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An epidemiological study was carried out to explore the relationship between climatic factors and non-specific low-back and neck-shoulder symptoms in working populations. In a review of published literature, 27 studies were found which related climatic factors to musculoskeletal symptoms, but none of these studies specifically addressed the subject. It can be concluded that a relationship between climatic factors and musculoskeletal symptoms is considered at least plausible by both researchers, workers and patients, but that the epidemiological evidence appearing from literature is very weak. Questionnaire data which were collected on musculoskeletal symptoms, workload and perceptions of climatic conditions of 2030 workers in 24 different occupations were analysed multi-variately. About one-quarter of the workers related symptoms of the low back and neck-shoulders to climatic factors. They perceived climatic factors in most cases as aggravating factors for their symptoms. No seasonal influence on prevalence rates was reported. For low-back and neck-shoulder symptoms and for sick leave due to neck-shoulder symptoms, an association was found with climatic factors, and in particular with respect to draughts in relation to neck-shoulder symptoms. In addition, neck-shoulder symptoms were negatively related to frequent outdoor work. The findings suggest a relationship between climatic factors and musculoskeletal symptoms and call for further detailed investigations.

The objective of this study was to determine whether there are gender differences in the effect of exposure to work-related physical and psychosocial risk factors on low back, neck, shoulder, or hand-arm symptoms and related sickness absence.Data of a prospective cohort (study on musculoskeletal disorders, absenteeism stress and health) with a follow-up period of three years were used. Questionnaires were used to assess exposure to risk factors and musculoskeletal symptoms. Sickness absence was registered continuously. Female-to-male gender ratios (GR) were calculated to determine whether there were any differences in the effect. A GR value1.33 or0.75 was regarded as relevant.Except for the effect of bending the wrist and the neck backwards (GR 1.52-2.55), men generally had a higher risk of symptoms (GR range 0.50-0.68) with equal exposure. For sickness absence, a GR value of1.33 was found for twisting the upper body, working in uncomfortable postures, twisting the wrist, bending the neck backwards, and coworker and supervisor support (GR range 1.66-2.63). For driving vehicles, hand-arm vibration, squeezing, working above shoulder level or below knee level, reaching, twisting the neck, job demands, and skill discretion, the GR value was0.75. For job satisfaction, a GR value of 0.50 was found for absence due to back symptoms, while the GR value was 1.78 for sickness absence due to neck, shoulder, or hand-arm symptoms.Although women are expected to be more vulnerable to exposure to work-related risk factors, the results of this study show that, in many cases, men are more vulnerable. This study could not explain the gender difference in musculoskeletal symptoms among workers.

Determine whether there are gender differences in the effect of exposure to work-related physical and psychosocial risk factors on low back, neck, shoulder, or hand–arm symptoms and related sickness absence was the objective. Data of a prospective cohort with a follow-up period of three years were used. Questionnaires were used to assess exposure to risk factors and musculoskeletal symptoms. Sickness absence was registered. Female- to-male gender ratios (GR) were calculated to determine whether there were any differences in the effect. A GR value >1.33 or 1.33 was found for twisting the upper body, working in uncomfortable postures, twisting the wrist, bending the neck backwards, and coworker and supervisor support (GR range 1.66–2.63). For driving vehicles, hand–arm vibration, squeezing, working above shoulder level or below knee level, reaching, twisting the neck, job demands, and skill discretion, the GR value was

Objectives: The aim of this study is to examine the role of coping styles in sickness absence. In line with findings that contrast the reactive-passive focused strategies, problem-solving strategies are generally associated with positive results in terms of well-being and overall health outcomes; our hypothesis is that such strategies are positively related to a low frequency of sickness absence and with short lengths (total number of days absent) and durations (mean duration per spell). Methods: Using a prospective design, employees' (N = 3,628) responses on a self-report coping inventory are used to predict future registered sickness absence (i.e. frequency, length, duration, and median time before the onset of a new sick leave period). Results and conclusions: In accordance with our hypothesis, and after adjustment for potential confounders, employees with an active problem-solving coping strategy are less likely to drop out because of sickness absence in terms of frequency, length (longer than 14 days), and duration (more than 7 days) of sickness absence. This positive effect is observed in the case of seeking social support only for the duration of sickness absence and in the case of palliative reaction only for the length and frequency of absence. In contrast, an avoidant coping style, representing a reactive-passive strategy, increases the likelihood of frequent absences significantly, as well as the length and duration of sickness absence. Expression of emotions, representing another reactive-passive strategy, has no effect on future sickness absenteeism. The median time before the onset of a new episode of absenteeism is significantly extended for active problem-solving and reduced for avoidance and for a palliative response. The results of the present study support the notion that problem-solving coping and reactive-passive strategies are inextricably connected to frequency, duration, length and onset of sickness absence. Especially, active problem-solving decreases the chance of future sickness absence. © Springer-Verlag 2007.

