Skip to main content
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2004 Mar;61(3):254–261. doi: 10.1136/oem.2002.005983

Effect of employee worktime control on health: a prospective cohort study

L Ala-Mursula 1, J Vahtera 1, J Pentti 1, M Kivimaki 1
PMCID: PMC1740736  PMID: 14985521

Abstract

Aims: To investigate the health effects of employee worktime control.

Methods: Prospective cohort study among 4218 permanent full time municipal employees linking questionnaire data from 1997 and 2000 with sickness absence records from 1997 and 2001. Worktime control was considered high for the highest tertile in both 1997 and 2000, low for the lowest tertile for both years, and intermediate for all other combinations. Self rated health status, psychological distress, and medically certified periods of sickness absence were used as the health outcomes. Adjustments were made for age, baseline health status, occupational status, marital status, dependent children, and behavioural health risks.

Results: In the follow up, women with a low level of worktime control had a 1.9 times (95% CI 1.4 to 2.5) higher odds ratio for poor self rated health, a 1.4 times (95% CI 1.1 to 1.8) higher odds ratio for psychological distress, and a 1.5 times (95% CI 1.3 to 1.7) higher risk of medically certified sickness absences than women with a high level of worktime control. The health effects of worktime control were particularly evident among women with families. Among men, worktime control was not associated with self rated health or distress, but it predicted sickness absences in two subgroups: those with dependent children and those with manual occupations.

Conclusions: A low level of worktime control increases the risk of future health problems. The risk is highest among women, especially those with families, and among manual workers. The results suggest that worktime control can help workers integrate their work and private lives successfully.

