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Ohm E, Madsen C, Gravseth HM, Brage S, Grøholt EK, Alver K, Holvik K. Post-injury long-term sickness absence and risk of disability pension: The role of socioeconomic status. Injury 2024; 55:111480. [PMID: 38452702 DOI: 10.1016/j.injury.2024.111480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/02/2024] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Previous research has identified low socioeconomic status (SES) as a risk factor for long-term sickness absence (LTSA) and disability pension (DP) following trauma. However, most studies lack information on medical diagnoses, limiting our understanding of the underlying factors. To address this gap, we retrieved information about diagnostic causes for receipt of welfare benefits to explore the role of SES in the transition from post-injury LTSA to permanent DP among the working population in Norway. MATERIALS AND METHODS We conducted a population-based cohort study of all Norwegian residents aged 25-59 years registered with a spell of LTSA due to injury commencing in the period 2000-2003. This cohort was followed through 2014 by linking information on receipt of welfare benefits with sociodemographic data from administrative registers. SES was defined as a composite measure of educational attainment and income level. We used flexible parametric survival models to estimate hazard ratios (HR) with 95 % confidence intervals (CI) for all-cause and diagnosis-specific DP according to SES, adjusting for sex, age, marital status, immigrant status and healthcare region of residence. RESULTS Of 53,937 adults with post-injury LTSA, 9,665 (18 %) transferred to DP during follow-up. The crude risk of DP was highest for LTSA spells due to poisoning and head injuries. Overall, individuals in the lowest SES category had twice the risk of DP compared to those in the highest SES category (HR = 2.25, 95 % CI 2.13-2.38). The difference by SES was greatest for LTSA due to poisoning and smallest for LTSA due to head injuries. A majority (75 %) of DP recipients had a non-injury diagnosis as the primary cause of DP. The socioeconomic gradient was more pronounced for non-injury causes of DP (HR = 2.47, 95 % CI 2.31-2.63) than for injury causes (HR = 1.73, 95 % CI 1.56-1.92) and was especially steep for DP due to musculoskeletal diseases and mental and behavioural disorders. CONCLUSIONS The relationship between SES and DP varied by both the type of injury that caused LTSA and the diagnosis used to grant DP, highlighting the importance of taking diagnostic information into account when investigating long-term consequences of injuries.
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Affiliation(s)
- Eyvind Ohm
- Department of Health and Inequality, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway.
| | - Christian Madsen
- Department of Disease Burden, Norwegian Institute of Public Health, Zander Kaaesgt. 7 5015 Bergen, Norway
| | - Hans Magne Gravseth
- Department of Occupational Health Surveillance, National Institute of Occupational Health, PO Box 5330 Majorstuen 0304 Oslo, Norway
| | - Søren Brage
- Retired medical doctor with a PhD in epidemiology/social medicine. Before retirement SB held a position in the Norwegian Labour and Welfare Administration, leading the unit responsible for medical coding of welfare benefits from 1998 to 2015
| | - Else Karin Grøholt
- Department of Health and Inequality, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway
| | - Kari Alver
- Department of Health and Inequality, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway
| | - Kristin Holvik
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway
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Hoekstra T, Boersema HJ, Abma FI, Brouwer S. Residual Work Capacity and (In)Ability to Work Fulltime Among a Year-Cohort of Disability Benefit Applicants Diagnosed with Mental and Behavioural Disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:739-749. [PMID: 36899152 PMCID: PMC10684610 DOI: 10.1007/s10926-023-10109-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
AIMS Residual work capacity and inability to work fulltime are important outcomes in disability benefit assessment for workers with mental and behavioural disorders. The aim of this study is to gain insight into the prevalence and associations of socio-demographic and disease-related factors of these outcomes across different mental and behavioural diagnoses groups. METHODS A year cohort of anonymized register-data of patients diagnosed with a mental or behavioural disorder who claim a work disability benefit after two years of sick-leave was used (n = 12,325, age 44.5 ± 10.9, 55.5% female). Limitations in mental and physical functioning caused by disease are indicated according to the Functional Ability List (FAL). No residual work capacity was defined as having no possibilities to work, whereas inability to work fulltime was defined as being able to work less than 8 h per day. RESULTS The majority (77.5%) of the applicants were assessed with residual work capacity, of these 58.6% had an ability to work fulltime. Applicants diagnosed with (post-traumatic) stress, mood affective and delusional disorders showed significant higher odds for no residual work capacity and for inability to work fulltime, while other diagnoses groups, like adjustment and anxiety disorders, showed decreased odds for both assessment outcomes. CONCLUSIONS The type of mental and behavioural disorder seems important in the assessment of residual work capacity and inability to work fulltime, as the associations differ significantly between the specific diagnoses groups.
