Sickness Absence Episodes Research Articles

Are long nursing shifts on hospital wards associated with sickness absence? A longitudinal retrospective observational study.

ObjectiveTo investigate whether working 12 hr shifts is associated with increased sickness absence among registered nurses and health care assistants.BackgroundPrevious studies reported negative impacts on nurses’ 12 hr shifts; however, these studies used cross‐sectional techniques and subjective nurse‐reported data.MethodsA retrospective longitudinal study using routinely collected data across 32 general inpatient wards at an acute hospital in England. We used generalized linear mixed models to explore the association between shift patterns and the subsequent occurrence of short (<7 days) or long‐term (≥7 days) sickness absence.ResultsWe analysed 601,282 shifts and 8,090 distinct episodes of sickness absence. When more than 75% of shifts worked in the past 7 days were 12 hr in length, the odds of both a short‐term (adjusted odds ratio = 1.28; 95% confidence index: 1.18–1.39) and long‐term sickness episode (adjusted odds ratio = 1.22; 95% confidence index: 1.08–1.37) were increased compared with working none.ConclusionWorking long shifts on hospital wards is associated with a higher risk of sickness absence for registered nurses and health care assistants.Implications for Nursing ManagementThe higher sickness absence rates associated with long shifts could result in additional costs or loss of productivity for hospitals. The routine implementation of long shifts should be avoided.

Sickness absenteeism of Healthcare Workers in a Teaching Hospital

Background: Absence from work for health reasons is known as “sickness absenteeism”. Frequent sick leave is a major concern to any organization, especially hospitals. Objective: This study analyzed the extent and causes of sickness absenteeism in a teaching hospital and evaluated its corelation with demographic and occupational factors. Methods: In a cross-sectional study, data was extracted from computerized records regarding sickness absenteeism of healthcare workers (HCWs) in the Occupational Health Department of a teaching hospital in Tehran. Studied variables included demographic characteristics, occupational factors, and causes of sickness absenteeism. The sickness absence rate (SAR) and absence frequency rate (AFR) in the study period were calculated. Chi-square and Mann-Whitney tests were used for the comparison of categorical and quantitative variables, respectively. Results: In the current study, SAR and AFR were 0.011 and 0.68, respectively. Job type was the only factor that had a significant correlation with sickness absenteeism. The major disease-causing sicknesses were flu (21%) and musculoskeletal disorders (18.9%). Conclusion: A significant relationship was found between the nursing group and sickness absence episodes. Flu, musculoskeletal disorders, and infectious diseases were the most frequent causes of sickness absence. Based on these findings, it can be concluded that factors such as availability of the flu vaccine and providing principles of personal protection and infection control can reduce sickness absence due to infectious disease.

Sickness absence among municipal workers in a Brazilian municipality: a secondary data analysis

BackgroundSickness absence, work disability associated with illness or injury, is a major public health problem worldwide. Some studies have investigated determinants of sickness absence among workers with shorter job tenure, but have only focused on certain diagnostic groups. Although it is well established that job tenure has an inverse relationship with work injury rate, less is known about its association with sickness absence for other disorders. Therefore, this study aimed to investigate the risk factors for incidence and duration of sickness absence according to diagnosis over a 7-year period. A dynamic cohort consisting of all permanent civil servants hired from 2005 to 2011 by the Goiania municipality-Brazil. Data of certified sickness absences longer than 3 days were analyzed. The incidence density was calculated per 1000 person-years in each ICD-10 category. The association between sickness absence and socio-demographic and occupational characteristics was examined using negative binomial regression models.Results18,450 workers, mean age of 32 years, accumulated 14,909 episodes of sickness absence. Overall, the incidence density was 234.6 episodes per 1000 person years. Diagnostic groups with the highest incidence density of sickness absences were injuries (49.1), musculoskeletal disorders (31.3) and mental disorders (29.2). Factors predicting any sickness absence were female gender, older age, low education, being a health professional, multiple jobs and full-time employment. Mental health disorders were more common among education professionals, musculoskeletal disorders among blue collar workers and injuries among inspection workers. Prolonged time on sick leave was associated with male gender, older age groups, low education and income, blue-collar workers, more than one job contract and full time employment.ConclusionsThese findings demonstrate a substantial sickness absentee burden and they provide relevant information for targeting prevention and health promotion policies to the most vulnerable occupational groups.

