Gender differences in the duration of non-work-related sickness absence episodes due to musculoskeletal disorders

Prevalence, Patterns, and Associated Factors for Musculoskeletal Disorders Among the Healthcare Workers of Northern Saudi Arabia: A Multicenter Cross-Sectional Study

Background

Musculoskeletal disorders (MSDs) have emerged as a pressing concern among healthcare workers (HCWs), gaining significant attention, particularly in the aftermath of the COVID-19 pandemic. This study evaluated the prevalence, pattern, and associated factors for MSDs among HCWs in northern Saudi Arabia.

Participants and Methods

Employing a cross-sectional study design, the standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to collect data from participants. Systematic sampling method was employed to select 384 HCWs from diverse healthcare settings. Multivariate logistic regression analysis was conducted to identify factors associated with MSDs.

Results

Among the participants, 72.4% reported one or more NMQ-listed MSDs. The most commonly affected body regions were the neck, shoulder, and lower back. MSDs showed significant associations with physical activity (adjusted odds ratio [AOR]= 0.72, 95% confidence interval [CI] = 0.53-0.93, p = 0.024), obesity status (AOR = 3.08, 95% CI = 1.56-4.71, p = 0.003), and ergonomic training (AOR = 0.38, 95% CI = 0.23-0.55, p < 0.001).

Conclusion

Implementing preplacement and periodic ergonomic training for HCWs is recommended. This proactive measure holds the potential to alleviate MSD-related discomfort, reduce sickness absenteeism, and enhance overall productivity. Future longitudinal studies across different regions of Saudi Arabia are essential to establish causal links between risk factors and MSDs.

Women's Health and Working Life: A Scoping Review

Women's health matters for participation in working life. The objective of this study was to explore female physiology in a work-life context and to investigate possible associations between women's health, sickness absence and work ability. A scoping review was conducted to develop a systematic overview of the current research and to identify knowledge gaps. The search strategy was developed through a population, concept and context (PCC) model, and three areas of women's health were identified for investigation in the context of work. A total of 5798 articles were screened by title and abstract and 274 articles were screened by full text; 130 articles were included in the review. The material included research from 19 countries; the majority of the studies used quantitative methods. The results showed an impact on the occupational setting and an association between sickness absence, work ability and all three areas of women's health, but a holistic and overall perspective on female biology in the work context is missing. This review calls for more knowledge on health and work and possible gender differences in this regard. Women's health and working life involve a complex connection that has the potential to develop new knowledge.

Extreme temperatures and sickness absence in the Mediterranean province of Barcelona: An occupational health issue

Objectives

This study aims to assess the association between daily temperature and sickness absence episodes in the Mediterranean province of Barcelona between 2012 and 2015, according to sociodemographic and occupational characteristics.

Methods

Ecological study of a sample of salaried workers affiliated to the Spanish social security, resident in Barcelona province between 2012 and 2015. The association between daily mean temperature and risk of new sickness absence episodes was estimated with distributed lag non-linear models. The lag effect up to 1 week was considered. Analyses were repeated separately by sex, age groups, occupational category, economic sector and medical diagnosis groups of sickness absence.

Results

The study included 42,744 salaried workers and 97,166 episodes of sickness absence. The risk of sickness absence increased significantly between 2 and 6 days after the cold day. For hot days there was no association with risk of sickness absence. Women, young, non-manual and workers in the service sector had a higher risk of sickness absence on cold days. The effect of cold on sickness absence was significant for respiratory system diseases (RR: 2.16; 95%CI: 1.68-2.79) and infectious diseases (RR: 1.31; 95%CI: 1.04-1.66).

Conclusion

Low temperatures increase the risk of having a new episode of sickness absence, especially due to respiratory and infectious diseases. Vulnerable groups were identified. These results suggest the importance of working in indoor and possibly poorly ventilated spaces in the spread of diseases that eventually lead to an episode of sickness absence. It is necessary to develop specific prevention plans for cold situations.

Community Assessment for a Low-Carbohydrate Nutrition Education Program in South Africa

Eat Better South Africa (EBSA) is an organization that provides low-carbohydrate, high-fat (LCHF) nutrition and health education programs for women from under-resourced South African communities. Community assessments are essential to explore participants' potential facilitators and challenges of adhering to new dietary behaviours and should be implemented before any dietary interventions. This study is a qualitative community assessment to enable the EBSA program to better meet potential participants' needs and explore their willingness to enrol in the EBSA program. Sixty women from two communities in the Western Cape were interviewed through six focus group discussions. A thematic analysis was conducted using NVivo 12 software, and four themes were developed around the women's (1) role within the households; (2) dietary behaviour; (3) health perceptions; and (4) willingness to participate in an LCHF program. Women mentioned that they were responsible for cooking and shopping for their households. They expressed their understanding of healthy and unhealthy behaviours and their dietary patterns. Some women showed concerns about LCHF diets, but others wanted to learn more due to their knowledge of other people's positive experiences with the diet. There was a general desire to become healthy. However, the women anticipated dietary behaviour change to be challenging. Those challenges mostly revolved around their socioeconomic environments. The findings are intended to inform EBSA (or other nutrition interventions) on what to consider when implementing their interventions in these communities.