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Affiliation(s)
- Tialda Hoekstra
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Groningen, The Netherlands.
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands.
| | - Henk-Jan Boersema
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Groningen, The Netherlands
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
- Dutch Social Security Institute: The Institute for Employee Benefit Schemes (UWV), Amsterdam, The Netherlands
| | - Femke I Abma
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Groningen, The Netherlands
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD, Groningen, The Netherlands
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
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Hasting RL, Mehlum IS, Undem K, Robroek SJW, Burdorf A, Gran JM, Merkus SL. The effects of a national, voluntary agreement for a more inclusive working life on work participation following long-term sickness absence: a Norwegian cohort study. Scand J Work Environ Health 2023; 49:466-476. [PMID: 37548319 PMCID: PMC10838625 DOI: 10.5271/sjweh.4112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVES This study aimed to estimate the average individual effect of the company-level Norwegian Agreement on a More Inclusive Working Life (IA Agreement) on individuals' (i) sustained return to work after a sickness absence (SA) episode, and (ii) recurrent SA. METHODS Using register data, 79 253 men and 94 914 women born in Norway 1967-1976 were followed for one year between 2005 and 2010 after returning to work from an SA episode (>16 days). Weighted Cox proportional hazard models analysed time to first exit from work by companies' IA status (IA/non-IA). Weighted cumulative incidence differences between IA and non-IA groups with 95% bootstrapped confidence intervals (CI) were calculated for the competing events of full SA, graded (<100%) SA, unemployment/economic inactivity, education, disability pension, and death/emigration. Stabilised inverse probability of treatment weights balanced IA/non-IA groups according to nine covariates. Analyses were stratified by gender, and separately for two initial SA diagnoses (musculoskeletal and psychological). RESULTS Both men [adjusted hazard ratio (HR) 0.96, 95% CI 0.93-0.99] and women (adjusted HR 0.97, 95% CI 0.94-0.99) in IA companies were less likely to exit work in the year following SA. Similar findings were seen among individuals with musculoskeletal diagnoses and women with psychological diagnoses. Men with psychological diagnoses were more likely to exit work. Recurrent full and graded SA were more likely, and unemployment/economic inactivity less likely, in IA companies. However, the estimated effects were small and the CI often included the null. CONCLUSIONS Individuals working in IA companies were more likely to remain in work. This was mainly due to reduced unemployment/economic inactivity, suggesting the IA Agreement may have influenced work participation through other means than reduced SA.
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Affiliation(s)
- Rachel L Hasting
- National Institute of Occupational Health, Research Group for Occupational Medicine and Epidemiology, PB 5330 Majorstuen, 0304 Oslo, Norway.
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Kaila-Kangas L, Haukka E, Lallukka T, Rahkonen O, Toppinen-Tanner S, Leino-Arjas P. Work-family conflicts and long-term medically certified sickness absence due to mental disorders - a follow-up study of female municipal employees. BMC Public Health 2023; 23:1137. [PMID: 37312062 DOI: 10.1186/s12889-023-16075-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 06/08/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND . Decreased work ability due to mental disorders is a growing concern in Europe. We studied the role of work-family conflicts in association with long-term sickness absence due to mental disorders (LTSA-MD). METHODS . Baseline data were extracted from the Helsinki Health Study for women aged 40 to 55 in full-time work in 2001 - 2002 (N = 2386). Questionnaire responses were linked with register data from the Social Insurance Institution of Finland on SA spells due to mental disorders during 2004-2010. We studied an overall question on satisfaction with combining work and family (WFS) and composite scores of work-to-family conflicts (WTFC) and family-to-work-conflicts (FTWC), and their components in association with the first certified SA spell (≥ 12 calendar days) due to a mental disorder during the follow-up. We performed Cox regression analyses with hazard ratios (HR) and their 95% confidence intervals (CI) adjusted for sociodemographic factors, work schedule, perceived mental and physical strenuousness at work, and self-rated health. First, we examined all participants, and second, only those who reported no prior mental disorder. RESULTS . Poor work-family satisfaction (WFS) was associated with subsequent LTSA-MD, adjusting for all covariates (HR 1.60; 95% CI 1.10-2.16). Both high WTFC (1.64; 1.15-2.23), and high FTWC (1.43; 1.02-2.00) increased the probability of LTSA-MD in the full model. When participants with prior mental disorder were excluded, the association between poor WFS and WTFC with LTSA-MD retained while that between FTWC and LTSA-MD attenuated; however, two items of the FTWC were still associated with LTSA-MD: 'Family worries and problems distract you from your work' and 'Family matters prevent you from sleeping enough to do your job well'. Of the WTFC items, the following remained associated with LTSA-MD: 'Problems at work make you irritable at home' and 'Your job takes so much energy you do not feel up to doing things that need attention at home'. The experience of decreased time for work or family did not associate with LTSA-MD. CONCLUSIONS . Among female municipal employees, dissatisfaction with combining work and family and both work-to-family and family-to-work conflicts were associated with subsequent long-term sickness absence due to mental disorders.