Incidence of non-work-related sickness absence in Spain by economic activity of the company

The management of sickness absence due to non-work-related diseases in Spain has typically focused on the control of its duration. The goal of this study was to provide estimates for the incidence of sickness absence due to nonwork-related diseases by economic activity to help shift the focus of management of sickness absence towards prevention. Retrospective study based on 646,337 workers and 133,812 episodes of sickness absence started in 2009, from the Working Continuous Life Sample. Incidence rate and its 95% confidence interval (CI) were calculated using Poisson regression models, crude and adjusted for age, company size, and occupational category, separately for men and women. The overall incidence rate was 29.8 per 100 person-years; 24.7 (95%CI: 24.5-24.9) in men and 36.3 (36.0- 36.5) in women. By economic activity, the highest crude incidence rates in men were found in "Water supply, sanitation and wastes" (35.4) and "Health activities" (33.9); for women, "Health activities" (48.3), "Public administration" (41.2) and "Transportation and storage" (41.0) were the highest sectors. Companies can compare their sickness absence incidence rates to these benchmark values to determine if they are within the expected reference range, which may guide management decisions more towards the prevention of sickness absence.

Cumulative exposure to shift work and sickness absence: associations in a five-year historic cohort

BackgroundExposure to shift work has been associated with negative health consequences, although the association between shift work and sickness absence remains unclear. The aim of this study is to investigate associations between cumulative exposure to shift work and sickness absence among ground staff employees of an airline company.MethodsThis study used data from the MORE (Monitoring Occupational Health Risks in Employees) cohort, which is a 5-year historic cohort. The population of the present study consisted of 7562 ground staff employees. For each employee, work schedules and sickness absence days between 2005 and 2009 were obtained from company records. For the exposure to different shift schedule types and to the cumulative number of night shifts, the association with long-term sickness absence (>7 consecutive sickness absence days) and the number of sickness absence episodes during 2009, was calculated using logistic and Poisson regression analyses. Socio-demographic variables, work-related variables, job classification variables, and previous sickness absence days were regarded as confounders.ResultsAfter adjusting for previous sickness absence and job classification variables, only the group of employees that switched into working in a three-shift schedule, showed a significantly increased risk for long-term sickness absence (OR = 1.31, 95%CI 1.02–1.69). Night shift exposure was not significantly associated with long-term sickness absence. Exposure to shift work was negatively associated with more sickness absence episodes. Employees who were exposed to more than 46 night shifts also showed a lower risk for more sickness absence episodes. Subgroup analyses showed that single employees and employees without children had an increased risk for long-term sickness absence when exposed to a three-shift schedule, and when they had changed between shift schedule types.ConclusionsCumulative exposure to shift work proved to be negatively associated with more sickness absence episodes, and was not associated with more long-term sickness absence, although selection bias could not be ruled out. Future research should explore the influence of household composition, and take into account both previous sickness absence and psychosocial and physical work factors to obtain a better estimation of the association between shift work and sickness absence.

Preventing Sickness Absence With Career Management Intervention: A Randomized Controlled Field Trial.

This study examined whether a group intervention focusing on building up preparedness for career management can prevent future sickness absence.Register-based data on the number of sickness absence days and sickness absence episodes were examined as outcomes of the intervention among 684 employees in 17 organizations in a randomized controlled trial. Sickness absence data were collected covering a period from 1 year before (baseline) to approximately 2 years after the intervention (follow-up). The data were analyzed using zero-inflated negative binomial models.After controlling for baseline absence, age, gender, and organization, the intervention was effective in decreasing the number of longer sickness absences (lasting longer than > 2 weeks), but no other significant effects were found.These findings point out that it is feasible to use a career management intervention to prevent future sickness absence in work organizations.

Incidence of sickness absence by type of employment contract: one year follow-up study in Spanish salaried workers.

BackgroundTo examine the differences in the incidence of registered sickness absence by type of employment contract in a large representative sample of salaried workers in Spain in 2009.MethodA study of 653,264 salaried workers covered by the Social Security system who had 133,724 sickness absence episodes in 2009. Crude and adjusted rate ratios and their corresponding 95 % confidence intervals (CIs) were calculated with Poisson regression models.ResultsThe incidence rate per 100 workers-year of sickness absence for temporary workers (IR = 32.2) was slightly higher than that of permanent workers (IR = 28.9). This pattern was observed in both men (RR = 1.12; 95 % CI 1.10–1.14) and women (RR 1.11; 95 % CI 1.09–1.12). However, after adjusting for age, company size, and occupational category, the differences disappeared in men (aRR = 1.01; 95 % CI 0.99–1.02) and decreased in women (aRR = 1.06; 95 % CI 1.04–1.07).ConclusionOur findings provide evidence on the independence of sickness absence benefits from the type of employment contract as well as on the nonexistence of incentives for taking sickness absence in workers with a permanent employment contract. In the context of increasing market flexibility, these results show a positive functioning of the Social Security system.Electronic supplementary materialThe online version of this article (doi:10.1186/s13690-016-0152-x) contains supplementary material, which is available to authorized users.