Perceived causes of work-related sick leave among hospital nurses in Norway: a pre-pandemic study

Background

Although sick leave is a complex phenomenon, it is believed that there is potential for prevention at the workplace. However, little is known about this potential and what specific measures should be implemented. The purpose of the study was to identify perceived reasons to take work-related sick leave and to suggest preventive measures. The study was completed before the COVID-19 pandemic emerged, and the risk factors identified may have been amplified during the pandemic.

Methods

An in-depth cross-sectional survey was conducted across a randomly selected sample of hospital nurses in Norway. The national sample comprised 1,297 nurses who participated in a survey about their sick leave during the previous 6 months. An open-ended question about perceived reasons for work-related sick leave was included to gather qualitative information.

Results

Among hospital nurses, 27% of the last occurring sick leave incidents were perceived to be work-related. The most common reasons were high physical workload, high work pace, sleep problems, catching a viral or bacterial infection from patients or colleagues, and low staffing.

Conclusions

Over a quarter of the last occurring sick leave incidents among Norwegian hospital nurses are potentially preventable. To retain and optimize scarce hospital nursing resources, strategies to reduce work-related sick leave may provide human and financial benefits. Preventive measures may include careful monitoring of nurses’ workload and pace, optimizing work schedules to reduce the risk of sleep problems, and increasing staffing to prevent stress and work overload.

How does Gender Influence Sustainable Return to Work Following Prolonged Work Disability? An Interpretive Description Study

PURPOSE

A sustainable return to work (S-RTW) following prolonged work disability poses different challenges, depending on gender. This article provides a synthesis of gender differences in the issues and factors influencing the S-RTW of workers following such a disability.

METHODS

Using an interpretive description method, an integrative review was conducted of the literature on gender differences in S-RTW issues and factors associated with four major causes of work disability. The initial review concerned the 2000-2016 literature; it was subsequently updated for November 2016-March 2020. To explore and contextualise the results, four focus groups were held with stakeholders representing the workplace, insurance, and healthcare systems and workers. Qualitative thematic analysis was performed.

RESULTS

A total of 47 articles were reviewed, and 35 stakeholders participated in the focus groups. The prevailing traditional gender roles were found to have a major gender-specific influence on the attitudes, behaviours, processes and outcomes associated with S-RTW. These differences related to the (1) cumulative workload, (2) work engagement, and (3) expressed and addressed needs.

CONCLUSIONS

The results highlight the importance of taking into account both professional and personal aspects when integrating gender issues into the assessment of workers' needs and subsequently into interventions.

Do birthrates contribute to sickness absence differences in women? A cohort study in Catalonia, Spain, 2012-2014

Aims

This study explores the differences in sickness absence trends in women according to reproductive age group and medical diagnoses.

Methods

Data were obtained from two administrative registries: the Continuous Working Life Sample and the Catalonian Institute of Medical Evaluations from 2012 to 2014, containing 47,879 female employees. Incidence rates and incidence risk ratios derived from Poisson and negative binomial models were calculated to compare sickness absence trends among reproductive age groups based on Catalonian birthrates: early-reproductive (25–34 years old), middle-reproductive (35–44) and late-reproductive (45–54), according to diagnostic groups, selected diseases, type of contract, occupational category, and country of origin.

Results

Younger women show a higher incidence of overall sickness absence compared to late-reproductive-aged women. Incidence risk ratios of sickness absence decreased significantly from early-reproductive to late-reproductive age for low back pain, hemorrhage in early pregnancy, nausea and vomiting, and abdominal and pelvic pain.

Discussion

The higher incidence of sickness absence due to pregnancy-related health conditions in early-reproductive women compared to other reproductive age groups, may explain the sickness absence differences by age in women. Proper management of sickness absence related to pregnancy should be a goal to reduce the sickness absence gap between younger and older women.