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Affiliation(s)
- Leena Kaila-Kangas
- Specialized Researcher, Finnish Institute of Occupational Health, 00032 Työterveyslaitos, Box 18, Helsinki, Finland.
| | - Eija Haukka
- Specialized Researcher, Finnish Institute of Occupational Health, 00032 Työterveyslaitos, Box 18, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Salla Toppinen-Tanner
- Specialized Researcher, Finnish Institute of Occupational Health, 00032 Työterveyslaitos, Box 18, Helsinki, Finland
| | - Päivi Leino-Arjas
- Specialized Researcher, Finnish Institute of Occupational Health, 00032 Työterveyslaitos, Box 18, Helsinki, Finland
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Fagerlund P, Shiri R, Suur-Uski J, Kaartinen S, Rahkonen O, Lallukka T. Separate and joint associations of chronic pain, multisite pain and mental health with sickness absence among younger employees: a register based longitudinal study. Arch Public Health 2023; 81:97. [PMID: 37248528 DOI: 10.1186/s13690-023-01115-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Pain conditions and poorer mental health are associated with work disability. However, few studies have examined the association of concurrent pain and poorer mental health with sickness absence among younger employees. We examined separate and joint associations of chronic pain, multisite pain, and mental health with total and long-term all-cause sickness absence days among younger Finnish municipal employees. METHODS The Young Helsinki Health-study data were collected in 2017 from 19-39-year-old employees of the City of Helsinki, Finland. Chronic (≥ 3 months) and multisite (≥ 2 body sites) pain and mental health (RAND-36 emotional wellbeing subscale dichotomized by median score) were self-reported (n = 3911). Chronic pain, multisite pain and mental health were analyzed separately and combined. Register data on total (≥ 1 workdays) and long-term (≥ 11 workdays) sickness absence days during the following year were obtained. Negative binomial regression analyses were performed with sociodemographic, socioeconomic, and health-related factors as confounders. Gender interaction and synergistic indices were examined. RESULTS Chronic multisite pain was associated with long-term sickness absence days (rate ratio [RR] 2.51, 95% CI 1.17-5.42). Chronic pain (RR 5.04, 95% CI 2.14-11.87) and multisite pain (RR 4.88, 95% CI 2.30-10.33) were associated with long-term sickness absence days among employees with poorer mental health. There was a synergistic interaction between gender and multisite pain for total sickness absence days (synergy index 1.80, 95% CI 1.27-2.54), with stronger associations among women. CONCLUSIONS Chronic and multisite pain are associated with long-term sickness absence among younger employees, particularly among women and employees with concurrent poorer mental health. Consideration of this knowledge at workplaces and in healthcare could help to identify and support employees at increased risk of later sickness absence.
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Affiliation(s)
- Pi Fagerlund
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland.