The effect of multimorbidity on sickness absence by specific diagnoses.

As the world's population ages, the prevalence of multiple chronic and non-chronic health-related conditions is increasing. Research on multimorbidity, the co-occurrence of two or more health-related conditions, has mainly involved patient and older populations. Its effect in working populations, presumably younger and healthier, is not well known but could conceivably affect sickness absence (SA) and ability to return to work. To examine the effect of multimorbidity on the incidence and duration of SA episodes by frequent diagnostic groups. A prospective study (in 2006-2008) of workers in Spain. Information on health-related conditions was gathered with a standardized questionnaire and used to construct a sex-specific multidimensional multimorbidity score (MDMS). In order to estimate the effect of MDMS on incidence and duration of SA episodes due to cardiovascular diseases (CVD), musculoskeletal disorders (MSD) and mental health disorders (MHD), we fitted Cox models adjusted by age, occupational social class and number of prior SA episodes for both sexes. The study population was 372370. Men with high MDMS showed a trend towards higher incidence risk for SA due to CVD and MSD [adjusted hazard ratio (aHR) = 2.03; 95% confidence interval (CI) 1.48-2.78 and aHR = 1.20; 95% CI 1.01-1.43, respectively]. Women showed a similar trend for MSD, but MHD had the strongest association (aHR = 4.78; 95% CI 1.97-11.62) for high MDMS. In both sexes, the effect of MDMS was strongest among those without a prior SA. No consistent associations with SA duration were observed. Multimorbidity increased the risk of incident musculoskeletal, mental and cardiovascular SA episodes but not their duration.

Unwanted sexual attention at work and long-term sickness absence: a follow-up register-based study.

BackgroundThe current understanding of the relationship between unwanted sexual attention at work and long-term sickness absence (LTSA) is limited for three reasons: 1) the under-researched role of unwanted sexual attention perpetrated by individuals outside the work organization; 2) a widespread use of self-reported measures of sickness absence, with an unclear identification of sickness absence episodes of long duration; 3) the cross-sectional design of most existing studies. The aim of this study was therefore to investigate the relationship between self-reported unwanted sexual attention at work and subsequent LTSA (≥3 weeks), stratifying by gender and source of exposure (i.e., colleagues, managers and/or subordinates vs. clients/customers/patients).MethodsThis prospective study is based on a pooled sample of 14,605 employees from three Danish surveys conducted in 2000, 2004 and 2005, providing a total of 19,366 observations. A single questionnaire-based item was used to assess exposure to unwanted sexual attention. The pooled dataset was merged with Danish register data on LTSA. The risk of first-onset episode of LTSA (up to 18 months after baseline) in connection with unwanted sexual attention was examined using Cox proportional hazards models. We estimated Hazard ratios (HR) and 95 % confidence intervals (95 % CI) adjusted for age, influence at work, work pace, occupational group and mode of data collection. We also adjusted for repeated measures from individual respondents by stratifying the Cox models by wave of survey.ResultsUnwanted sexual attention from colleagues, managers and/or subordinates predicted LTSA among men (HR 2.66; 95 % CI 1.42-5.00). Among women, an elevated but non-statistically significant risk of LTSA (HR 1.18; 95 % CI 0.65-2.14) was found. Unwanted sexual attention from clients/customers/patients did not predict LTSA, neither among men nor among women.ConclusionsThe findings indicate a significantly elevated risk of LTSA, among men only, in relation to exposure to unwanted sexual attention from colleagues, managers and/or subordinates. This study therefore suggests both individual and organizational costs associated with unwanted sexual attention at work. Due to the low prevalence of unwanted sexual attention, larger studies with more statistical power are needed to confirm (or disconfirm) the present findings.

Effectiveness of very early workplace interventions to reduce sickness absence: a systematic review of the literature and meta-analysis.

