Sickness-absenteeism, job demand-control model, and social support: a case-control study nested in a cohort of hospital workers, Santa Catarina, Brazil.

The aim of the study was to identify the Job Demand-Control (JDC) and social support contribution for sickness-absenteeism duration of Health Treatment Licences (HTL) in hospital workers (civil servants) of the Santa Catarina State Department of Health of (SES/SC), Brazil. These health workers have the second highest HTL among civil servants in the state, especially those working in hospitals. This is a case-control study nested in a cohort of hospital workers followed up between 07/01/2008 and 06/30/2009. The workers with HTL in this period were selected as cases and those without HTL were selected as cases matched by sex, age and working sector. The outcome was the duration of HTL and the exposure variables were JDC and supervisor and coworker social support. We used both primary and secondary data, zero-inflated negative binomial regression analysis, and socioeconomic and occupation variables in the adjustments. The data used for analysis included 425 participants (144 cases; 281 controls). Low coworker support added 2,04 (95% confidence interval (CI): 1,05-3,93) HTL days. This effect increased to 2,68 days (95% CI: 1,37-5,27) when combined with low job strain and raised 78% (95% CI: 1,02-3,12) more than JDC with high coworker support combined with high strain (iso-strain). This study uncovered the importance of coworker support for the duration of sickness-absenteeism and suggested its use for the interventions aiming to decrease the duration of HTL.