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Investigation of the relations between job demands, health and sickness absence is required to design a strategy for the prevention of absence and disability.To study the relationships between (physical and psychological) job demands, health perception and sickness absence.Prospective study of 414 male employees working in two organizations with low company absence levels. Job demands and health were examined using the Basic Occupational Health Questionnaire. Sickness absence was followed for 1 year thereafter. The number of days and episodes of absence were counted.The questionnaires of 247 workers (60%) were suitable for statistical analysis. Physical job demands (r=0.41; P <0.01) and, to a lesser extent, psychological job demands (r=0.16; P=0.01) were related to the number of health complaints. Short (1–7 days) duration absence was neither related to job demands nor to the number of health complaints. Longer (>7 days) duration absence was positively related to psychological job demands and to the number of health complaints.Job demands, particularly physical demands, correlated with perceived health. Poor health predicted long-term sickness absence. Early recognition of poor health should be the basis of a strategy that prevents long-term sickness absence.