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Johanna Suur-Uski
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
| | - Sara Kaartinen
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Hyvinkää, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
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Alkaabi FA. Predicting disability retirement among Abu Dhabi police using multiple measure of sickness absence. BMC Public Health 2022; 22:1318. [PMID: 35810280 PMCID: PMC9270810 DOI: 10.1186/s12889-022-13713-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/24/2022] [Indexed: 11/15/2022] Open
Abstract
Background Disability retirement has been investigated in the last two decades using predictors such as measures of sickness absence, psychological, social, and organizational work factors. The impact of various health-related and sickness measures on disability retirement across various occupational group reveal a significant relation. However, current literature lacks understanding in police personnel. Methods This study examines the roles of demographic and measures of sickness absence on disability retirement among police personnel in Abu Dhabi, UAE. The case–control design was used to predict disability retirement wherein controls were matched with cases according to age and gender from those who worked in the same administration as the case at baseline, to reduce the possible confounding influence of these variables. Conditional logistic regression models were used determine the odds-ratio of various measures of sickness absence in predicting disability retirement. Results Results indicate that increased number of spells, and number of days of sickness absence can predict disability retirements among police personnel in the UAE. Results indicate that odds ratios for disability retirement for the total exposure period increased from 1.76 (95% CI = 1.42-2.20) for spells of 4-7d to 2.47 (95%CI = 1.79-3.40) for spells of > 4 weeks. When compared with their married counterparts, non-married police employees had a statistically significant increase in odds of disability retirement of almost three fold (OR = 2.93, 95% CI = 1.55-5.56). Non-field and field police officers, on the other hand, had significantly reduced odds of disability retirement compared with admin/supportive staff (OR = 0.43 and 0.28 with 95% CI = 0.19-0.96 and 0.13-0.61 respectively). Odds ratios of disability retirement at end of the exposure period for the matching variables with those obtained after additionally adjusting for all demographic variables (model b), namely, marital status, occupation, employment grade and type, and educational level. The odds ratios of disability retirement remained significantly raised for the total number of days of sickness absence and for the number of spells of sickness absence for all spell types. Conclusions Recommendation to reduce the number of future disability retirements among Abu Dhabi Police include structured problem-solving process addressed through stepwise meetings between the line-managers and the employee.
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Leite WKDS, Araújo AJDS, da Silva LB, de Souza EL, Silva JMND, Bolis I, Silva MPDOE, Neves RDF, Colaço GA. Sickness absence from work in the footwear industry: A longitudinal study. Work 2022; 72:431-451. [DOI: 10.3233/wor-205312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Studies on illness in the footwear industry have prioritized specific work sectors and diseases. OBJECTIVES: To analyze the main factors related to sickness absence and the indicators of illness in terms of recurrence and workdays lost among workers at a footwear company, ranging from storage of raw material to distribution of the final product. METHODS: A total of 9072 cases of absence from work were investigated in shoe production units from 2014 to 2017. Univariate models estimated the risk of bodily dysfunction (physiological and psychological) and the severity of recurrence and work days lost. RESULTS: (1) Most production units and work sectors were related to one or more affected bodily functions; (2) Neuromusculoskeletal and movement-related functions and the work sectors of prefabrication; cutting, assembly and finishing; and quality inspection of the final product required a longer recovery time before return to work and had a greater recurrence of leave; and (3) Women seemed to be more affected than men in terms of the reappearance of symptoms. CONCLUSIONS: Illness differs according to occupational sectors. The production sectors present more serious situations due to physical overload, intense rhythm and concentration, monotony and low autonomy.
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Affiliation(s)
| | | | - Luiz Bueno da Silva
- Department of Production Engineering, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - Erivaldo Lopes de Souza
- Department of Production Engineering, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | | | - Ivan Bolis
- Postgraduate Program in Social Psychology, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | | | - Robson da Fonseca Neves
- Postgraduate Program in Physical Therapy, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
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Altena R, Gernaat SAM, Wilking U, Kiani NA, Johnsson A, Hedayati E. Use of sickness benefits by patients with metastatic breast cancer-A Swedish cohort study. Eur J Cancer Care (Engl) 2022; 31:e13626. [PMID: 35621269 PMCID: PMC9541357 DOI: 10.1111/ecc.13626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/05/2022] [Accepted: 05/16/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of this study is to determine the prevalence and predictors of sickness absence (SA) and disability pension (DP) in women with metastatic breast cancer (mBC). METHODS Data were obtained from Swedish registers concerning 1,240 adult women diagnosed 1997-2011 with mBC, from 1 year before (y-1) to 2 (y1) and 2 (y2) years after diagnosis. SA and DP prevalence was calculated. Odds ratios (AOR) were determined for factors associated with using long-term (SA > 180 days or DP > 0 days) sickness benefits. RESULTS Prevalence of SA and DP was 56.0% and 24.8% during y-1, 69.9% and 28.9% during y1, and 64.0% and 34.7% during y2, respectively. Odds of using long-term sickness benefits were higher y1 and y2 in patients using long-term sickness benefits the year before diagnosis (AOR = 3.82, 95% CI 2.91-5.02; AOR = 4.31, 95% CI 2.96-6.29, respectively) and y2 in patients with mBC diagnosis 1997-2000 (AOR = 1.84, 95% CI 1.10-3.08) and using long-term sickness benefits the year after diagnosis (AOR = 22.10, 95% CI 14.33-34.22). CONCLUSIONS The prevalence of sickness benefit utilisation was high and increased after mBC diagnosis, particularly for patients using long-term sickness benefits prior to diagnosis. Additional study is needed to determine factors that might reduce the need for sickness benefits and enhance work ability in these patients.
