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Hashemi NS, Dalen I, Skogen JC, Sagvaag H, Gimeno Ruiz de Porras D, Aas RW. Do Differences in Drinking Attitudes and Alcohol-Related Problems Explain Differences in Sick Leave? A Multilevel Analysis of 95 Work Units Within 14 Companies From the WIRUS Study. Front Public Health 2022; 10:817726. [PMID: 35712266 PMCID: PMC9194082 DOI: 10.3389/fpubh.2022.817726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background Systematic reviews have shown a strong relationship between alcohol consumption and sick leave. The effect of alcohol consumption on sick leave may, however, vary according to the work environment. While attitudes toward drinking may impact sick leave, there is little research on the contribution of drinking attitudes to sick leave. Moreover, alcohol-related problems and drinking attitudes may be influenced by the broader sociocultural contexts of the organizational units where people work. Objectives This study aimed to explore the relationship of alcohol-related problems and drinking attitudes with sick leave while considering the nesting of employees within working units within companies. Method Data from the WIRUS (Workplace Interventions preventing Risky alcohol Use and Sick leave) study were linked to company-registered sick leave data for 2,560 employees from 95 different work units in public (n = 9) and private companies (n = 5) in Norway. Three-level (employee, work unit, and company) negative binomial regression models were estimated to explore the 12-month prospective association of alcohol-related problems and drinking attitudes with four measures of sick leave (one-day, short-term, long-term, and overall sick leave days). Models were adjusted for gender, age, cohabitation status, educational attainment, work position, and employment sector. Results We observed higher variation of one-day, short-term, and overall sick leave days between companies than between work units within companies (15, 12, and 30% vs. 0, 5, and 8%, respectively). However, neither alcohol-related problems nor drinking attitudes were associated with sick leave and, thus, those variations in sick leave were not explained by alcohol-related problems or drinking attitudes. Conclusion Our findings suggest company-level differences are more important than within company differences when explaining differences in sick leave. While alcohol-related problems or drinking attitudes were not associated with sick leave, future studies may need to explore the role of company policies, practices, or social norms in variations in sick leave rates.
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Affiliation(s)
- Neda S Hashemi
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Ingvild Dalen
- Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway.,Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Jens Christoffer Skogen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
| | - Hildegunn Sagvaag
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - David Gimeno Ruiz de Porras
- Southwest Center for Occupational and Environmental Health, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health in San Antonio, The University of Texas Health Science at Houston, San Antonio, TX, United States.,Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Barcelona, Spain
| | - Randi Wågø Aas
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
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2
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S. Hashemi N, Skogen JC, Sevic A, Thørrisen MM, Rimstad SL, Sagvaag H, Riper H, Aas RW. A systematic review and meta-analysis uncovering the relationship between alcohol consumption and sickness absence. When type of design, data, and sickness absence make a difference. PLoS One 2022; 17:e0262458. [PMID: 35015789 PMCID: PMC8752011 DOI: 10.1371/journal.pone.0262458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 12/23/2021] [Indexed: 12/29/2022] Open
Abstract
AIM Earlier research has revealed a strong relationship between alcohol use and sickness absence. The aim of this review was to explore and uncover this relationship by looking at differences in type of design (cross-sectional vs. longitudinal), type of data (self-reported vs. registered data), and type of sickness absence (long-term vs. short term). METHOD Six databases were searched through June 2020. Observational and experimental studies from 1980 to 2020, in English or Scandinavian languages reporting the results of the association between alcohol consumption and sickness absence among working population were included. Quality assessment, and statistical analysis focusing on differences in the likelihood of sickness absence on subgroup levels were performed on each association, not on each study. Differences in the likelihood of sickness absence were analyzed by means of meta-analysis. PROSPERO registration number: CRD42018112078. RESULTS Fifty-nine studies (58% longitudinal) including 439,209 employees (min. 43, max. 77,746) from 15 countries were included. Most associations indicating positive and statistically significant results were based on longitudinal data (70%) and confirmed the strong/causal relationship between alcohol use and sickness absence. The meta-analysis included eight studies (ten samples). The increased risk for sickness absence was likely to be found in cross-sectional studies (OR: 8.28, 95% CI: 6.33-10.81), studies using self-reported absence data (OR: 5.16, 95% CI: 3.16-8.45), and those reporting short-term sickness absence (OR: 4.84, 95% CI: 2.73-8.60). CONCLUSION This review supports, but also challenges earlier evidence on the association between alcohol use and sickness absence. Certain types of design, data, and types of sickness absence may produce large effects. Hence, to investigate the actual association between alcohol and sickness absence, research should produce and review longitudinal designed studies using registry data and do subgroup analyses that cover and explain variability of this association.
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Affiliation(s)
- Neda S. Hashemi
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- * E-mail: (NSH); , (RWA)
| | - Jens Christoffer Skogen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
| | - Aleksandra Sevic
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Mikkel Magnus Thørrisen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Oslo, Norway
| | - Silje Lill Rimstad
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- West Norway Competence Centre (KoRus Stavanger)/Rogaland A-Centre, Stavanger, Norway
| | - Hildegunn Sagvaag
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Heleen Riper
- Department of Clinical, Neuro, & Developmental Psychology, Faculty of Behavioral and Movement Sciences, VU Amsterdam, Amsterdam, Netherlands
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
- Department of Clinical Research, Research Unit for Telepsychiatry and e-Mental Health, University of Southern Denmark, Odense, Denmark
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Randi Wågø Aas
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Oslo, Norway
- * E-mail: (NSH); , (RWA)
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3
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Lund I, Moan IS. The role of alcohol use and cigarette smoking in sickness absence: Are there social inequalities? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 94:103190. [PMID: 33713965 DOI: 10.1016/j.drugpo.2021.103190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 11/21/2020] [Accepted: 02/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND While studies have found a social gradient in negative consequences of drinking and smoking, evidence is less clear for a gradient also in alcohol use and smoking's association with sickness absence. We investigate the association between alcohol use and cigarette smoking and general sickness absence, and examine the moderating role of socio-economic status for these associations when controlling for general health status. METHOD Questions on alcohol use, measured by the Alcohol Use Disorders Identification Test (AUDIT-C), smoking, general health and sickness absence were included in annual national cross-sectional telephone surveys on alcohol, tobacco and drug use (2015-18) amongst Norwegian adults aged 16-79-years (average response rate=59%). The analytic sample comprised 4719 full- and part-time employees aged 25-79 years (46.7% were female, mean age=44.3 years). Individual-level data on education were obtained from national registries. RESULTS In adjusted negative binomial regression analyses, current and former daily smoking were associated with a higher occurrence of sickness absence in groups with low educational attainment, but not in groups with high educational attainment. Alcohol use was negatively associated with sickness absence. While a significantly higher number of sickness days was reported by smokers in the low compared with the high education group, educational attainment did not moderate the alcohol use - sickness absence association. CONCLUSION Daily smoking is associated with sickness absence. A negative social gradient was found in the smoking - absence association. Reduced daily smoking might give a reduction in sickness absence.
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Affiliation(s)
- Ingeborg Lund
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Tobacco and Drugs PB 222 Skøyen, 0213 Oslo, Norway.
| | - Inger Synnøve Moan
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Tobacco and Drugs PB 222 Skøyen, 0213 Oslo, Norway
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4
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Hori A, Inoue Y, Kuwahara K, Kunugita N, Akter S, Nishiura C, Kinugawa C, Endo M, Ogasawara T, Nagahama S, Miyamoto T, Tomita K, Yamamoto M, Nakagawa T, Honda T, Yamamoto S, Okazaki H, Imai T, Nishihara A, Sasaki N, Uehara A, Murakami T, Shimizu M, Eguchi M, Kochi T, Konishi M, Kashino I, Yamaguchi M, Nanri A, Kabe I, Mizoue T, Dohi S. Smoking and Long-Term Sick Leave in a Japanese Working Population: Findings of the Japan Epidemiology Collaboration on Occupational Health Study. Nicotine Tob Res 2021; 23:135-142. [PMID: 31679035 PMCID: PMC7789951 DOI: 10.1093/ntr/ntz204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/30/2019] [Indexed: 12/28/2022]
Abstract
Background Few studies have investigated the association between tobacco smoking and sick leave (SL) in Japan. Methods We followed 70 896 workers aged 20–59 years (60 133 males, 10 763 females) between April 2012 and March 2017. A Cox proportional hazards model was used to investigate the associations between smoking (smoking status and intensity) and long-term SL (ie, SL lasting ≥30 consecutive days). Cause-specific analyses were also conducted. Results A total of 1777 people took long-term SL during a follow-up of 307 749 person years. Compared with never-smokers, current smokers were at a higher risk of long-term SL (hazard ratio [HR] = 1.32; 95% confidence interval [CI] = 1.19 to 1.48). Cause-specific analyses revealed that current smoking was associated with a higher risk of SL due to all physical disorders (HR = 1.44, 95% CI = 1.22 to 1.69), cancer (HR = 1.49, 95% CI = 1.10 to 2.01), cardiovascular disease (CVD; HR = 2.16, 95% CI = 1.31 to 3.55), and injuries/external causes (HR = 1.83, 95% CI = 1.31 to 2.58). Former smokers were at a higher risk of SL due to cancer at a borderline significance level (HR = 1.38, 95% CI = 0.99 to 1.92). Low-intensity smoking (ie, 1–10 cigarettes smoked per day) was associated with all-cause SL, SL due to CVD, and SL due to injuries/external causes compared with never-smokers. Conclusion In a large cohort of working-age Japanese, smoking was associated with a greater risk of long-term SL. Greater effort is needed to mitigate disease burden associated with smoking at workplace in Japan. Implications Our study contributes to the literature on the association between smoking and SL in several ways. First, the study was conducted among a Japanese working population. While the association has been extensively studied in Western setting, few attempts have been made elsewhere. Second, cause-specific analyses were undertaken in our study. Third, we paid attention to the effect of low-intensity smoking on SL given that there is growing evidence of an elevated health risk associated with low-intensity smoking.
