Sickness presenteeism in Spanish-born and immigrant workers in Spain

Absence Due to Sickness Among Female Immigrants: Disadvantages Over the Career?

The extent to which and where immigrants’ health may deteriorate in the integration process is less understood. This study extends the current knowledge by focusing on sickness absence in Norway among female immigrants working within eight occupations where few formal skills are required. Administrative register data with a total sample of 261,291 native women and 9251 female refugees or families reunited are used to examine the native-immigrant gap in absence due to sickness during a 10-year period. The main findings are that female immigrants are less likely to have at least one sickness absence spell compared to natives, and that the native-immigrant gap in sickness absence was rather stabile when the number of years worked in these occupations was considered. This study shows that immigrants follow the same pattern as natives and suggests that the native-immigrant gap in absence due to health should be nuanced and focus more on why several years in these occupations increase the probability of sickness absence, independent of country of origin.

Racial and Ethnic Differences in the Perceptions of Health, Work Environment and Experiences of Work-Related Symptoms Among Cleaning Workers

This study explored racial and ethnic differences in perception of work environment, safe work practices, general health status, experience of work-related injury or illness and subsequent symptom reporting and health care seeking behaviors among cleaning workers. This study analyzed cross-sectional data obtained from 183 cleaning workers employed in a university hospital or a health sciences campus in Northern California. The sample included 120 Asians (65.6%), 37 Hispanics (20.2%), and 27 other ethnicities (14.2%); 85.7% were foreign-born. Asian workers perceived lower job control and supervisor support and higher job strain than other workers. The odds of perceiving general health as excellent or very good were lower among Asians compared to Hispanics and Others. Asians who experienced chemical-related symptoms were less likely than Hispanics and others to report the symptoms to their supervisor or seek healthcare. Our study findings indicated racial/ethnic differences in perceptions of work and general health, seeking healthcare, and reporting behaviors among cleaning workers. Asian workers, specifically, may need special attention to improve their experiences of work environments and health in the workplace.

Migrant workers occupational health research: an OMEGA-NET working group position paper

Objective

The aims of the study were: (1) to clarify the definitions of “migrant” used in occupational health research; (2) to summarize migrant workers’ industry sectors, occupations and employment conditions; (3) to identify the occupational health and safety services available to migrant workers; (4) to summarize work-related health problems found among migrant workers; (5) to identify the methodological challenges to research into occupational health of migrant workers; and (6) to recommend improvements in migrant occupational health research.

Methods

This position paper was prepared by researchers from several European countries and Australia, working within the EU COST Action OMEGA-NET. The paper drew on two recent systematic reviews on the occupational health of international migrant workers and other literature, and also identified uncertainties and gaps in the research literature. Migrants may, for example, be temporary or permanent, moving for specific jobs migrants or other reasons. Their ethnicity and language capabilities will affect their work opportunities.

Results

The occupational health literature seldom adequately identifies the heterogeneity or characteristics of the migrant group being studied. Migrants tend to work in more physically and mentally demanding environments with higher exposures than native workers. Migrants tend to have an increased risk of physical and mental ill health, but less access to health care services. This has been demonstrated recently by high rates of COVID-19 and less access to health care. There have been a number of cross-sectional studies of migrant health but few long-term cohort studies were identified. Other study designs, such as registry-based studies, surveys and qualitative studies may complement cross-sectional studies. Mixed-methodology studies would be valuable in research on migrants’ occupational health. Language and lack of trust are barriers to migrant research participation.

Conclusion

Targeted research, especially longitudinal, identifying how these economically important but often-vulnerable workers can be best assisted is needed. Researchers should identify the characteristics of the migrant workers that they are studying including visa/migration circumstances (temporary, permanent, undocumented), racial and ethnic characteristics, existing skills and language abilities.