Objectives: The aim of this study is to examine the role of coping styles in sickness absence. In line with findings that contrast the reactive-passive focused strategies, problem-solving strategies are generally associated with positive results in terms of well-being and overall health outcomes; our hypothesis is that such strategies are positively related to a low frequency of sickness absence and with short lengths (total number of days absent) and durations (mean duration per spell). Methods: Using a prospective design, employees' (N = 3,628) responses on a self-report coping inventory are used to predict future registered sickness absence (i.e. frequency, length, duration, and median time before the onset of a new sick leave period). Results and conclusions: In accordance with our hypothesis, and after adjustment for potential confounders, employees with an active problem-solving coping strategy are less likely to drop out because of sickness absence in terms of frequency, length (longer than 14 days), and duration (more than 7 days) of sickness absence. This positive effect is observed in the case of seeking social support only for the duration of sickness absence and in the case of palliative reaction only for the length and frequency of absence. In contrast, an avoidant coping style, representing a reactive-passive strategy, increases the likelihood of frequent absences significantly, as well as the length and duration of sickness absence. Expression of emotions, representing another reactive-passive strategy, has no effect on future sickness absenteeism. The median time before the onset of a new episode of absenteeism is significantly extended for active problem-solving and reduced for avoidance and for a palliative response. The results of the present study support the notion that problem-solving coping and reactive-passive strategies are inextricably connected to frequency, duration, length and onset of sickness absence. Especially, active problem-solving decreases the chance of future sickness absence. © Springer-Verlag 2007.

Objective: The purpose of this study was to investigate associations among three modifiable risk factors (ie, physical activity, cardiorespiratory fitness, and body mass index), work productivity, and sickness absence in computer workers. Methods: All participants were computer workers with neck and upper limb symptoms in the preceding 6 months, the last 2 weeks, or both. Productivity and sickness absence were assessed with the Health and Performance Questionnaire (HPQ). Results: Physical activity and cardiorespiratory fitness were not associated with work productivity or sickness absence. Obese male workers reported lower absolute productivity than lean workers. Lean and overweight workers reported similar productivity levels. Body mass index was not associated with sickness absence. Conclusions: In a population of white-collar workers with neck and upper limb symptoms, obese male workers showed significantly lower productivity than did lean or overweight workers. ©Medline

Objective: The purpose of this study was to investigate associations among three modifiable risk factors (ie, physical activity, cardiorespiratory fitness, and body mass index), work productivity, and sickness absence in computer workers. Methods: All participants were computer workers with neck and upper limb symptoms in the preceding 6 months, the last 2 weeks, or both. Productivity and sickness absence were assessed with the Health and Performance Questionnaire (HPQ). Results: Physical activity and cardiorespiratory fitness were not associated with work productivity or sickness absence. Obese male workers reported lower absolute productivity than lean workers. Lean and overweight workers reported similar productivity levels. Body mass index was not associated with sickness absence. Conclusions: In a population of white-collar workers with neck and upper limb symptoms, obese male workers showed significantly lower productivity than did lean or overweight workers. ©Medline

Objectives: The aim of the study was to evaluate the effectiveness of two brief preventive stress reduction programs - a cognitive focused program and a combined intervention of physical exercise and relaxation - on sickness absence in stressed and non-stressed employees working in various jobs in a telecom company. Methods: The study was designed as an a priori randomized trial and the follow-up period for sickness absence was 1 year. Sickness absence data of 242 employees were analyzed with respect to spells of sickness (frequency, incidence rate), days (length, duration) and time between intervention and first subsequent absent spell. Results: For stressed employees this study suggests that the illness burden represented by absenteeism is not affected by the interventions. There is no substantial difference in effectiveness between the cognitive and physical interventions. However, in comparison with the physical intervention the cognitive intervention decreases the period between the intervention and the first recurrence of a sick leave period with 144 days (marginal significant). Conclusion: The illness burden represented by absenteeism is effected in detail but not substantially by the interventions. © Springer-Verlag 2006.

Objectives: The aim of the study was to evaluate the effectiveness of two brief preventive stress reduction programs - a cognitive focused program and a combined intervention of physical exercise and relaxation - on sickness absence in stressed and non-stressed employees working in various jobs in a telecom company. Methods: The study was designed as an a priori randomized trial and the follow-up period for sickness absence was 1 year. Sickness absence data of 242 employees were analyzed with respect to spells of sickness (frequency, incidence rate), days (length, duration) and time between intervention and first subsequent absent spell. Results: For stressed employees this study suggests that the illness burden represented by absenteeism is not affected by the interventions. There is no substantial difference in effectiveness between the cognitive and physical interventions. However, in comparison with the physical intervention the cognitive intervention decreases the period between the intervention and the first recurrence of a sick leave period with 144 days (marginal significant). Conclusion: The illness burden represented by absenteeism is effected in detail but not substantially by the interventions. © Springer-Verlag 2006.

