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Salonen L, Hartikainen E, Solovieva S, Viikari-Juntura E, Leinonen T. Contribution of compositional changes in the workforce to sickness absence trends in Finland. SSM Popul Health 2023; 24:101525. [PMID: 37808232 PMCID: PMC10550613 DOI: 10.1016/j.ssmph.2023.101525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/23/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023] Open
Abstract
In this study, we assessed whether the long-term decrease in sickness absences in Finland is explained by observed and unobserved compositional changes in the workforce. Utilizing register-based panel data on Finnish wage earners aged 30-62, we examined the annual onset of compensated sickness absence (granted after 10 weekdays) in the period 2005-2016. We applied random effects models adjusting for changes in the observed sociodemographic and occupational characteristics of the study population. We also applied fixed effects models, with corrections of the estimates for cohort ageing, to additionally account for the unobserved time-invariant characteristics of the study population over the years. Of the observed characteristics, increasing educational level partly explained the decreasing trend in sickness absences, and the further contribution of the occupational class was weak. Additionally, accounting for unobserved individual characteristics further explained the decreasing trend in sickness absences among those aged 30-47 years and led to a reverse increasing trend among those aged 48-62 years irrespective of sex and employment sector. Particularly for those over 47 years old, the decrease in sickness absences appeared to be more strongly influenced by compositional changes in characteristics that are established before fully entering the labour market - such as educational level as well as unmeasured individual characteristics that remain unchanged after childhood and early adulthood - than in the work environment or other factors contributing at working age. Sickness absence trends fluctuated during economic cycles, which did not appear to be explained by immediate changes in the observed or unobserved characteristics. Different mechanisms are likely to explain long-term sickness absence trends and trends around economic cycles. Attempts to improve work ability and labour market inclusion in long-term should rely more on increasing educational levels among the workforce and on interventions carried out early during the life course.
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Affiliation(s)
- Laura Salonen
- Finnish Institute of Occupational Health, 00032, Helsinki, Finland
| | - Elli Hartikainen
- Finnish Institute of Occupational Health, 00032, Helsinki, Finland
| | | | | | - Taina Leinonen
- Finnish Institute of Occupational Health, 00032, Helsinki, Finland
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2
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Sun R, Lam LW, Wu AMS. Work addiction in Chinese white-collar workers: the psychometric properties of its measure and its comorbidity with general anxiety in network analysis. BMC Psychol 2023; 11:214. [PMID: 37491337 PMCID: PMC10369739 DOI: 10.1186/s40359-023-01247-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/10/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Work addiction (WA) threatens occupation-related health in many countries including China. This research aims to evaluate the psychometric properties of the Chinese version of Bergen Work Addiction Scale (BWAS), the most common measure of WA, to facilitate relevant studies in Chinese workers. A network analysis was further conducted to identify central and bridge symptoms within the WA-anxiety network to improve intervention practices. METHODS A total of 694 Chinese white-collar workers completed an online questionnaire survey in March of 2022, and the responses to BWAS from a subsample of 50 participants one month after this survey were also collected. RESULTS The unidimensionality of BWAS was supported by results of exploratory factor analysis, exploratory graph analysis, and confirmatory factor analysis and we found satisfactory internal consistency and acceptable test-retest reliability. Multiple-group factor analyses confirmed the measurement invariance of BWAS across genders, districts (i.e., central China, eastern China, western China, and northeastern China), and age groups (i.e., young and middle-aged adults) while the convergent validity of BWAS was demonstrated by its significant correlations with Dutch Work Addiction Scale (r = 0.62, p < 0.001) and its criterion validity was indicated by its significant correlations with general anxiety, weekly work hours, and health status (r = -0.16 to 0.31, p < 0.001-0.01). Network analysis further revealed two central symptoms (WA-tolerance and WA-problems) and three bridge symptoms (WA-problems, WA-mood modification, and mouth dryness of general anxiety) maintaining the WA-anxiety comorbidity. CONCLUSIONS Our findings suggest that BWAS is a valid measure of WA in Chinese workers and interventions should put special attention to the identified central and bridge symptoms underlying the WA-anxiety network.
