Competing demands from work and family as predictors of sickness absence in the GAZEL occupational cohort

A high rate of sickness absence from work can indicate poor health and lead to suboptimal organizational productivity. However, sickness absence is a global outcome associated with multiple exposures. In this study, we sought to determine the effect of competing work-family demands on all-cause sickness absence in a socioeconomically diverse occupational cohort.

We studied members of the French GAZEL cohort employed in 1995 (n=13,032). We measured work-family demands at baseline using an index of job strain scores and number of dependents, and counted medically certified sickness absence days accrued over the eight-year study period. We calculated employees' proportion of absence days to total person-days, then calculated rate ratios of sickness absence across levels of work-family demands using Poisson regression in the SAS GENMOD procedure. We tested for effect modification by occupational grade and gender, factors associated with work-family demands and themselves risk factors for sickness absence.

In fully adjusted models, individuals with the highest work-family demands had rate ratios for absence of 1.64 (95% CI 1.41-1.92) compared with low-demand workers. When we tested the established relationship between occupational grade and absence for moderation by work-family demands, we found that manual workers with high demands had rate ratios for absence 3.49 (2.12-5.74) times that of executives with the same demands. The effect was not modified by gender.

This study demonstrates the negative effects of competing work-family demands and suggests the joint health and organizational benefits of interventions to ease such conflict. Low-wage workers may be targets for such programs.