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Aims: In 1993, a qualifying day without sickness benefit was introduced to the Swedish sickness benefit system. The aim of the present study is to investigate sickness absenteeism before and after the introduction of the qualifying day, in the light of conditions inside and outside working life. Methods: The study was based on 1,952 female and 2,229 male employees of Sweden Post. Sickness absence was measured by sickness incidence one year before and one year after the introduction of the qualifying day (sick-leave events/person days at risk). Information about explanatory factors was collected by a postal questionnaire in 1994. Results: A decrease in sickness incidence was observed after the introduction of the qualifying day as well as an increase in the mean duration of sick-leave events. The proportion of long-term sick-leave events (15-365 days) increased; among men this increase was also found in absolute terms. There were no suggestions of economy being an important determinant for reduced sickness incidence. Women with long-term or serious disease did not show a reduction of sickness incidence to the same extent as those without disease, and for men a coherent result was observed. Men with heavy lifting at work more often showed an increase in incidence compared to men without heavy lifting, and the same tendency was found for women. Conclusion: The reduction in sickness incidence following the introduction of the qualifying day was fairly independent of different work-related and non-work-related factors. The impact of the qualifying day differed depending on health status and the physical workload.