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Affiliation(s)
- Ruimei Sun
- Department of Psychology, Faculty of Social Sciences, University of Macau, Avenida da Universidade, Taipa, Macao SAR, China
- Center for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, Macao SAR, China
| | - Long W Lam
- Center for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, Macao SAR, China
- Department of Management and Marketing, Faculty of Business Administration, University of Macau, Avenida da Universidade, Taipa, Macao SAR, China
| | - Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Avenida da Universidade, Taipa, Macao SAR, China.
- Center for Cognitive and Brain Sciences, University of Macau, Avenida da Universidade, Taipa, Macao SAR, China.
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3
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Karjala A, Pietiläinen O, Salonsalmi A, Lahti J, Lallukka T, Rahkonen O. Changes in occupational class differences in leisure-time physical activity and the contribution of retirement. Scand J Med Sci Sports 2023; 33:283-291. [PMID: 36326782 DOI: 10.1111/sms.14256] [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: 07/22/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
Occupational class differences in leisure-time physical activity (LTPA) are well recognized. Less is known about how these differences develop as individuals age, and how retirement is associated with this change. We investigated how occupational class differences in LTPA change in a cohort over a 15-17 years follow-up. We further examined, how the transition into mandatory or disability retirement contributed to the change in LTPA levels and occupational class differences. We used the data from the Helsinki Health Study surveying the aging City of Helsinki employees. In all, 8773 individuals were included in the analyses. We evaluated LTPA levels using weekly metabolic equivalent task (MET) hours and used generalized linear mixed effect models (GLMM) to estimate the development of LTPA levels. Commuting was included in the LTPA measure. Occupational class differences in LTPA emerged and widened during the follow-up. The physical activity levels decreased in the lower occupational class and slightly increased in the higher occupational class, resulting in a difference of 4.3 MET-hours at the end of follow-up, accounting for 50 min of brisk walking per week. The occupational class differences emerged during transition into mandatory retirement and persisted after this. Transition into disability retirement temporarily widened the occupational class differences in LTPA levels, but the differences diminished during the follow-up. Research on interventions to counteract the declining LTPA is needed to discover ways to prevent the widening of occupational health disparities during aging. The transition into old-age retirement could be an optimal period for focusing these interventions.
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Affiliation(s)
- Anni Karjala
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Aino Salonsalmi
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jouni Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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4
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Utzet M, Ayala-Garcia A, Benavides FG, Basagaña X. Extreme temperatures and sickness absence in the Mediterranean province of Barcelona: An occupational health issue. Front Public Health 2023; 11:1129027. [PMID: 36891341 PMCID: PMC9986628 DOI: 10.3389/fpubh.2023.1129027] [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: 12/21/2022] [Accepted: 01/31/2023] [Indexed: 02/22/2023] Open
Abstract
Objectives This study aims to assess the association between daily temperature and sickness absence episodes in the Mediterranean province of Barcelona between 2012 and 2015, according to sociodemographic and occupational characteristics. Methods Ecological study of a sample of salaried workers affiliated to the Spanish social security, resident in Barcelona province between 2012 and 2015. The association between daily mean temperature and risk of new sickness absence episodes was estimated with distributed lag non-linear models. The lag effect up to 1 week was considered. Analyses were repeated separately by sex, age groups, occupational category, economic sector and medical diagnosis groups of sickness absence. Results The study included 42,744 salaried workers and 97,166 episodes of sickness absence. The risk of sickness absence increased significantly between 2 and 6 days after the cold day. For hot days there was no association with risk of sickness absence. Women, young, non-manual and workers in the service sector had a higher risk of sickness absence on cold days. The effect of cold on sickness absence was significant for respiratory system diseases (RR: 2.16; 95%CI: 1.68-2.79) and infectious diseases (RR: 1.31; 95%CI: 1.04-1.66). Conclusion Low temperatures increase the risk of having a new episode of sickness absence, especially due to respiratory and infectious diseases. Vulnerable groups were identified. These results suggest the importance of working in indoor and possibly poorly ventilated spaces in the spread of diseases that eventually lead to an episode of sickness absence. It is necessary to develop specific prevention plans for cold situations.