The aim of this review was to investigate the effectiveness of workplace return-to-work (RTW) interventions delivered at very early stages (<15 days) of sickness absence (SA). A systematic literature search was conducted in PubMed, Health Management Information Consortium (HMIC), Cochrane library database, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychInfo and Embase. Using pre-established criteria, independent pairs of researchers carried out the study selection, quality appraisal and data extraction. Workplace interventions before day 15 of SA, were included. Primary outcome measures included rates of and time until RTW, productivity loss, and recurrences of SA. We found limited available evidence on the benefits of "very early" workplace interventions in terms of RTW after a SA episode compared to usual care. Only three randomized controlled trials classed as high or intermediate quality were identified. Early part-time sick leave together with appropriate job modifications led to a reduction in the duration and recurrence of SA. There is evidence of benefit of intervening during the first two weeks of SA for musculoskeletal disorders. Our review has identified a lack of evidence from the literature at this time point to support "very early" intervention compared to usual care. The methodological design of the studies, notably the extent and timing of usual care provided and variable compliance/crossover between groups could however explain the lack of demonstrated benefit. Consensus is required on the definition of "early" and "very early" interventions, and further research is recommended to improve understanding of the factors influencing when and how best to intervene for maximum gain.

Joint association of sleep problems and psychosocial working conditions with registered long-term sickness absence. A Danish cohort study.

Sleep problems and adverse psychosocial working conditions are associated with increased risk of long-term sickness absence. Because sleep problems affect role functioning they may also exacerbate any effects of psychosocial working conditions and vice versa. We examined whether sleep problems and psychosocial working conditions interact in their associations with long-term sickness absence. We linked questionnaire data from participants to two surveys of random samples of the Danish working population (N=10 752) with registries on long-term sick leave during five years after questionnaire response. We defined sleep problems by self-reported symptoms and/or register data on hypnotics purchases of hypnotics. Psychosocial working conditions included quantitative and emotional demands, influence, supervisor recognition and social support, leadership quality, and social support from colleagues. Using time-to-event models, we calculated hazard ratios (HR) and differences and examined interaction as departure from multiplicativity and additivity. During 40 165 person-years of follow-up, we identified 2313 episodes of long-terms sickness absence. Sleep problems predicted risk of long-term sickness absence [HR 1.54, 95% confidence interval (95% CI) 1.38-1.73]. This association was statistically significantly stronger among participants with high quantitative demands and weaker among those with high supervisor recognition (P<0.0001). High quantitative demands exacerbated the association of sleep problems with risk of long-term sickness absence whereas high supervisor recognition buffered this association. To prevent long-term sickness absence among employees with sleep problems, workplace modifications focusing on quantitative demands and supervisor recognition may be considered. Workplace interventions for these factors may more effectively prevent sickness absence when targeted at this group. The efficacy and effectiveness of such interventions needs to be established in future studies.

Indications of a Scarring Effect of Sickness Absence Periods in a Cohort of Higher Educated Self-Employed

ObjectivesLittle is known regarding incidence and recurrence of sickness absence in self-employed. The primary aim of this study was to evaluate the influence of the number of prior episodes of sickness absence on the risk of subsequent periods of sickness absence in higher educated self-employed.MethodsIn a historic register study based on the files of a Dutch private disability insurance company all sickness absence periods of 30 days or more were analysed.ResultsA total of 15,868 insured persons contributed 141,188 person years to the study. In total, 5608 periods of sickness absence occurred during follow-up. The hazard of experiencing a new period of sickness absence increased with every previous period, ranging from a hazard ratio of 2.83 in case of one previous period of sickness absence to a hazard ratio of 6.72 in case of four previous periods. This effect was found for both men and women and for all diagnostic categories of the first period of sickness absence.ConclusionsOur study shows that for all diagnostic categories the hazard of experiencing a recurrence of sickness absence is appreciably higher than for experiencing a first episode. This suggests that this increased hazard may be related to the occurrence of sickness absence itself rather than related to characteristics of the insured person or of the medical condition. These findings could indicate that sickness absence periods may have a scarring effect on the self-employed person experiencing the sickness absence.

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

BackgroundThere is wide evidence that women present longer duration of sickness absence (SA) than men. Musculoskeletal disorders are influenced by gender due to the sexual division of work.Methods354 432 episodes...

Has the Spanish economic crisis affected the duration of sickness absence episodes?

