Association between long working hours and psychological distress: The effect of sick leave criteria in the workplace during the COVID-19 pandemic

Objective This study investigated the effect of sick leave criteria on the association between long working hours and psychological distress. Methods We conducted a cross-sectional survey in December 2020, and 27,032 workers completed the questionnaire. First, after testing the interaction effect of overtime work hours and sick leave criteria on psychological distress, we conducted stratified analyses using sick leave criteria. Results A significant interaction effect was found. When we conducted stratified analyses, the odds ratios increased with longer working hours, both with and without sick leave criteria groups; however, the risk was greater in the without sick leave criteria group, compared with the criteria group. Conclusion We revealed that working without sick leave criteria could strengthen the association between long working hours and psychological distress during the COVID-19 pandemic. Clinical significance Workers working without sick leave criteria had a significantly higher risk of psychological distress due to long working hours than those who worked with the criteria. Our findings contribute to preventing the deterioration of mental health during the COVID-19 pandemic.