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Affiliation(s)
- Mireia Utzet
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Center for Biomedical Research Network (CIBER) of Epidemiology and Public Health, Madrid, Spain
| | - Amaya Ayala-Garcia
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Center for Biomedical Research Network (CIBER) of Epidemiology and Public Health, Madrid, Spain
| | - Fernando G Benavides
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Center for Biomedical Research Network (CIBER) of Epidemiology and Public Health, Madrid, Spain
| | - Xavier Basagaña
- Center for Biomedical Research Network (CIBER) of Epidemiology and Public Health, Madrid, Spain.,Institute for Global Health (ISGlobal), Barcelona, Spain.,Departament de Medicina i Ciències de la Vida, Universitat Pompeu Fabra, Barcelona, Spain
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5
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Sickness absence due to common mental disorders in young employees in Sweden: are there differences in occupational class and employment sector? Soc Psychiatry Psychiatr Epidemiol 2022; 57:1097-1106. [PMID: 34386867 PMCID: PMC9042979 DOI: 10.1007/s00127-021-02152-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 07/30/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND A large proportion of sickness absence (SA) in young adults is due to common mental disorders (CMDs). Still studies on CMD-related SA in young workers are lacking, especially studies for those employed in the private sector. The current study investigated the associations between sector of employment, occupational class and SA due to CMDs. In addition, associations between type of employment branch and SA due CMDs within each sector were examined. METHODS This population-based longitudinal cohort study included 663,583 employees, 19-29 years, residing in Sweden in 2009. Employment sector (i.e., private/public) and occupational class (non-manual/manual workers) were measured in 2009. Risk estimates of SA due to CMDs, between 2010 and 2016, were calculated as Hazard Ratios (HR) with 95% confidence intervals (CI), using Cox regression analysis. RESULTS Sector of employment was associated with SA due to CMDs, such that public sector workers had an elevated risk when compared with private sector employees (adjusted HR: 1.31 (95% CI 1.29-1.33). Moreover, manual workers had a slightly elevated risk for SA due to CMDs compared to non-manual workers. Within the private sector, in both manual and non-manual workers, those employed in education and health and social services evidenced the highest rates and risks of SA due to CMDs. CONCLUSION Sector of employment and occupational class play a role in SA due to CMDs in young employees. These findings should be considered when identifying high-risk groups for SA in the young working population.
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Mänty M, Kouvonen A, Nordquist H, Harkko J, Pietiläinen O, Halonen JI, Rahkonen O, Lallukka T. Physical working conditions and subsequent sickness absence: a record linkage follow-up study among 19-39-year-old municipal employees. Int Arch Occup Environ Health 2021; 95:489-497. [PMID: 34687341 PMCID: PMC8795030 DOI: 10.1007/s00420-021-01791-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/14/2021] [Indexed: 11/25/2022]
Abstract
Purpose Physical work exposures are associated with sickness absence among older employees. We aimed to examine if they similarly contribute to all-cause sickness absence during early and mid-careers. Methods We used questionnaire data on physical work exposures linked to register data on sickness absence from 3542 municipal employees aged 19–39 years. Follow-up for the number of sickness absence days was 12 months. Exposures to physical workload, occupational environmental hazards, and sedentary work were divided into quartiles. In addition, duration of daily exposure to heavy work was included. Negative binomial regression models were used. Results Higher exposure to physical workload or hazardous exposures was associated with a higher number of sickness absence days. The age and gender adjusted rate ratios for sickness absence days among the participants whose exposure to physical workload was in the highest exposure quartile were 2.1 (95% CI 1.8‒2.5) compared with those whose exposure was in the lowest quartile. In addition, rate ratios for sickness absence days among participants who reported that they do heavy physical work 1.1‒2.0 h, 2.1‒4.0 h or over 4 h daily were 1.6 (1.3‒1.9), 1.5 (1.3‒1.8) and 1.7 (1.5‒2.1), respectively, compared with those who reported not doing physical work. Further adjustment for lifestyle factors or health characteristics attenuated the associations only slightly. Conclusion Exposure to physically demanding work is associated with a higher number of sickness absence days among municipal employees below 40 years of age. Physical working conditions should be considered when aiming to support later work ability. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-021-01791-y.