Occupational Health and Safety of Immigrant Workers in Italy and Spain: A Scoping Review

The main aim of the present study was to summarize the available literature on the topic of occupational health and safety (OH&S) among immigrant workers (IMWs) in Italy and Spain. We conducted a scoping review, searching Medline, Social Sciences Citation Index, PsycINFO, CINAHL Plus, SciELO, and EMBASE for peer-reviewed articles, published in English, Italian, or Spanish, between 1999–2018. 34 studies were included, 28 with quantitative methodology and 6 with qualitative. Main findings were that, compared to natives, IMWs in Italy and Spain showed higher prevalence of low-skilled jobs and of perceived discrimination at work; higher physical demands, poorer environmental working conditions, and more exposure to occupational risks (e.g., ergonomic and psychosocial hazards); a greater risk of occupational injuries; worse general and mental health; and a plausible worsening of their health status, especially in Spain, as a result of the economic crisis. The findings of the present scoping review constitute warning signs that indicate the need for a holistic global response to ensure that adverse OH&S outcomes among IMWs workers are improved and that equitable access to health care is guaranteed. Such a response will require a concrete and evidence-based approach to prevent and monitor occupational risk factors and associated outcomes in the workplaces.

Sickness presenteeism: Are we sure about what we are studying? A research based on a literature review and an empirical illustration

BACKGROUND

There has been an increasing interest in studying sickness presenteeism (SP). An ever-increasing amount of scientific literature is published using this term, yet there appears to be considerable heterogeneity in how it is assessed, which could result in substantial differences in the definition and interpretation of the phenomenon really being studied. We aim to discuss what really is being studied, depending on how the phenomenon is operationalized, measured, and analyzed.

METHODS

A study based on a literature review and an empirical illustration using data of the third Spanish Psychosocial Risks Survey (2016).

RESULTS

Differences are observed based on the population in which SP is measured, the cut-off points used to define a worker as presenteeist, the reasons for an SP episode and even an analysis of the phenomenon treated as a count or as a dichotomous.

CONCLUSIONS

Without being completely exclusive, it seems that restricting the population of analysis to only those workers who consider that they should not have gone to work due to their health, and/or establishing low cut-off points to define someone as presenteeist, would more clearly delimit the study of SP to the exercise of a right to sick leave. In contrast, working with the entire population or using high cut-off points appears to relate the study of SP more with health status and less with the exercise of rights. On the other hand, taking the reasons for SP into account would probably help to improve interpretation of the phenomenon.

Anteceding factors predicting absenteeism and presenteeism in urban area in Malaysia

Background

Organization productivity is strongly linked to employees’ socioeconomic characteristics and health which is marked by absenteeism and presenteeism. This study aims to identify anteceding factors predicting employees’ absenteeism and presenteeism by income, physical and mental health.

Methods

An online health survey was conducted between May to July 2017 among employees from 47 private companies located in urban Malaysia. A total of 5235 respondents completed the 20-min online employee health survey on a voluntary basis. Chi-Square or Fisher’s exact tests were used to determine association between income with demographic and categorical factors of absenteeism and presenteeism. Multivariate linear regression was used to identify factors predicting absenteeism and presenteeism.

Results

More than one third of respondents’ monthly income were less than RM4,000 (35.4%), 29.6% between RM4,000-RM7,999 and 35.0% earned RM8,000 and above. The mean age was 33.8 years (sd ± 8.8) and 49.1% were married. A majority were degree holders (74.4%) and 43.6% were very concerned about their financial status. Mean years of working was 6.2 years (sd ± 6.9) with 68.9% satisfied with their job. More than half reported good general physical health (54.5%) (p = 0.065) and mental health (53.5%) (p = 0.019). The mean hours of sleep were 6.4 h (sd ± 1.1) with 63.2% reporting being unwell due to stress for the past 12 months. Mean work time missed due to ill-health (absenteeism) was 3.1% (sd ± 9.1), 2.8% (sd ± 9.1) and 1.8% (sd ± 6.5) among employees whose monthly income was less than RM4,000, RM4,000-RM7,999 and over RM8,000 respectively (p = 0.0066). Mean impairment while working due to ill-health (presenteeism) was 28.2% (sd ± 25.3), 24.9% (sd ± 25.5) and 20.3% (sd ± 22.9) among employees whose monthly income was less than RM4,000, RM4,000-RM7,999 and over RM8,000 respectively (p < 0.0001). Factors that predict both absenteeism and presenteeism were income, general physical health, sleep length and being unwell due to stress.

Conclusions

A combination of socioeconomic, physical and mental health factors predicted absenteeism and presenteeism with different strengths. Having insufficient income may lead to second jobs or working more hours which may affect their sleep, subjecting them to stressful condition and poor physical health. These findings demand holistic interventions from organizations and the government.

