Effort-Reward Imbalance at Work and Risk of Long-Term Sickness Absence in the Danish Workforce

Objective: To examine whether effort-reward imbalance (ERI) at work predicts onset of register-based long-term sickness absence (LTSA) in a representative sample of the Danish workforce. Methods: We measured effort, reward, ERI, and covariates with self-administered questionnaires in a sample of 4775 employees. LTSA during 12-months of follow-up was assessed with a national register. We calculated hazard ratios (HRs) with Cox proportional hazard models. Results: The HR of LTSA for a one-SD increase in ERI was 1.03 (95% confidence interval [CI], 0.93-1.15) in the most-adjusted model. For effort, the HR for a one-SD increase was 0.95 (95% CI, 0.85-1.06) and for reward the HR for a one-SD decrease was 1.14 (95% CI, 1.03-1.26). Conclusions: ERI was not associated with onset of LTSA. Low reward, however, predicted LTSA