The global economic crisis has had particularly intense effects on the Spanish labor market. We investigated whether the duration of non-work related sickness absence (SA) episodes in salaried workers had experienced any changes before and after the crisis started. This was a repeated cross-sectional analysis conducted in a dynamic cohort in 2006 and 2010. Database was provided by eight mutual insurance companies, covering 983,108 workers and 451,801 SA episodes. Descriptive analysis and crude, bivariate and multivariate analyses using Cox proportional hazards modeling were performed, to quantify the changes in duration of SA episodes between 2006 and 2010, stratified by sex. There was a higher number of episodes in 2010 for both sexes, but especially for women. Unadjusted median duration in men was similar for both years, while for women it was shorter in 2010. Final multivariate models show a greater risk of longer episode duration for men in 2010 (HR 0.95; 95% CI, 0.95–0.95), but a shorter one for women (HR 1.07; 95% CI, 1.07–1.07). Once the economic crisis started affecting the Spanish labor market, the number of SA episodes in women equalized with those in men. There was a decrease of episodes in the youngest age groups, in the construction and in temporary contracts. The relative ranking of leading diagnoses was similar in both years with an increase in infectious, nervous system and respiratory diseases and in mental disorder episodes for both sexes, but especially for women. The risk of longer episode duration was greater in 2010 among men, but smaller in women.

Recurrence of sickness absence episodes certified by general practitioners in the UK

Background: Compared to other areas of sickness certification, recurrence of certified sickness absence has been relatively under-researched.Objectives: This study aims to report the extent and patterns of recurrence and to identify factors associated with higher rates of recurrence.Methods: Sickness certification (‘fit note’) data were collected from 68 general practices in eight regions of the UK for 12 months.Results: Twenty percent of 31,453 patients in the study had a recurrent certified sickness episode, with over half of these having the second episode in the same diagnostic category as their first. Mental health problems accounted for over a half of all days certified in same-diagnosis recurrent episodes. Male gender, residing in an area of social deprivation, a longer episode of initial certified sickness absence, not having return to work (‘may be fit’) advice in the first episode, having a mental disorder or musculoskeletal (particularly back) problem were all independently associated with a higher incidence of recurrence.Conclusion: Differential risk of recurrence needs to be considered when designing return-to-work interventions. Evaluation of effectiveness of interventions (particularly for sickness absentees with mental health problems) has to consider the sustainability of employment after a return to work.

Sickness certification for common mental disorders and GP return-to-work advice.

Aim To report the types and duration of sickness certification for different common mental disorders (CMDs) and the prevalence of GP advice aimed at returning the patient to work. In the United Kingdom, common mental health problems, such and depression and stress, have become the main reasons for patients requesting a sickness certificate to abstain from usual employment. Increasing attention is being paid to mental health and its impact on employability and work capacity in all parts of the welfare system. However, relatively little is known about the extent to which different mental health diagnoses impact upon sickness certification outcomes, and how the GP has used the new fit note (introduced in 2010) to support a return to work for patients with mental health diagnoses. Sickness certification data was collected from 68 UK-based general practices for a period of 12 months. Findings The study found a large part of all sickness absence certified by GPs was due to CMDs (29% of all sickness absence episodes). Females, younger patients and those living in deprived areas were more likely to receive a fit note for a CMD (compared with one for a physical health problem). The highest proportion of CMD fit notes were issued for 'stress'. However, sickness certification for depression contributed nearly half of all weeks certified for mental health problems. Only 7% of CMD fit notes included any 'may be fit' advice from the GP, with type of advice varying by mental health diagnostic category. Patients living in the most socially deprived neighbourhoods were less likely to receive 'may be fit' advice on their CMD fit notes.

Musculoskeletal disorders and temporary disability. Characteristics and duration. Catalonia, 2007-2010

