Simulated Improvements in Influence at Work and Reduction in Sickness Absence Among Young Employees: A Nationwide Register-Based Study.

Objective: To estimate the reduction in sickness absence associated with simulated improvements in influence at work (employees' ability to influence how and when work tasks are performed) among young Danish employees. Methods: We used register data from the Danish Work Life Course Cohort, which included 301,185 individuals aged 15-30 who entered the labor market between 2010 and 2018 (mean follow-up: 2.6 years). Annual influence at work was assessed using a job-exposure matrix, which assigned an average level of influence based on job title. Inspired by the parametric g-formula, we used Poisson regression to predict sickness absence days under a simulated scenario in which the influence increased by one standard deviation. Results: Higher influence was associated with fewer days of sickness absence (rate ratio per one-point increase, range 1-5: 0.71, 95% CI 0.66-0.77). Simulating a standard deviation increase in influence corresponded to a reduction of 0.16 days of sickness absence per person annually, which is equivalent to an estimated reduction of 126,400 (3%) days during the follow-up period. The largest reductions were observed in care work and education. Conclusion: Simulated improvements in influence at work may lead to meaningful reductions in sickness absence among young employees.