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Organizational
Organizational justice, sickness justice, sickness
absence and employee age absence
Aino Tenhiälä
Department of Industrial Engineering and Management, Aalto University, 805
Helsinki, Finland
Anne Linna Received April 2011
Revised December 2011
Research Unit for Psychosocial Factors, March 2012
Finnish Institute of Occupational Health, Turku, Finland Accepted March 2012

Monika von Bonsdorff

Gerontology Research Center and Department of Health Sciences,
University of Jyväskylä, Jyväskylä, Finland
Jaana Pentti
Research Unit for Psychosocial Factors,
Finnish Institute of Occupational Health, Turku, Finland
Jussi Vahtera
Department of Public Health,
University of Turku and Turku University Hospital, Turku, Finland
Mika Kivimäki
Department of Epidemiology and Public Health, University College London,
London, UK, and
Marko Elovainio
Department of Health Services Research,
National Institute for Health and Welfare, Helsinki, Finland
Abstract
Purpose – The aim of this paper is to study age-related differences in how perceptions of two forms
of organizational justice, i.e. procedural and interactional justice, are related to short (i.e. non-certified)
spells and long (i.e. medically certified) spells of sickness absence.
Design/methodology/approach – The authors conducted a study on a large sample of Finnish
public sector employees (n ¼ 37; 324), in which they matched employees’ 2004 survey data with their
records-based sick absences in 2005 and 2006.
Findings – The results suggest that age moderates the association between perceptions of
procedural justice and long sickness absences after controlling for gender, tenure, occupational group,
work unit, job demands and health behaviors. When older employees experienced a high level of
procedural justice, they were 12 percent less likely to miss work due to medically certified illnesses.
Overall, older employees were less likely to take short, non-certified sickness absences from work.
Finally, the results suggest that high-quality relationships with supervisors can prevent both short
and long spells of sickness absence at all ages
Originality/value – The study contributes to the literature on age-related differences in the effects of Journal of Managerial Psychology
psychosocial workplace conditions (organizational justice) on employee behavior (absenteeism). Vol. 28 No. 7/8, 2013
pp. 805-825
Keywords Organizational justice, Older workers, Age groups, Absenteeism q Emerald Group Publishing Limited
0268-3946
Paper type Research paper DOI 10.1108/JMP-07-2013-0246
JMP Sickness absence is costly for businesses, public sector organizations and taxpayers.
28,7/8 The costs include the basic salary of the absent employee, payments for overtime work,
and/or payments to replacement workers, as well as management costs, including line
management and HR functions. For example, PricewaterhouseCoopers (Lynn, 2011)
estimates that 80 percent of all absenteeism is due to illness, and in the UK, sickness
absences cost £32bn annually, not including replacement costs and lost productivity.
806 In Finland, the Ministry of Labor has estimated that sickness absences costs the
Finnish governmental sector over e257m euro annually (Lehtonen, 2010). Although we
could consider that older employees account for more of these absences than younger
employees, research has found that older employees have lower overall levels of
absenteeism. More specifically, according to meta-analytic evidence, age is strongly
negatively related to measures of voluntary absence, such as absence frequency
(Hackett, 1990; Martocchio, 1989), while there is a modest but significant positive
association between age and sickness absence (Ng and Feldman, 2008).
A factor consistently related to absenteeism, particularly to sickness absence, is
organizational justice (for a review, see Greenberg, 2010). On a positive note, research
has consistently shown that employees who feel that they are treated fairly at work are
usually healthier, resulting in a lower incidence of sickness absences. Perceptions of
how employees are treated in the workplace in terms of fairness of procedures in
organizational decision making (i.e. procedural justice; Thibaut and Walker, 1975) and
interpersonal treatment of employees with respect to enactment of organizational
procedures (i.e. interactional justice; Bies and Moag, 1986) are subjective experiences
about organizational justice (Greenberg, 1987), and thus there are individual
differences in the extent to which employees are affected by organizational justice (or
injustice). Even though many individual differences have been studied, age differences
in whether younger or older employees would benefit more from a higher level of
organizational justice, as demonstrated in their sickness absence behaviors, has not
been focused on in earlier studies. The study draws from the selection, optimization
and compensation model (Baltes and Baltes, 1990) and from socioemotional selectivity
theory (Carstensen, 1998; Carstensen et al., 1999) to outline a theoretical basis for
predicting age-related differences in sickness absences as a response to perceived
procedural and interpersonal justice in the workplace.

