Open Access Research article

School environment as predictor of teacher sick leave: data-linked prospective cohort study

Jenni Ervasti1*, Mika Kivimäki123, Ichiro Kawachi4, SV Subramanian4, Jaana Pentti1, Tuula Oksanen1, Riikka Puusniekka5, Tiina Pohjonen6, Jussi Vahtera178 and Marianna Virtanen1

Author Affiliations

1 Finnish Institute of Occupational Health, Centre of Expertise for Work Organizations, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland

2 Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK

3 Department of Behavioral Sciences, PB 9, 00014 University of Helsinki, Helsinki, Finland

4 Harvard School of Public Health, Department of Society, Human Development and Health, 677 Huntington Avenue, Kresge Building 7th Floor, 716 Boston, Massachusetts, 2115-6096, USA

5 National Institute for Health and Welfare, PB 30, 00271, Helsinki, Finland

6 City of Helsinki, Occupational Health Centre, PB 5603, 00099, Helsinki, Finland

7 Department of Public Health, University of Turku, Lemminkäisenkatu 1, 20014, Turun yliopisto, Finland

8 Turku University Hospital, PB52, 20521, Turku, Finland

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BMC Public Health 2012, 12:770  doi:10.1186/1471-2458-12-770

Published: 11 September 2012

Abstract

Background

Poor indoor air quality (IAQ) and psychosocial problems are common in schools worldwide, yet longitudinal research on the issue is scarce. We examined whether the level of or a change in pupil-reported school environment (IAQ, school satisfaction, and bullying) predicts recorded sick leaves among teachers.

Methods

Changes in the school environment were assessed using pupil surveys at two time points (2001/02 and 2004/05) in 92 secondary schools in Finland. Variables indicating change were based on median values at baseline. We linked these data to individual-level records of teachers’ (n = 1678) sick leaves in 2001–02 and in 2004–05.

Results

Multilevel multinomial logistic regression models adjusted for baseline sick leave and covariates showed a decreased risk for short-term (one to three days) sick leaves among teachers working in schools with good perceived IAQ at both times (OR = 0.6, 95% CI: 0.5-0.9), and for those with a positive change in IAQ (OR = 0.6, 95% CI: 0.4-0.9), compared to teachers in schools where IAQ was constantly poor. Negative changes in pupil school satisfaction (OR = 1.8, 95% CI: 1.1-2.8) and bullying (OR = 1.5, 95% CI: 1.0-2.3) increased the risk for short-term leaves among teachers when compared to teachers in schools where the level of satisfaction and bullying had remained stable. School environment factors were not associated with long-term sick leaves.

Conclusions

Good and improved IAQ are associated with decreased teacher absenteeism. While pupil-related psychosocial factors also contribute to sick leaves, no effect modification or mediation of psychosocial factors on the association between IAQ and sick leave was observed.

Keywords:
Bullying; Multilevel; Perceived indoor air; School satisfaction; Ventilation