Good work-time control decreases risk for musculoskeletal and mental symptoms, sickness absence and occupational accidents

Good work-time control improves work-life balance and allows employees to self-determine the timing of, e.g., the start and ending times of the workday, and timing of vacations and breaks. New Nordic studies indicate that good work-time control protects against the risk for musculoskeletal and mental symptoms, sickness absence and occupational accidents.

Press release 43/2020, WOW Symposium, Espoo, Finland

Flexible working hours have increased dramatically recently, also due to the COVID-19 pandemic. Flexible working hours are linked with the surge in new technology enabling to work not only in offices and at home, but also while travelling, at customers’ premises, and in other locations. In Finland, for example, the proportion of workers in regular telework has increased from 16% to 28% among employees during the last five years even before the COVID-19.

Work-time control is closely related to flexible work but concerns only an individual’s ability to influence their work hours. This type of control gives more flexibility to the employees to self-determine the length of their workday, the start and end times of a duty period, which days to work, the taking of breaks and running of private errands during work, and the scheduling of vacations and other type of leave from work (1).

Good control over working hours improves work-life balance especially among women

A large NordForsk-funded project (Working Hours, Health, Well-being and Participation in Working Life, WOW) has added to the body of evidence demonstrating the positive effects of good work-time control on work-life balance, health, work participation and accident risk.

“Work-time control is a potentially useful way of improving the work environment, given that in most occupations it is modifiable to some extent. Good work-time control seems to benefit all employees, but in particular employees with older age and those with reduced work ability,” says Dr. Constanze Leineweber from the Stress Research Institute in the Stockholm University.

Based on the European Working Conditions Survey, an early WOW study demonstrated that positive perceptions of work-life balance are most prevalent in the Nordic countries with high work-time control (2). In a large sample of Swedish working population (Swedish Longitudinal Occupational Survey of Health SLOSH), stable low work-time control predicted an increase in work-life interference especially among women, but not in men (3).

“Also, good work-time control lead to a reduction in symptoms of depression and musculoskeletal disorders, and these associations are partly mediated by work-life interference” Constanze Leineweber continues (1, 4-5).

Employees with low work-time control, and in particular low control over taking time-off, were also more likely to report having an accident in the subsequent two years (6).

Participatory working time scheduling decreases sickness absence and is beneficial for well-being

Participatory working time scheduling is a collaborative approach to scheduling of shifts in which working time legislation, operation of the ward, and employees´ equality and fairness are all taken into account in cycles of negotiations and adjustments in co-operation among the employees. A WOW study compared amount of sickness absence in Finnish Public Sector study hospital wards using participatory working time scheduling software and those continuing with traditional working time scheduling between 2014 and 2017 (7). Short (1–3 days) sickness absences decreased by 7% in the wards using participatory scheduling compared to those using traditional scheduling.

“We also saw that sickness absences decreased as the time used for participatory working time scheduling increased” confirms MSc Jarno Turunen from the Finnish Institute of Occupational Health. Perceived control over scheduling of shifts increased among employees using the participatory scheduling compared to traditional scheduling (8).
“The positive effect on work-time control was significant, even though the actual changes in realized working hour characteristics were minor” mentions Dr Kati Karhula from the Finnish Institute of Occupational Health.

WOW project has produced several practical recommendations on working hours

WOW recommendations on work-time control:

  • Increase of work-time control and the use of participatory working time scheduling are potential and feasible ways to improve health, well-being and work participation.
  • Guidelines on flexible working practices should be tailored according to age, gender, work ability and the type of work.
  • Workers with especially low levels of control should be targeted in interventions to guarantee the availability of a minimum level of autonomy.

See also other WOW recommendations on shift work, health and well-being (public 13 November 2020)

The WOW Project Working hours, health, well-being and participation in working life (WOW) – creating new working time models and solutions for Nordic countries has developed evidence-based models and solutions related to working hours in order to support health, well-being and work participation. The researchers from Finland, Denmark, Norway and Sweden have produced already over 110 Scientific publications. The project is financed by NordForsk. The WOW Working Time Symposium is streamed on 13th November2020 to present WOW research results and recommendations.


Additional information:

Constanze Leineweber, Associate professor, Stress Research Institute, Department of Psychology, Stockholm University, tel. +46737078937, email: constanze.leineweber[at]

Kati Karhula, Specialist Researcher, Finnish Institute of Occupational Health (FIOH), tel. +358438242267, email: kati.karhula[at]

WOW Report: Working hours, health, wellbeing and participation in working life. Current knowledge and recommendations for health and Safety
WOW Project website


  1. Albrecht SC, Kecklund G, Tucker P, Leineweber C. Investigating the factorial structure and availability of work time control in a representative sample of the Swedish working population. Scandinavian Journal of Public Health. 2016;44(3):320-8.
  2. Anttila T, Oinas T, Tammelin M, Nätti J. Working-Time Regimes and Work-life Balance in Europe. European Sociological Review. 2015;31(6):713-24.
  3. Leineweber C, Kecklund G, Lindfors P, Magnusson Hanson LL. Change in Work-Time Control and Work-Home Interference Among Swedish Working Men and Women: Findings from the SLOSH Cohort Study. International Journal of Behavioral Medicine. 2016;23(6):670-8.
  4. Albrecht SC, Kecklund G, Rajaleid K, Leineweber C. The longitudinal relationship between control over working hours and depressive symptoms: Results from SLOSH, a population-based cohort study. Journal of Affective Disorders. 2017;215:143-51.
  5. Albrecht SC, Kecklund G, Leineweber C. The mediating effect of work-life interference on the relationship between work-time control and depressive and musculoskeletal symptoms. Scandinavian Journal of Work Environment and Health. 2020; 46(5), 469-479. doi:10.5271/sjweh.3887
  6. Tucker P, Albrecht S, Kecklund G, Beckers DG, Leineweber C. Work time control, sleep & accident risk: A prospective cohort study. Chronobiology International. 2016;33(6):619-29.
  7. Turunen J, Karhula K, Ropponen A, Koskinen A, Hakola T, Puttonen S, Hämäläinen K, Pehkonen J, Härmä M. The effects of using participatory working time scheduling software on sickness absence: A difference-in-differences study. International Journal of Nursing Studies. 2020, Jul 14;103716. doi: 10.1016/j.ijnurstu.2020.103716. [Online ahead of print.]
  8. Karhula K, Turunen J, Hakola T, Ojajärvi A, Puttonen S, Ropponen A, Kivimäki M, Härmä M. (2020). The effects of using participatory working time scheduling software on working hour characteristics and wellbeing: A quasi-experimental study of irregular shift work. International Journal of Nursing Studies. Jun 24;103696. doi: 10.1016/j.ijnurstu.2020.103696. [Online ahead of print.]
  9. Report: Härmä M and Karhula K (editors). Working hours, health, well-being and participation in working life. Current knowledge and recommendations for health and safety. Finnish Institute of Occupational Health, 2020.

See more publications on the WOW Project Web Site

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