Objectives: To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Methods: Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. Results: In the subgroup of patients who scored high on the pain copying scale "worrying" the hazard ratio of sick leave was 1.32 (95% CI 1.07-1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale "worrying" (adjusted HR = 0.17, 95%-CI 0.04-0.72). Other work-related risk factors were not significantly related to sick leave. Conclusions: Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results. © Springer-Verlag 2007.

Background: Information on prognostic factors for duration of sick leave due to low-back pain (LBP) is growing. In this prospective cohort study prognostic factors for duration of sick leave and course of disability were identified in a very early stage of sick leave due to LBP in an occupational health care setting. Methods: A total of 615 workers calling in sick from work due to LBP at an occupational health service (OHS) of one institution completed a questionnaire. Duration of follow-up was 26 weeks. Prognostic factors were identified by means of Cox regression analysis and multiple linear regression analysis, and explained variance was calculated. Results: Median time to first return to work (RTW) was 5 days (Inter Quartile Range (IQR) = 2–12). Median time to lasting return to work (LRTW) was 6 days (IQR = 3–13). The final model for delayed RTW included self-reported expected duration of sick-leave, treatment by GP or specialist, care-seeking, diminished mobility, and the interaction between care-seeking and diminished mobility. The final model for LRTW included: self-reported expected duration of sick-leave, treatment by GP or specialist, care-seeking, the interaction between the self-reported expected duration of sick-leave and seeking care at OHS, complaints due to job stress, diminished mobility, and the interactions between expected duration of more then 10 days and seeking OP care and diminished mobility. Median total days on sick leave (TDSL) was 6 days (IQR = 3–13 days). The final model for TDSL included: age, expected duration of sick leave, treatment by GP or medical specialist, seeking OP care, complaints due to physical load, and diminished mobility. Explained variance (R 2) of these models ranged from 30 to 35%. Conclusions: Poor prognosis for duration of sick leave can be identified by means of a simple questionnaire administered on the first day of sick leave. Workers at high risk for longer duration of sick leave (all outcomes) expected to stay off work longer, were already being treated by a MD, sought OP care, and had diminished mobility. In case of delayed LRTW workers reported job stress as a possible cause of sick leave. Interactions were found in both RTW and LRTW between care-seeking and diminished mobility and in LRTW between expected duration of sick leave and seeking OP care. Older age increased TDSL with borderline significance.

Objectives: The aim of this study was to investigate the effect of raised bricklaying on physical workload, reported musculoskeletal disorders, sickness absence, and job satisfaction. Methods: A controlled intervention study with a follow-up period of 10 months was performed among 202 bricklayers from 25 construction companies. Results: The introduction of devices for raised bricklaying decreased the physical load on the lower back and, to a less extent, on the shoulders and upper extremities. Although raised bricklaying had no effect on the number of lifts, decreases in trunk bending lowered the biomechanical moment. The results showed no decrease in reported musculoskeletal symptoms as a result of the adoption of raised bricklaying. Irrespective of the reason(s), the percentage of bricklayers in the intervention group reporting sickness absence was significantly lower than the same percentage in the control group. The results also showed that, in general, the bricklayers in this study were very satisfied with the use of devices for raised bricklaying. Conclusions: Controlled intervention studies on ergonomic improvements are rare. This study shows that the introduction of an ergonomic improvement in the construction industry may reduce physical load and the incidence of sickness absence. This work is licensed under a Creative Commons Attribution 4.0 International License.

Objectives: The aim of this study was to investigate the effect of raised bricklaying on physical workload, reported musculoskeletal disorders, sickness absence, and job satisfaction. Methods: A controlled intervention study with a follow-up period of 10 months was performed among 202 bricklayers from 25 construction companies. Results: The introduction of devices for raised bricklaying decreased the physical load on the lower back and, to a less extent, on the shoulders and upper extremities. Although raised bricklaying had no effect on the number of lifts, decreases in trunk bending lowered the biomechanical moment. The results showed no decrease in reported musculoskeletal symptoms as a result of the adoption of raised bricklaying. Irrespective of the reason(s), the percentage of bricklayers in the intervention group reporting sickness absence was significantly lower than the same percentage in the control group. The results also showed that, in general, the bricklayers in this study were very satisfied with the use of devices for raised bricklaying. Conclusions: Controlled intervention studies on ergonomic improvements are rare. This study shows that the introduction of an ergonomic improvement in the construction industry may reduce physical load and the incidence of sickness absence. This work is licensed under a Creative Commons Attribution 4.0 International License.

