摘要：Objectives. To estimate the contribution of stress-related and physical work factors to occupational class disparities in sickness absence from work. Methods. Our sample consisted of 8847 men and 2886 women participating in the French GAZEL cohort study. Occupational class and medically certified sickness absence data (1995–2001) were obtained from the participants’ employer. Work characteristics (physical and stress-related) were self-reported. We calculated rate ratios with Poisson regression models; fractions of sickness absence attributable to work factors were estimated with the Miettinen formula. Results. Sickness absence was distributed along an occupational gradient. Work characteristics accounted for 19% (women) and 21% (men) of all absences. Physical work conditions accounted for 42% and 13% of absences for musculoskeletal reasons, and work stress accounted for 48% and 40% of psychiatric absences. Overall, about 20% of the occupational class gradient in sickness absence could have been associated with deleterious work conditions. Conclusion. Work conditions contribute to sickness absence, particularly among manual workers and clerks. Policies that decrease ergonomic constraints and work stress also could reduce the burden of ill health and sickness absence among the lowest strata of working populations. Among working populations, occupational hazards and job stress may contribute to occupational class disparities in health. 1 Specifically, adverse work conditions may influence the risk of musculoskeletal disorders, psychiatric symptoms, and injury that occur frequently among middle-aged populations and may constitute some of the leading reasons for taking sick leave. 2 , 3 There is some evidence that job stress contributes to occupational class differences in both health and sickness-related absence from work (sickness absence) 4 , 5 ; however, little research has examined the contribution of other work conditions. To date, only 2 studies have investigated the joint contribution of physical and psychosocial work characteristics to occupational class health disparities; however, both were cross-sectional and used self-reported health as an outcome. 6 , 7 In a previous analysis of the GAZEL cohort study, we showed that job stress is most prevalent among manual workers and office clerks and predicts the occurrence of sickness absence. 8 In this study, we examined the contribution of both stress-related and physical work exposures to the occupational class gradient in overall and cause-specific sick leave.