Organizational justice as a psychosocial predictor of sickness absence

Previous research on employee perceptions of organizational justice has typically
focused on organizational decision making (i.e. organizational foci) and the immediate
supervisor (i.e. supervisory foci). It has also been found that the fairness experiences
related to these foci have been distinguished both at the individual and aggregate
levels (for a review, see Li and Cropanzano, 2009). Procedural justice, conceptualized as
the fairness of procedures in organizational decision making, is rooted in discussions
regarding the importance of control for individuals (Colquitt et al., 2005). Thibaut and
Walker (1975) were the first to identify two forms of control as sources of procedural
justice: decision control (control over outcomes) and process control (control over the
factors that are used to make decisions on outcomes). Procedures can reduce
uncertainty about outcomes (Lind and van den Boos, 2002) by promoting consistency,
suppressing bias, and being accurate, correctable, representative and ethical
(Leventhal, 1980). These elements imply that individuals should be able to express
their own views and have the opportunity to attain some control over the Organizational
decision-making process to experience a high level of procedural justice. justice, sickness
Interactional justice is an indication of the nature of interpersonal treatment of
employees by key organizational authorities (Colquitt et al., 2005). Most interactional absence
justice research has concentrated on the importance of respectful and socially sensitive
treatment by an employee’s immediate supervisors (Bies, 2005). Employees feel that
there is a high level of interactional justice if supervisors explain decisions to them and 807
treat them with dignity and respect. Research shows that supervisors can be trained to
successfully use interactional justice in conjunction with negative procedures (that
employees may not be able to control) when necessary. In a study by Greenberg (2006),
training of supervisors in interactional justice was related to a lower level of insomnia
among nurses who experienced a pay cut. The training covered skills such as treating
others with dignity and respect, demonstrating emotional support, avoiding
intimidation, providing complete and accurate explanations, communicating details
in a timely matter, and being accessible to others. Thus, these types of skills and
activities are important for supervisors to acquire so that employees experience a high
level of interactional justice.
Both forms of organizational justice are related to lower levels of employee sickness
absence (for a review, see Greenberg, 2010). In previous research, organizational justice
has been conceptualized as a psychosocial predictor of health (Elovainio et al., 2002).
Independent cohort studies indicate that a high level of perceived organizational justice
is associated with a lower risk of psychiatric symptoms and insomnia (Kalimo et al.,
2003; Tepper, 2001), a reduced incidence of medically certified coronary heart disease
(Kivimäki et al., 2005) and cardiovascular mortality (Elovainio et al., 2006). One
explanation for the concurrent health outcomes of organizational justice is experienced
stress (e.g. de Boer et al., 2002); evidence has shown that high levels of justice are
related to decreased levels of workplace stress (e.g. Zohar, 1995). This result implies
that a high level of perceived justice at work may decrease the likelihood of
hypothalamic-pituitary-adrenal (HPA) axis deregulation and thus lower the risk of
physiological health problems, such as metabolic syndrome (Gimeno et al., 2010) and
chronic systemic inflammation (Elovainio et al., 2010). Similarly as a rise in perceptions
of organizational justice over time has been correlated with good health, a drop in
organizational justice over time is related to poor health (Kivimäki et al., 2004). Our
baseline hypothesis is consistent with previous research.
H1. Perceptions of (a) procedural and (b) interactional justice are negatively
related to sickness absence.

Age-related differences in the effects of organizational justice on sickness

absence
Generally, employees who remain with their employers until old age tend to miss work
less often than their younger counterparts (Hackett, 1990; Martocchio, 1989; Ng and
Feldman, 2008). Previous meta-analytic evidence suggests that age (not tenure) is
negatively associated with avoidable absenteeism (Hackett, 1990) or both frequency of
absenteeism and work hours lost, often used as measures of voluntary and involuntary
absenteeism (Martocchio, 1989). Ng and Feldman (2008) distinguished three forms of
absenteeism in their meta-analysis. Age was negatively (2 0.26) related to objective
JMP measures of overall levels of absence, irrespective of the causes. Age was negatively
28,7/8 related (2 0.10) to objective measures of non-sickness-related absence, and a weak
positive relationship was demonstrated between objective measures of sickness
absence and age (0.02). The general inverse relationship between age and absenteeism
can be explained by the person-environment fit perspective, which posits that people
select environments compatible with their behavioral tendencies (Schneider, 1983). A
808 poor fit between an individual’s and an organization’s values, goals and traits results in
the individual’s unwillingness to maintain his or her current work position (Hoffman
and Woehr, 2006; Verquer et al., 2003). Thus, as employees age, they are likely to
withdraw from unsatisfactory work conditions (through turnover or retirement)
because they discover that these conditions are poor fits. There is overwhelming
evidence that older employees are generally more satisfied with their work and more
attached to their social environments (Rhodes, 1983).
In the study, we utilized two measures of sickness absence: short (1-3 days),
non-certified sickness absences and long (. 3 days), medically certified sickness
absences. Evidence suggests that these two measures represent different causes of
absence. Certified absences reflect actual illness, such as psychiatric disorders and
injuries, while non-certified absences reflect shorter periods of absence that may be
related to milder illness or other factors, such as lack of motivation or domestic crises
(Vahtera et al., 2004). Thomson et al. (2000) argue that non-certified and certified
absences can be considered measures of voluntary and involuntary absence because
they indicate the amount of time lost from work (short or long) and control for when
illness is a causal factor (certified absence is validated by a physician). The distinction
between them is based on an objective characteristic (i.e. presence of a physician’s
certificate in support of illness) rather than the judgment of the researcher, which is the
case in the commonly used measures for frequency and duration of absences. In
accordance with previous research, we expect that age is negatively related to short
non-certified absence and expect it to have a non-significant or weak positive
correlation with long, medically certified absences (e.g. Ferris et al., 1988; Leigh, 1986;
Vahtera et al., 1996).
H2. Age is (a) negatively related to short non-certified sickness absences but (b)
positively related to long spells of medically certified absences.
The selection, optimization and compensation (SOC) model (Baltes and Baltes, 1990)
explains how the focus of goals changes with age, which may affect how employees of
various ages respond to their psychosocial work environment. SOC builds on the
premise that an individual’s biological, mental and social resources are limited at any
specific time and that selection, optimization and compensation strategies can help an
individual successfully allocate these resources in the workplace when opportunities or
losses arise (Baltes et al., 1998). SOC also posits that goal orientation is an adaptive
mechanism that individuals use to manage opportunities and constraints during
adulthood. Whereas younger adults typically enjoy a trajectory of growth in resources,
older adults face an increasing number of losses (Baltes and Smith, 2003). Loss
compensation is more important for the older than it is for the younger, who are
primarily interested in performance optimization (de Lange et al., 2010; Freund, 2006).
As older employees experience more decline in their cognitive and physical
resources, they have been found to require more job control than younger employees in
order to cope with workplace stress resulting from job demands (Shultz et al., 2010). Organizational
Thus, job control, such as flexible schedules, autonomy and time management, can be justice, sickness
regarded as SOC strategies that assuage and compensate for a worker’s reduction in
resources. It is not surprising that an individual’s desire for job control is predicted to absence
increase with age (Sterns and Miklos, 1995). Evidence also suggests that with age,
control-enhancing interventions become more beneficial (Heckhousen and Schultz,
1995). Similarly, procedural justice may serve as a form of control that compensates for 809
an older employee’s biological, mental and social resource losses, resulting in improved
coping ability and fewer sickness absences. Further, as older employees become more
selective about where they invest their resources, procedural justice may foster an
environment in which they are more likely to invest resources (i.e. optimize) because
their investments are more likely to be influential in such environments. Overall,
age-related changes might lead to a higher need for control and a higher impact for
conditions that foster such a feeling (e.g. procedural justice), which could be evidenced
in older employees taking fewer sickness absences in a high procedural justice
environment.
H3. Age moderates the relationship between perceptions of procedural justice and
sickness absence; thus, the relationship between procedural justice and
sickness absence is more negative for older employees than for younger
employees.
Socioemotional selectivity theory (SST; Carstensen, 1995, 1998) stipulates that
boundaries on perceived time lead to the prioritization of emotional goals. Social
networks grow smaller across adulthood and increasingly focus on fewer but
emotionally more significant social partners. Despite physical decline and other
age-related problems, this does not reduce subjective wellbeing (called the “paradox of
aging”). The evidence suggests instead that the emotional domain may be preserved
and perhaps selectively optimized, resulting in lower levels of negative emotions and in
equivalent if not higher levels of positive emotions (Carstensen and Charles, 1998).
Consequently, age is related to a higher emotional balance and wellbeing (Löckenhoff
and Carstersen, 2004). Older adults enjoy positive life satisfaction, which, according to
SST, is due to the heightened value they place on the emotional aspects of life. This
also affects memory: with age, there is a tendency to remember more positive aspects
of one’s experiences (Löckenhoff and Carstersen, 2004).
Perception of restrictions in time leads to prioritization of different goals (Lang and
Carstensen, 2002). Because younger adults typically have long futures for which to
prepare, they are motivated by the pursuit of knowledge, even when this pursuit
requires them to suppress their emotional wellbeing in the present. The opposite
tendency is expected in older adults; facing shorter futures, they prioritize emotional
goals, such as one-on-one relationships, because they prefer positive experiences in the
current moment. Thus, the purpose of social interaction changes with age. When time
is limited, individuals prefer emotion-focused coping strategies to problem-focused
strategies and emotionally gratifying social contacts to contacts with new social
partners (Folkman et al., 1987). Older employees prefer to invest in emotionally close
relationships (Carstensen and Charles, 1998). This age-related motivational shift alters
the dynamic interplay between individuals and their environment such that they
prioritize the optimization of socioemotional experience in later life. We propose, in line
JMP with the central tenets of SST, that high-quality relationships with supervisors
28,7/8 improve the wellbeing of older employees more than the wellbeing of younger
employees, resulting in fewer sickness absences when a high level of interactional
justice is perceived by older employees.
H4. Age moderates the relationship between perceptions of interactional justice
and sickness absence; thus, the relationship between interactional justice and
810 sickness absence is more negative for older employees than for younger
employees.
In summary, we expect aging to act as a boundary condition for the effect of
organizational justice on sickness absence whereby older employees benefit more from
higher levels of procedural justice (fulfilling a need for control) and interactional justice
(fulfilling a need for emotional goals) than their younger counterparts, demonstrated
by fewer short and long sickness absences. The hypothesized research model is
depicted in Figure 1.