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Affiliation(s)
- Ai Hori
- Department of Global Public Health, University of Tsukuba, Ibaraki Japan
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.,Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Naoki Kunugita
- School of Health Sciences, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Shamima Akter
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chihiro Nishiura
- Department of Safety and Health, Tokyo Gas Co., Ltd., Tokyo, Japan
| | | | - Motoki Endo
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | | | | | | - Naoko Sasaki
- Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan
| | | | - Taizo Murakami
- Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan
| | - Makiko Shimizu
- East Japan Works (Keihin), JFE Steel Corporation, Kanagawa, Japan
| | | | | | - Maki Konishi
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ikuko Kashino
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Miwa Yamaguchi
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akiko Nanri
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
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5
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Risk factors for sick leave in Brazilian oil industry workers. Int Arch Occup Environ Health 2021; 94:1223-1231. [PMID: 33677678 DOI: 10.1007/s00420-021-01650-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 01/03/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Studies point to a complex and multifactorial aetiology for sickness absence, but there is still insufficient evidence on how occupational and non-occupational risk factors contribute to this phenomenon. This study aimed to identify occupational and non-occupational factors related to sickness absence in oil industry workers, as well as their population attributable fractions (PAF). METHODS A retrospective cohort study of 2028 oil industry workers was conducted in the state of Bahia, Brazil, between January 1, 2012 and December 31, 2016. Study data were obtained from workers´ medical register. The dependent variable was the first event of sick leave for five or more days, and the independent variables were gender, age, years of work, type of work activity, level of education, work schedule, awkward working postures, body mass index, smoking, physical activity and alcohol consumption. Cox regression analysis identified risk factors to the outcome and PAF were calculated. RESULTS Being female (HR 1.79), being older (HR 1.44), non-graduated ones (HR 1.44), being of operational staff (HR 1.18), overweight (HR 1.13), obesity (HR 1.39), smoking (HR 1.61) and former smoking (HR 1.30) were risk factors for sickness absence in this cohort. Of all sickness absence in the study population, 6% could be attributed to overweight, 10% to obesity, and 8% to smoking. CONCLUSION To prevent sick leave, we recommend programs focused on combating smoking and encouraging healthy habits, aiming at weight control and the prevention of chronic diseases. Population attributable fractions point that a universal approach, aimed at the total population will be more cost-effective than health promotion programmes restricted for high-risk populations.
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6
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Affiliation(s)
- Sohrab Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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7
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Endo M, Inoue Y, Kuwahara K, Nishiura C, Hori A, Ogasawara T, Yamaguchi M, Nakagawa T, Honda T, Yamamoto S, Okazaki H, Imai T, Nishihara A, Miyamoto T, Sasaki N, Uehara A, Yamamoto M, Murakami T, Shimizu M, Eguchi M, Kochi T, Nagahama S, Tomita K, Kunugita N, Tanigawa T, Konishi M, Nanri A, Kabe I, Mizoue T, Dohi S. BMI and Medically Certified Long-Term Sickness Absence Among Japanese Employees. Obesity (Silver Spring) 2020; 28:437-444. [PMID: 31970914 PMCID: PMC7004170 DOI: 10.1002/oby.22703] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/02/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE In contrast to the association between excess weight and sickness absence (SA), the association in relation to underweight has been under-researched. This study aimed to examine the effects of BMI at both extremes of its distribution on SA. METHODS Data came from the Japan Epidemiology Collaboration on Occupational Health study of 77,760 workers aged 20 to 59 years (66,166 males, 11,594 females). Information was collected on medically certified long-term SA (LTSA) (i.e., SA lasting ≥ 30 consecutive days) from April 2012 to March 2017. A sex-specific Cox proportional hazards model was used to investigate the associations. RESULTS Among males, both obesity (hazard ratio [HR] = 1.81, 95% CI: 1.50-2.17) and underweight (HR = 1.56, 95% CI: 1.23-1.96) were significantly associated with LTSA compared with normal weight. This U-shaped association between BMI categories and LTSA was observed both for mental and physical disorders. Among females, an elevated risk was observed among those with overweight (HR = 1.54, 95% CI: 1.16-2.05). CONCLUSIONS In a cohort of the Japanese working-age population, both obesity and underweight were associated with a greater risk of LTSA in males. Future research should not overlook the excess risk of LTSA associated with underweight.
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Affiliation(s)
- Motoki Endo
- Department of Public HealthJuntendo University Graduate School of MedicineTokyoJapan
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
| | - Yosuke Inoue
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
| | - Keisuke Kuwahara
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
- Graduate School of Public HealthTeikyo UniversityTokyoJapan
| | | | - Ai Hori
- Department of Global Public HealthFaculty of MedicineUniversity of TsukubaIbarakiJapan
| | | | - Miwa Yamaguchi
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
| | | | | | | | | | | | | | | | - Naoko Sasaki
- Mitsubishi Fuso Truck and Bus CorporationKanagawaJapan
| | | | | | - Taizo Murakami
- Mizue Medical ClinicKeihin Occupational Health CenterKanagawaJapan
| | - Makiko Shimizu
- East Japan Works (Keihin)JFE Steel CorporationKanagawaJapan
| | | | | | | | | | - Naoki Kunugita
- School of Health SciencesUniversity of Occupational and Environmental HealthFukuokaJapan
| | - Takeshi Tanigawa
- Department of Public HealthJuntendo University Graduate School of MedicineTokyoJapan
| | - Maki Konishi
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
| | - Akiko Nanri
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
- Department of Food and Health SciencesInternational College of Arts and SciencesFukuoka Women's UniversityFukuokaJapan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
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8
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Kerner I, Rakovac M, Lazinica B. Leisure-time physical activity and absenteeism. Arh Hig Rada Toksikol 2018; 68:159-170. [PMID: 28976887 DOI: 10.1515/aiht-2017-68-2963] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 09/01/2017] [Indexed: 11/15/2022] Open
Abstract
Regular physical activity has a significant impact on health. There is scientific evidence for prescription of exercise in the treatment of at least 26 different chronic non-communicable diseases. Furthermore, it has an indirect role in the preservation of work capacity. The aim of this study was to review the published results of research on the relationship between leisure-time PA and absenteeism due to sickness. Medline database was searched using the keywords "leisuretime physical activity AND (sick leave OR sickness absence OR absenteeism)". Fifteen studies were included in the final analysis. A negative correlation between leisure-time PA and absenteeism due to sickness in working population was determined in 11 studies. The results support the inclusion of PA promotion in the programmes intended to reduce absenteeism prevalence, the latter being an important public health issue.
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9
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Nordstoga AL, Mork PJ, Steiro Fimland M. Improved cardiorespiratory fitness after occupational rehabilitation in merged diagnostic groups. Ann Occup Environ Med 2018; 30:16. [PMID: 29507732 PMCID: PMC5831230 DOI: 10.1186/s40557-018-0227-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/22/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Various occupational inpatient rehabilitation programs are established in Norway. This study aimed to assess change in cardiorespiratory fitness, pain, anxiety, depression, and quality of life in persons on long-term sick leave due to musculoskeletal-, mental or unspecific disorders after participation in multicomponent inpatient occupational rehabilitation. METHODS Twenty-five women and five men (mean age 45.2 years, SD 6.7, range 30-57) volunteered to participate in the study. The participants attended either 8 or 17 full days of occupational multicomponent rehabilitation including physical exercise, cognitive behavioral therapy in the form of acceptance and commitment therapy (ACT), and development of a tailored plan for return to work. Cardiorespiratory fitness was assessed by the Åstrand/Ryhming cycle test at the start and end of rehabilitation program, and at one-year follow-up. Changes in somatic and mental health were measured by questionnaires up to 4 months after start of the program. RESULTS Linear mixed models showed that the maximal oxygen uptake increased by 1.1 mL°kg-1°min- 1 during the rehabilitation program and by 3.7 mL°kg-1°min- 1 at one-year follow-up. There were minor improvements in somatic and mental health, and quality of life. CONCLUSIONS This study indicates that occupational inpatient multicomponent rehabilitation including physical exercise and ACT may promote a long-term increase in physical exercise that is sufficient to induce a significant increase in cardiorespiratory fitness. TRIAL REGISTRATION The current study is not registered, but is part of a larger trial registered at clinicaltrials.gov (No.: NCT01926574, registered 21. Aug 2013).