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Affiliation(s)
- M Mänty
- Department of Public Health, University of Helsinki, Helsinki, Finland. .,Unit of Strategy and Research, City of Vantaa, Vantaa, Finland.
| | - A Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - H Nordquist
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Department of Health Care and Emergency Care, South-Eastern Finland University of Applied Sciences, Kotka, Finland
| | - J Harkko
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - O Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J I Halonen
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - O Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - T Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Incidence and Length of Sickness Absence among Hierarchical Occupational Classes and Non-Wage-Earners: A Register Study of 1.6 Million Finns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020501. [PMID: 33435424 PMCID: PMC7827837 DOI: 10.3390/ijerph18020501] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/30/2020] [Accepted: 01/06/2021] [Indexed: 11/22/2022]
Abstract
Socioeconomic differences in sickness absence are well known, but previous studies have tended to focus on wage earners only. This study examined incidence and length of sickness absence comparing the employee groups of upper and lower non-manual employees and manual workers, but also entrepreneurs, the unemployed and other non-wage-earners. The study utilized register data on a nationally representative 70% sample of Finns aged 25–62 at the end of year 2012 (N = 1,615,352). Sickness absence spells compensated by sickness allowance and initiated during 2013 were retrieved from the register of the Social Insurance Institution of Finland (SIIF) and followed until the end of each episode and linked to socio-demographic covariates collected from the registers of the SIIF and of Statistics Finland. Zero-inflated negative binomial regression was used in multivariate models. After adjusting for age, marital status, region and income, there were clear differences in the occurrence and length of sickness absence across socioeconomic groups. Compared to upper non-manual employees, lower non-manual employees and especially manual workers had higher cumulative annual incidence of sickness absence among both men and women, but the entrepreneurs, the unemployed and other non-wage-earners had a clearly higher expected number of sickness absence days. Results varied by diagnostic group. The results highlight the importance of different types of preventive measures for reducing the occurrence of sickness absence and for preventing prolongations of sickness absence spells in different socioeconomic groups.
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Sumanen H, Harkko J, Piha K, Pietilainen O, Rahkonen O, Kouvonen A. Association between socioeconomic position and occupational health service utilisation trajectories among young municipal employees in Finland. BMJ Open 2019; 9:e028742. [PMID: 31780585 PMCID: PMC6887011 DOI: 10.1136/bmjopen-2018-028742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To identify groups of municipal employees between the ages of 20 and 34 years with distinct utilisation trajectories of primary care services provided by occupational health service (OHS), measured as the annual number of OHS visits, and to identify demographic and socioeconomic risk factors that distinguish employees in the high utilisation trajectory group(s). METHODS The present study is a retrospective register-based cohort study. All municipal employees of the City of Helsinki, Finland, aged 20-34 in the Helsinki Health Study, recruited from 2004 to 2013, with follow-up data for 4 years were included in the study (n=9762). The outcome measure was group-based trajectories of OHS utilisation, identified with a group-based trajectory analysis. The demographic and socioeconomic variables used to predict the outcome were age, first language, educational level and occupational class. The analyses were stratified by gender. RESULTS A large proportion of the young employees do not use OHS. Trajectory groups of 'No visits' (50%), 'Low/increasing' (18%), 'Low/decreasing' (22%) and 'High/recurrent' (10%) use were identified. We found occupational class differences in OHS utilisation patterns showing that lower occupational classes had a higher propensity for 'High/recurrent' OHS utilisation for both genders. CONCLUSIONS Preventive measures should be targeted particularly to the trajectory groups of 'Low/increasing' and 'High/recurrent' in order to intervene early. In addition, OHS utilisation should be closely monitored among the two lowest occupational classes. More research with longitudinal OHS data is needed.