Prevalence, associated factors and reasons for sickness presenteeism: a cross-sectional nationally representative study of salaried workers in Spain, 2016

OBJECTIVES

The aim of this study was to estimate the prevalence of sickness presenteeism (SP), its associated factors and the reasons given for SP episodes, among the overall salaried population and excluding the 'healthy' workers.

DESIGN

Population-based cross-sectional study.

SETTING

Salaried population in Spain.

PARTICIPANTS

Data were obtained from the third Spanish Psychosocial Risks Survey (2016), carried out between October and December 2016, n=1615.

MAIN OUTCOME MEASURES

Self-reported episodes of SP and their reasons.

RESULTS

23.0% (95% CI 19.2 to 26.8) of the workers exhibit SP, whereas among those manifesting having had some health problem in the preceding year, the figure was 53.0% (95% CI 46.9 to 59.1). The factors associated with SP when we study all workers are age, seniority, salary structure, working more than 48 hours, the contribution of worker's wage to the total household income and downsizing; factors among the 'unhealthy' workers are working more than 48 hours and not having a contract. The most common reason for SP is 'did not want to burden my colleagues', 45.7% (95% CI 37.3 to 54.4), whereas 'I could not afford it for economic reasons' ranked third, 35.9% (29.4% to 42.9%), and 27.5% (21.3% to 34.6%) of the workers report 'worried about being laid off' as a reason for going to work despite being ill.

CONCLUSIONS

The estimated frequency of SP in Spain is lower than certain other countries, such as the Scandinavian countries. The factors associated vary depending on the population analysed (all workers or excluding 'healthy' workers). The reason 'I was worried about being laid off' was much more common than the estimates for Sweden or Norway.

A systematic review of working conditions and occupational health among immigrants in Europe and Canada

Background

A systematic attempt to summarize the literature that examines working conditions and occupational health among immigrant in Europe and Canada.

Methods

We established inclusion criteria, searched systematically for articles included in the Medline, Embase and Social Sciences Citation Index databases in the period 2000–2016 and checked the reference lists of all included papers.

Results

Eighty-two studies were included in this review; 90% were cross-sectional and 80% were based on self-report. Work injuries were consistently found to be more prevalent among immigrants in studies from different countries and in studies with different designs. The prevalence of perceived discrimination or bullying was found to be consistently higher among immigrant workers than among natives. In general, however, we found that the evidence that immigrant workers are more likely to be exposed to physical or chemical hazards and poor psychosocial working conditions is very limited. A few Scandinavian studies support the idea that occupational factors may partly contribute to the higher risk of sick leave or disability pension observed among immigrants. However, the evidence for working conditions as a potential mediator of the associations between immigrant status and poor general health and mental distress was very limited.

Conclusion

Some indicators suggest that immigrant workers in Europe and Canada experience poorer working conditions and occupational health than do native workers. However, the ability to draw conclusions is limited by the large gaps in the available data, heterogeneity of immigrant working populations, and the lack of prospectively designed cohort studies.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5703-3) contains supplementary material, which is available to authorized users.

Motives for sickness presence among students at secondary school: a cross-sectional study in five European countries

OBJECTIVES

This article investigates various motives for sickness presence (SP) among students in secondary school.

DESIGN

Cross-sectional study.

SETTING

25 secondary schools in Belgium, Estonia, Finland, Italy and Latvia.

PARTICIPANTS

5002 students between 16 and 19 years of age, 49% female.

RESULTS

Almost half of the students reported two or more incidents of SP. The study indicated that the practice of SP was mainly extrinsically motivated. The most often reported motives for SP were that absence could affect grades negatively, that important curriculum material was explained at the school and attendance requirements. Some students practising SP expressed intrinsic motivation, such as maintaining their social network and interest in what was learnt at school.

CONCLUSION

The study investigated various motives for SP in secondary schools in five European countries. Extrinsic motivation for SP was more often reported than intrinsic motivation for SP. Multivariate analyses indicated that boys, students in vocational education, immigrants and students with low-educated parents more often reported intrinsic motivation for SP, while girls and students with high absence more often reported extrinsic motivation. There were also notable cross-country differences regarding reported motives for SP.

The relation between indicators of low employment quality and attendance behavior in countries of the European Union

Background

Previous research demonstrated an association between low employment quality and lower sickness absence, which may be explained by presenteeism. Therefore, this study aimed exploring the relation between three indicators of employment quality (long working hours, precarious employment, job insecurity) and attendance behavior.

