-2015-205719. 

21. Niessen MA, Laan EL, Robroek SJ, Essink-Bot ML, Peek N, Kraaijenhagen RA, et al. Determinants of participation in a web-based health risk assessment and consequences for health promotion programs. J Med Internet Res. 2013 Aug 9;15(8):e151. doi: 10.2196/jmir.2387.  

22. Tuomi K, Ilmarinen J, Jahkola A, Katajarinne L. Work Ability Index. 2nd revised edn. Helsinki: Finnish Institute of Occupational Health; 1998. [Internet]. Available from: https://eprovide.mapi-trust.org/instruments/wai >

23. Van Nieuwenhuyse A, Somville PR, Crombez G, Burdorf A, Verbeke G, Johannik K, et al. The role of physical workload and pain related fear in the development of low back pain in young workers: evidence from the BelCoBack Study; results after one year of follow up. Occup Environ Med 2006;63(1):45-52. doi: http://dx.doi.org/10.1136/oem.2004.015693 >

24. Van Veldhoven M, Meijman T. Het meten van psychosociale arbeidsbelasting met een vragenlijst: de Vragenlijst Beleving en Beoordeling van de Arbeid (VBBA) (Dutch Questionnaire on psychosocial job demands and job stress). NIA, Amsterdam (Published in Dutch). 1994. ISBN: 906365085X. [Internet]. Available from: 

http://resolver.tudelft.nl/uuid:d231f2f3-8574-4e77-862b-4abe1ebd4df5 >

25. Reeuwijk KG, Robroek SJ, Niessen MA, Kraaijenhagen RA, Vergouwe Y, Burdorf A. The Prognostic Value of the Work Ability Index for Sickness Absence among Office Workers. PLoS One. 2015 May 27;10(5):e0126969. doi: 10.1371/journal.pone.0126969.  

26. Richter M, Moor I, van Lenthe FJ. Explaining socioeconomic differences in adolescent self-rated health: the contribution of material, psychosocial and behavioural factors. J Epidemiol Community Health. 2012 Aug;66(8):691-7. doi: 10.1136/jech.2010.125500.  

27. Lesuffleur T, Chastang JF, Sandret N, Niedhammer I. Psychosocial factors at work and sickness absence: results from the French national SUMER survey. Am J Ind Med. 2014 Jun;57(6):695-708. doi: 10.1002/ajim.22317.  

28. Eng A, 't Mannetje A, McLean D, Ellison-Loschmann L, Cheng S, Pearce N. Gender differences in occupational exposure patterns. Occup Environ Med. 2011 Dec;68(12):888-94. doi: 10.1136/oem.2010.064097. 

29. Laaksonen M, Mastekaasa A, Martikainen P, Rahkonen O, Piha K, Lahelma E. Gender differences in sickness absence--the contribution of occupation and workplace. Scand J Work Environ Health. 2010 Sep;36(5):394-403. doi: 10.5271/sjweh.2909.  

30. Bryngelson A, Bacchus Hertzman J, Fritzell J. The relationship between gender segregation in the workplace and long-term sickness absence in Sweden. Scand J Public Health. 2011 Aug;39(6):618-26. doi: 10.1177/1403494811414242. 

31. van den Heuvel SG, Geuskens GA, Hooftman WE, Koppes LL, van den Bossche SN. Productivity loss at work; health-related and work-related factors. J Occup Rehabil. 2010 Sep;20(3):331-9. doi: 10.1007/s10926-009-9219-7.  

32. Hansen CD, Andersen JH. Going ill to work--what personal circumstances, attitudes and work-related factors are associated with sickness presenteeism? Soc Sci Med. 2008 Sep;67(6):956-64. doi: 10.1016/j.socscimed.2008.05.022. 

33. Padkapayeva K, Chen C, Bielecky A, Ibrahim S, Mustard C, Beaton D, et al. Male-Female Differences in Work Activity Limitations: Examining the Relative Contribution of Chronic Conditions and Occupational Characteristics. J Occup Environ Med. 2017 Jan;59(1):6-11. doi: 10.1097/JOM.0000000000000906.  

34. Gustafsson Sendén M, Schenck-Gustafsson K, Fridner A. Gender differences in Reasons for Sickness Presenteeism - a study among GPs in a Swedish health care organization. Ann Occup Environ Med. 2016 Sep 20;28:50. doi: 10.1186/s40557-016-0136-x. 