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Affiliation(s)
- Anne Lovise Nordstoga
- Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - Marius Steiro Fimland
- Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, 7491 Trondheim, Norway
- Hysnes Rehabilitation Center, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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10
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Høgsbro C, Davidsen M, Sørensen J. Long-term sickness absence from work due to physical inactivity: A registry-based study. Scand J Public Health 2018; 46:306-313. [PMID: 29366394 DOI: 10.1177/1403494817751328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aim of this study was to explore the relationship between leisure-time physical inactivity and long-term sickness absence in a representative sample of individuals aged 16-54 years, within the labour market and in good health. It was hypothesised that physically inactive individuals have a higher risk of long-term sickness absence and longer duration of sickness absence. METHODS The study population was identified from the National Health and Morbidity Survey, 2010. Weekly data on long-term sickness absence were obtained from the National Register on Social Transfer Payments (the DREAM registry). The association of incidence and duration of long-term sickness absence with physical inactivity was explored using logistic and Poisson regression. Data were fitted to models with levels of physical activity, demographic, social and lifestyle characteristics as independent variables. A combined hurdle model was used to estimate the difference in mean number of absence weeks. RESULTS Logistic regression showed that physically inactive individuals had a 27% higher incidence of long-term sickness absence compared with physically active individuals. The Poisson regression showed that long-term sickness absence was only slightly shorter (1 week less) for moderately active individuals compared with inactive individuals. The hurdle model estimated longer absence periods for inactive individuals (additional 2.5 weeks) in comparison with moderately and highly active individuals. CONCLUSIONS The study showed that physically inactive individuals have a higher incidence of long-term absence and that physically inactive individuals have longer periods with sickness absence than moderately and highly active individuals. When adjustments for social and health behaviour were included, the estimated associations became statistically insignificant.
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Affiliation(s)
- Cecilie Høgsbro
- 1 COHERE - Centre for Health Economics Research, University of Southern Denmark, Denmark
| | - Michael Davidsen
- 2 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Jan Sørensen
- 1 COHERE - Centre for Health Economics Research, University of Southern Denmark, Denmark.,3 Healthcare Outcome Research Centre, Royal College of Surgeons in Ireland, Ireland
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11
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Kaila-Kangas L, Koskinen A, Leino-Arjas P, Virtanen M, Härkänen T, Lallukka T. Alcohol use and sickness absence due to all causes and mental- or musculoskeletal disorders: a nationally representative study. BMC Public Health 2018; 18:152. [PMID: 29343233 PMCID: PMC5773150 DOI: 10.1186/s12889-018-5059-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 01/10/2018] [Indexed: 12/29/2022] Open
Abstract
Background Previous studies have not distinguished between different alcohol-use histories, which could have contributed to the current inconsistent evidence regarding the relationship between alcohol use and subsequent sickness absence. We thus examined alcohol use and subsequent diagnosis-specific sickness absence in groups with different levels of alcohol use, as well as in lifelong abstainers, former drinkers, and people with clinical alcohol use disorders. Methods The data of the population-based Health 2000 Survey (BRIF8901) of 3666 Finns aged 30–55 were linked with national registers on medically certified sickness absences lasting for > 10 working days (long-term) for all causes (2000 − 2010) and for mental or musculoskeletal disorders (2004-2010), as well as with registers on pensions and death (2000-2010). Alcohol use was assessed by questionnaire. Chronic somatic diseases were evaluated at baseline in a clinical examination, and common mental and alcohol use disorders using the Composite International Diagnostic Interview (CIDI). Cox regression analyses were conducted with censoring for death and retirement from work. Results During an average 10-year follow-up, 56.0% of the participants had at least one long-term sickness absence period. Compared with light drinkers, those having an alcohol use disorder had increased risk of all-cause sickness absence (HR = 1.27; 95% CI = 1.04 − 1.54) and sickness absence due to mental disorders (HR = 2.16; 95% CI = 1.39 − 3.35), when somatic and mental disorders as well as demographic, lifestyle-related and occupational factors at baseline were accounted for. Lifelong abstainers did not differ from light drinkers. Also high-volume drinking (HR = 1.52; 95% CI 1.03 − 2.25) and former drinking (HR = 1.57; 95% CI = 1.15 − 2.15) were associated with long-term sickness absence due to mental disorders. Alcohol use was not predictive of sickness absence due to musculoskeletal disorders. Conclusions These results highlight the need to distinguish between former drinking and lifelong abstinence, as only former drinking was associated with sickness absence. Alcohol use disorder and high-volume drinking were strongly predictive of sickness absence due to mental disorders. Identifying people with excessive alcohol use e.g. in occupational health care, and mapping and supporting their mental health may help in preventing sickness absences.
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Affiliation(s)
- Leena Kaila-Kangas
- Work ability and working careers, Finnish Institute of Occupational Health, PL 40, 00251, Helsinki, Finland.
| | - Aki Koskinen
- Creating Solutions, Statistics and Health Economics Team, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Päivi Leino-Arjas
- Work ability and working careers, Finnish Institute of Occupational Health, PL 40, 00251, Helsinki, Finland
| | - Marianna Virtanen
- Work ability and working careers, Finnish Institute of Occupational Health, PL 40, 00251, Helsinki, Finland
| | - Tommi Härkänen
- Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Tea Lallukka
- Work ability and working careers, Finnish Institute of Occupational Health, PL 40, 00251, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
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12
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Abstract
We identified factors protective of all-cause sickness absence (SA) among subjects with multisite musculoskeletal pain (MSP). The nationally representative source sample comprised 3420 actively working Finns aged 30 to 55 in year 2000 and alive at follow-up. Pain in 18 body locations was combined into four sites (neck, low back, upper limbs, and lower limbs). The baseline prevalence of MSP (pain in ≥ 2 sites) was 32%. Baseline data on sociodemographic factors, work ability, work, health, and lifestyle were gathered by questionnaire, interview, and clinical examination and linked with national registers on all-cause SA (periods lasting ≥10 workdays) for 2002 to 2008. Based on trajectory analysis, 74% of those with MSP had a low and 26% a high probability of SA. In logistic regression analysis, younger age, male sex, and professional occupational group were inversely associated with SA. Allowing for these, good physician-assessed work ability, physically light work, possibility to adjust workday length, encouraging workplace atmosphere, no problems with working community or mental stress, normal weight, and no sleep disorders were predictive of lower SA rates (odds ratios between 0.47 and 0.70). In a final stepwise model adjusted for age, sex, and occupational group, no exposure to lifting (odds ratio 0.58, 95% confidence interval 0.39-0.85) and to repetitive hand movements (0.57, 0.39-0.83), possibility to adjust workday length (0.73, 0.53-0.99), and normal weight (0.59, 0.40-0.87) were inversely associated with SA. In conclusion, several modifiable factors related to work and lifestyle were found as predictive of lower rates of longer SA among occupationally active subjects with MSP.
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13
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Bouwhuis S, Garde AH, Geuskens GA, Boot CRL, Bongers PM, van der Beek AJ. The longitudinal association between multiple job holding and long-term sickness absence among Danish employees: an explorative study using register-based data. Int Arch Occup Environ Health 2017; 90:799-807. [PMID: 28669035 PMCID: PMC5640740 DOI: 10.1007/s00420-017-1243-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/26/2017] [Indexed: 11/26/2022]
Abstract
Purpose Multiple job holding (MJH) is common in many countries, but little is known about its (health) consequences. Our aim is to explore the longitudinal association between MJH and long-term sickness absence (LTSA) among Danish employees. Methods We included employees (N = 8968) who participated in the Danish Work Environment Cohort Study (DWECS), based on a representative sample of the Danish working population. Three dichotomous independent variables were created: MJH in general, combination MJH (i.e. second job as employee) and hybrid MJH (i.e. self-employed in second job). LTSA (≥5 weeks) was measured using the Danish Register for Evaluation of Marginalization during 78 weeks of follow-up. Potential confounders included demographics, health, and work characteristics. Logistic regression analyses were performed to study whether LTSA was associated with MJH in general, combination MJH, and hybrid MJH. Interaction effects for gender, age, total working hours per week (≤37 or >37 h a week), and shift work were tested. Results In total, 11.7% (N = 1048) of the respondents reported having multiple jobs and 7.6% (N = 678) experienced LTSA during follow-up. After adjustment for confounders, no significant association between LTSA and MJH in general (OR = 0.82), combination MJH (OR = 0.81), or hybrid MJH (OR = 0.83) was found. Among employees working more than 37 h per week, combination MJH was associated with a higher likelihood of LTSA (OR = 1.50). Conclusions We did not find evidence for an increased likelihood of LTSA among multiple job holders. Future research should study the likelihood of LTSA among subgroups of multiple job holders, e.g. those working long hours.