Information on prognostic factors for duration of sick leave due to low-back pain (LBP) is growing. In this prospective cohort study, prognostic factors for duration of sick leave and course of disability were identified at a very early stage of sick leave due to LBP. A total of 615 workers calling in sick from work due to LBP at an occupational health service (OHS) of one institution, completed a questionnaire. Duration of follow-up was 26 weeks. Median time to first return to work (RTW) was 5 days (Inter Quartile Range (IQR) = 2–12). Median time to lasting return to work (LRTW) was 6 days (IQR = 3–13). Analysis resulted in final models for delayed RTW, for LRTW, and for total days on sick leave (TDSL). Explained variance (R2) of these models ranged from 30 to 35%. On the basis of the models is concluded that poor prognosis for duration of sick leave can be identified by means of a simple questionnaire administered on the first day of sick leave. Workers at high risk for longer duration of sick leave (all outcomes) expected to stay off work longer, were already being treated by a MD, sought OP care, and had diminished mobility. In case of delayed LRTW workers reported job stress as a possible cause of sick leave. Interactions were found in both RTW and LRTW between care-seeking and diminished mobility and in LRTW between expected duration of sick leave and seeking OP care. Older age increased TDSL with borderline significance.

In order to promote individuals’ participation in society and to reduce individuals’ dependence on allowances, governments have developed and implemented policies containing elements of income support and reintegration as well as strategies for the prevention of disease and disability. An important element with regard to policies on disability is the evaluation of disability in a percentage or a category. These evaluations are the crossroads for people in the journey from work through sickness to disability or reintegration. Changes in policies on disability take place against a background of Europeanisation of social policies and of a growing contribution from private insurers in social security provision. Benchmarking of practices is an important topic in these changes. This study places similarities and differences in the practices of disability evaluation in a general public scheme in 15 countries (Belgium, Denmark, Finland, France, Germany, Hungary, Ireland, Italy, the Netherlands, Norway, the Russian Federation, Slovenia, Spain, the UK and the USA) with respect to the organisation of the evaluation process and quality control.

The aim of this study is to investigate the effectiveness of a worksite health promotion programme by individual counselling on sick leave. Three municipal services of Enschede, the Netherlands, participated in this trial. A total of 299 civil servants were measured at baseline and were randomised by cluster into the intervention (n = 131) or the control group (n = 168). During nine months, subjects in the intervention group received a total of seven consultations, particularly aimed at increasing their physical activity level and improving their dietary habits. Both the intervention and the control subjects received written information as to several lifestyle factors. Sick leave data regarding the nine month intervention period (from May until January) were collected from each municipal service's personnel department. In addition, sick leave data concerning the nine month period pre- and post-intervention were collected. Results showed no significant effect of individual counselling on sick leave. Continued research investigating the effectiveness of this individual counselling programme on several health related outcomes is useful to clarify the trend observed in sick leave.

In order to promote individuals’ participation in society and to reduce individuals’ dependence on allowances, governments have developed and implemented policies containing elements of income support and reintegration as well as strategies for the prevention of disease and disability. An important element with regard to policies on disability is the evaluation of disability in a percentage or a category. These evaluations are the crossroads for people in the journey from work through sickness to disability or reintegration. Changes in policies on disability take place against a background of Europeanisation of social policies and of a growing contribution from private insurers in social security provision. Benchmarking of practices is an important topic in these changes. This study places similarities and differences in the practices of disability evaluation in a general public scheme in 15 countries (Belgium, Denmark, Finland, France, Germany, Hungary, Ireland, Italy, the Netherlands, Norway, the Russian Federation, Slovenia, Spain, the UK and the USA) with respect to the organisation of the evaluation process and quality control.

This thesis at the University of Maastricht, defended at May 7, 2004, yields several important and new findings with regard to work related quality of life, participation in the labour force and its determinants of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and juvenile chronic arthritis (JCA) in the Netherlands. The four research questions were: 1. What is the importance of paid work for the quality of life of patients with rheumatic diseases; 2. To what extent do patients with rheumatic diseases participate in the labour force, and what is their labour market position compard to peers in the general population?; 3. Which determinants of early withdrawal from the labour foce can be identified, and what ist hte relative importance of some of those determinants?; 4. Which problems do adult patients with childhood rhematic disease have at the labour market? The main conclusion of this thesis is that, at least in the Netherlands, the labour market position of subgroups of patients with chronic rheumatic disease is unfavourable compared to non-diseased peers.

This thesis at the University of Maastricht, defended at May 7, 2004, yields several important and new findings with regard to work related quality of life, participation in the labour force and its determinants of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and juvenile chronic arthritis (JCA) in the Netherlands. The four research questions were: 1. What is the importance of paid work for the quality of life of patients with rheumatic diseases; 2. To what extent do patients with rheumatic diseases participate in the labour force, and what is their labour market position compard to peers in the general population?; 3. Which determinants of early withdrawal from the labour foce can be identified, and what ist hte relative importance of some of those determinants?; 4. Which problems do adult patients with childhood rhematic disease have at the labour market? The main conclusion of this thesis is that, at least in the Netherlands, the labour market position of subgroups of patients with chronic rheumatic disease is unfavourable compared to non-diseased peers.

This study tries to explain the relationship between characteristics of the employees (e.g., gender and working hours) and short-term absenteeism by examining the social cohesiveness of a team. Hypotheses are formulated concerning gender and working hours of employees, social cohesiveness, and short-term absenteeism. To test these hypotheses, network data on 56 employees in 8 comparable teams within an organization were collected. The results show that similarity in gender and percentage of full-time employees within a team were positively related to the social cohesiveness of a team and that social cohesiveness is negatively related to short-term absenteeism.

