More than one out of three (37 percent) employees in Germany took sick leave at least once in the first six months of this year. On average, people were out of commission for 7.9 days, compared to 7.4 days last year, the German DAK health report 2016 says.

While the survey looks only at people insured with the DAK, it can be regarded as more or less representative of the German population as a whole, Jörg Marschall, of the IGES research institute and the author of the survey, told DW.

Hips, legs, knees and back: muscular and skeletal disorders are the number one reason German employees are unable to come to work, found the annual survey conducted by one of Germany's largest health insurance companies.

In fact, one out of five of the missed days at work is due to such health issues, and men are affected more often than women. With about 17 percent of cases, respiratory disorders are the second most common reason doctors in Germany write sick leave slips, the DAK report said.

Increased work loads

Why was sick leave on the rise this year? Increased workloads, the labor market and working conditions all play a role, according to the survey. More sick leave is taken in sound economic times "because more people with poor health are employed," Marschall said, as currently seems to be the case in Germany.

Doctors handed employees in the eastern German states 25 percent more sick leave notes than in the west this year, and for a lengthier period of time, the DAK study noted.

Employers in Germany require a sick leave slip from a doctor after three days of absence. Employees on sick leave receive their full salary for six weeks, after which the health insurance fund picks up the tab - though less than the full salary - until people return to work or are forced to retire because of health problems.

With about 16 percent, psychological health problems come in third as a reason for sick leave, according to the new DAK study.

Depression, burn-out and anxiety

In fact, taking sick leave for psychological health problems in Germany's offices, factory floors and workshops has risen more than threefold since 1997, Marschall says.

It's not clear whether greater stress in the workplace - time pressure, multitasking, round the clock availability on smartphones - is responsible, Marschall says, pointing instead to the fact that today, doctors are better trained in diagnosing mental health issues, while patients are more willing to accept such diagnoses.

The DAK study urges promoting health in the workplace by decreasing "psycho-social strain, such as chronic time pressures and excessive demands."

In the 1970, 1980s and 1990s, Marschall said, far more sick leave days were taken than today - perhaps, he adds, due to harsher physical working conditions.