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Affiliation(s)
- Stef Bouwhuis
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
- Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 77-89, 2316 ZL, Leiden, The Netherlands.
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands.
| | - Anne Helene Garde
- Department of Psychosocial Work Environment, National Research Center for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen Ø, Copenhagen, Denmark
| | - Goedele A Geuskens
- Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 77-89, 2316 ZL, Leiden, The Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Paulien M Bongers
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 77-89, 2316 ZL, Leiden, The Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
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14
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Mittendorfer-Rutz E, Dorner TE. Socio-economic factors associated with the 1‑year prevalence of severe pain and pain-related sickness absence in the Austrian population. Wien Klin Wochenschr 2017. [PMID: 28639082 PMCID: PMC5772134 DOI: 10.1007/s00508-017-1222-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background The aim of this study was to (1) investigate the relation of socio-economic status (SES), measured as education, occupation, and income, with the 12-month prevalence of severe pain and with pain-related sickness absence, and (2) analyse to what extent sociodemographic and medical factors influence these associations. Methods The study population comprised 8084 subjects aged between 15 and 65 years from the Austrian Health Interview Survey in 2006/07. Associations of SES with the 1‑year prevalence of severe pain and sickness absence due to pain in those with severe pain was assessed with logistic regression analysis and adjusted for socio-demographic and chronic medical conditions. Results The 1‑year prevalence of severe pain was 33.7%. Among those with severe pain, 32.9% were on sickness absence due to pain. SES was significantly associated with the prevalence of severe pain and even more strongly with sickness absence due to pain. Stepwise adjustment for socio-demographics and medical factors had only marginal effects on these associations. Multivariate odds ratios (ORs) for severe pain were 1.14; 1.18 and 1.32 for low income, blue-collar workers, and low education, respectively. Related ORs for sickness absence due to pain were 1.52; 1.14 and 2.05. Conclusions There was an association between SES, particularly measured as educational level, and the prevalence of severe pain, which was even stronger with sickness absence due to pain.
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Affiliation(s)
- Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Berzelius väg 3, 17177, Stockholm, Sweden
| | - Thomas Ernst Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/I, 1090, Vienna, Austria.
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15
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Choi B. One-year weight change and long-term sickness absence in professional firefighters. Am J Ind Med 2017; 60:548-556. [PMID: 28514022 DOI: 10.1002/ajim.22722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Little is known about the association between weight change (particularly moderate weight loss, 5-10% in initial weight) and long-term sickness absence (LSA) in working populations. METHODS Three hundred and forty professional firefighters reported their current and past (1 year ago) weights in a cross-sectional survey, along with their LSA experience due to a severe accident, injury, or illness during the previous 12 months. RESULTS The prevalence of LSA was 14.7%. In the non-smoking male firefighters, the prevalence of LSA was 3.4% in those with moderate weight loss over the past year; 13.3% in those who maintained their weight; and 21.7% in those who gained their weight moderately: gamma coefficient, 0.44 (95%CI: 0.05, 0.66). The linear association remained significant after further controlling for age and alcohol consumption. And it was similar across the adiposity strata (normal weight, overweight, and obesity) of the firefighters 1 year ago. CONCLUSIONS One-year weight loss was associated with decreased risk of LSA in professional firefighters.
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Affiliation(s)
- BongKyoo Choi
- Center for Occupational and Environmental Health; University of California Irvine; Irvine California
- Environmental Health Sciences Graduate Program; University of California Irvine; Irvine California
- Program in Public Health; University of California Irvine; Irvine California
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16
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Roelen C, Thorsen S, Heymans M, Twisk J, Bültmann U, Bjørner J. Development and validation of a prediction model for long-term sickness absence based on occupational health survey variables. Disabil Rehabil 2016; 40:168-175. [PMID: 27830962 DOI: 10.1080/09638288.2016.1247471] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study is to develop and validate a prediction model for identifying employees at increased risk of long-term sickness absence (LTSA), by using variables commonly measured in occupational health surveys. MATERIALS AND METHODS Based on the literature, 15 predictor variables were retrieved from the DAnish National working Environment Survey (DANES) and included in a model predicting incident LTSA (≥4 consecutive weeks) during 1-year follow-up in a sample of 4000 DANES participants. The 15-predictor model was reduced by backward stepwise statistical techniques and then validated in a sample of 2524 DANES participants, not included in the development sample. Identification of employees at increased LTSA risk was investigated by receiver operating characteristic (ROC) analysis; the area-under-the-ROC-curve (AUC) reflected discrimination between employees with and without LTSA during follow-up. RESULTS The 15-predictor model was reduced to a 9-predictor model including age, gender, education, self-rated health, mental health, prior LTSA, work ability, emotional job demands, and recognition by the management. Discrimination by the 9-predictor model was significant (AUC = 0.68; 95% CI 0.61-0.76), but not practically useful. CONCLUSIONS A prediction model based on occupational health survey variables identified employees with an increased LTSA risk, but should be further developed into a practically useful tool to predict the risk of LTSA in the general working population. Implications for rehabilitation Long-term sickness absence risk predictions would enable healthcare providers to refer high-risk employees to rehabilitation programs aimed at preventing or reducing work disability. A prediction model based on health survey variables discriminates between employees at high and low risk of long-term sickness absence, but discrimination was not practically useful. Health survey variables provide insufficient information to determine long-term sickness absence risk profiles. There is a need for new variables, based on the knowledge and experience of rehabilitation professionals, to improve long-term sickness absence risk profiles.
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Affiliation(s)
- Corné Roelen
- a Department of Health Sciences, Community and Occupational Medicine , University Medical Center Groningen, University of Groningen, Groningen , Groningen , The Netherlands.,b Department of Epidemiology and Biostatistics , VU University Medical Center, VU University , Amsterdam , The Netherlands
| | - Sannie Thorsen
- c National Research Center for the Working Environment , Copenhagen , Demark
| | - Martijn Heymans
- b Department of Epidemiology and Biostatistics , VU University Medical Center, VU University , Amsterdam , The Netherlands
| | - Jos Twisk
- b Department of Epidemiology and Biostatistics , VU University Medical Center, VU University , Amsterdam , The Netherlands
| | - Ute Bültmann
- a Department of Health Sciences, Community and Occupational Medicine , University Medical Center Groningen, University of Groningen, Groningen , Groningen , The Netherlands.,c National Research Center for the Working Environment , Copenhagen , Demark
| | - Jakob Bjørner
- c National Research Center for the Working Environment , Copenhagen , Demark.,d Department of Public Health , University of Copenhagen , Copenhagen , Denmark
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17
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Momsen AMH, Stapelfeldt CM, Nielsen CV, Nielsen MBD, Aust B, Rugulies R, Jensen C. Effects of a randomized controlled intervention trial on return to work and health care utilization after long-term sickness absence. BMC Public Health 2016; 16:1149. [PMID: 27829455 PMCID: PMC5103458 DOI: 10.1186/s12889-016-3812-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 11/03/2016] [Indexed: 11/28/2022] Open
Abstract
Background The aim of the RCT study was to investigate if the effect of a multidisciplinary intervention on return to work (RTW) and health care utilization differed by participants’ self-reported health status at baseline, defined by a) level of somatic symptoms, b) health anxiety and c) self-reported general health. Methods A total of 443 individuals were randomized to the intervention (n = 301) or the control group (n = 142) and responded to a questionnaire measuring health status at baseline. Participants were followed in registries measuring RTW and health care utilization. Relative risk (RR) and odds ratio (OR) were used as measures of associations. Results were adjusted for gender, age, educational level, work ability and previous sick leave. Results Among all responders we found no effect of the intervention on RTW. Among participants with low health anxiety, the one-year probability of RTW was lower in the intervention than in the control group (RR = 0.79 95 % CI 0.68-0.93), but for those with high health anxiety there was no difference between the groups (RR = 1.15 95 % CI 0.84-1.57). Neither general health nor somatic symptoms modified the effect of the intervention on RTW. The intervention had no effect on health care utilization. Conclusions The multidisciplinary intervention did not facilitate RTW or decrease health care utilization compared to ordinary case management in subgroups with multiple somatic symptoms, health anxiety or low self-rated health. However, the intervention resulted in a reduced chance of RTW among participants with low health anxiety levels. Trial registration ISRCTN43004323, and ISRCTN51445682
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Affiliation(s)
- Anne-Mette H Momsen
- DEFACTUM - Social & Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark. .,MarselisborgCentret, P.P. Oerums Gade 11, 1B, 8000, Aarhus C, Denmark.