35. Mechanic D. 1983. Illness behaviour: an overview. In: McHugh S, Vallis TM, editors. Illness Behavior: A Multidisciplinary Model. New York: Plenum Press. ISBN: 978-1-4684-5259-4.

36. Verstappen SM. Rheumatoid arthritis and work: The impact of rheumatoid arthritis on absenteeism and presenteeism. Best Pract Res Clin Rheumatol 2015;29(3):495-511. doi: http://dx.doi.org/10.1016/j.berh.2015.06.001 >

37. Lenssinck ML, Burdorf A, Boonen A, Gignac MA, Hazes JM, Luime JJ. Consequences of inflammatory arthritis for workplace productivity loss and sick leave: a systematic review. Ann Rheum Dis. 2013 Apr;72(4):493-505. doi: 10.1136/annrheumdis-2012-201998.  

38. Tunceli K, Bradley CJ, Nerenz D, Williams LK, Pladevall M, Elston Lafata J. The impact of diabetes on employment and work productivity. Diabetes Care. 2005 Nov;28(11):2662-7. doi: 10.2337/diacare.28.11.2662. 

39. Breton MC, Guénette L, Amiche MA, Kayibanda JF, Grégoire JP, Moisan J. Burden of diabetes on the ability to work: a systematic review. Diabetes Care. 2013 Mar;36(3):740-9. doi: 10.2337/dc12-0354.  

40. Schuch JJ, Roest AM, Nolen WA, Penninx BW, de Jonge P. Gender differences in major depressive disorder: results from the Netherlands study of depression and anxiety. J Affect Disord. 2014 Mar;156:156-63. doi: 10.1016/j.jad.2013.12.011.  

41. Duijts SF, van Egmond MP, Spelten E, van Muijen P, Anema JR, van der Beek AJ. Physical and psychosocial problems in cancer survivors beyond return to work: a systematic review. Psychooncology. 2014 May;23(5):481-92. doi: 10.1002/pon.3467. 

42. IJzelenberg W, Molenaar D, Burdorf A. Different risk factors for musculoskeletal complaints and musculoskeletal sickness absence. Scand J Work Environ Health. 2004 Feb;30(1):56-63. doi: 10.5271/sjweh.765. 

43. Cho SS, Lee DW, Kang MY. The Association between Shift Work and Health-Related Productivity Loss due to Either Sickness Absence or Reduced Performance at Work: A Cross-Sectional Study of Korea. Int J Environ Res Public Health. 2020 Nov 16;17(22):8493. doi: 10.3390/ijerph17228493.

44. Voglino G, Savatteri A, Gualano MR, Catozzi D, Rousset S, Boietti E, et al. How the reduction of working hours could influence health outcomes: a systematic review of published studies. BMJ Open. 2022 Apr 1;12(4):e051131. doi: 10.1136/bmjopen-2021-051131.

45. Hartner-Tiefenthaler M, Zedlacher E, El Sehity TJ. Remote workers' free associations with working from home during the COVID-19 pandemic in Austria: The interaction between children and gender. Front Psychol. 2022 Aug 4;13:859020. doi: 10.3389/fpsyg.2022.859020. 

46. Nixon P, Ebert DD, Boß L, Angerer P, Dragano N, Lehr D. The Efficacy of a Web-Based Stress Management Intervention for Employees Experiencing Adverse Working Conditions and Occupational Self-efficacy as a Mediator: Randomized Controlled Trial. J Med Internet Res. 2022 Oct 20;24(10):e40488. doi: 10.2196/40488. 

47. Engels M, Boß L, Engels J, Kuhlmann R, Kuske J, Lepper S, et al. Facilitating stress prevention in micro and small-sized enterprises: protocol for a mixed method study to evaluate the effectiveness and implementation process of targeted web-based interventions. BMC Public Health. 2022 Mar 26;22(1):591. doi: 10.1186/s12889-022-12921-7.

48. Robroek SJ, Coenen P, Oude Hengel KM. Decades of workplace health promotion research: marginal gains or a bright future ahead. Scand J Work Environ Health. 2021 Nov 1;47(8):561-564. doi: 10.5271/sjweh.3995.

49. Boot CRL, Schelvis RMC, Robroek SJW. Ways to study changes in psychosocial work factors. Scand J Work Environ Health. 2023 Mar 1;49(2):95-98. doi: 10.5271/sjweh.4081.

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Published
2023/04/01
Section
Original articles