Method
Sample and participants
The data were drawn from an ongoing Finnish study of public sector employees on
psychosocial factors, organizational behavior, and health in ten towns and 21 public
hospitals in Finland (for more information, see Vahtera et al., 2001). In 2004, 48,076
employees responded to a survey (66 percent response rate) that was subsequently
linked to sickness absence data retrieved from the employer registers of consenting
respondents. Of the respondents, we excluded 4,747 participants who were either
unidentifiable or with short-term work contracts (less than six months). In addition,
6,005 employees were excluded because they did not consent to having their
questionnaire responses linked to their sickness absence records. As a result, the final

Figure 1.
Conceptual research model
sample size is n ¼ 37; 324. The Ethics Committee of the Finnish Institute of Organizational
Occupational Health approved the study. justice, sickness
Most respondents in the final sample were women (81 percent) and served in
non-manual occupations (83 percent). The mean age was 46.2 years (SD 9.13 years; 14 absence
percent under 35 years of age; 18 percent over 55 years of age). Fourteen percent of the
employees in the sample had a chronic disease.
The sample did not differ from the eligible population in terms of the proportion of 811
women (76 percent), non-manual occupations (80 percent), mean age (45.3 years), and the
presence of any chronic disease (13.3 percent). The sample did not differ from the complete
sample of respondents (including the excluded respondents) in terms of the proportion of
women (80 percent), non-manual occupations (82 percent), mean age (46.0 years) and the
presence of any chronic disease (13.6 percent). The mean levels of procedural and
interactional justice perception were practically the same for those who did and did not
consent to linking their questionnaires to their absence data. Thus, the missing data
analysis shows that our sample was representative of the population and does not indicate
that older employees or those with chronic diseases would have opted out.