Methods

The association between employment quality and attendance behavior was investigated in 28.999 workers (mean age: 40.0 years, 53% males) of the fifth wave of the European Working Conditions Survey, using multilevel multinomial logistic regression analysis. Attendance behavior was operationalized as different combinations of sickness absence and presenteeism.

Results

Those working >48 h/week, had a higher risk to report presenteeism (with or without sickness absence). They had a lower risk to report sickness absence without presenteeism. Workers with a precarious contract had a lower risk to report absenteeism without presenteeism and the combination of both presenteeism and absenteeism. Finally, for workers perceiving job insecurity, the risk for presenteeism without sickness absence was significantly higher.

Conclusions

Several indicators of low employment quality were associated with attendance behavior, suggesting a complex behavioral mechanism in workers facing low job quality employment. Therefore, policy makers are recommended to re-establish the indefinite contractual employment as the standard, avoiding long working hours.

A methodological proposal to evaluate the cost of duration moral hazard in workplace accident insurance

The cost of duration moral hazard in workplace accident insurance has been amply explored by North-American scholars. Given the current context of financial constraints in public accounts, and particularly in the Social Security system, we feel that the issue merits inquiry in the case of Spain. The present research posits a methodological proposal using the econometric technique of stochastic frontiers, which allows us to break down the duration of work-related leave into what we term "economic days" and "medical days". Our calculations indicate that during the 9-year period spanning 2005-2013, the cost of sick leave amongst full-time salaried workers amounted to 6920 million Euros (in constant 2011 Euros). Of this total, and bearing in mind that "economic days" are those attributable to duration moral hazard, over 3000 million Euros might be linked to workplace absenteeism. It is on this figure where economic policy measures might prove more effective.

Health conditions and role limitation in three European Regions: a public-health perspective

OBJECTIVE

To describe the distribution of role limitation in the European population aged 18-64 years and to examine the contribution of health conditions to role limitation using a public-health approach.

METHODS

Representative samples of the adult general population (n=13,666) aged 18-64 years from 10 European countries of the World Mental Health (WMH) Surveys Initiative, grouped into three regions: Central-Western, Southern and Central-Eastern. The Composite International Diagnostic Interview (CIDI 3.0) was used to assess six mental disorders and standard checklists for seven physical conditions. Days with full and with partial role limitation in the month previous to the interview were reported (WMH-WHODAS). Population Attributable Fraction (PAFs) of full and partial role limitation were estimated.

RESULTS

Health conditions explained a large proportion of full role limitation (PAF=62.6%) and somewhat less of partial role limitation (46.6%). Chronic pain was the single condition that consistently contributed to explain both disability measures in all European Regions. Mental disorders were the most important contributors to full and partial role limitation in Central-Western and Southern Europe. In Central-Eastern Europe, where mental disorders were less prevalent, physical conditions, especially cardiovascular diseases, were the highest contributors to disability.

CONCLUSION

The contribution of health conditions to role limitation in the three European regions studied is high. Mental disorders are associated with the largest impact in most of the regions. There is a need for mainstreaming disability in the public health agenda to reduce the role limitation associated with health conditions. The cross-regional differences found require further investigation.

Global healthcare use by immigrants in Spain according to morbidity burden, area of origin, and length of stay

BACKGROUND

The healthcare of immigrants is an important aspect of equity of care provision. Understanding how immigrants use the healthcare services based on their needs is crucial to establish effective health policy.

METHODS

This retrospective, observational study included the total population of Aragon, Spain (1,251,540 individuals, of whom 11.9 % were immigrants). Patient-level data on the use of primary, specialised, hospital, and emergency care as well as prescription drug use in 2011 were extracted from the EpiChron Cohort and compared between immigrants and nationals. Multivariable standard or zero-inflated negative binomial regression models were generated, adjusting for age, sex, length of stay, and morbidity burden.

RESULTS

The annual visit rates of immigrants were lower than those of nationals for primary care (3.3 vs 6.4), specialised care (1.3 vs 2.7), planned hospital admissions/100 individuals (1.6 vs 3.8), unplanned hospital admissions/100 individuals (2.7 vs 4.7), and emergency room visits/10 individuals (2.3 vs 2.8). Annual prescription drug costs were also lower for immigrants (€47 vs €318). These differences were only partially attenuated after adjusting for age, sex and morbidity burden.

