Socio-demographic and work-related risk factors for medium- and long-term sickness absence among Italian workers

Background: Few studies investigated determinants of sickness absence in representative samples of the general population, none of which in Italy. Aim of this study was to assess influence and relative importance of socio-demographic and work-related characteristics on medium- and long-term sickness absence in a random sample of Italian workers. Methods: Approximately 60 000 workers participating in a national survey in 2007 were interviewed regarding sickness absence during the whole previous week, and on socio-demographics, employment characteristics and exposure to a set of physical and psychosocial hazards in the workplace. The association between sickness absence and potential determinants was estimated by multivariable logistic regression models stratified by gender. Results: From the final multivariate models, in both genders sickness absence was statistically significantly associated with tenure employment, working in larger firms, exposure to risk of injury and to bullying or discrimination and, among employees, with shift work. In males, sickness absence was also associated with lower education, employment in the public administration and with exposure to noise or vibration, whereas among women also with manual work and ergonomic factors. In both genders, the attributable fraction for employment-related characteristics was higher than that for socio-demographic ones. Conclusions: The association with tenure or salaried jobs, and with employment in larger firms or in the public sector suggests that, besides illness, job security is the most important determinant of sickness absence, consistently with the results of previous studies. However, our results indicate that a reduction in exposure to workplace hazards may contribute to reduce absenteeism.