Measures
Perceptions of organizational justice. The questionnaire assessed employees’
perceptions of procedural and interactional justice. Using the procedural justice
scale (seven items, a ¼ 0:92; Moorman, 1991), respondents were asked to assess the
formal procedures followed in the workplace, including procedures for collecting
accurate information to decision making, providing opportunities to appeal or
challenge decisions, generating standards that ensure consistent decisions, and
hearing the concerns of all individuals affected by decisions (Leventhal, 1980). The
interactional justice scale (six items, a ¼ 0:92; Moorman, 1991) included questions
regarding the respondents’ perceptions of their supervisors, such as whether
supervisors suppressed personal biases, treated subordinates with kindness and
consideration, and managed subordinates in a truthful manner. Responses were chosen
from a five-point scale ranging from 1 ¼ strongly disagree to 5 ¼ strongly agree.
We calculated the intra-class correlation (ICC1) of a random intercept model using
the equation t00 =ðt00 þ s 2 Þ, where t00 is the between-group variance of the dependent
variable and s 2 is the within-group variance of the dependent variable (Bryk and
Raudenbush, 1992). With this analysis, it was estimated that the degree of variance in
the individual-level dependent variable can be explained by group-level properties.
The ICC1 indicated that between work units, there was 11 percent variance in
procedural justice and 18 percent variance in interactional justice. In addition to
examining the homogeneity of justice perceptions within work groups, we calculated
the inter-rater agreement index (rwg). This index shows the consensus among
employees within a single work group with respect to a justice variable. Across the
3,377 work groups, a mean rwg of 0.84 was calculated for procedural justice, and the
corresponding value for interactional justice was 0.81. These values were above the
conventionally acceptable rwg value of 0.70 (James et al., 1993). Based on these results,
we concluded that justice perceptions varied between work groups and that there was
significant intra-group agreement.
Sickness absence. Employers in the Finnish public sector maintain registers of
information on each employee’s sickness absence, listing the beginning and end dates
JMP of each absence. In accordance with the regulations, each sickness absence certificate,
28,7/8 irrespective of the place of issuance, must be forwarded to these registers. For short
spells (1-3 days), employees inform their supervisors on the morning of the first day of
absence and fill their own certificates explaining their absences. For long spells (longer
than three days), a physician’s examination and a medical certificate are required.
Maternity leaves and absences due to caring for a sick child are not included as
812 sickness absences[1].
Information regarding the participants’ sickness absences in this study was
obtained from employers’ registers between January 1, 2005 and December 31, 2006.
Both short (1-3 days) and long (. 3 days) spells of sickness absence were used.
Overlapping, consecutive, or duplicated spells of absence were identified. We counted
the number of days worked during 2005 and 2006 for each respondent. The number of
days at work represented the “days at risk” for each respondent and was weighted in
the statistical models. Rates of sickness absences were computed and expressed as the
number of absences per two years for each person whose data were included in the
analysis.
Age of respondents. Information regarding the participants’ dates of birth was
obtained from the employers’ registers. We constructed the age variable based on the
birth date and treated it as a continuous variable. Respondents’ ages ranged from 18 to
67 years in 2004 (mean 46.2 years, SD 9.13 years).
Control variables. We controlled for employee gender (female/male), tenure (years in
current work position during 2001-2004), occupational group (non-manual/manual),
work unit, job demands and health behaviors that may confound the relation between
organizational justice and sickness absences.
The gender, tenure and occupational group data were obtained from the employers’
registers. The occupational group data were based on the Statistics Finland (1987)
classification of five-digit occupational titles. Each participant’s work unit was
identified from the employers’ records. Using employers’ work unit registers (used for
administrative purposes), we identified work units at the lowest organizational level.
These are functional work units that typically pertain to a single location (e.g. a
kindergarten, a school, or a hospital ward). The number of work units was 3,377. The
number of employees in the work units ranged from one to 352, with a mean size of
11.05 (SD ¼ 14:3) employees.
Job demands were measured on a three-item scale (a ¼ 0:89) from Karasek’s Job
Content Questionnaire (Karasek et al., 1998), which assesses the employees’ workload
and work pace. Typical scale items included the following: “I have to work very fast”
and “I am often pressured to work overtime”. The response scale was a five-point
Likert scale (1 ¼ strongly agree, 5 ¼ strongly disagree).
We controlled for the following risky health behaviors:
.
smoking (current smoker/non-smoker);
.
alcohol consumption (. 210 g of alcohol intake per average in a week; Kaprio
et al., 1987);
.
physical activity (, 30 minutes of fast walking per week; Kujala et al., 1998);
.
obesity (body mass index . 30 kg/m2); and
. psychological distress (General Health Questionnaire GHQ-12, $ 4 symptoms;
Goldberg and Williams, 1988).
In addition, the presence of any chronic disease (i.e. diabetes, asthma, rheumatoid Organizational
arthritis, hypertension and ischemic heart disease) was controlled for using data from justice, sickness
the Drug Reimbursement Register maintained by the Social Insurance Institution of
Finland and was coded as yes/no. absence

Statistical analysis
The frequency of sickness absence is not normally distributed (Goldberg and 813
Waldman, 2000). Instead, this frequency assumes discrete non-negative values (0, 1, 2,
. . .) and is strongly skewed; low values are frequently observed, and high values are
rarely observed. Traditional regression models, which are based on a normal
distribution, are insufficient for modeling a dependent variable that follows a Poisson
distribution (McCullagh and Nelder, 1989). Furthermore, the analysis must account for
potentially confounding variables. Thus, we conducted Poisson regression analyses
using the generalized estimating equations (GEE) method. The method takes into
account the correlation between spells of sickness absence within work units. GEE is a
population-averaged or marginal model that accounts for correlations solely through
the specification of a marginal variance-covariance structure. We used GEE analysis to
estimate the strength of the association between organizational justice and sickness
absences. According to the assumptions of the Poisson model, the between-employee
variance in the rates of sickness absence equals the expected rate. Because rate ratios
of Poisson regression models are more informative than those of traditional regression
models, we adjusted the rate ratios and their 99 percent confidence intervals for
demographics (gender, tenure, occupational group and work unit), job demands, and
health behaviors (smoking, alcohol consumption, physical activity, obesity,
psychological distress and chronic disease). Because the data set was large, we used
p , 0:01 to indicate statistical significance.
We analyzed the hypothesized relationships in three steps. In Model 1, only central
hypothesized variables were included. In Model 2, covariates were added to Model 1 to
eliminate the effects of these potentially confounding variables. In Model 3, the
respective interaction effect between standardized age and organizational justice
(product term age £ justice) was additionally included in the model to examine whether
an interaction occurred (McCullagh and Nelder, 1989). The results are presented
separately for short and long sickness absences. All of the analyses were performed
using the Statistical Analyses System (SAS), Version 9.2.