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Affiliation(s)
- Hilla Sumanen
- Health Care and Emergency Care, South-Eastern Finland University of Applied Sciences, Kotka, Finland
- Public Health, University of Helsinki, Helsinki, Finland
- Social Sciences, University of Helsinki, Helsinki, Finland
| | - Jaakko Harkko
- Social Sciences, University of Helsinki, Helsinki, Finland
| | - Kustaa Piha
- Public Health, University of Helsinki, Helsinki, Finland
| | | | - Ossi Rahkonen
- Public Health, University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Social Sciences, University of Helsinki, Helsinki, Finland
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Research Institute of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
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Leinonen T, Viikari-Juntura E, Husgafvel-Pursiainen K, Solovieva S. Cause-specific sickness absence trends by occupational class and industrial sector in the context of recent labour market changes: a Finnish panel data study. BMJ Open 2018; 8:e019822. [PMID: 29627810 PMCID: PMC5892784 DOI: 10.1136/bmjopen-2017-019822] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES We aimed to provide previously unestablished information on population-based differences in cause-specific sickness absence trends between occupational classes and further between four large industrial sectors within the different occupational classes while controlling for other socioeconomic factors and employment patterns. We focused on the period 2005-2013, during which the labour market underwent large economic and structural changes in many countries. DESIGN Register-based panel data study. SETTING Large representative datasets on Finnish wage earners aged 25-59 years. OUTCOME MEASURE Annual risk of sickness absence (>10 working days) based on repeated logistic regression. RESULTS Between 2005 and 2013, the proportion of employees with sickness absence decreased. Occupational class differences in sickness absence trends varied by disease group. Overall, the decrease in absences was smallest among lower non-manual employees. Sickness absence levels were highest in the health and social work sector and in the manufacturing sector within the non-manual and manual classes, respectively. Absences due to musculoskeletal diseases decreased temporarily during the peak of the economic recession in 2009, particularly in the manufacturing sector within the manual class. The decrease in absences due to musculoskeletal diseases was smallest in the trade sector within the lower occupational classes. Overall, education, income and employment patterns partly explained the differences in the absence levels, but not in the trends. CONCLUSIONS We found a complex interplay between the associations of occupational class and industrial sector with sickness absence trends. During the economic recession, absences due to musculoskeletal diseases decreased temporarily in a segment of wage earners who were known to have been hit hard by the recession. However, the trend differences were not explained by the measured structural changes in the characteristics of the study population. Both occupational class and industrial sector should be taken into account when tackling problems of work disability.
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Affiliation(s)
- Taina Leinonen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Sumanen H, Pietiläinen O, Mänty M. Self-Certified Sickness Absence among Young Municipal Employees-Changes from 2002 to 2016 and Occupational Class Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101131. [PMID: 28954443 PMCID: PMC5664632 DOI: 10.3390/ijerph14101131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 09/17/2017] [Accepted: 09/23/2017] [Indexed: 11/23/2022]
Abstract
We examined changes in self-certified, one-to-three day sickness absence (SA) among young employees from 2002 to 2016 and the magnitude of occupational class differences during that period. All 18–34-year-old employees of the City of Helsinki, Finland were included (2002–2016, n = ~11,725 per year). Employer’s personnel and SA registers were used. Occupational class was categorized to four groups. Changes in self-certified SA from 2002 to 2016 were analyzed with Joinpoint regression and the magnitudes of occupational class differences were estimated with the relative index of inequality (RII). Most of the trends first increased and turned to decrease in 2007/2010. Managers and professionals had the least amount of SA, but steadily increasing trends were observed among men. Self-certified SA followed only partially the typical socioeconomic gradient, as routine non-manuals had the highest levels of SA. The magnitude of occupational class differences in self-certified SA was stable during the study period only among women. Self-certified SA and occupational class differences have increased in recent years among men in the lower occupational classes. Socioeconomic differences exist in self-certified SA among young employees, but gradient is only partial. Overall, high amounts of self-certified SA especially in the lower occupational classes require further studies and preventive measures.
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Affiliation(s)
- Hilla Sumanen
- Department of Public Health, University of Helsinki, P.O. Box 20 (Tukholmankatu 8B), FIN-00014 Helsinki, Finland.
- Department of Health Care and Emergency Care, South-Eastern Finland University of Applied Sciences, FIN-48220 Kotka, Finland.
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, P.O. Box 20 (Tukholmankatu 8B), FIN-00014 Helsinki, Finland.
| | - Minna Mänty
- Department of Public Health, University of Helsinki, P.O. Box 20 (Tukholmankatu 8B), FIN-00014 Helsinki, Finland.
- Department of Research, Development and Innovation, Laurea University of Applied Sciences, FIN-01300 Vantaa, Finland.
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