This article tries to explain the relationship between characteristics of the employees as gender and working hours, and short-term absenteeism by examining the social cohesiveness of a team. Hypotheses are formulated concerning gender and working hours of employees, social cohesiveness, and short-term absenteeism. To test these hypotheses, network data on 56 employees in 8 comparable teams within an organization were collected. The results show that similarity in gender and percentage of full-time employees within a team were positively related to the social cohesiveness of a team and that social cohesiveness is negatively related to short-term absenteeism.

An estimate of the multiple costs incurred by workplace accidents, illnesses and long-term absence puts the amount at 3% of total GNP in the Netherlands. Musculoskeletal disorders and psychosocial diseases are responsible for 83% of the cost of work-related health issues.

This study aimed at determining the prognostic factors related to the recurrence of low-back pain and future sickness absence due to low-back pain. Data were used from a prospective cohort study in a working population with a three year follow-up period. They were collected with annual questionnaires. A generalised estimating equation model was used to study the relation between pain characteristics, individual characteristics, and work-related factors and the recurrence of low-back pain or sickness absence due to low-back pain in the following year. Adjustments were made for potential confounders. According to this study, high disability due to low-back pain is a prognostic factor for recurrent low-back pain and future sickness absence due to low-back pain. In addition, the following work-related factors predict a poor prognosis of low-back pain: flexion or rotation of the trunk, low job satisfaction, low decision authority, and low social support. This work is licensed under a Creative Commons Attribution 4.0 International License.

This report explores the gender differences in occupational safety and health. There is strong segregation of women and men into different jobs and tasks at work. Both men and women face significant risks. In general, men suffer more accidents and injuries at work than women do, whereas women report more health problems such as upper limb disorders and stress. The fact that women still carry out the majority of unpaid work in the home puts extra pressure on many women workers. This report stresses the need to take a holistic approach to occupational safety and health, including the work-life interface, broader work organisation and employments issues, and all issues related to the changing world of work. Such an approach would improve accupational risk prevention to the benefit both men and women.

Aims: To (1) evaluate the psychometric properties and (2) examine the ability to detect cases with anxiety disorder and depression in a population of employees absent from work because of mental health problems. Methods: Internal consistency, construct validity, and criterion validity of the Depression Anxiety Stress Scales (DASS) were assessed. Furthermore, the ability to identify anxiety disorders or depression was evaluated by calculating posterior probabilities of these disorders following positive and negative test results for different cut off scores of the DASS-Depression and DASS-Anxiety subscales. Results: Internal consistency of the DASS subscales was high, with Cronbach's alphas of 0.94, 0.88, and 0.93 for depression, anxiety, and stress respectively. Factor analysis revealed a three factor solution, which corresponded well with the three subscales of the DASS. Construct validity was further supported by moderately high correlations of the DASS with indices of convergent validity (0.65 and 0.75), and lower correlations of the DASS with indices of divergent validity (range -0.22 to 0.07). Support for criterion validity was provided by a statistically significant difference in DASS scores between two diagnostic groups. A cut off score of 5 for anxiety and 12 for depression is recommended. The DASS showed probabilities of anxiety and depression after a negative test result of 0.05 and 0.06 respectively. Probabilities of 0.29 for anxiety disorder and 0.33 for depression after a positive test result reflect relatively low specificity of the DASS. Conclusion: The psychometric properties of the DASS are suitable for use in an occupational health care setting. The DASS can be helpful in ruling out anxiety disorder and depression in employees with mental health problems.

This report explores the gender differences in occupational safety and health. There is strong segregation of women and men into different jobs and tasks at work. Both men and women face significant risks. In general, men suffer more accidents and injuries at work than women do, whereas women report more health problems such as upper limb disorders and stress. The fact that women still carry out the majority of unpaid work in the home puts extra pressure on many women workers. This report stresses the need to take a holistic approach to occupational safety and health, including the work-life interface, broader work organisation and employments issues, and all issues related to the changing world of work. Such an approach would improve accupational risk prevention to the benefit both men and women.

An epidemiological study was carried out to explore the relationship between climatic factors and non-specific low-back and neck-shoulder symptoms in working populations. In a review of published literature, 27 studies were found which related climatic factors to musculoskeletal symptoms, but none of these studies specifically addressed the subject. It can be concluded that a relationship between climatic factors and musculoskeletal symptoms is considered at least plausible by both researchers, workers and patients, but that the epidemiological evidence appearing from literature is very weak. Questionnaire data which were collected on musculoskeletal symptoms, workload and perceptions of climatic conditions of 2030 workers in 24 different occupations were analysed multivariately. About one-quarter of the workers related symptoms of the low back and neck-shoulders to climatic factors. They perceived climatic factors in most cases as aggravating factors for their symptoms. No seasonal influence on prevalence rates was reported. For low-back and neck-shoulder symptoms and for sick leave due to neck-shoulder symptoms, an association was found with climatic factors, and in particular with respect to draughts in relation to neck-shoulder symptoms. In addition, neck-shoulder symptoms were negatively related to frequent outdoor work. The findings suggest a relationship between climatic factors and musculoskeletal symptoms and call for further detailed investigations.