Results
The descriptive characteristics and intercorrelations of the study variables are shown
in Table I. On average, employees were absent 1.48 short spells and 0.83 long spells per
person year. The bivariate results indicate that age is negatively correlated with short
spells (r ¼ 20:20, p , 0:01), but there is no significant relationship between age and
long spells (r ¼ 0:00, NS). Both procedural (r ¼ 20:06, p , 0:01) and interactional
justice (r ¼ 20:06, p , 0:01) are negatively correlated with short spells. Similarly,
procedural justice (r ¼ 20:07, p , 0:01) and interactional justice (r ¼ 20:09,
p , 0:01) are negatively correlated with long spells.
The Poisson regression analysis on main effects of age and organizational justice on
absence are reported in Models 1 and 2 (Tables II and III). According to Model 2 (which
controls for the confounding factors), higher levels of procedural justice were
 JMP

814
28,7/8

Table I.

variables
Descriptive statistics and
intercorrelations of study
Variable M SD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1. Gender (female ¼ 1,
male ¼ 2) 1.19 0.40 –
2. Age 46.2 9.13 2 0.00 –
3. Tenure 3.56 0.77 2 0.01 0.42 * –
4. Occupational group (upper
grade non-manual
worker ¼ 1, lower grade
non-manual worker ¼ 2,
manual worker ¼ 3) 1.86 0.67 0.04 * 0.02 * 0.05 * –
5. Smoking
(non-smoking ¼ 0,
smoking ¼ 1) 0.17 0.37 0.07 * 2 0.05 * 0.00 0.16 * –
6. Alcohol consumption
(non-drinking ¼ 0,
drinking ¼ 1) 0.09 0.28 0.22 * 0.03 * 0.02 * 2 0.02 * 0.11 * –
7. Physical activity (other ¼ 0,
low activity ¼ 1) 0.23 0.42 0.02 * 0.08 * 0.02 * 0.06 * 0.09 * 0.02 * –
8. Obesity (BMI index,
(, 30 ¼ 0, . 30 ¼ 1) 0.13 0.34 0.02 * 0.08 * 0.03 * 0.08 * 0.01 0.03 * 0.15 * –
9. Psychological distress
(GHQ index, , 4 ¼ 0,
$ 4 ¼ 1) 0.24 0.43 2 0.05 * 0.02 * 0.02 * 2 0.02 * 0.03 * 0.02 * 0.05 * 0.02 * –
10. Chronic disease (no ¼ 0,
yes ¼ 1) 0.14 0.34 0.03 * 0.16 * 0.07 * 0.06 * 2 0.01 * 0.03 * 0.07 * 0.14 * 0.03 * –
11. Job demands 3.19 0.90 2 0.09 * 0.04 * 0.05 * 2 0.09 * 2 0.02 * 2 0.03 * 0.01 0.00 0.21 * 0.01 –
12. Procedural justice 3.03 0.85 0.02 * 0.04 * 2 0.04 * 2 0.04 * 2 0.01 2 0.01 0.02 * 2 0.02 * 2 0.17 * 2 0.01 2 0.22 * –
13. Interactional justice 3.70 0.93 2 0.01 2 0.02 * 2 0.05 * 2 0.06 * 2 0.02 * 2 0.03 * 2 0.01 * 2 0.03 * 2 0.17 * 2 0.02 * 2 0.19 * 0.45 * –
14. Short spells (1-3 days) per
person year 1.48 1.66 2 0.15 * 2 0.20 * 2 0.09 * 0.07 * 0.09 * 2 0.01 0.03 * 0.05 * 0.09 * 0.02 * 0.03 * 2 0.06 * -0.06 * –
15. Long spells (. 3 days) per
person year 0.83 1.11 2 0.11 * 2 0.00 2 0.01 0.22 * 0.12 * 2 0.02 * 0.06 * 0.11 * 0.12 * 0.12 * 0.06 * 2 0.07 * -0.09 * 0.35 * –

Note: *p , 0:01
 Model 1 Model 2 Model 3
Sickness absence Variable RR 99 percent CI p RR 99 percent CI p RR 99 percent CI p

