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18.11.2019 | Original Article

Can work-unit social capital buffer the association between workplace violence and long-term sickness absence? A prospective cohort study of healthcare employees

International Archives of Occupational and Environmental Health
Eszter Török, Naja Hulvej Rod, Annette Kjær Ersbøll, Johan Høj Jensen, Reiner Rugulies, Alice Jessie Clark
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The online version of this article (https://​doi.​org/​10.​1007/​s00420-019-01484-7) contains supplementary material, which is available to authorized users.

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To determine the prospective relation between workplace violence and the risk of long-term sickness absence (LTSA), and study if work-unit social capital could buffer this effect. As an explorative analysis, the association between work-unit social capital and workplace violence is also tested.


The study is based on the Well-being in HospitAL Employees (WHALE) cohort, including healthcare employees in Denmark. The study sample consisted of 30,044 employees nested within 2304 work-units. Exposure to workplace violence and threats of violence during the past 12 months was measured by self-report. Work-unit social capital was computed by aggregating the mean individual responses within work-units. LTSA was defined as one or more episodes of ≥ 29 consecutive sickness absence days initiated within 2 years following baseline.


Employees experiencing workplace violence had a higher risk of LTSA (OR = 1.55; 95% CI 1.39–1.72), but there was no evidence in support of work-unit social capital buffering the effect of workplace violence on LTSA (RERI = 0.24; 95%CI: − 0.36 to 0.84; p = 0.12 for multiplicative interaction). High compared to low work-unit social capital was associated with a lower prevalence of workplace violence (OR = 0.47; 95% CI 0.36–0.61).


There was a prospective association between workplace violence and LTSA, but work-unit social capital did not buffer this effect. Furthermore, the results revealed an inverse association between work-unit social capital and workplace violence. The findings indicate that  in order to effectively reduce LTSA, preventive interventions need to both prevent workplace violence and strengthen social capital.

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