Subjective health complaints in relation to sickness absence

Objective: The Dutch population is healthy in terms of living and working conditions, but the levels of subjective health complaints (SHC) and sickness absence are high in the Dutch workforce. Are SHC related to sickness absence? Participants: The study population included the personnel of four companies: a library (n = 185), an administrative office (n = 114), a cheese factory (n = 201) and a company producing metal constructions (n = 65). Methods: The employees received the Basic Occupational Health Questionnaire including 22 common SHC. For each employee, the number and type of SHC but not their intensity was linked to the number of sickness absence episodes between January 2003 and December 2004. Results: The questionnaires of 409 employees (72%) were suitable for statistical analysis. The prevalence of SHC in the study population was 78% between January and June 2003. Employees who reported >= 5 SHC had higher rates of both short (1-7 days) and medium (8-42 days) sickness absence episodes. Long (> 42 days) episodes were strongly related to SHC amounting to a rate ratio (RR) of 4.2 with a 95% confidence interval [CI] 1.7 to 10.4 in workers reporting multiple SHC relative to those without complaints. Fatigue was associated with medium duration sickness absence (RR = 1.6; 95% CI 1.1-2.2) and musculoskeletal complaints, particularly low back pain (RR = 1.8; 95% CI 1.2-2.8), with long episodes. Conclusions: The number of SHC was related to sickness absence. The 20% of participants reporting most SHC were responsible for about 40% of work days lost in the two-year period of study