Short spells (1-3 days) Age 0.82 0.81-0.84 ,0.0001 0.82 0.80-0.83 , 0.0001 0.82 0.80-0.83 , 0.0001
Procedural justice 0.94 0.93-0.95 ,0.0001 0.97 0.95-0.98 , 0.0001 0.97 0.95-0.98 , 0.0001
Women (versus men) 1.57 1.49-1.66 , 0.0001 1.57 1.49-1.66 , 0.0001
Tenure 0.98 0.96-1.00 0.0054 0.98 0.96-1.00 0.0061
Manual (versus non-manual) work 1.28 1.23-1.34 , 0.0001 1.28 1.23-1.34 , 0.0001
Current smoking (versus no) 1.23 1.18-1.28 , 0.0001 1.23 1.18-1.28 , 0.0001
Drinking yes (versus no) 1.10 1.04-1.15 , 0.0001 1.10 1.04-1.15 , 0.0001
No physical activity (versus yes) 1.08 1.04-1.11 , 0.0001 1.08 1.04-1.11 , 0.0001
BMI .30 (versus ,30) 1.15 1.10-1.21 , 0.0001 1.15 1.10-1.21 , 0.0001
GHQ index . 4 (versus ,4) 1.19 1.15-1.24 , 0.0001 1.19 1.15-1.24 , 0.0001
Chronic disease (versus no) 1.17 1.12-1.22 , 0.0001 1.17 1.12-1.22 , 0.0001
Job demands 1.02 1.00-1.04 0.0038 1.02 1.00-1.04 0.0038
Age £ Procedural justice 1.00 0.98-1.01 0.4939
Long spells (.3 days) Age 1.02 1.00-1.04 0.0368 0.99 0.97-1.01 0.3498 0.99 0.97-1.01 0.2998
Procedural justice 0.91 0.89-0.93 ,0.0001 0.96 0.94-0.98 , 0.0001 0.96 0.94-0.98 , 0.0001
Women (versus men) 1.51 1.41-1.61 , 0.0001 1.51 1.41-1.61 , 0.0001
Tenure 0.95 0.93-0.98 , 0.0001 0.95 0.93-0.98 , 0.0001
Manual (versus non-manual) work 1.64 1.55-1.72 , 0.0001 1.64 1.55-1.72 , 0.0001
Current smoking (versus no) 1.28 1.23-1.35 , 0.0001 1.28 1.23-1.35 , 0.0001
Drinking yes (versus no) 1.02 0.96-1.10 0.3629 1.02 0.96-1.10 0.3751
No physical activity (versus yes) 1.06 1.02-1.11 0.0003 1.06 1.02-1.11 0.0002
BMI .30 (versus ,30) 1.27 1.20-1.34 , 0.0001 1.27 1.20-1.34 , 0.0001
GHQ index . 4 (versus ,4) 1.30 1.25-1.35 , 0.0001 1.30 1.25-1.35 , 0.0001
Chronic disease (versus no) 1.41 1.35-1.48 , 0.0001 1.41 1.35-1.48 , 0.0001
Job demands 1.08 1.05-1.10 , 0.0001 1.08 1.05-1.10 , 0.0001
Age £ Procedural justice 0.98 0.96-1.00 0.0059

demographic variables,
Organizational

absence

procedural justice
health behaviors and
justice, sickness

short and long spells of

confidence intervals) of

sickness absence for

815

Rate rations (99 percent

Table II.
 JMP

816
28,7/8

Table III.

interactional justice
sickness absence for

health behaviors and

confidence intervals) of

demographic variables,
short and long spells of
Rate rations (99 percent
Model 1 Model 2 Model 3
Sickness absence Variable RR 99 percent CI p RR 99 percent CI p RR 99 percent CI p

Short spells (1-3 days) Age 0.82 0.81-0.83 ,0.0001 0.82 0.80-0.83 , 0.0001 0.82 0.80-0.83 , 0.0001
Interactional justice 0.93 0.91-0.94 ,0.0001 0.95 0.94-0.97 , 0.0001 0.95 0.93-0.97 , 0.0001
Women (versus men) 1.57 1.49-1.66 , 0.0001 1.57 1.49-1.66 , 0.0001
Tenure 0.98 0.96-1.00 0.0056 0.98 0.96-1.00 0.0081
Manual (versus non-manual) work 1.28 1.23-1.33 , 0.0001 1.28 1.22-1.33 , 0.0001
Current smoking (versus no) 1.23 1.18-1.28 , 0.0001 1.23 1.18-1.28 , 0.0001
Drinking yes (versus no) 1.09 1.04-1.15 , 0.0001 1.09 1.04-1.15 , 0.0001
No physical activity (versus yes) 1.07 1.04-1.11 , 0.0001 1.07 1.04-1.11 , 0.0001
BMI .30 (versus ,30) 1.16 1.11-1.21 , 0.0001 1.16 1.11-1.21 , 0.0001
GHQ index . 4 (versus ,4) 1.19 1.15-1.23 , 0.0001 1.19 1.14-1.23 , 0.0001
Chronic disease (versus no) 1.17 1.02-1.13 , 0.0001 1.17 1.13-1.22 , 0.0001
Job demands 1.02 1.00-1.04 0.0193 1.02 1.00-1.04 0.0192
Age £ Interactional justice 0.99 0.97-1.00 0.0544
Long spells (.3 days) Age 1.01 0.99-1.04 0.0769 0.99 0.97-1.01 0.2834 0.99 0.97-1.01 0.2362
Interactional justice 0.88 0.86-0.90 ,0.0001 0.93 0.91-0.95 , 0.0001 0.93 0.91-0.95 , 0.0001
Women (versus men) 1.51 1.42-1.61 , 0.0001 1.51 1.42-1.61 , 0.0001
Tenure 0.95 0.93-0.98 , 0.0001 0.96 0.93-0.98 , 0.0001
Manual (versus non-manual) work 1.63 1.55-1.72 , 0.0001 1.63 1.55-1.72 , 0.0001
Current smoking (versus no) 1.28 1.22-1.34 , 0.0001 1.28 1.22-1.34 , 0.0001
Drinking yes (versus no) 1.02 0.95-1.09 0.4931 1.02 0.95-1.09 0.4971
No physical activity (versus yes) 1.07 1.02-1.11 , 0.0001 1.07 1.02-1.11 , 0.0001
BMI .30 (versus ,30) 1.27 1.20-1.33 , 0.0001 1.27 1.20-1.33 , 0.0001
GHQ index . 4 (versus , 4) 1.29 1.24-1.34 , 0.0001 1.29 1.24-1.34 , 0.0001
Chronic disease (versus no) 1.41 1.34-1.48 , 0.0001 1.41 1.34-1.48 , 0.0001
Job demands 1.07 1.05-1.10 , 0.0001 1.07 1.05-1.10 , 0.0001
Age £ Interactional justice 0.99 0.97-1.01 0.1483
associated with a lower frequency of both short (RR ¼ 0:97) and long spells of absence Organizational
(RR ¼ 0:96), in line with H1(a). Similarly, higher levels of interactional justice were justice, sickness
associated with a lower frequency of short absences (RR ¼ 0:95) and long absences
(R ¼ 0:93) in line with H1(b). The main effects revealed that low levels of both absence
procedural and interactional justice are negatively related to short and long spells of
sickness absence even after we controlled for individual factors, job demands, and
lifestyle factors. The results also demonstrate that the frequency of short (but not long) 817
absences (RR ¼ 0:82) declines with age. This result is in line with H2a but not with
H2b. Older employees are less likely to take short spells of sickness absence.
According to the Model 3 (Tables II and III), age moderates the relationship between
procedural justice and long absences (RR ¼ 0:98) but does not moderate the
relationship between procedural justice and short absences (RR ¼ 1:00). The
interaction results for interactional justice are not statistically significant. To
interpret the significant interaction effect, we plotted it with the cut-off points for high
and low levels of procedural justice, 1 SD above and 1 SD below the mean. As shown in
Figure 2, older employees (over 55 years of age) who perceived a higher level of
procedural justice in their work demonstrated a lower frequency of long spells of
sickness absence compared with younger employees (under 37 years of age). Older
employees were 12 percent less likely to be absent from work due to medically certified
illnesses, while no significant effect was observed for younger employees (RR for
young employees ¼ 0:95 (CI 0.90-1.01); RR for older employees ¼ 0:88 (CI 0.83-0.93)).
Thus, H3 is supported for long spells of sickness absence but not for short spells of
sickness absence. H4 is not supported by the results.