CONCLUSION

In a universal coverage health system offering broad legal access to immigrants, the global use of healthcare services was lower for immigrants than for nationals. These differences may be explained in part by the healthy migration effect, but also reveal possible inequalities in healthcare provision that warrant further investigation.

Work organization, exposure to workplace hazards and sickness presenteeism in the European employed population

BACKGROUND

Aim of the study was to identify work organization features and workplace hazards associated with sickness presenteeism (SP) among European workers.

METHODS

The study was conducted on data from the European Working Conditions Survey 2010 and included a study population of 30,279 employees. The relationship between work-related factors and SP was assessed through Poisson multivariate robust regression models, adjusting for significant (P < 0.05) individual and work-related characteristics.

RESULTS

SP for at least 2 days in the previous year was reported by 35% of the workers. In fully adjusted model, several psychosocial (decision authority, skill discretion, reward, abuse; psychological, cognitive, and emotional demand), and organizational factors (shift work, working with clients, long work hours) were positively associated with SP, whereas job insecurity and exposure to physical factors (lifting or moving people, vibration) decreased SP risk.

CONCLUSIONS

Our results support the importance of work-related factors, especially psychosocial exposures and organizational features, in determining workers' SP.

Sick and still at school: an empirical study of sickness presence among students in Norwegian secondary school

OBJECTIVES

This paper investigates sickness presence (SP) among students. The research questions asked are: What is the distribution of SP among students in Norwegian secondary school? What characterises students with high SP in Norwegian secondary schools?

DESIGN

A cross-sectional survey conducted in 10th grade in lower secondary school (LSS) and level 2 in upper secondary school (USS). The study was conducted using multivariate binomial logistic regression analysis.

PARTICIPANTS

The survey was administered to 66 schools, and 2 or 3 classes participated at each school. The response rate was 84% in LSS (n=1880) and 81% in USS (n=1160).

PRIMARY AND SECONDARY OUTCOME MEASURES

The paper provides information about the distribution of SP in secondary schools. The paper also examines which factors influence high SP.

RESULTS

75% of students in LSS and 80% of students in USS reported SP in the previous school year. 24% of students in LSS and 33% of students in USS reported high SP (4 episodes or more). Students with high absence from school were more likely to report high SP (ORLSS=1.7, ORUSS=2.0) than those with low/no absence. Girls were more likely to report high SP (ORLSS=1.5, ORUSS=1.5) than boys. In LSS, students with high school motivation reported high SP more often than students with low/medium motivation. In USS, students in vocational studies programmes reported high SP more often than students in general/academic studies programmes.

CONCLUSIONS

Some SP during a school year may be more common than no SP. Gender, absence, motivation and education programme were important factors for high SP in secondary school.

Why do ethnic Chinese in the Netherlands underutilize mental health care services? Evidence from a qualitative study

Chinese immigrants in the Netherlands are less likely than other ethnic groups to utilize mainstream mental health care services. This study investigated the experiences of Chinese with mental health problems, to inform measures to make services more responsive to the needs of this group. Qualitative methods of analysis were applied to interview data in order to explore ways of finding help, barriers to accessing mainstream mental health care, experiences in care, factors jeopardizing the quality of care, and views on mental health services among Chinese migrants in the Netherlands. Rather than recruiting individuals with mental health problems, an indirect method was used in which ethnic Chinese participants were invited to tell us about one or more Chinese individuals in their social environment whom they regarded as having (had) mental health problems (Symbol: see text). Although most Chinese regarded mainstream Dutch care as the appropriate resource for dealing with mental health problems, many barriers to access and threats to care quality were reported. In contrast to the widely accepted view that cultural differences in health beliefs underlie the low utilization of mental health services by Chinese in the West, the main obstacles identified in this study concerned practical issues such as communication problems and lack of knowledge of the health system. Respondents also described concerns about entitlement to care and discrimination (actual or anticipated). Measures suggested by respondents for improving care included increased use of interpreters and cultural mediators, encouraging migrants to increase their language proficiency, and better dissemination of information about the health system. The article concludes with a discussion of the policy implications of these findings.

Is sickness presenteeism a risk factor for depression? A Danish 2-year follow-up study

OBJECTIVE

To examine the prospective association between sickness presenteeism (SP), that is, working while ill, and the onset of depression.