Full Text

The Full Text of this article is available as a PDF (316.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ala-Mursula Leena, Vahtera J., Kivimäki M., Kevin M. V., Pentti J. Employee control over working times: associations with subjective health and sickness absences. J Epidemiol Community Health. 2002 Apr;56(4):272–278. doi: 10.1136/jech.56.4.272. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Alfredsson L., Spetz C. L., Theorell T. Type of occupation and near-future hospitalization for myocardial infarction and some other diagnoses. Int J Epidemiol. 1985 Sep;14(3):378–388. doi: 10.1093/ije/14.3.378. [DOI] [PubMed] [Google Scholar]
  3. Cheng Y., Kawachi I., Coakley E. H., Schwartz J., Colditz G. Association between psychosocial work characteristics and health functioning in American women: prospective study. BMJ. 2000 May 27;320(7247):1432–1436. doi: 10.1136/bmj.320.7247.1432. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Goldberg D. P., Gater R., Sartorius N., Ustun T. B., Piccinelli M., Gureje O., Rutter C. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997 Jan;27(1):191–197. doi: 10.1017/s0033291796004242. [DOI] [PubMed] [Google Scholar]
  5. Hammar N., Alfredsson L., Theorell T. Job characteristics and the incidence of myocardial infarction. Int J Epidemiol. 1994 Apr;23(2):277–284. doi: 10.1093/ije/23.2.277. [DOI] [PubMed] [Google Scholar]
  6. Idler E. L., Angel R. J. Self-rated health and mortality in the NHANES-I Epidemiologic Follow-up Study. Am J Public Health. 1990 Apr;80(4):446–452. doi: 10.2105/ajph.80.4.446. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Kaplan G. A., Goldberg D. E., Everson S. A., Cohen R. D., Salonen R., Tuomilehto J., Salonen J. Perceived health status and morbidity and mortality: evidence from the Kuopio ischaemic heart disease risk factor study. Int J Epidemiol. 1996 Apr;25(2):259–265. doi: 10.1093/ije/25.2.259. [DOI] [PubMed] [Google Scholar]
  8. Khlat M., Sermet C., Le Pape A. Women's health in relation with their family and work roles: France in the early 1990s. Soc Sci Med. 2000 Jun;50(12):1807–1825. doi: 10.1016/s0277-9536(99)00419-0. [DOI] [PubMed] [Google Scholar]
  9. Kivimäki M., Vahtera J., Thomson L., Griffiths A., Cox T., Pentti J. Psychosocial factors predicting employee sickness absence during economic decline. J Appl Psychol. 1997 Dec;82(6):858–872. doi: 10.1037/0021-9010.82.6.858. [DOI] [PubMed] [Google Scholar]
  10. Kivimäki Mika, Leino-Arjas Päivi, Luukkonen Ritva, Riihimäki Hilkka, Vahtera Jussi, Kirjonen Juhani. Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees. BMJ. 2002 Oct 19;325(7369):857–857. doi: 10.1136/bmj.325.7369.857. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Knauth P. Innovative worktime arrangements. Scand J Work Environ Health. 1998;24 (Suppl 3):13–17. [PubMed] [Google Scholar]
  12. Kujala U. M., Kaprio J., Sarna S., Koskenvuo M. Relationship of leisure-time physical activity and mortality: the Finnish twin cohort. JAMA. 1998 Feb 11;279(6):440–444. doi: 10.1001/jama.279.6.440. [DOI] [PubMed] [Google Scholar]
  13. Lahelma Eero, Arber Sara, Kivelä Katariina, Roos Eva. Multiple roles and health among British and Finnish women: the influence of socioeconomic circumstances. Soc Sci Med. 2002 Mar;54(5):727–740. doi: 10.1016/s0277-9536(01)00105-8. [DOI] [PubMed] [Google Scholar]
  14. Lundberg U., Mårdberg B., Frankenhaeuser M. The total workload of male and female white collar workers as related to age, occupational level, and number of children. Scand J Psychol. 1994 Dec;35(4):315–327. doi: 10.1111/j.1467-9450.1994.tb00956.x. [DOI] [PubMed] [Google Scholar]
  15. Marmot M. G., Bosma H., Hemingway H., Brunner E., Stansfeld S. Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet. 1997 Jul 26;350(9073):235–239. doi: 10.1016/s0140-6736(97)04244-x. [DOI] [PubMed] [Google Scholar]
  16. Marmot M., Feeney A., Shipley M., North F., Syme S. L. Sickness absence as a measure of health status and functioning: from the UK Whitehall II study. J Epidemiol Community Health. 1995 Apr;49(2):124–130. doi: 10.1136/jech.49.2.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Miilunpalo S., Vuori I., Oja P., Pasanen M., Urponen H. Self-rated health status as a health measure: the predictive value of self-reported health status on the use of physician services and on mortality in the working-age population. J Clin Epidemiol. 1997 May;50(5):517–528. doi: 10.1016/s0895-4356(97)00045-0. [DOI] [PubMed] [Google Scholar]
  18. North F. M., Syme S. L., Feeney A., Shipley M., Marmot M. Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study. Am J Public Health. 1996 Mar;86(3):332–340. doi: 10.2105/ajph.86.3.332. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Rimm E. B., Williams P., Fosher K., Criqui M., Stampfer M. J. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. BMJ. 1999 Dec 11;319(7224):1523–1528. doi: 10.1136/bmj.319.7224.1523. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Stansfeld S. A., Fuhrer R., Shipley M. J., Marmot M. G. Work characteristics predict psychiatric disorder: prospective results from the Whitehall II Study. Occup Environ Med. 1999 May;56(5):302–307. doi: 10.1136/oem.56.5.302. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Vahtera J., Kivimäki M., Pentti J. Effect of organisational downsizing on health of employees. Lancet. 1997 Oct 18;350(9085):1124–1128. doi: 10.1016/S0140-6736(97)03216-9. [DOI] [PubMed] [Google Scholar]
  22. Vahtera J., Kivimäki M., Pentti J. The role of extended weekends in sickness absenteeism. Occup Environ Med. 2001 Dec;58(12):818–822. doi: 10.1136/oem.58.12.818. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Vahtera J., Kivimäki M., Pentti J., Theorell T. Effect of change in the psychosocial work environment on sickness absence: a seven year follow up of initially healthy employees. J Epidemiol Community Health. 2000 Jul;54(7):484–493. doi: 10.1136/jech.54.7.484. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Vahtera Jussi, Poikolainen Kari, Kivimäki Mika, Ala-Mursula Leena, Pentti Jaana. Alcohol intake and sickness absence: a curvilinear relation. Am J Epidemiol. 2002 Nov 15;156(10):969–976. doi: 10.1093/aje/kwf138. [DOI] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES