Employee control over working times:: associations with subjective health and sickness absences

Study objective: To investigate the impact of employees' worktime control on health, taking into account other aspects of job control. Design: Analysis of questionnaire data in 1997 and register data on sickness absence during 1996-1998. Setting: Eight towns in Finland. Participants: 6442 municipal employees (11490 men and 4952 women) representing the staff of the towns studied. Follow up was 17 706 person years. Main results: In women, poor health and psychological distress were more prevalent among those in the lowest quartile of worktime control than those in the highest (after adjustment for potential confounders including other aspects of job control, odds ratios and their 95% confidence intervals for poor health and psychological distress were 1.8 (1.5 to 2.3) and 1.6 (1.3 to 2.0), respectively). Correspondingly, the adjusted sickness absence rate was 1.2 (1.1 to 1.2) times higher in women with low worktime control than in women with high worktime control. In men, no significant associations between worktime control and health were found. These results, obtained from the total sample, were replicable, within a homogeneous occupational group comprising women and men. Conclusions: Exploration of specific aspects of job control provides new information about potentially reversible causes of health problems in a working population. Worktime control is an independent predictor of health in women but not in men. Dissimilarities in the distribution of occupations between men and women are not a probable explanation for this difference.