Discussion
This study explored whether the relationship between employee perceptions of
procedural and interactional justice and their sickness absence differs by age. As

Figure 2.
Age as a moderator of the
effect of procedural justice
on long sickness absence
spells
JMP hypothesized, older employees were more sensitive to procedural justice; long spells of
28,7/8 sickness absence decreased more strongly among older employees than younger
employees in relation to increasing levels of procedural justice. When older employees
experienced higher levels of procedural justice, they were 12 percent less likely to be
absent from work due to medically certified illnesses (i.e. long sickness absences). This
result is aligned with the SOC model (Baltes and Baltes, 1990), which posits that
818 selection, optimization and compensation are necessary to successfully handle
developmental opportunities or losses of biological, mental and social resources.
In conjunction with stress theories that have been used to explain absence behavior
( Johns, 1997), older employees may not be able to cope with work conditions as easily
as younger employees. Thus, older employees may compensate for their losses by
assuming more control in the work through a higher level autonomy or schedule
flexibility, for example (Shultz et al., 2010). Thus, evidence suggests that age is a
boundary condition for both the stress-buffering effect of job control (Shultz et al., 2010)
and procedural justice as an indication of a psychosocial work environment.
Furthermore, in a positive psychosocial work environment, older employees might be
more likely to optimize their performance. This is in line with social exchange theory,
which posits that justice creates trust and reciprocity. An organizational situation that
is characterized by reciprocity is considered as fair and stimulates individual behaviors
that strengthen the relation (Cropanzano and Rupp, 2008). On the contrary, a low
organizational justice environment could be perceived as unequal, socially exclusive,
stressful and, in the long run, harmful to individual health. Especially older employees
with a high level of trust have been found to demonstrate a lower level of
counterproductive behaviors such as turnover in a high procedural justice
environment (Bal et al., 2011).
We also predicted that considerate interactional treatment from supervisors would
be related to a lower level of sickness absence, particularly among older employees,
because socioemotional selectivity theory (e.g. Carstensen, 1998) claims that
boundaries on perceived time lead to the prioritization of emotional goals (such as
one-on-one interactions) for older employees. However, the data did not support this
hypothesis. Instead, high levels of interactional justice were related to lower sickness
absence rates for all ages. Thus, high-quality relationships with supervisors (high
levels of interactional justice) are important in preventing both short and long absences
at all ages. In the case of older employees, one’s immediate supervisor may not fulfill
emotional goals. To conduct a more comprehensive test of SST in the organizational
justice domain, it might be beneficial to account for other sources for interpersonal
treatment in a broader network, such as treatment by colleagues and customers, for
comparison with the importance of support from other sources (e.g. family and friends)
in future studies.
It is important to note that the results were somewhat different for the short and
long spells of absence. The incidence of short, non-certified absences was significantly
lower for older employees than for younger ones. Because short, non-certified absences
are less likely to be related to illness than long, certified absences (Vahtera et al., 2004),
the lower incidence of short absences in older employees is in line with the
person-environment fit perspective (Schneider, 1983). The result is consistent with
previous meta-analytic evidence showing that age and voluntary absenteeism are
inversely related; older employees are less likely to miss work due to “avoidable”
causes (Hackett, 1990; Martocchio, 1989; Ng and Feldman, 2008). Further, our Organizational
female-dominated sample may have suppressed the correlation between age and justice, sickness
non-certified absence in this study. According to previous research, the inverse
relationship between age and voluntary absenteeism is higher for men than for women absence
(Hackett, 1990; Martocchio, 1989). However, somewhat contrary to previous results (Ng
and Feldman, 2008), age was not significantly related to the incidence of long,
medically certified absences. The type of measure used could explain the differing 819
results. This study did not measure the exact length of absences; it may be the case
that the average length of a long absence is significantly higher for an older employee
than for a younger one because it may take longer for an older employee to recover
from an illness.
The prospective study design and the lack of common method variance between
perceptions of organizational justice and sickness absence can be considered as
strengths of our study. We also were able to utilize a large-scale dataset with over
37,000 public sector employees working in more than 3,300 work groups, and the
missing data analysis did not reveal any concerns that the sample would not have been
representative of the population. The possibility to take into account the fact that
employees are nested within work groups and several control variables is a further
strength of our study.
There are some limitations to this study that offer suggestions for future research.
First, although we controlled for many health risk factors, cohort effects cannot be
eliminated. Even though the missing data analysis did not indicate that the employees
who answered the survey would have been less healthy than those who did not
participate, there is an inherent selection effect in all cross-sectional analyses involving
employees of different ages. The older participants may have been self-selected and
thus healthier than those who had withdrawn from working life. Research from a
life-span perspective emphasizes both observable regularities in age group differences
and intra-individual changes over the course of lifetime (Kanfer and Ackerman, 2004).
A longitudinal research design with multiple study points would be preferable, and
individual changes in behavioral patterns, including reasons for workplace withdrawal
(such as turnover and retirement), should be considered in more detail.
Second, one can argue that studying the two components of organizational justice
separately is ineffective because they are highly correlated with each other (r ¼ 0:45).
However, previous research has underscored that it is important to separate these two
aspects of organizational justice (e.g. Konovsky, 2000; Bies, 2005) and when two
variables are theoretically separate concepts, they can be used to predict various
criteria even if they are moderately or highly correlated (Cronbach and Meehl, 1955;
McCornack, 1956). Indeed, the age-related differences in the importance of on
organizational justice experiences should be studied in various foci and at various
levels (Liao and Rupp, 2005) in future research.
Third, the proposed mechanisms related to procedural justice (i.e. a need for control)
and interactional justice (i.e. a need for emotional goals) should be explicitly tested in
future research. Because the effects of organizational justice and work control have
been found to reinforce each other in previous research (Elovainio et al., 2005), future
studies should explore both individual job control factors and psychosocial factors
(e.g. organizational justice) to determine whether these factors function as SOC
strategies and interact with age. As SST predicts that emotional regulation is better at
JMP higher ages, research is also inconclusive whether age is a protecting factor from the
28,7/8 effects of injustice (Bal et al., 2011) or fairness interventions would have a higher
impact on older employees because of emotional goal fulfillment.
Finally, we investigated the perceptions of organizational justice in the Finnish
work context. It should be noted that the employment conditions in Finland are
relatively similar to those in other EU countries (Gallie, 2003). Thus, our findings are
820 not necessarily restricted only to the Finnish context. However, additional research in
different contexts is required.
Preliminary evidence on the use of interventions to promote organizational justice
have demonstrated positive effects on stress-related employee health outcomes, such
as lower levels of insomnia and burnout (Greenberg, 2010). What kind of interventions
should be used in the workplace to increase perceptions of organizational justice that
would lead to lower levels of sickness absence? Given that meta-analytic evidence
suggests that stress-intervention programs are generally ineffective in resolving
absenteeism problems and the influence of voluntary factors related to short absences
in particular, managers might instead give employees more control and flexibility
(Darr and Johns, 2008). With regard to changes in the workplace, it is important to
reduce uncertainty (Lind and van den Boos, 2002) by implementing procedures in a
consistent manner, suppressing biases, being accurate, correctable, representative and
ethical. Our results suggest that this is especially important for older employees.
Greenberg (2009) has recently argued that most studies focus on the impact of
perceptions of injustice on various outcomes but that only few have studied
interventions that would improve the situation. Nevertheless, the initial results suggest
that participative interventions have impact on employees’ perceptions of
organizational justice (Linna et al., 2011). Employees tend to get less upset and
stressed when they know what is going on and feel that they can have a say. Investing
in supervisory training in how changes are handled in the workplace might be
beneficial (Greenberg, 2006). Managers should bear in mind that albeit subject to
individual interpretation, experiences about procedural and interactional justice tend
to be shared within units creating “justice climates”, which have an impact on
organizational outcomes, such as employee turnover (Simons and Roberson, 2003).