Trajectories of sickness absence among salaried workers: evidence from the WORKss cohort in Catalonia (Spain), 2012-2014

OBJECTIVES

Sickness absence (SA) is a widely studied integrated measure of health status. To better understand how SA behaves over time (SA trajectory) a longitudinal and individual-centred approach will allow identifying groups of individuals who share common characteristics. The aim of this study was to identify and describe SA trajectories and to assess employment conditions and diagnosis groups as determinants.

SETTING

Working-life and sickness absence administrative records from a representative sample of affiliated with the Spanish Social Security system.

PARTICIPANTS

38 420 workers affiliated with the Spanish Social Security system, born 1949 to 1969 or 1970 to 1990, resident in Catalonia who had SA between 2012 and 2014 (75 212 episodes).

RESULTS

We identified three different SA trajectories in both birth cohorts for men and women: low-stable (86.2% to 90.8% of individuals), decreasing (4.4% to 5.9% of individuals) and increasing (4.1% to 8.7% of individuals) accumulated days of SA. The main characteristic of SA trajectories was the medical diagnosis group. The increasing SA trajectory had a higher proportion of workers with SA due to mental disorders compared with the other trajectories. The association analysis showed diagnosis group strongly related with all SA trajectories, particularly SA due to mental disorders showed the strongest association with the increasing trajectory among young men (adjusted OR (aOR): 42.40, 95% CI 17.03 to 105.57). Low salary levels exhibited a strong relationship with decreased accumulation of SA days over time for old women (aOR: 2.08, 95% CI 1.36 to 3.18) and men (aOR: 2.75, 95% CI 1.77 to 4.27). Unskilled manual occupations were associated with increasing trajectories among young women (aOR: 1.36, 95% CI 1.01 to 1.84). No significant differences were observed for other employment conditions across trajectories.

CONCLUSIONS

Workers with mental disorders are more likely to have increased days of SA, whereas low salary levels at later ages are related to a decrease in SA days over time. Special attention to preventing the course of mental disorders at young and middle age is warranted.

New episodes of musculoskeletal conditions among employed people in Norway, sickness certification and return to work: a multiregister-based cohort study from primary care

OBJECTIVES

To identify new cases of musculoskeletal (MSK) disorders among employed people presenting in Norwegian primary care in 2012, frequency of sickness certification and length of sick leave. To identify patient-, diagnosis- and GP-related predictors of sickness certification, prolonged sick leave and return to work (RTW).

METHODS

An observational multiregister-based cohort study covering all employed persons in Norway(1 176 681 women and 1 330 082 men) based on claims data from all regular GPs merged with individual sociodemographic data from public registers was performed. Participants were employed patients without any GP consultation during the previous 3 months who consulted a GP with a diagnosis of a MSK condition. Those not on sick leave and with a known GP affiliation were included in the analyses. Outcomes were incidence, proportion sickness certified and proportion on sick leave after 16 days, according to the diagnosis, ORs with 95% CIs for sickness certified and for sick leave exceeding 16 days and HRs with 95% CIs for RTW.

RESULTS

One-year incidence of MSK episodes was 159/1000 among employed women and 156/1000 among employed men. 27.1% of the women and 28.2% of the men were sickness certified in the initial consultation. After 16 days, 10.5% of women and 9.9% of men were still on sick leave. Upper limb problems were most frequent. After adjustments, medium/high education predicted a lower risk of absence from work due to sickness and rapid RTW after 16 days. Back pain, fractures and female gender carried a higher risk of sickness certification but faster RTW. Older age was associated with less initial certification, more sick leave exceeding 16 days and slower RTW. Male patients with male GPs had a lower risk of sickness absence, which was similar to patients with GPs born in Norway and GPs with many patients. After 16 days, GP variables had no effect on RTW.

CONCLUSION

Upper limb problems and GPs as stakeholders in 'the inclusive workplace' strategy need more attention.

Predictors of Depression and Musculoskeletal Disorder Related Work Disability Among Young, Middle-Aged, and Aging Employees

OBJECTIVE

The aim of this study was to investigate the level and predictors of work disability in different age groups.

METHODS

We followed young (18 to 34 years), middle-aged (35 to 50 years), and aging (>50 years) employees (n = 70,417) for 7 years (2005 to 2011) for all-cause and cause-specific work disability (sickness absence and disability pension). Using negative binomial regression, we obtained both relative risk estimates and absolute rates, that is, days of work disability per person-year.

RESULTS

The greatest relative difference in all-cause, and specifically depression-related work disability, was between young women and young men, and between employees with low versus high levels of education. Aging employees with a low education and chronic somatic disease had the highest levels of musculoskeletal disorder related work disability.

CONCLUSIONS

The predictors of work disability vary by age and diagnosis. These results help target age-specific measures for the prevention of permanent work disability.