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Workplace Factors
Does control over working hours influence sickness absence?

At a glance:
More medically certified sick leave is taken by people who:

have low control over their working hours
spend long hours doing domestic work
spend a long time commuting
have more hours of total work (paid, domestic and commuting) per week

The researchers suggested that giving employees more control and flexibility in their working hours might help reduce sick leave and its costs for the employer. It may also improve employees' health and their ability to combine full-time work with domestic work and travel.
Perspectives:
Employee
People who work long hours both in their job and at home are more likely to have sickness absences. This is particularly true if they also travel for long periods getting to and from work.

Employers can help by making job hours flexible. This is not always practical, but may be possible in a variety of jobs.

If you feel your days are ‘overfull' with work and home duties, have a look at what can be done to change the situation. Discussions with children and teenagers about doing home chores can be difficult and require patience and persistence. However kids who help out at home grow up to be more community minded, so in assigning chores you might be helping them in the longer term (even if they don't quite see it that way).

A discussion with your employer about work hours might also help.
Employer
This study has been included to help employers and others understand the range of factors that influence people being at work or off work.

If the employee perceives they have control over their working hours, the balance between work and home improves. People who have long hours of paid work combined with domestic work have more sickness absence, but this is reduced if they perceive they have control over their working hours.

Some jobs have fixed time needs and it is not possible to be flexible. However many jobs can be modified in the hours of work. This can be a useful way of increasing job flexibility and helping employees stay at work.
Treater
People working long hours have more days of sickness absence. People working longer combined hours at home and at work also have greater sickness absence.

Employers can help by looking at whether the job hours can be made more flexible.

 Treating practitioners
treating practitioner
A health professional that treats patients. In return to work this may include doctors, physiotherapists, chiropractors, osteopaths, psychologists, masseurs, etc.
  may be able to assist by discussing options with the patient who is in this predicament. Maybe others at home can assist. Conversations with teenagers about domestic chores can be challenging. However, studies have shown that children grow up to be better contributors in the community if they contribute at home in their teenage years.

Are there suitable jobs closer to home, without long hours of commuting?
Insurer
Many factors influence return to work. Getting to know the person‘s situation out of the workplace can help understand the broader picture. Whilst some people may get into a habit of inactivity there are many others who work long hours either at work or at home. Consider what can be done to assist them to return to work.
Original Article, Authors & Publication Details:
L. Ala-Mursula1,2, J. Vahtera3, A. Kouvonen4, A. Vaananen3, A. Linna3, J. Pentti3 and M. Kivimaki3,4 (2006).

Long hours in paid and domestic work and subsequent sickness absence: does control over daily working hours matter? Occupational & Environmental Medicine; 63(9):608-616.

1Centre of Occupational Health, Oulu, Finland
2Department of Public Health Science and General Practice, University of Oulu, Finland
3Centre of Expertise in Work Organizations, Finnish Institute of Occupational Health, Helsinki, Finland
4Department of Psychology, University of Helsinki, Finland
Background, Study Objectives, How It Was Done:
Previous research has shown that working long hours may increase the risk of ill health. Workers may not have enough time outside of work to recover mentally and physically, and long hours may also have a negative impact on behaviour and lifestyle. Working long hours in poor conditions is particularly risky. Long hours of domestic work and commuting may also endanger health.

If an employee perceives that they have control over when they work, this can reduce both work stress and the stress of trying to balance domestic and paid work. Employees who believe they have control over their working hours report better health and take less sick leave and less time off due to stress.

This study looked at the effect of long hours of paid work, domestic work and commuting on the amount of sick leave taken by employees. It investigated whether the effect of long hours on sick leave was lessened if the employee had control over their working hours.

25,703 full-time employees in Finland completed questionnaires in 2000 and 2001. They reported how many hours per week they spent doing paid work, domestic work and commuting. These numbers were added to give their “total working hours.” The employees were also asked to rate on a scale of 1 to 5 how much control they had over their working hours, including whether they could control the length of their working day or their start and finish times. The sick leave records of the employees were collected for the next two years, and the researchers recorded the amount of certified sick leave and uncertified sick leave they had taken (certified sick leave is sick leave of more than three days, which requires a medical certificate). The association between sick leave, working hours and control over working hours was then determined. The information collected was analysed separately for men and women.

The researchers took into account other factors that might influence sick leave. These included age, gender, type of work, type of work contract (permanent or fixed-term) marital status, number and age of children, lifestyle, alcohol consumption, smoking and weight.
Study Findings:
People who worked longer hours took less uncertified time off work, regardless of how much control they had over their working hours

People who commuted and/or did many hours of domestic work took more sick leave, and this effect was greater if they also had low control over their working hours

People who did more domestic work took more medically certified sick leave

People who spent more time commuting took more medically certified and more uncertified sick leave

People who had more total hours of work each week (in paid work, domestic work and commuting) took 20-30% more certified sick leave, and this effect was greater if they had low control over their working hours (50-60% more sick leave).

People who did more hours of work each week (in total) did not take more uncertified sick leave unless they also had low job-control

People with low control over their working hours took 40% more certified sick leave and 10-30% more uncertified sick leave than people with high control over their working hours

People with high control over their working hours took less medically certified sick leave

On average, manual workers and shift workers worked longer hours and reported less control over their working hours than white-collar workers. Women and men with a spouse or small children did more domestic work. Women did more domestic work than men. Shift workers spent more time commuting.
Conclusions:
In this study, researchers surveyed over 25,000 participants and found that more medically certified sick leave was taken by people who:

had low control over their working hours
spent more hours doing domestic work
spent more time commuting
had more hours of total work (paid, domestic and commuting) per week

When people had control over their working hours, doing long hours of domestic work, total work or commuting did not increase their days on sick leave as much. The researchers suggested that this was because these people were able to manage their time flexibly to fulfil their competing responsibilities. They also suggested that people with low job control may take additional sick leave in order gain a little control over their working hours and cope with their competing demands

People who had long hours of paid work, however, took less uncertified sick leave than people who had fewer hours of paid work (and took a similar amount of medically certified sick leave). This might be because people working long hours are very committed to their jobs, or are harder to replace and therefore are more likely to work while sick. Or it might simply be that healthier workers are chosen to work the longest hours. Other research, on the other hand, has shown that working over 50 hours per week may have health risks.

The researchers suggested that giving employees more control and flexibility in their working hours might help reduce sick leave and its associated costs to the employer. It may improve employees' health and their ability to combine full-time work with domestic work and travel.
References:
PubMed Abstract
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