Prospective association between high stress profile as defined using the Japanese Stress Check Program manual and long-term sickness absence among a working population with various backgrounds: a two-wave longitudinal study

Abstract

Objectives: We aimed to examine the prospective association between stress profile as defined using the Stress Check Program manual and long-term sickness absence among a working population with various backgrounds. Methods: We analyzed 1,741 participants who participated in two online surveys in December 2023 and October 2024. In the first survey, we asked participants to complete the Brief Job Stress Questionnaire and evaluated their stress profile using the Japanese Stress Check Program manual. In the second survey, we asked participants if they had experienced sickness absence for 1 month or longer between the first and second surveys. We then examined the association between stress status in the first survey and experience of sickness absence during the waves. We calculated the odds ratio after adjusting for gender, age, marital status, educational attainment, household income, employment contract, average working hours per week, occupation, and industrial sector. To estimate the impact of high stress on sickness absence, we calculated the population attributable risk for high stress. Results: After adjusting for confounding factors, we found that high stress was associated with sickness absence, with an odds ratio of 3.54 (95% confidence interval, 2.05–6.12). The corresponding population attributable risk for high stress was 21.4%. Conclusions: The observed prospective association between high stress (as defined using the Stress Check Program manual) and long-term sickness absence among a working population from a wide range of occupations and industries provides evidence supporting the usability of the index in occupational health practice.