| | | | - Claus Vinther Nielsen
- Section of Clinical Social Medicine and Rehabilitation, Institute of Public Health, Aarhus University, Aarhus, Denmark
| | - Maj Britt D Nielsen
- COWI A/S, Lyngby, Denmark.,The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Birgit Aust
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- The National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Chris Jensen
- National Centre for Occupational Rehabilitation, Rauland, Norway.,Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
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18
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Schou L, Moan IS. Alcohol use-sickness absence association and the moderating role of gender and socioeconomic status: A literature review. Drug Alcohol Rev 2015; 35:158-69. [PMID: 26331574 DOI: 10.1111/dar.12278] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/19/2015] [Indexed: 11/28/2022]
Abstract
ISSUES How strong is the available empirical evidence for an association between alcohol use and sickness absence? Does type of measures influence the association, and is the association moderated by gender and socioeconomic status? APPROACH We designed a search strategy to find all studies on the alcohol use-sickness absence association using individual-level data, published in peer-reviewed journals from 1980 onwards. The quality of the associations was evaluated, giving a score of 0-4 points. KEY FINDINGS Our inclusion criteria were met by 27 papers containing 28 separate studies, testing 48 associations. There is empirical evidence for an association between alcohol use and both long- and short-term absence. High-quality associations were statistically significant in 100% of the cases. Among low-medium-quality associations, alcohol was less consistently related to long-term than to short-term absence (significant in 25% and 100% of the cases, respectively). Second, the association did not vary systematically across measures of alcohol use. Third, the association applies to both genders and in all socioeconomic strata, but in some instances more strongly in lower socioeconomic strata. IMPLICATIONS Preventive strategies have to be targeted at all drinking employees, but more research into group differences for example across gender, socioeconomics, occupations and age, could prove valuable. More longitudinal studies are needed to explore causal mechanisms. CONCLUSION The alcohol use-sickness absence association is well founded in research. The association may be moderated by gender and socioeconomics, but more research is needed to draw firm conclusions on this issue.
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Affiliation(s)
- Line Schou
- Norwegian Institute for Alcohol and Drug Research, Oslo, Norway
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19
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Abstract
Increasing levels of physical activity are proven to have a positive impact on physical health and mental well-being. Physical activity is also known to influence work-related outcomes such as reducing sickness absence. Sickness absence is a major public health problem with wide economic impact on society and there may be much to gain from physical activity interventions aimed at preventing long-term sickness absence. Examining the relationship between physical activity and sickness absence is therefore important as it may provide benefits to organisations globally. This article provides a review of the evidence on the relationship between physical activity and sickness absence among employees. A search of databases (Web of Science, ScienceDirect, MEDLINE and Google Scholar) and references of published studies (from inception to 14 November 2012) were conducted to identify intervention studies and observational studies involving employees. A total of 37 studies published between 1981 and 2012 met the inclusion criteria. Evidence from the review suggests that physical activity is effective in reducing sickness absence. However, the studies highlighted a number of methodological concerns, including lack of description of the physical activity programme in intervention studies and use of self-report physical activity in observational studies. We conclude that, overall, the available evidence provides limited support that physical activity is effective in reducing sickness absence, due to the low quality of many of these studies. Future research should provide more detailed descriptions of the physical activity programme and use more reliable objective measures of physical activity such as accelerometers and fitness tests.
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Affiliation(s)
- Neha Mukesh Amlani
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK
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20
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Fimland MS, Vie G, Johnsen R, Nilsen TIL, Krokstad S, Bjørngaard JH. Leisure-time physical activity and disability pension: 9 years follow-up of the HUNT Study, Norway. Scand J Med Sci Sports 2014; 25:e558-65. [PMID: 25487654 DOI: 10.1111/sms.12369] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2014] [Indexed: 11/29/2022]
Abstract
The objective of this study was to prospectively examine the association between leisure-time physical activity and risk of disability pension, as well as risk of disability pension because of musculoskeletal or mental disorders in a large population-based cohort. Data on participants aged 20-65 years in the Norwegian Nord-Trøndelag Health Study 1995-1997 (HUNT2) were linked to the National Insurance Database. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals for disability pension across physical activity categories. During a follow-up of 9.3 years and 235,657 person-years, 1266 of 13,823 men (9%) and 1734 of 14,531 women (12%) received disability pension. Compared with individuals in the inactive group, those in the highly active group had a 50% lower risk of receiving disability pension (HR for men: 0.50, 0.40-0.64; women: 0.50, 0.39-0.63). After comprehensive adjustment for potential confounders, the risk remained 32-35% lower (HR for men: 0.68, 0.53-0.86; women: 0.65, 0.51-0.83). The associations were stronger for disability pension due to musculoskeletal disorders than mental disorders. In summary, we observed strong inverse associations between leisure-time physical activity and disability pension. Our findings strengthen the hypothesis that leisure-time physical activity may be important for occupational health in reducing disability pension.
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Affiliation(s)
- M S Fimland
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Hysnes Rehabilitation Centre, St. Olav's University Hospital, Rissa, Norway
| | - G Vie
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - R Johnsen
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - T I L Nilsen
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - S Krokstad
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Levanger, Norway
| | - J H Bjørngaard
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Forensic Department and Research Centre Bröset, St. Olav's University Hospital Trondheim, Trondheim, Norway
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21
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Rabacow FM, Luiz ODC, Malik AM, Burdorf A. Lifestyle factors, direct and indirect costs for a Brazilian airline company. Rev Saude Publica 2014; 48:949-57. [PMID: 26039398 PMCID: PMC4285830 DOI: 10.1590/s0034-8910.2014048005227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 05/23/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.
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Affiliation(s)
- Fabiana Maluf Rabacow
- Programa de Pós-Graduação em Medicina Preventiva. Faculdade de Medicina. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Olinda do Carmo Luiz
- Departamento de Medicina Preventiva. Faculdade de Medicina. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Ana Maria Malik
- Departamento de Medicina Preventiva. Faculdade de Medicina. Universidade de São Paulo. São Paulo, SP, Brasil
- Departamento de Administração e Recursos Humanos. Escola de Administração de Empresas de São Paulo, Faculdade Getulio Vargas. São Paulo, SP, Brasil
| | - Alex Burdorf
- Department of Public Health. Erasmus MC. University Medical Center. Rotterdam, The Netherlands
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22
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Quist HG, Thomsen BL, Christensen U, Clausen T, Holtermann A, Bjorner JB, Andersen LL. Influence of lifestyle factors on long-term sickness absence among female healthcare workers: a prospective cohort study. BMC Public Health 2014; 14:1084. [PMID: 25326786 PMCID: PMC4216344 DOI: 10.1186/1471-2458-14-1084] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 10/13/2014] [Indexed: 11/24/2022] Open
Abstract
Background While previous research has indicated that unhealthy lifestyle is associated with sickness absence, this association may be confounded by occupational class. To avoid this potential confounding, we examined the association between lifestyle factors (smoking, leisure-time physical activity and body mass index) and the occurrence of long-term sickness absence (LTSA; more than three consecutive weeks of registered sickness absence) within a cohort of female health care workers. Methods A total of 7401 employees filled out a questionnaire about their health behaviour and work environment. Subsequently, they were followed for 12 months in a national register on social transfer payments (DREAM register). Cox’s regression analyses, applied to grouped survival data, were used to estimate the prospective association between these lifestyle factors and LTSA. Results We found significant associations between all three lifestyle factors and risk of LTSA. The strongest lifestyle factor was current smoking, which increased the risk of LTSA by 35% (95% CI: 1.17-1.54) compared to non- smokers. For body mass index, the risk of LTSA increased with the distance away from 18.5 kg/m2 in either direction (below 18.5 kg/m2: HR: 1.32 per kg/m2; 95% CI. 1.06-1.66; above 18.5 kg/m2: HR: 1.04 per kg/m2; 95% CI: 1.03-1.05). In other words, the more underweight or overweight the women were, the higher the risk of LTSA. A dose–response relationship was found between LTSA and leisure-time physical activity (trend test p-value = 0.01), so that increasing physical activity results in decreasing risk of LTSA. Conclusion In female healthcare workers, an unhealthy lifestyle (too high/ too low body mass index, smoking, and low physical activity) is associated with higher risk of LTSA.
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Affiliation(s)
- Helle Gram Quist
- National Research Centre for the Working Environment, Lerso Parkallé 105, 2100 Copenhagen, Denmark.
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23
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Wijnvoord LEC, Van der Klink JJL, De Boer MR, Brouwer S. Predictors of sickness absence in college and university educated self-employed: a historic register study. BMC Public Health 2014; 14:420. [PMID: 24886527 PMCID: PMC4108014 DOI: 10.1186/1471-2458-14-420] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 04/25/2014] [Indexed: 11/10/2022] Open
Abstract
Background Despite a large proportion of the workforce being self-employed, few studies have been conducted on risk factors for sickness absence in this population. The aim of this study is to identify risk factors for future sickness absence in a population of college and university educated self-employed. Methods In a historic register study based on insurance company files risk factors were identified by means of logistic regression analysis. Data collected at application for private disability insurance from 634 applicants were related to subsequent sickness absence periods of 30 days or more during a follow-up period of 7.95 years. Variables studied were self-reported lifestyle variables, variables concerning medical history and present health conditions and variables derived from the general medical examination including blood tests and urinary analysis. Results Results from analysis of data from 634 applicants for private disability insurance show that previous periods of sickness absence (OR 2.07), female gender (OR 2.04), health complaints listed in the health declaration (OR 1.88), elevated erythrocyte sedimentation rate (ESR) (OR 4.05) and the nature of the profession were related to a higher risk of sickness absence. Conclusions Sickness absence was found to be related to demographic variables (gender, profession), medical variables (health complaints and erythrocyte sedimentation rate) and to variables with both a medical and a behavioural component (previous sickness absence).