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Affiliation(s)
- Renske Altena
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet, Stockholm, Sweden.,Breast Cancer Center, Cancer Theme, Karolinska University Hospital and Karolinska CCC, Stockholm, Sweden
| | - Sofie A M Gernaat
- Department of Medicine, Division of Clinical Epidemiology, Karolinska Institute, Stockholm, Sweden
| | - Ulla Wilking
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet, Stockholm, Sweden
| | - Narsis A Kiani
- Department of Oncology-Pathology, Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Algorithmic Dynamics Lab, Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Aina Johnsson
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet, Stockholm, Sweden.,Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden.,Department of Oncology, South Hospital, Stockholm, Sweden
| | - Elham Hedayati
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet, Stockholm, Sweden.,Breast Cancer Center, Cancer Theme, Karolinska University Hospital and Karolinska CCC, Stockholm, Sweden
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Perhoniemi R, Blomgren J. Outpatient healthcare use before and during a long-term sickness absence spell: a register-based follow-up study comparing healthcare use by the length of sickness absence and transition to disability pension in Finland. BMJ Open 2022; 12:e053948. [PMID: 35217537 PMCID: PMC8883273 DOI: 10.1136/bmjopen-2021-053948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The objective of the study was to examine outpatient healthcare use before and during a long-term sickness absence (LTSA), and to compare the development of healthcare use between groups defined through LTSA lengths and disability pension (DP) transition. DESIGN Register-based longitudinal study with five 6-month periods before and after the start of the LTSA spell in early 2016.LTSA groups 1 (N=210) and 2 (N=187) went on to reach the statutory maximum LTSA length, with group 1 transitioning to DP. Group 3 (N=3082) had a shorter LTSA spell. Control group 4 (N=92 921) had no LTSA. SETTING AND PARTICIPANTS Non-retired individuals aged 20-59, with no LTSA during 2015 (N=96 400) were included from the total population of the city of Oulu, Finland. Register data were linked on LTSA spells and outpatient healthcare use 2013-2018, DP status in 2018, and various covariates. MAIN OUTCOME MEASURES Negative binomial regression models were used to examine the covariate-adjusted number of healthcare visits, and to examine the association of the LTSA groups with healthcare use before and after the start of LTSA (incidence rate ratios and predicted means). RESULTS Individuals eventually reaching the maximum LTSA length (groups 1 and 2) had a higher level of healthcare use before the LTSA and especially after the start of LTSA than others. Individuals transferring to DP after the maximum LTSA (group 1) used healthcare the most after the start of LTSA. CONCLUSIONS The risk for at least 1 year's disability may be identified by frequent outpatient healthcare use years before LTSA. However, future disability retirees could not be identified through their pre-LTSA healthcare use. Instead, their high use of healthcare after the start of the LTSA was consistent with their increasing health problems leading to retirement.
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Affiliation(s)
- Riku Perhoniemi
- The Social Insurance Institution of Finland (Kela), Research Unit, Helsinki, Finland
| | - Jenni Blomgren
- The Social Insurance Institution of Finland (Kela), Research Unit, Helsinki, Finland
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Hertling S, Loos F, Matziolis G, Kirschner I, Graul I. [The influence of occupational activity on diseases of the musculoskeletal system of the upper extremity]. DER ORTHOPADE 2021; 51:669-676. [PMID: 34939146 PMCID: PMC9352613 DOI: 10.1007/s00132-021-04199-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/03/2022]
Abstract
