Exploring the impact of mental and work-related stress on sick leave among middle-aged women: observations from the population study of women in Gothenburg, Sweden

Objective: To investigate whether mental and work-related stress predicts a one-year incidence of sick leave in a cohort of middle-aged working women. Design: The 2016/17 survey was part of the Population Study of Women in Gothenburg, Sweden, with registry data information on sick leave during one year pre- and post-baseline. Subjects: A cohort of women aged 38 and 50 in 2016/17 (n = 573; 68% participation), of which 504 women were gainfully employed and not on sick leave +/- 2 weeks around baseline examination; 493 women had complete data on stress exposure. Methods: We studied associations between self-assessed mental and work-related stress and incident sick leave of >14 days during the year following the baseline examination. We used multiple logistic regression, adjusting for age and previous sick leave, and additionally for sleep quality, well-being, and physical activity. Results: Overall, 75 women (16%) experienced at least one period of sick leave after baseline. Permanent stress during the last five years almost tripled the risk for incident sick leave, OR = 2.8 (95% CI 1.2-6.3), independent of previous sick leave, OR = 2.3 (95% CI 1.3-4.2). Among 21 specific work-related problems, conflicts at work, OR = 2.2 (95% CI 1.3-3.6), and low decision latitude, OR = 1.7 (95% CI 1.0-2.9), were associated with incident sick leave. The association with conflicts at work remained upon further covariate adjustment. Conclusion: Low decision latitude and conflicts at work are risk factors for incident sick leave among working women. The impact of conflicts at work, irrespective of own involvement, may indicate a specific vulnerability among women of interest for future interventions.