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Affiliation(s)
- Liesbeth E C Wijnvoord
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, 1, 9713 AV, Groningen, The Netherlands.
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Rabacow FM, Levy RB, Menezes PR, do Carmo Luiz O, Malik AM, Burdorf A. The influence of lifestyle and gender on sickness absence in Brazilian workers. BMC Public Health 2014; 14:317. [PMID: 24708760 PMCID: PMC3983852 DOI: 10.1186/1471-2458-14-317] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 04/02/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite an increasing body of knowledge concerning gender and lifestyle factors as determinants of sickness absence in well-developed countries, the relationship between these variables has not been elucidated in emerging economic power countries, where the burden of non-communicable diseases is particularly high. This study aimed to analyze the relationships among lifestyle-related factors and sick leave and to examine whether gender differences in sickness absence can be explained by differences in socio-demographic, work and lifestyle-related factors among Brazilian workers. METHODS In this longitudinal study with a one year follow-up among 2.150 employees of a Brazilian airline company, sick leave was the primary outcome of interest. Independent variables collected by interview at enrolment in the study were gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity and smoking). In addition, the risk for coronary heart disease was determined based on measurement of blood pressure, total cholesterol and glucose levels. The total number of days on sick leave during 12 months follow-up was available from the company register. Logistic regression analysis was used to determine the influence of socio-demographic, type of work and lifestyle-related factors on sick leave. RESULTS Younger employees, those with lower educational level, those who worked as air crew members and those with higher levels of stress were more likely to have sick leave. Body mass index and level of physical activity were not associated with sick leave. After adjustment by socio-demographic variables, increased odds for 10 or more days of sick leave were found in smokers (OR=1.51, CI=1.05-2.17), and ex-smokers (OR=1.45, CI=1.01-2.10). Women were more likely to have 10 or more days of sick leave. Gender differences were reduced mainly when adjusted for type of work (15%) and educational level (7%). CONCLUSIONS The higher occurrence of sick leave among women than among men was partly explained by type of work and educational level. Our results suggest that type of work, a stressful life, and smoking are important targets for health promotion in this study population.
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Affiliation(s)
- Fabiana Maluf Rabacow
- Department of Preventive Medicine, University of São Paulo, School of Medicine, FMUSP, Avenida Dr Arnaldo, 455-2° andar, 01246-903 São Paulo, SP, Brazil.
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Updating and prospective validation of a prognostic model for high sickness absence. Int Arch Occup Environ Health 2014; 88:113-22. [PMID: 24664456 DOI: 10.1007/s00420-014-0942-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 03/14/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To further develop and validate a Dutch prognostic model for high sickness absence (SA). METHODS Three-wave longitudinal cohort study of 2,059 Norwegian nurses. The Dutch prognostic model was used to predict high SA among Norwegian nurses at wave 2. Subsequently, the model was updated by adding person-related (age, gender, marital status, children at home, and coping strategies), health-related (BMI, physical activity, smoking, and caffeine and alcohol intake), and work-related (job satisfaction, job demands, decision latitude, social support at work, and both work-to-family and family-to-work spillover) variables. The updated model was then prospectively validated for predictions at wave 3. RESULTS 1,557 (77 %) nurses had complete data at wave 2 and 1,342 (65 %) at wave 3. The risk of high SA was under-estimated by the Dutch model, but discrimination between high-risk and low-risk nurses was fair after re-calibration to the Norwegian data. Gender, marital status, BMI, physical activity, smoking, alcohol intake, job satisfaction, job demands, decision latitude, support at the workplace, and work-to-family spillover were identified as potential predictors of high SA. However, these predictors did not improve the model's discriminative ability, which remained fair at wave 3. CONCLUSIONS The prognostic model correctly identifies 73 % of Norwegian nurses at risk of high SA, although additional predictors are needed before the model can be used to screen working populations for risk of high SA.
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Hjarsbech PU, Christensen KB, Andersen RV, Borg V, Aust B, Rugulies R. Do psychosocial working conditions modify the effect of depressive symptoms on long-term sickness absence? Am J Ind Med 2013; 56:1329-40. [PMID: 23970474 DOI: 10.1002/ajim.22230] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND The objective of this study was to investigate whether work unit-levels of psychosocial working conditions modify the effect of depressive symptoms on risk of long-term sickness absence (LTSA). METHODS A total of 5,416 Danish female eldercare workers from 309 work units were surveyed using questionnaires assessing depressive symptoms and psychosocial working conditions. LTSA was derived from a national register. We aggregated scores of psychosocial working conditions to the work unit-level and conducted multi-level Poisson regression analyses. RESULTS Depressive symptoms, but not psychosocial working conditions, predicted LTSA. Psychosocial working conditions did not statistically significantly modify the effect of depressive symptoms on LTSA. CONCLUSIONS Psychosocial working conditions did not modify the effect of depressive symptoms on LTSA. The results, however, need to be interpreted with caution, as we cannot rule out lack of exposure contrast and non-differential misclassification of the exposure.
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Affiliation(s)
| | - Karl Bang Christensen
- Department of Biostatistics; Institute of Public Health; University of Copenhagen; Copenhagen; Denmark
| | | | - Vilhelm Borg
- National Research Centre for the Working Environment; Copenhagen; Denmark
| | - Birgit Aust
- National Research Centre for the Working Environment; Copenhagen; Denmark
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Jørgensen MB, Villadsen E, Burr H, Mortensen OS, Holtermann A. Does workplace health promotion in Denmark reach relevant target groups? Health Promot Int 2013; 30:318-27. [PMID: 23770769 DOI: 10.1093/heapro/dat041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of the current study was to investigate whether Workplace Health Promotion (WHP) is available for workers with poor health status (overweight, musculoskeletal disorders, sickness absence and poor self-rated health) or health behaviour (smoking, poor diet and sedentarism) and whether they participate in WHP. In total, 9835 workers responded to questions regarding availability to 6 different types of WHP through The Danish Work Environment Cohort Study in 2010. Logistic regression analyses adjusted for age, gender and industry were performed to calculate odds ratios for availability and participation of WHP among groups with different health behaviours and health status. In general, poor health behaviours were associated with reduced availability of and participation in WHP. In contrast, poor health status was generally associated with higher availability of WHP and increased participation. However, poor self-rated health was associated with lower availability of several types of WHP and reduced participation. In general, workers with health challenges that are visible to others had WHP available, whereas workers with less visible health challenges had WHP less frequently available. Health challenges visible to others were associated with higher participation in WHP, whereas poor health behaviour and reduced self-rated health were associated with reduced participation in WHP programmes.
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Affiliation(s)
- Marie Birk Jørgensen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark
| | - Ebbe Villadsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark
| | - Hermann Burr
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Ole Steen Mortensen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark Department of Occupational Medicine, Køge Hospital, Køge, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark
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Pain in multiple sites and sickness absence trajectories: A prospective study among Finns. Pain 2013; 154:306-312. [DOI: 10.1016/j.pain.2012.11.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 10/12/2012] [Accepted: 11/06/2012] [Indexed: 11/27/2022]
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Weng SF, Ali S, Leonardi-Bee J. Smoking and absence from work: systematic review and meta-analysis of occupational studies. Addiction 2013; 108:307-19. [PMID: 23078132 DOI: 10.1111/add.12015] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 08/14/2012] [Accepted: 10/12/2012] [Indexed: 11/28/2022]
Abstract
AIMS This study aimed to assess the association between smoking and absenteeism in working adults. METHODS A systematic review and meta-analysis was performed by electronic database searches in MEDLINE, EMBASE, CAB Abstracts, PubMed, Science Direct and National Health Service Economic Evaluation Database (February 2012). Longitudinal, prospective cohorts or retrospective cohorts were included in the review. Summary effect estimates were calculated using random-effects meta-analysis. Heterogeneity was assessed by I(2) and publication bias was investigated. RESULTS A total of 29 longitudinal or cohort studies were included. Compared with non-smokers, current smokers had a 33% increase in risk of absenteeism [95% confidence interval (CI): 1.25-1.41; I(2) = 62.7%; 17 studies]. Current smokers were absent for an average of 2.74 more days per year compared with non-smokers (95% CI: 1.54-3.95; I(2) = 89.6%; 13 studies). Compared with never smokers, ex-smokers had a 14% increase in risk of absenteeism (95% CI: 1.08-1.21; I(2) = 62.4%; eight studies); however, no increase in duration of absence could be detected. Current smokers also had a 19% increase in risk of absenteeism compared with ex-smokers (95% CI: 1.09-1.32, P < 0.01, eight studies). There was no evidence of publication bias. The total cost of absenteeism due to smoking in the United Kingdom was estimated to be £1.4 billion in 2011. CONCLUSIONS Quitting smoking appears to reduce absenteeism and result in substantial cost-savings for employers.