Objective: To determine whether physical and psychosocial load at work influence sickness absence due to low back pain. Methods: The research was a part of the study on musculoskeletal disorders, absenteeism, stress, and health (SMASH), a 3 year prospective cohort study on risk factors for musculoskeletal disorders. Workers from 21 companies located throughout The Netherlands participated in the part of this study on sickness absence due to low back pain. The study population consisted of 732 workers with no sickness absences of 3 days or longer due to low back pain in the 3 months before the baseline survey and complete data on the reasons for absences during the follow up period. The mean (range) period of follow up in this group was 37 (7-44) months. Physical load at work was assessed by analyses of video recordings. Baseline information on psychosocial work characteristics was obtained by a questionnaire. Data on sickness absence were collected from company records. The main outcome measure was the rate of sickness absences of 3 days or longer due to low back pain during the follow up period. Results: After adjustment of the work related physical and psychosocial factors for each other and for other potential determinants, significant rate ratios ranging from 2.0 to 3.2 were found for trunk flexion, trunk rotation, lifting, and low job satisfaction. A dose-response relation was found for trunk flexion, but not for trunk rotation or lifting. Non-significant rate ratios of about 1.4 were found for low supervisor support and low coworker support. Quantitative job demands, conflicting demands, decision authority, and skill discretion showed no relation with sickness absence due to low back pain. Conclusions: Flexion and rotation of the trunk, lifting, and low job satisfaction are risk factors for sickness absence due to low back pain. Some indications of a relation between low social support, either from supervisors or coworkers, and sickness absence due to low back pain are also present.

This study examines effects of stability and change in exposure to job demands and job control (demand-control histories) in relation to the strain hypothesis of Karasek's demand-control model. The hypotheses of the model were tested with a group-by-time analysis of variance using data from a four-phase Dutch cohort study on musculoskeletal disorders, absenteeism, stress, and health. Associations between demand-control histories and job changes were tested in a log-linear analysis. The results of the study were: the hypotheses for the stable exposure groups were supported for depression and job satisfaction. Those for positive and negative changes were partially supported. There was no relation, however, between the level of stability or changes in exposure to demands and control for the registered duration and frequency of sickness absence. Finally, the results showed that workers reporting major changes in demand-control histories over time had more job changes, and those reporting job changes towards high strain jobs evaluated the changes as more distressful. This work is licensed under a Creative Commons Attribution 4.0 International License.

Objective: To determine whether physical and psychosocial load at work influence sickness absence due to low back pain. Methods: The research was a part of the study on musculoskeletal disorders, absenteeism, stress, and health (SMASH), a 3 year prospective cohort study on risk factors for musculoskeletal disorders. Workers from 21 companies located throughout The Netherlands participated in the part of this study on sickness absence due to low back pain. The study population consisted of 732 workers with no sickness absences of 3 days or longer due to low back pain in the 3 months before the baseline survey and complete data on the reasons for absences during the follow up period. The mean (range) period of follow up in this group was 37 (7-44) months. Physical load at work was assessed by analyses of video recordings. Baseline information on psychosocial work characteristics was obtained by a questionnaire. Data on sickness absence were collected from company records. The main outcome measure was the rate of sickness absences of 3 days or longer due to low back pain during the follow up period. Results: After adjustment of the work related physical and psychosocial factors for each other and for other potential determinants, significant rate ratios ranging from 2.0 to 3.2 were found for trunk flexion, trunk rotation, lifting, and low job satisfaction. A dose-response relation was found for trunk flexion, but not for trunk rotation or lifting. Non-significant rate ratios of about 1.4 were found for low supervisor support and low coworker support. Quantitative job demands, conflicting demands, decision authority, and skill discretion showed no relation with sickness absence due to low back pain. Conclusions: Flexion and rotation of the trunk, lifting, and low job satisfaction are risk factors for sickness absence due to low back pain. Some indications of a relation between low social support, either from supervisors or coworkers, and sickness absence due to low back pain are also present.

This paper was presented at the tenth Congress on Work and Organizational Psychology (EAWOP Congress) in Prague (May 16-19, 2001) and is based on a study among 1,600 employees in health care and welfare institutions, to find out what these institutions do about absenteeism and to see if whatever they do has the desired effect. The institutions that were selected are known to deal with the problem more systematically than others. There was found that sickness absenteeism policies were indeed actively carried out, but most employees are not familiar with them. Still, they report that they call in sick less often and go back to work sooner than they did two years ago.