Einleitung Erkrankungen des Bewegungsapparates der oberen Extremität sind Grund für zunehmende krankheitsbedingte Fehlzeiten bei Erwerbspersonen. Zielsetzung Ziel dieser Studie ist es, den Einfluss der Berufsabhängigkeit auf die Entstehung von Erkrankungen des Bewegungsapparates der oberen Extremität zu untersuchen und neben berufsspezifischen Faktoren, gesundheitsbezogene Risiken darzustellen. Material und Methoden Es wurden 1070 Patienten eingeschlossen, bei denen zwischen 2016 und 2019 bei einer Läsion der Rotatorenmanschette (RM) eine operative RM-Rekonstruktion durchgeführt wurde. Die relevanten Daten wurden retrospektiv aus dem Krankenhausinformationssystem dokumentiert. Die Berufszweige der Patienten wurden nach der Klassifikation der Berufe 2010 (KldB 2010) eingeteilt und mit routinemäßig erfassten und anonymisierten, frei verfügbaren Daten (Statistisches Bundesamt, Bundesagentur für Arbeit) verglichen. Ergebnisse Von den 1070 Patienten waren 844 Patienten im arbeitsfähigen Alter. Die Altersstruktur der einzelnen Bereiche zeigten keine signifikanten Unterschiede. Anhand der Vergleiche der Patientendaten mit der Bevölkerung ergaben sich signifikant höhere RM-Erkrankungsraten in den Bereichen Land‑, Forst- und Tierwirtschaft sowie Gartenbau (p = 0,003); Bau, Architektur, Vermessung und Gebäudetechnik (p < 0,001); Verkehr, Logistik, Schutz und Sicherheit (p < 0,001) und Unternehmensorganisation, Buchhaltung, Recht und Verwaltung (p < 0,001). Ein signifikant reduziertes Risiko bestand in Naturwissenshaft, Geografie und Informatik (p = 0,015); kaufmännische Dienstleistungen, Warenhandel, Vertrieb, Hotel und Tourismus (p < 0,001); Gesundheit, Soziales, Lehre und Erziehung (p < 0,001). Schlussfolgerung Die Prävalenz von RM-Läsionen zeigt einen statistischen Zusammenhang zur ausgeführten Berufstätigkeit in Abhängigkeit von den Berufszweigen. Neben der Berufsabhängigkeit spielen geschlechtsspezifische Arbeitsfaktoren eine Rolle. Schulterschmerzen bei Erwerbstätigkeiten sollten differenzierter betrachtet werden. Dadurch sollen gezielt Präventivmaßnahmen eingeleitet werden können, um vorzubeugen.
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Affiliation(s)
- Stefan Hertling
- Klinik und Poliklinik für Frauenheilkunde und Fortpflanzungsmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland. .,Waldkliniken Eisenberg, Deutsches Zentrum für Orthopädie, Campus Eisenberg, Universitätsklinikum Jena, Eisenberg, Deutschland. .,, Heinrich-Schütz-Straße 16, 07548, Gera, Deutschland.
| | - Franziska Loos
- Praxis für Orthopädie und Schulterchirurgie, 04177, Leipzig, Deutschland
| | - Georg Matziolis
- Waldkliniken Eisenberg, Deutsches Zentrum für Orthopädie, Campus Eisenberg, Universitätsklinikum Jena, Eisenberg, Deutschland
| | - Isabella Kirschner
- Waldkliniken Eisenberg, Deutsches Zentrum für Orthopädie, Campus Eisenberg, Universitätsklinikum Jena, Eisenberg, Deutschland
| | - Isabel Graul
- Waldkliniken Eisenberg, Deutsches Zentrum für Orthopädie, Campus Eisenberg, Universitätsklinikum Jena, Eisenberg, Deutschland.,Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland
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11
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Occupation and Sickness Absence in the Different Autonomous Communities of Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111453. [PMID: 34769969 PMCID: PMC8583026 DOI: 10.3390/ijerph182111453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/22/2021] [Accepted: 10/28/2021] [Indexed: 12/02/2022]
Abstract
The occupation of a worker is a determining factor of sickness absence (SA) and can influence both the beginning and continuation of the latter. This study describes SA in Spain, separately in the different Autonomous Communities (AC) in relation to the occupation of workers, with the aim of determining the possible differences in its frequency and duration, relating it also to the diagnosis. A total of 6,543,307 workers, aged 16 years and older, who had at least one episode of SA in the year 2019, constituted the study sample. The obtained results indicate that SA is more frequent and shorter in more elemental occupations. The average duration increases with age and is longer in women, except in technical and administrative occupations, where there is no gender divide. Sickness absences caused by musculoskeletal and mental disorders are more frequent in the lower occupational classes, although their average duration is shorter than in other, more qualified groups. The ACs with shorter duration in almost all the occupational groups are Madrid, Navarre and the Basque Country. In conclusion, SA is more frequent and shorter in lower occupational classes.
