Job demands and control and sickness absence, disability pension and unemployment among 2,194,692 individuals in Sweden

Background: Knowledge is needed on associations between job demands and job control and long-term sickness absence (SA) and unemployment. We explored associations of job demands and job control with SA/disability pension (DP) and unemployment among women and men in paid work. Methods: We included all 2,194,694 individuals living in Sweden in 2001, aged 30-54 years, and in paid work. The Swedish Job Exposure Matrix (JEM) was used to ascertain levels of job demands and job control. Individuals were categorized into nine groups based on combinations of high, medium, or low values on both demands and control. Using multinomial logistic regression, we estimated odds ratios (OR) with 95% confidence intervals (CI) for the association of job demands and job control with risk of long-term SA/DP (>183 net days) and long-term unemployment (>183 days). Results: Regarding SA/DP, among women the risk was highest for those in occupations with low demands and low control (OR=1.32; 95% CI: 1.28-1.36), whereas among men the risk was highest among those in occupations with high demands and low control (OR=1.22; 1.11-1.34). Regarding unemployment, among women the risk was highest among those in occupations with low demands and medium control (OR=1.30; 1.24-1.37), whereas among men the risk was highest for those in occupations with low demands and high control (OR=1.54; 1.46-1.62). Conclusions: Using a JEM among all in a population rather than for specific occupations gives a more comprehensive view of the associations between job demands/job control and long-term SA/DP and unemployment, respectively.