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Affiliation(s)
- Stephen F Weng
- UK Centre for Tobacco Control Studies, Division of Epidemiology and Public Health, School of Community Health Sciences, University of Nottingham, Nottingham, UK.
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Poulsen OM, Persson R, Kristiansen J, Andersen LL, Villadsen E, Ørbæk P. Distribution of subjective health complaints, and their association with register based sickness absence in the Danish working population. Scand J Public Health 2013; 41:150-7. [PMID: 23287396 DOI: 10.1177/1403494812471909] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS To describe the distribution of subjective health complaints (SHCs) in a Danish working population and the associations between SHC and register based sickness absence. METHODS The study entailed 2876 men and 3574 women aged 18-59 years that constituted the 2005 panel in the Danish Work Environment Cohort Study (DWECS). All had completed a subjective health complaints inventory and the Nordic Musculoskeletal Questionnaire (NMQ). Seven SHC/NMQ indices were constructed and merged with subsequently collected data on prolonged sickness absence periods (each period > 14 days) that was registered in the national Danish register on social transfer payments: the DREAM register. Ordinal logistic regression was used to model the cumulative odds for sickness absence as a function of strata. RESULTS The majority of participants reported at least one SHC during a 30-day period (circa 89% of the men and 95% of the women). The reports of severe SHC, defined as recurring SHC within the 30-day period, were less common. About 55% of the men and 68% of the women reported at least one severe SHC during a 30-day period. The odds ratios of sickness absence increased with the number of SHC a participant acknowledged. The odds ratios were slightly reduced after adjusting for age, disease history and social class. CONCLUSIONS The majority of the working population in Denmark report at least one SHC during a 30-day period. Roughly half of the population report having at least one recurrent (often to very often) SHC during the last 30-days (severe SHC). Reporting the presence of several SHCs increases the likelihood of having more prospectively registered periods of sickness absence above two weeks.
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Stapelfeldt CM, Jensen C, Andersen NT, Fleten N, Nielsen CV. Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality. BMC Public Health 2012; 12:661. [PMID: 22894644 PMCID: PMC3511193 DOI: 10.1186/1471-2458-12-661] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 07/18/2012] [Indexed: 12/04/2022] Open
Abstract
Background Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1) validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2) validate self-reported sick leave days during one year against workplace-registered sick leave. Methods Agreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI) were used. Results The probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6). Specificity was close to 100% (95% CI: 98.3-100). The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9) weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1). The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 – 95.5) % and 58.5 (95% CI: 51.1 – 65.6) % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 – 88.6) % and 98.9 (95% CI: 98.3 – 99.3) %. Conclusions The DREAM register offered valid measures of sick leave spells of at least 15 days among eldercare employees. Pregnancy-related sick leave should be excluded in studies planning to use DREAM data on sickness benefit. Self-reported sick leave became more imprecise when number of absence days increased, but the sensitivity and specificity were acceptable for lengths not exceeding one week.
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Exposure to disturbing noise and risk of long-term sickness absence among office workers: a prospective analysis of register-based outcomes. Int Arch Occup Environ Health 2012; 86:729-34. [DOI: 10.1007/s00420-012-0810-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 08/01/2012] [Indexed: 11/26/2022]
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Skogen JC, Knudsen AK, Mykletun A, Nesvåg S, Øverland S. Alcohol consumption, problem drinking, abstention and disability pension award. The Nord-Trøndelag Health Study (HUNT). Addiction 2012; 107:98-108. [PMID: 21707810 DOI: 10.1111/j.1360-0443.2011.03551.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS To examine associations of abstention, alcohol consumption and problem drinking with subsequent disability pensioning (DP), and whether previous excessive consumption ('sick-quitting') could explain some of the increased risk for DP among abstainers. DESIGN Prospective population-based study. SETTING AND PARTICIPANTS Data were from two waves of the Nord-Trøndelag Health Study (HUNT) linked with the national insurance database. The two main analyses included 37,729 (alcohol consumption) and 34,666 (problem drinking) participants. MEASUREMENTS Alcohol consumption was measured by self-reported consumption, while problem drinking was assessed by the Cut down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire. Information on subsequent DP, including diagnosis for which the DP was awarded, was gathered from the national insurance database. Covariates included somatic illness and symptoms, mental health, health-related behaviour, socio-economic status and social activity. FINDINGS Those reporting the highest level of alcohol consumption were not at increased risk for DP [hazard ratio (HR) 1.12, 95% confidence interval (CI): 0.92-1.38], whereas problem drinking was a strong predictor (HR 2.79, 95% CI: 2.08-3.75) compared to their corresponding reference groups. Alcohol abstainers were also at increased risk for DP, but among them, the previous consumers (HR 1.95, 95% CI: 1.48-2.57) and previous excessive consumers (HR 1.67, 95% CI: 1.01-2.74) were at higher risk for DP than constant abstainers. CONCLUSIONS Problem drinking is linked to subsequent requirement for a disability pension but mere alcohol consumption is not. This is partly explained by 'sick-quitting'.
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Affiliation(s)
- Jens Christoffer Skogen
- Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Bergen, Norway
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Burr H, Pedersen J, Hansen JV. Work environment as predictor of long-term sickness absence: linkage of self-reported DWECS data with the DREAM register. Scand J Public Health 2011; 39:147-52. [PMID: 21775374 DOI: 10.1177/1403494811401480] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The present overview discusses ten papers dealing with four research topics using self-reported work environment in the Danish Work Environment Cohort Study (DWECS) linked with register data on long-term sickness absence (LTSA) in the Danish Register for Evaluation of Marginalisation (DREAM). RESEARCH TOPICS Research relied on self-reported data among 3000-5000 employees linked with registered LTSA data. Analyses were performed with Cox regression models. Risk groups: Kindergarten teachers and daycare workers were at high risk for LTSA. RISK FACTORS Mainly physical exposures but also psychosocial factors were risk factors for LTSA. Attributable fractions: A quarter of LTSA spells could be attributed to the physical work environment. Most of the association between social class and LTSA was explained by physical work environment and smoking. Mechanisms: Depressive symptoms, severe pain in hands, and low back and pain intensity were risk factors for LTSA. Only in work sites with traditional leadership did health problems predict LTSA. CONCLUSION The linking of DWECS with DREAM has made it possible to estimate the importance of work environment factors for LTSA. Future research should deal with possible risk factors such as health problems and organisational factors.
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Affiliation(s)
- Hermann Burr
- Centre of Maritime Health and Safety, University of Southern Denmark, Denmark.
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Hensing G, Holmgren K, Mårdby AC. Harmful alcohol habits were no more common in a sample of newly sick-listed Swedish women and men compared with a random population sample. Alcohol Alcohol 2011; 46:471-7. [PMID: 21486930 DOI: 10.1093/alcalc/agr033] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS To estimate harmful alcohol habits in a sample of incident sick-listed individuals compared with a random sample from the general population taking social background, health and work-related factors into account. METHODS Data for this cross-sectional questionnaire study were collected in 2008 in the Västra Götaland region, Sweden. The study population (19-64 year olds) consisted of 2888 consecutive incident sick-leave sample (ISS) and 3567 individuals from a random population sample (RPS). The mailed questionnaire included Alcohol Use Disorder Identification Test and validated instruments on health and work-related factors. Socio-demographic data came from register data. Analyses were made with χ(2) tests and logistic regression analyses. RESULTS No differences in prevalence of harmful alcohol habits were found between men in the ISS (22%) and the RPS (21%). Compared with women in the ISS, a higher proportion of women in the RPS were likely to report harmful alcohol habits [14 versus 9% (P < 0.001)]. This difference was confirmed in the logistic regression analyses where women in the RPS had higher odds of having harmful alcohol habits compared with women in the ISS [odds ratio (OR) = 1.54 (95% confidence interval (CI): 1.23-1.89)]. Even after controlling for significant confounders (age, low income, high self-reported health and high level of perceived symptoms), we found that the differences in harmful alcohol habits remained [OR = 1.44 (95% CI: 1.16-1.81)]. CONCLUSIONS Harmful alcohol habits were no commoner in men and women who belonged to the sample of incident sick-leave cases. Future studies are needed to analyse the predictive value of harmful alcohol habits on sickness absence length and the time until return to work after sickness absence.
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Affiliation(s)
- G Hensing
- Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, PO Box 453, SE-405 30 Göteborg, Sweden.
