How to Prevent Loss of Manpower Due to Work Stress in a Shrinking and Aging Workforce

Introduction: The demographic change leads to a shrinking and aging workforce in industrialized countries like Germany. Therefore sickness absence can become a relevant problem. Increasing absenteeism and retirement rates due to mental disorders raise the question about an association between work-related stress and sickness absence. Studies about this matter are rare so far. We investigate the relationship between work-related stress and overall or long-term sickness absence in older employees and discuss the preventive implications of our findings.

Methods: LidA (engl.: ‘living at work’) is a German cohort study on work, age, health and work participation. 6339 employees born in 1959 and 1965 and subject to social insurance were interviewed nationwide by a representative sample concept. The response rate was relatively low (27.3%). Selectivity was negligible, yet. Sickness absence was defined as at least one, long-time sickness absence as at least 43 days absenteeism. Work-related stress was measured by an imbalance between efforts spent (e.g., work under time pressure, responsibility) and rewards gained (e.g., loan, job security). It was parameterized by effort-reward-imbalance(ERI)-tertiles. Stepwise multiple logistic regressions adjusting for age, sex, mental disorders, occupational status, education, income and working time were performed. Missing values were imputed by the fully conditional specification method.

Results: High work-related stress was significantly associated with overall (OR: 1.64; 95%-CI: 1.42-1.90) and long-term sickness absence (OR: 1.66; 95%-CI: 1.19-2.31) among older employees in the multiple logistic regression analysis after adjusting for mental disorders and other covariates. Significant associations of socio-demographic covariates with both outcomes were observed, additionally.

Conclusions: Our findings on work-related stress and sickness absence agree with those of the majority of international prospective studies. The associations we found were mainly independent of mental disorders. Sickness leave caused by other diseases or absenteeism with the intention to avoid work-related stress may explain these independent effects. Public policy makers and employers in industrialized countries should be aware that investments in preventive measures to reduce work-related stress (e.g., workplace health promotion) may help preserve manpower in times of a shrinking workforce due to the demographic change.