METHODS

We carried out a two-wave (2006 to 2008) questionnaire-based study among 1271 employees from 60 Danish workplaces. Sickness presenteeism was assessed by asking participants to report the number of days that they went to work despite illness in the preceding year.

RESULTS

Multivariate logistic regression revealed that, after controlling for several health-related variables and other relevant confounders, reporting 8 or more days of SP was associated with an increased risk of depression among initially nondepressed participants (odds ratio, 2.45; 95% confidence interval, 1.06 to 5.64). No significant sex-related differences were observed in this relationship.

CONCLUSION

Adding to previous evidence on the health effects of SP, this study suggests that working while ill may also be a significant risk factor for the development of depression.

Work productivity among adults with varied Body Mass Index: Results from a Canadian population-based survey

BACKGROUND

The relationship between Body Mass Index (BMI) and work productivity, including absenteeism and presenteeism remains unclear. The objective of this study was to examine work productivity among adults with varied BMI using population-based data.

METHODS

Data source was the 2009-2010 Canadian Community Health Survey. The outcomes reflected work absence (absenteeism) and reduced activities at work (presenteeism). The key explanatory variable was BMI in six categories. Logistic regressions were used to measure the association between outcome and explanatory variables adjusting for potential confounders.

RESULTS

The sample consisted of 56,971 respondents ranging in age from 20 to 69 years. Relative to normal BMI, the odds of absenteeism were higher for those in the obesity class III (OR=1.60, 95% CI: 1.39; 1.83). Presenteeism was weakly associated with all obesity categories (OR=1.49, 95% CI: 1.38; 1.61, for obesity class I). Overweight was marginally associated with absenteeism and presenteeism. Underweight was inversely associated with absenteeism.

CONCLUSIONS

This study found that obesity is an independent risk factor for reduced work productivity. Both absenteeism and presenteeism were associated with obesity. However, being overweight was weakly associated with work productivity.

Understanding sickness presenteeism through the experience of immigrant workers in a context of economic crisis

BACKGROUND

Previous economic recessions show that immigrant workers may experience longer periods of unemployment, a situation that may lead employees to presenteeism, the act of working in spite of a health problem. This study explored perceptions about the factors that lead to presenteeism in immigrant workers considering the context of economic crisis.

METHODS

Six focus group discussions were held (February 2012), with men and women from Colombia, Ecuador, and Morocco (n=44) living in Spain and selected by theoretical sample. A qualitative content analysis was performed.

RESULTS

Four categories were identified as factors that influence the occurrence of presenteeism in a context of economic crisis: poor employment conditions, fear of unemployment, employer/employee relationship, and difficulties in finding temporary replacement workers. Furthermore, musculoskeletal, respiratory, and mental problems were related to presenteeism.

CONCLUSIONS

It is important to develop strategies to protect workers from negative working conditions that are associated with deterioration of health.

Access to health programs at the workplace and the reduction of work presenteeism: a population-based cross-sectional study

OBJECTIVE

To examine access to health programs at workplace as a determinant of presenteeism among adults.

METHODS

Data source was a subsample of the 2009-2010 Canadian Community Health Survey. The outcome was self-reported reduced activities at work (presenteeism). The explanatory variable was self-reported access to a health program at workplace. Logistic regression was used to measure the association between outcome and explanatory variables adjusting for potential confounders.

RESULTS

Adjusting for sex, age, education, income, work stress, and chronic conditions, presenteeism was not associated with having access to a health program at workplace (adjusted odds ratio, 1.23; 95% confidence interval, 0.91 to 1.65). The odds of presenteeism were higher in workers who reported high work stress and those with chronic medical conditions.

CONCLUSIONS

This study found that access to health programs at workplace is not significantly associated with a decline in presenteeism.

Positive and negative reasons for sickness presenteeism in Norway and Sweden: a cross-sectional survey

OBJECTIVES

This article investigates various reasons for sickness presenteeism (SP), that is, going to work despite illness. The research questions asked is: What are the main reported reasons for SP in Norway and Sweden?

DESIGN

Cross-sectional survey in Norway and Sweden. Use of binomial logistic regression analysis.

PARTICIPANTS

A random sample of people aged between 20 and 60 years was obtained from complete and updated databases of the Norwegian and Swedish populations. A postal questionnaire was sent to the selected individuals, with response rate 33% (n=2843). 2533 workers responded to questions about SP during the last 12 months.