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12
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Bláfoss R, Vinstrup J, Skovlund SV, López-Bueno R, Calatayud J, Clausen T, Andersen LL. Musculoskeletal pain intensity in different body regions and risk of disability pension among female eldercare workers: prospective cohort study with 11-year register follow-up. BMC Musculoskelet Disord 2021; 22:771. [PMID: 34507585 PMCID: PMC8431848 DOI: 10.1186/s12891-021-04655-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 08/21/2021] [Indexed: 11/18/2022] Open
Abstract
Background Musculoskeletal pain is a risk factor for leaving the labour market temporarily and permanently. While the presence of multi-site pain increases the risk of disability pension, we lack detailed knowledge about pain intensity as a risk factor. This study investigated the association between musculoskeletal pain intensity in different body regions and risk of future disability pension among eldercare workers. Methods Eight thousand seven hundred thirty-one female eldercare workers replied to a questionnaire on work and health in 2005 and were followed for 11 years in the Danish Register for Evaluation of Marginalization. Time-to-event analyses estimated hazard ratios (HR) for disability pension from pain intensities (0–9 numeric rating scale (NRS)) in the low-back, neck/shoulders, and knees during the previous 3 months. Analyses were mutually adjusted for pain regions, age, education, lifestyle, psychosocial work factors, and physical exertion at work. Results During 11-year follow-up, 1035 (11.9%) of the eldercare workers received disability pension. For all body regions among all eldercare workers, dose-response associations were observed between higher pain intensity and risk of disability pension (p < 0.001). The risk for disability pension was increased when reporting “very high” pain levels (≥7 points on the 0–9 NRS) in the low-back (HR 2.19, 95% CI 1.70–2.82), neck/shoulders (HR 2.34, 95% CI 1.88–2.92), and knees (HR 1.89, 95% CI 1.44–2.47). Population attributable risks (PAR) were 15.5, 23.2, and 9.6% for pain > 2 on NRS in the low-back, neck/shoulders, and knees, respectively, indicating that 15.5, 23.2, and 9.6% fewer eldercare workers would likely receive disability pension if the pain intensity was reduced to 2 or less. For workers ≤45 years and > 45 years, PAR was highest for neck/shoulder pain (27.6%) and low-back pain (18.8%), respectively. Conclusions The present study found positive dose-response associations between pain intensity in the low-back, neck/shoulders, and knees, and risk of disability pension during 11-year follow-up. Moderate to very high levels of musculoskeletal pain in eldercare workers should, therefore, be considered an early warning sign of involuntary premature exit from the labour market. These findings underscore the importance of preventing, managing, and reducing musculoskeletal pain to ensure a long and healthy working life.
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Affiliation(s)
- Rúni Bláfoss
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark. .,Research Unit for Muscle Physiology and Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - Jonas Vinstrup
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Sebastian Venge Skovlund
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Research Unit for Muscle Physiology and Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Rubén López-Bueno
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Joaquin Calatayud
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Thomas Clausen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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13
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Perhoniemi R, Blomgren J. Frequent attenders of three outpatient health care schemes in Finland: characteristics and association with long-term sickness absences, 2016-2018. BMC Public Health 2021; 21:870. [PMID: 33957897 PMCID: PMC8101095 DOI: 10.1186/s12889-021-10866-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/12/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Frequent attenders (FAs) impose a significant burden on service capacity and public health funding. Although the characteristics of the group and their risk for sickness absences (SA) have been studied, an understanding of FAs in different health care schemes is lacking. The aim of the study was to investigate FAs and their SA risk in the working-age population in public care, occupational health services (OHS) and private care schemes. The average number of SA days was also examined by diagnostic group. SETTING AND PARTICIPANTS Register data on the use of outpatient health care, sickness allowance spells and background characteristics (2015-2018) for 25-64 year old residents of the city of Oulu, Finland, (n = 91,737) were used. Subjects were categorized into non-attenders, non-frequent attenders and FAs (top decile of attenders) both for all outpatient health care and specifically for each care scheme in 2016. The number of sickness absence days was measured yearly in 2016, 2017 and 2018. The data were analyzed with descriptive methods and negative binomial regression models. RESULTS FAs consumed 31 to 44% of all visits depending on scheme in 2016. Frequent attendance was common among low socioeconomic groups in the public scheme, among lower non-manual employees and manual workers in OHS, and among entrepreneurs in the private scheme. FAs had a higher average number of SA days than others in each scheme, although group differences decreased from 2016 to 2017 and 2018. In public care, the adjusted effect of frequent attendance was strong especially for SA due to mental disorders (adjusted incidence rate ratio [IRR] for FAs 13.40), and in OHS for SA due to musculoskeletal disorders (adjusted IRR for FAs 8.68). CONCLUSION In each outpatient health care scheme, frequent attenders pose a great challenge both by consuming services and through their increased risk of disability. FAs in different schemes have partially different characteristics and risks. Common patient registers covering various service schemes would enable an identification of FAs visiting multiple schemes and services. Better coordinated services are needed for public care FAs in particular.