Note
1. In the public sector, employees are paid their full salary during periods of sick leave.
Employers receive compensation from the Finnish Social Insurance Institution for salaries
paid to employees after the first eight days of sick leave.

Acknowledgements
The research is funded by the Academy of Finland (projects 124271, 129262), the
Finnish Work Environment Fund (project 103432) and the participating towns. The
authors would like to extend their thanks to Kenneth S. Shultz for his comments on an
earlier version of the manuscript.

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About the authors

Aino Tenhiälä (formerly Salimäki) is a Postdoctoral Researcher at Aalto University, Department
of Industrial Engineering and Management. Her research interests include employee motivation,
well-being, fairness and compensation. She has a PhD in Work Psychology from Aalto
University, Finland. Aino Tenhiälä is the corresponding author and can be contacted at:
aino.tenhiala@aalto.fi
Anne Linna is a Specialized Researcher at the Finnish Institute of Occupational Health. Her
research interests include organizational justice, occupational health and employee well-being.
She has a PhD in Management from Turku School of Economics and Business Administration,
Finland.
Monika von Bonsdorff is a Postdoctoral Researcher at the University of Jyväskylä,
Gerontology Research Center and Department of Health Sciences and at Aalto University, School
of Economics. Her current research interests include ageing in working life, retirement
transitions and employee well-being. She has a PhD in Management and Leadership from
University of Jyväskylä, School of Business and Economics, Finland.
Jaana Pentti is a Statistician at the Finnish Institute of Occupational Health, Finland. She
received her BS from the University of Turku, Finland.
Jussi Vahtera is a Professor of Public Health at University of Turku and Research Professor
at the Finnish Institute of Occupational Health, Finland. He is the principal investigator of the
Ten Town Study. His research interests include psychosocial factors at work and their influence
on employee health and well-being. He has a PhD degree in Medical Science from the University
of Turku, Finland.
Mika Kivimäki is a Professor of Social Epidemiology at University College London Medical
School, Department of Epidemiology and Public Health, UK and Research Professor at the
Finnish Institute of Occupational Health, Finland. His research interests include psychosocial
factors at work and their influence on employee health and well-being. He has a PhD degree in
Psychology from the University of Helsinki, Finland.
Marko Elovainio is a Research Manager at the National Institute for Welfare and Health,
Department of Health Services Research, Finland. He has published articles on organizational
justice, personality and health. He received his PhD from the University of Helsinki, Finland.

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