PRIMARY AND SECONDARY OUTCOME MEASURES

The article informs about the distribution of reasons for SP in Norway and Sweden, selected by the respondents from a closed list. The article also examines which factors influence the most often reported reasons for SP.

RESULTS

56% of the Norwegian and Swedish respondents experienced SP in the previous year. The most frequently reported reasons for SP include not burden colleagues (43%), enjoy work (37%) and feeling indispensable (35%). A lower proportion of Norwegians state that they cannot afford taking sick leave adjusted OR (aOR 0.16 (95% CI 0.10 to 0.22)), while a higher proportion of Norwegians refer to that they enjoy their work (aOR=1.64 (95% CI 1.28 to 2.09)). Women and young workers more often report that they do not want to burden their colleagues. Managers (aOR=2.19 (95% CI 1.67 to 2.86)), highly educated persons and the self-employed more often report that they are indispensable.

CONCLUSIONS

Positive and negative reasons for SP are reported, and there are significant differences between respondents from the two countries. The response rate is low and results must be interpreted with caution.

STUDY DESIGN

Cross-sectional study.

Impact of economic crisis on mental health of migrant workers: what happened with migrants who came to Spain to work?

OBJECTIVES

To assess changes in mental health in a sample of migrant workers after the eruption of the economic crisis in Spain.

METHODS

318 migrant workers were interviewed. Mental health, sociodemographic, and economic crisis related variables were obtained through face-to-face (2008) and phone (2011) interviews. Prevalence of poor mental health (PMH) was compared (2011-2008) and multivariate logistic regression models were fitted.

RESULTS

Change in prevalence of PMH was higher in men (aOR 4.63; 95 % CI 2.11-10.16). Subgroups of men showing the largest detrimental mental health effects were: unemployed, with low salaries (≤1,200 euros) and those reporting family burden. An increase of PMH was found in women, without significant associations.

CONCLUSIONS

Mental health of migrant workers in Spain has worsened during the economic crisis.

Loss of labour productivity caused by disease and health problems: what is the magnitude of its effect on Spain's economy?

The aim of this study is to estimate the economic impact of the non-medical costs of diseases and accidents in Spain. Its main premise sustains the idea that in addition to the number of deaths, the loss of quality of life and the pain suffered by patients and their family members as a result of diseases and accidents, there are other indicators that provide us with a better understanding of their socioeconomic impact. Our analysis provides estimates of the loss of labour productivity in Spain as a result of health problems in 2005. Our main finding suggests an estimated loss amounting to over 37,969 millions euros, of which 9,136 millions euros are due to premature deaths, 18,577 millions to permanent disability and 10,255 millions to temporary disability. The loss in labour productivity due to accidents and health problems was estimated to a figure equivalent to nearly 4.2% of the Gross Domestic Product of Spain in 2005. This study underscores the strong economic impact of non-medical costs of diseases. In addition, it stresses the need for better information systems for collecting data that is relevant to the topic at hand.

The association between health and sickness absence among Danish and non-Western immigrant cleaners in Denmark

PURPOSE

The aim of the study is to investigate the association between health and sickness absence among Danish and non-Western immigrant cleaners in Denmark.

METHODS

This study is based on a cross-sectional analysis of baseline data from 2007 to 2008. The study population includes 276 cleaners, 144 Danish and 132 non-Western immigrant cleaners. Cumulative sickness absences during a 6-month period from administrative records were subdivided into no sickness absence (0 days), low occurrence of sickness absence (1-10 days) and high occurrence of sickness absence (over 10 days). Measures of health consisted of self-report and objective assessments. The relationship between sickness absence and health was analyzed through multinomial logistic regression, stratified by immigrant status.

RESULTS

For both Danish and non-Western immigrant cleaners, poor self-reported health was significantly related to high occurrence of sickness absence. Among Danish cleaners, high blood pressure was related to high occurrence of sickness absence. Among non-Western immigrant cleaners, total body pain and having one or more diagnosed chronic disease were related to high occurrence of sickness absence. No association between health and low occurrence of sickness absence was found.

CONCLUSIONS

The findings confirm the importance of health for high occurrence of sickness absence, in both ethnic groups. Moreover, low occurrence of sickness absence was not related to the health conditions investigated.