Changes in emotional demands at work and subsequent risk of long-term sickness absence: a nationwide cohort study in...

High emotional demands at work are associated with risk of poor health; however, it is debated whether the association is causal. To further elucidate the relation between emotional demands and health, we examined if changes in emotional demands were associated with subsequent risk of long-term sickness absence (LTSA) in the Danish workforce. We measured emotional demands in nationwide surveys from 2012 to 2018 among 14 602 workers, aged 18-64. We calculated changes in emotional demands from t0 to t1 (2 years apart) and followed the participants 2 years after t1 in a nationwide register of LTSA (sickness absence >30 days). Using Cox regression, we estimated hazard ratios (HRs) of LTSA among participants with changes in emotional demands, compared to participants without changes. Estimates were adjusted for sex, age, education, job group, depressive symptoms, and self-rated health. Increases in emotional demands were associated with an increased risk of LTSA, whereas decreases were associated with a reduced risk of LTSA. In the fully adjusted model, we observed the highest risk of LTSA among participants who changed from medium to high emotional demands (HR = 1.45, 95% CI: 1.16-1.82), compared to those retaining medium emotional demands. We observed the lowest risk of LTSA among participants who changed from high to low emotional demands (HR = 0.61, 95% CI: 0.40-0.92) compared to those retaining high emotional demands. Changes in emotional demands at work may affect the risk of LTSA. Workplace interventions should be developed and evaluated.