Work related musculoskeletal disorders constitute a major problem to modern society. They are a major cause of work absenteeism and disability, thus constituting one of the most expensive disease categories. There is a great need for effective ways to prevent or reduce musculoskeletal problems. Given the extent of the problem, priorities have to be set concerning the workplaces that need interventions most. Quantitative data on actual risks and morbidity are needed to take well-considered decisions. Occupational health services are often requested to supply these data; to obtain valid data from daily practice they need standardized and feasible collecting methods. this thesis describes the characteristics and use of such a method, the 'Dutch Musculoskeletal Questionnaire', DMQ. The aim of the DMQ is to measure both work related musculoskeletal risk factors and symptoms in worker populations in such a standardised way that it is feasible in daily practice of occupational health services and ergonomical counselling.

In Dutch health care and welfare institutions 75% of the employees are women. On the whole, women are more frequently absent because of illness than men. In the Dutch health care and welfare sector workplace absenteeism is in fact higher than the national average: in 1997 the national average was 5.1 per cent, compared to 8.2 per cent in health care and welfare (CBS 1998). In this paper the results of a study among 1.600 employees in 34 health care and welfare institutions in the Netherlands are presented. The relation between workplace absenteeism on the one hand, and sex differences in employee attitudes towards work and absenteeism on the other hand are investigated. The results show that while sickness absenteeism among men and women is about the same, their attitude to work and absenteeism differs in some respects.

In Dutch health care and welfare institutions 75% of the employees are women. On the whole, women are more frequently absent because of illness than men. In the Dutch health care and welfare sector workplace absenteeism is in fact higher than the national average: in 1997 the national average was 5.1 per cent, compared to 8.2 per cent in health care and welfare (CBS 1998). In this paper the results of a study among 1.600 employees in 34 health care and welfare institutions in the Netherlands are presented. The relation between workplace absenteeism on the one hand, and sex differences in employee attitudes towards work and absenteeism on the other hand are investigated. The results show that while sickness absenteeism among men and women is about the same, their attitude to work and absenteeism differs in some respects.

Work related musculoskeletal disorders constitute a major problem to modern society. They are a major cause of work absenteeism and disability, thus constituting one of the most expensive disease categories. There is a great need for effective ways to prevent or reduce musculoskeletal problems. Given the extent of the problem, priorities have to be set concerning the workplaces that need interventions most. Quantitative data on actual risks and morbidity are needed to take well-considered decisions. Occupational health services are often requested to supply these data; to obtain valid data from daily practice they need standardized and feasible collecting methods. this thesis describes the characteristics and use of such a method, the 'Dutch Musculoskeletal Questionnaire', DMQ. The aim of the DMQ is to measure both work related musculoskeletal risk factors and symptoms in worker populations in such a standardised way that it is feasible in daily practice of occupational health services and ergonomical counselling.

This paper was presented at the tenth Congress on Work and Organizational Psychology (EAWOP Congress) in Prague (May 16-19, 2001) and is based on a study among 1,600 employees in health care and welfare institutions, to find out what these institutions do about absenteeism and to see if whatever they do has the desired effect. The institutions that were selected are known to deal with the problem more systematically than others. There was found that sickness absenteeism policies were indeed actively carried out, but most employees are not familiar with them. Still, they report that they call in sick less often and go back to work sooner than they did two years ago.

This study investigates the demand-control-support (DCS) model by (a) using a more focused measure of job control, (b) testing for interactive and nonlinear relationships, and (c) further extending the model to the prediction of an objective outcome measure (i.e., company-administrated sickness absence). Hypotheses were tested in a heterogeneous sample of 1,739 employees from a 3-year prospective cohort study called SMASH (Study on Musculoskelatal Disorders, Absenteeism, Stress, and Health). Baseline results showed that a linear additive model was superior for job satisfaction, psychosomatic health complaints, and sickness absence, whereas a curvilinear model was superior for emotional effects. Second, it seems sensible to pay more attention to curvilinear relationships in future research. Finally, the DCS model was not supported using a more objective outcome measure.

This paper, presented at the ninth European Congress on Work and Organizational Psychology, Helsinki, Finland, 12-15 May 1999, gives the results of a study to document the processes and mechanisms of workplace initiatives to reduce absenteeism related with ill health, by identifying the methods used and the role played by different groups. Examples of 23 workplaces of actions to reduce absenteeism focused on the health of the workers, taken from eight European countries and covering a wide range of sectors, are analysed and described. The analysis revealed the following aspects as important to successfully reduce absenteeism relating to ill health: systematic approach; co-ordinating project team; clear tasks and responsibilities for the persons involved in the activities; active support from senior and line management; active worker participation; good information and communication with all staff; involvement of the personnel department and the occupational health service; involvement of works councils, health & safety committees or trade unions; a balanced package of measures and the treatment of workplace absenteeism as a normal company phenomenon.