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Affiliation(s)
- Riku Perhoniemi
- The Social Insurance Institution of Finland, P.O. Box 450, 00056 KELA, Helsinki, Finland
| | - Jenni Blomgren
- The Social Insurance Institution of Finland, P.O. Box 450, 00056 KELA, Helsinki, Finland
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14
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Leino-Arjas P, Seitsamo J, Nygård CH, K.C. P, Neupane S. Process of Work Disability: From Determinants of Sickness Absence Trajectories to Disability Retirement in A Long-Term Follow-Up of Municipal Employees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052614. [PMID: 33807823 PMCID: PMC7967364 DOI: 10.3390/ijerph18052614] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 11/16/2022]
Abstract
Work disability may originate early during work history and involve sickness absences (SA) and eventually permanent disability. We studied this process over 15 years. Questionnaire data collected in 1981 on health, working conditions, and lifestyle of Finnish municipal employees aged 44-58 years (n = 6257) were linked with registers on SA (≥10 workdays), disability pension, and death from the period 1986-1995. Trajectory analysis was used to assess development in SA (days/year) over 5 years (1981-1985). We analyzed determinants of the trajectories with multinomial regression, while trajectory membership was used as a predictor of disability pension (DP) during the subsequent 10 years in survival analysis. Three SA trajectories emerged: increasing (women: 6.8%; men: 10.2%), moderate (21.2%; 22.7%), and low. In a mutually adjusted model, the increasing trajectory in women was associated with baseline musculoskeletal (MSD), mental and respiratory disorders, injuries, obesity, sleep problems, and low exercise (effect sizes OR > 2), and in men with MSD, sleep problems, smoking, low exercise, and non-satisfaction with management. The moderate trajectory associated with MSD, 'other somatic disorders', sleep problems, and awkward work postures in both genders; in women, also overweight, cardiovascular and respiratory morbidity, and (inversely) knowledge-intensive work, and in men, smoking and mental disorders were thus associated. Ten-year risks of DP contrasting increasing vs. low SA were more than 10-fold in both genders and contrasting moderate vs. low SA 3-fold in women and 2-fold in men. These findings emphasize the need for early identification of workers with short-term problems of work ability and interventions regarding lifestyle, health, and working conditions, to help prevent permanent disability.
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Affiliation(s)
- Päivi Leino-Arjas
- Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland; (P.L.-A.); (J.S.)
| | - Jorma Seitsamo
- Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland; (P.L.-A.); (J.S.)
| | - Clas-Håkan Nygård
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, FI-33014 Tampere, Finland; (C.-H.N.); (P.K.C.)
- Gerontology Research Center, Tampere University, FI-33014 Tampere, Finland
| | - Prakash K.C.
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, FI-33014 Tampere, Finland; (C.-H.N.); (P.K.C.)
- Gerontology Research Center, Tampere University, FI-33014 Tampere, Finland
| | - Subas Neupane
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, FI-33014 Tampere, Finland; (C.-H.N.); (P.K.C.)
- Gerontology Research Center, Tampere University, FI-33014 Tampere, Finland
- Tampere University Hospital, 33521 Tampere, Finland
- Correspondence:
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15
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Incidence and Length of Sickness Absence among Hierarchical Occupational Classes and Non-Wage-Earners: A Register Study of 1.6 Million Finns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020501. [PMID: 33435424 PMCID: PMC7827837 DOI: 10.3390/ijerph18020501] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/30/2020] [Accepted: 01/06/2021] [Indexed: 11/22/2022]
Abstract
Socioeconomic differences in sickness absence are well known, but previous studies have tended to focus on wage earners only. This study examined incidence and length of sickness absence comparing the employee groups of upper and lower non-manual employees and manual workers, but also entrepreneurs, the unemployed and other non-wage-earners. The study utilized register data on a nationally representative 70% sample of Finns aged 25–62 at the end of year 2012 (N = 1,615,352). Sickness absence spells compensated by sickness allowance and initiated during 2013 were retrieved from the register of the Social Insurance Institution of Finland (SIIF) and followed until the end of each episode and linked to socio-demographic covariates collected from the registers of the SIIF and of Statistics Finland. Zero-inflated negative binomial regression was used in multivariate models. After adjusting for age, marital status, region and income, there were clear differences in the occurrence and length of sickness absence across socioeconomic groups. Compared to upper non-manual employees, lower non-manual employees and especially manual workers had higher cumulative annual incidence of sickness absence among both men and women, but the entrepreneurs, the unemployed and other non-wage-earners had a clearly higher expected number of sickness absence days. Results varied by diagnostic group. The results highlight the importance of different types of preventive measures for reducing the occurrence of sickness absence and for preventing prolongations of sickness absence spells in different socioeconomic groups.
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