Musculoskeletal disorders (MSD) are the leading cause of sickness absence (SA) in Spain and the second in Catalonia. A greater knowledge of this field could allow the refocusing of social protection policies and interventions to reduce their frequency and duration. The objective of the study was to describe the characteristics and duration of SA due to MSD in Catalonia between 2007 and 2010. The study population included all incident SA episodes due to MSD during the period 2007-2010, registered in the Institut Català d'AvaluacionsMèdiques (ICAM) database.We selected the 10 most frequentMSD (824.646 episodes) and extracted 607.732 (74%) SA episodes. We calculated the median duration of SA and analyzed the differences with Mann-Whitney U or Kruskal-Wallis tests, and studied the differences with a post-hoc test. We also conducted a survival analysis using Kaplan-Meier curves. The most frequent MSD were low back pain and neck pain. Median duration was greater for gonarthrosis and calcific tendonitis of the shoulder. The median duration of SA episodes was greater when pain was due to an organic disorder, in women (Z=51770950,5; p<0,001), increased with age (K=17335,72; p<0,001), and was longer in self-employed workers (Z=20965263,1; p<0.001) and in those working in agriculture and livestock (K=736,822; p<0,001). This study shows that the median duration of SA caused by MSD is influenced by the diagnosis, sex, age, type of work and type of social protection.

Descriptive Study of sickness absence in the health care sector of Catalonia (2009-2012)

To describe the incidence and evolution of sickness absence (SA) for non-occupational and occupational illness/injury in the population of workers in Catalonian Health Centers based on the definition of a set of common indicators. The study population consisted of 25,964 workers from 30 health centers in Catalonia, during 2009-2012. Information on SA episodes was obtained from records of the Directorate of Human Resources. SA indicators were defined, and SA incidence rates and temporal evolution were calculated, depending on the length and type of episode, and the size and activity of health centers. SA incidence rates for non-occupational illness and injury showed a decreasing trend during 2009-2012. Smaller centers had lower SA rates for non-occupational conditions than larger centers (p〈0.001). Social health centers had higher SA rates of non-occupational illness and injury, especially those with a very short duration (p〈0.001). Primary care centers had the lowest SA occupational illness and injury rates, with the highest rates occurring in the social health centers, especially long-term centers (p〈0.001). The differences in incidence rates of SA detected by type of activity of the health centers could be due to differences in working conditions.

Data warehouse for detection of occupational diseases in OHS data.

Occupational health and safety (OHS) services collect a wide range of data during health surveillance. To build a 'data warehouse' to make OHS data available for research and to investigate sector-specific health problems. Medical data were extracted, transformed and loaded into the data warehouse. After validation, data on lifestyle, categorized medication use, ICD-9-CM encoded sickness absences and health complaints, collected between 2010 and 2014, were analysed with logistic regression to compare proportions between employment sectors, taking into account age, gender, body mass index (BMI) and year of examination. The data set comprised 585000 employees. Average age and employment seniority were 39 ± 12 and 8 ± 9 years, respectively. BMI was 26 ± 5 kg/m(2). Health complaints, medication use and sickness absence significantly increased with BMI and age. The proportion of employees with health problems was highest in health care (64%), government (61%) and manufacturing (60%) and lowest in the service sector. In all sectors, 10% of workers reported locomotor health problems, apart from the service sector (8%) with similar results for medication consumption. Neuropsychological drugs were more frequently used by health care workers (8%). The transport sector contained the highest proportion of cardiological medication users (12%). Finally, 30-59% of employees reported at least one sickness absence episode. Sickness absence due to locomotor issues was highest in manufacturing (11%) and health care (10%), followed by government (9%) and construction (9%). Significant differences in indices of workers' health were observed between sectors. This information is now being used in the implementation of a sector-oriented health surveillance programme.

Trastornos mentales comunes derivados del trabajo en Navarra (2009-2012)

To determine work-related mental health morbidity and correct psychosocial risks. In this pilot study conducted at a mental health center, work-related common mental disorders were identified and population incidence was estimated.We next described cases reported from primary care centers in the period 2009 to 2012, via the Occupational Health Surveillance Program. Incidence was calculated by socioeconomic variables. Associations among variables (Chi2 test), their prevalence ratios (PR) and the correlation of risks (kappa coefficient) were compared. Reporting of these cases to the occupational health services and subsequent actions are described. In the pilot study, 17.5% of common mental disorders were work-related (7.2 x 1000 workers / year). Among the reported cases, incidence was higher in unskilled occupations, feminized economic activities and the services sector. Seventy per cent of cases were associated with hostile behavior and 14.2% with organizational factors. In addition, 83.2% of cases led to sickness absence episodes. Managing directors were at greater risk of bullying (PR 3.92 95%CI 2.35-6.53) as compared to other risks. Overall, 20% of cases ended in job dismissal, particularly in cases of mistreatment or bullying (PR 1.64 95%CI 1.24-2.16). It is necessary to implement reporting systems and prevention programs for work-relaed mental disorders, especially for collectives of workers with high risk profiles.