This paper, presented at the ninth European Congress on Work and Organizational Psychology, Helsinki, Finland, 12-15 May 1999, gives the results of a study to document the processes and mechanisms of workplace initiatives to reduce absenteeism related with ill health, by identifying the methods used and the role played by different groups. Examples of 23 workplaces of actions to reduce absenteeism focused on the health of the workers, taken from eight European countries and covering a wide range of sectors, are analysed and described. The analysis revealed the following aspects as important to successfully reduce absenteeism relating to ill health: systematic approach; co-ordinating project team; clear tasks and responsibilities for the persons involved in the activities; active support from senior and line management; active worker participation; good information and communication with all staff; involvement of the personnel department and the occupational health service; involvement of works councils, health & safety committees or trade unions; a balanced package of measures and the treatment of workplace absenteeism as a normal company phenomenon.

Ill-health is the main cause of workplace absenteeism yet relatively few enterprises have addressed this issue systematically. This portfolio of initiatives to prevent or reduce ill-health associated with absenteeism shows in some detail how leading business have developed innovative approaches to the problem. The detailed documentation of initiatives is based upon studies in eight European countries. This portfolio focuses upon case studies from 23 workplaces. These cases from main material for the assessment of organisational, prevention and reintegration initiatives designed to combat the causes of ill-health and absenteeism from work. The studies document the process of establishing such initiatives at the workplace, The participation of different groups in the workforce, and analyse the costs and benefits of the measures. These analyses lead to the identification of key factors influencing the success of the absenteeism initiatives, and the specification of lessons for good practice.

Ill-health is the main cause of workplace absenteeism yet relatively few enterprises have addressed this issue systematically. This portfolio of initiatives to prevent or reduce ill-health associated with absenteeism shows in some detail how leading business have developed innovative approaches to the problem. The detailed documentation of initiatives is based upon studies in eight European countries. This portfolio focuses upon case studies from 23 workplaces. These cases from main material for the assessment of organisational, prevention and reintegration initiatives designed to combat the causes of ill-health and absenteeism from work. The studies document the process of establishing such initiatives at the workplace, The participation of different groups in the workforce, and analyse the costs and benefits of the measures. These analyses lead to the identification of key factors influencing the success of the absenteeism initiatives, and the specification of lessons for good practice.

At the beginning of the nineties the high rate of absenteeism and the rising number of employees drawing disablement benefits prompted the Dutch government to review the financial arrangements around incapacity for work. The present cabinet is aiming to reshape the measures and provisions in the context of disablement and inability to work so that both employers and employees become more aware of the necessity of reducing the demand on social security provisions for persons on extended sick leave or with a long-term incapacity for work. On the other hand the government is introducing a number of supplementary measures to stimulate the use of reintegration instruments to make it more attractive for employers to retain or take on employees with a disability. Especially small businesses are reluctant to employ staff with a disability because they fear absenteeism and higher costs. Special training for managers, personnel department and company doctors must contribute to more successful reintegration.

At the beginning of the nineties the high rate of absenteeism and the rising number of employees drawing disablement benefits prompted the Dutch government to review the financial arrangements around incapacity for work. The present cabinet is aiming to reshape the measures and provisions in the context of disablement and inability to work so that both employers and employees become more aware of the necessity of reducing the demand on social security provisions for persons on extended sick leave or with a long-term incapacity for work. On the other hand the government is introducing a number of supplementary measures to stimulate the use of reintegration instruments to make it more attractive for employers to retain or take on employees with a disability. Especially small businesses are reluctant to employ staff with a disability because they fear absenteeism and higher costs. Special training for managers, personnel department and company doctors must contribute to more successful reintegration.

This report by the European Foundation for the Improvement of Living and Working Conditions shows that information is essential to pinpoint risk factors in the workplace, and is a crucial starting point for the preparation of efficient measures to improve the working environment. To this end, most European countries have established monitoring systems. However these systems differ in kind and were built to help policy formation at national rather than at European level. The report presents a new and reather broad overview of the state of the art of monitoring health and safety in Europe. This report is the result of the project 'The European Working Environment in Figures' in which information on sixteen European countries has been assembled. It describes the aims and methodology of the project, the problems encountered, the results, and discussion and conclusions on the situation in Europe with respect to figures on occupational health and safety issues. It also contains recommendations for future activities to improve both the working conditions in Europe and the monitoring thereof.

This publication covers work papers for the NIA workshop (8 December 1995). It deals with the work organization related to subjects like employment, quality, productivity, working hours, cost-benefit analysis, sick leave, work load and so on.

Absence of part-time employees in comparison with that of full-time employees has not received much attention in organisational research up to now. Personnel departments of three industrial firms in the Netherlands made information available with respect to personal/demographic characteristics (age, marital status, level of education, and distance between home and work), work characteristics (type of work, shift work, and length of work-week), and absence behaviour of their female full-time and part-time employees (n=215). Length of work week, the central variable in this study, had a minimum value of 166 hours and a maximum of 40 hours. All employees worked five days a week. With the help of correlational and regression analyses, it was shown that female part-time employees are older, are more often married, live nearer to their work, and work less in shifts than their full-time counterparts. The main conclusion was that no significant relation exists between length of work-week and absence behaviour, when conditioning variables are kept under control.