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Hjarsbech PU, Andersen RV, Christensen KB, Aust B, Borg V, Rugulies R. Clinical and non-clinical depressive symptoms and risk of long-term sickness absence among female employees in the Danish eldercare sector. J Affect Disord 2011; 129:87-93. [PMID: 20797794 DOI: 10.1016/j.jad.2010.07.033] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 07/05/2010] [Accepted: 07/27/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Depression has a high point and life time prevalence and is a major cause of reduced work ability and long-term sickness absence (LTSA). Less is known of the extent to which non-clinical depressive symptoms are related to the risk of LTSA. The aim of this study was to investigate how non-clinical and clinical depressive symptoms are prospectively associated to subsequent LTSA. METHODS In a cohort study of 6985 female employees from the Danish eldercare sector depressive symptoms were measured by the Major Depression Inventory (MDI) and scores (0-50) were divided into groups of 0-4, 5-9, 10-14, 15-19, ≥20 points and clinical depression. Data was linked to a national register with information on LTSA (≥3 weeks). Hazard ratios (HR) for LTSA during a 1-year follow-up were calculated by Cox's proportional hazards model. RESULTS Compared to the reference group (0-4) the HR was stronger for each subsequent group: MDI scores of 5-9: HR=1.07 (95% CI: 0.93-1.24); 10-14: 1.38 (1.15-1.66); 15-19: 1.54 (1.20-1.98); ≥20: 1.96 (1.45-2.64); clinical depression: 2.32 (1.59-3.38); after adjustment for previous LTSA, age, family status, smoking, leisure time physical activity, BMI, and occupational group. LIMITATIONS Missing information on the cause of sickness absence and prevalent somatic illness. CONCLUSION A clear dose-response relationship exists between increasing depressive symptoms and risk of LTSA. The adverse effect of non-clinical depressive symptoms on LTSA already manifests itself at relatively low scores. CLINICAL RELEVANCE this study illustrates the valuable information of considering the whole continuum of depressive symptoms.
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Affiliation(s)
- Pernille U Hjarsbech
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark.
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Impact of burnout and psychosocial work characteristics on future long-term sickness absence. Prospective results of the Danish PUMA Study among human service workers. J Occup Environ Med 2011; 52:964-70. [PMID: 20881631 DOI: 10.1097/jom.0b013e3181f12f95] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The objective of this study was to examine if burnout and psychosocial factors predicted long-term sickness absence (>2 weeks) at work unit level. METHODS Data were collected prospectively at 82-work units in human services (PUMA cohort, PUMA: Danish acronym for Burnout, Motivation and Job satisfaction) followed up during the proceeding 18 months regarding onset of long-term sickness absence. Questionnaire data regarding burnout and psychosocial factors were aggregated at work unit level. We used Poisson regression models with psychosocial factors and burnout as predictors of long-term sickness absence for more than 18 months based on data from a national absence register. RESULTS Long-term sickness absence was predicted by psychosocial factors and by burnout at work unit level. CONCLUSION To reduce sickness absence, organizations within human services should improve the psychosocial work environment, and equally important, the organizations should be attentive to employees with symptoms of burnout.
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Abstract
BACKGROUND Sick leave is a topical subject, particularly following the revision of the Agreement on a More Inclusive Working Life (the IA agreement). However, there has been little discussion about the extent to which sick leave may be related to work. MATERIAL AND METHODS The paper is based on a non-systematic literature search using PubMed combined with personal research and experience. RESULTS Various studies indicate that a significant proportion of all sick leaves may be due to illness caused by working conditions. Heavy physical work, awkward work postures and low job control are particularly important factors. People who suffer from work-related illnesses have a greater need for absence from work than people with similar illnesses caused by factors other than their work. Workplace interventions designed to prevent work-related illness may also prevent sick leave. Sick leaves which are due to an imbalance between an individual's resources and his/her job demands, may often be prevented or shortened by workplace interventions, irrespective of what causes the imbalance. INTERPRETATION It is my view that more importance should be attached to primary preventive measures to reduce work-related illness, combined with workplace interventions to accommodate people who carry a higher risk of sick leave. However, this is not given sufficient attention in the current IA agreement.
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Affiliation(s)
- Ingrid Sivesind Mehlum
- Department for occupational medicine and epidemiology, The National Institute of Occupational Health, PO Box 8149 Dep, 0033 Oslo, Norway.
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Lund T, Labriola M, Feveile H, Christensen KB. The fraction of disability pensions attributable to smoking and obesity. Results from a 15-year follow-up study. J Public Health (Oxf) 2009. [DOI: 10.1007/s10389-009-0304-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Frost P, Haahr JP, Andersen JH. Impact of work, health and health beliefs on new episodes of pain-related and general absence-taking. Scand J Public Health 2009; 37:569-76. [PMID: 19666673 DOI: 10.1177/1403494809341094] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate the impact of physical and psychosocial workloads, and self-reported health aspects and health beliefs, on the risk of new episodes of pain-related and general sickness absence. METHODS This was a cohort study with 2 years of follow-up of 3583 employed participants, 18-64 years of age. A questionnaire was used to obtain information about workloads, physical and mental health, fear avoidance and other health beliefs. Sickness absence data were collected from company reports, supplemented by self-report of the health problem to which absence was attributed, and by linkage to a central register of state-funded income loss compensation. RESULTS Sickness absence of at least 14 days and pain-related absence of at least 7 days was experienced by 24.9% and 5.2%, respectively, while 14.2% received state-funded income loss compensation. Physical work demands, working in the public sector, pain intensity, care-seeking behaviour, female gender and compensated sickness absence in the year prior to follow-up were the most important predictors of new episodes of sickness absence. Pain-related absence was associated with the same variables and also with high body mass index, but effect sizes differed. Psychosocial workloads, health anxiety and fear avoidance beliefs were unrelated to any of the absence measures used. CONCLUSION Risk factors for general absence and for pain-related absence in unselected working populations are similar but of different effect sizes. A potential primary prevention area could be the provision of accommodating workplaces for employees with pain problems. The mechanisms behind the influence of care-seeking behaviour warrant further research.
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Affiliation(s)
- Poul Frost
- Department of Occupational Medicine, Arhus University Hospital, Denmark.
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Predicting long-term sickness absence and early retirement pension from self-reported work ability. Int Arch Occup Environ Health 2009; 82:1133-8. [PMID: 19365638 DOI: 10.1007/s00420-009-0417-6] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Accepted: 03/11/2009] [Indexed: 10/20/2022]
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Lund T, Christensen KB, Vaez M, Labriola M, Josephson M, Villadsen E, Voss M. Differences in sickness absence in Sweden and Denmark: the cross national HAKNAK study. Eur J Public Health 2008; 19:343-9. [PMID: 19098065 DOI: 10.1093/eurpub/ckn128] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIM To investigate potential differences in sickness absence among public sector employees in Sweden and Denmark, and to what extent a difference was associated with age, gender, physical and psychosocial work environment exposures, lifestyle factors, self-rated health or work ability. METHODS In 2000, two cross-sectional samples of 8562 public sector employees in Sweden and Denmark were surveyed. The study outcome, self-reported number of sick-leave days the year preceding interview, was dichotomized into 7 days or less, and more than 7 days. Chi square test was used to analyse distribution of dependent and independent variables in the two sub-cohorts. Stratified logistic regression analysis was performed to identify causes for absence within the two sub-cohorts, and logistic regression analysis was performed to study differences in sickness absence levels between the two sub-cohorts. RESULTS More subjects from the Swedish study population reported more than 7 days of sickness absence. Factors associated with sickness absence were largely similar in the two countries. The difference in absence level between Sweden and Denmark was not associated with differences in age, gender, skill level, lifestyle, psychosocial or physical work environment, musculoskeletal symptoms or self-rated health, whereas work ability score decreased the difference in sickness absence level. CONCLUSION The results could indicate an increased retention of employees with health problems in the Swedish labour market compared with the Danish labour market. A possible explanation for the differences in sickness absence ascertained in this study could be due to differences in the sickness insurance legislation.
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Affiliation(s)
- Thomas Lund
- The Danish National Centre for Social Research, Copenhagen, Denmark.
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Smith DR. Tobacco smoking by occupation in Australia and the United States: a review of national surveys conducted between 1970 and 2005. INDUSTRIAL HEALTH 2008; 46:77-89. [PMID: 18270453 DOI: 10.2486/indhealth.46.77] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Tobacco use represents a key issue in workplace health, and much can be learned from countries where occupational smoking data has been regularly collected on a national basis. This article reviews national smoking surveys previously conducted in Australia and the United States between 1970 and 2005, and examines their relevance to the field of occupational tobacco control. When the first preliminary research was undertaken over 35 years ago, tobacco smoking was a regular feature in the general population of both countries, albeit with higher rates often documented among blue collar workers. Recent national investigations however, suggest that certain historical differences in smoking prevalence rates by occupation are persisting as we enter the 21st century. Detailed examination also indicates that employee sub-groups, such as cleaners and construction workers, are now bearing much of the occupational smoking burden in Australia and the United States. As such, there is an urgent need for more aggressive and finely targeted tobacco control activities in the workplace, as well as increased cooperation between tobacco control organizations, labor unions and other stakeholders, so that they may more effectively combat this ongoing threat to workers' health.
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Affiliation(s)
- Derek R Smith
- WorkCover New South Wales Research Center of Excellence, University of Newcastle, Ourimbah, Australia
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