Higher Risk Of Sickness Absence Research Articles

Extreme temperatures and sickness absence in the Mediterranean province of Barcelona: An occupational health issue.

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. 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. 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). 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.

Birth order and sickness absence: Register-based evidence from Finland.

In working ages, sickness absence is strongly related to persons' health condition. We studied how birth order was associated with receipt of sickness allowance, distinguishing between mental disorders, musculoskeletal disorders and injuries. A follow-up study based on the entire Finnish population was conducted for sibling groups born 1969-1982, in which each sibling was observed from age 35 years in the period 2004-2018. Focus was on within-family variation in first-time sickness allowance receipt. Results of stratified Cox regressions revealed that each increase in birth order was associated with a slightly higher risk of sickness absence from any cause. For mental disorders, associations were stronger; the hazard ratio as compared to first borns was 1.03 (95% CI: 0.98-1.08) of second borns, 1.10 (0.99-1.22) of third borns, and 1.52 (1.25-1.85) of fourth or higher borns. Corresponding numbers for musculoskeletal disorders were 1.12 (1.07-1.17), 1.19 (1.09-1.30) and 1.15 (0.96-1.38), and for injuries 1.06 (1.01-1.12), 1.09 (1.21-1.14) and 0.96 (0.77-1.20), respectively. Birth order effects were generally stronger for women than men, and to some extent influenced by educational level, occupation, income, and family composition. Possible latent mechanisms behind the associations may relate to within-family dynamics at childhood.

Birth order and sickness absence: register-based evidence from Finland

Abstract Background In working ages, sickness absence is strongly related to persons’ health condition. We studied how birth order was associated with receipt of sickness absence, distinguishing mental disorders, musculoskeletal disorders and injuries. Methods A follow-up study based on the entire Finnish population was conducted for sibling groups born 1969-1982, in which each sibling was observed from age 35 years in the period 2004-2018. Focus was on within-family variation in first-time sickness allowance receipt. Stratified Cox regressions were estimated using Stata 16. Results Each increase in birth order was associated with a higher risk of sickness absence. For mental disorders, the hazard ratio as compared to first borns was 1.03 (95% CI: 0.98, 1.08) of second borns, 1.10 (95% CI: 0.99, 1.22) of third borns, and 1.52 (95% CI: 1.25, 1.85) of fourth or higher borns. Corresponding numbers for musculoskeletal disorders were 1.12 (95% CI: 1.07, 1.17), 1.19 (95% CI: 1.09, 1.30) and 1.15 (95% CI: 0.96, 1.38), and for injuries 1.06 (95% CI: 1.01, 1.12), 1.09 (95% CI: 1.21, 1.14) and 0.96 (95% CI: 0.77, 1.20), respectively. These associations were notably stronger for women than men, but modestly influenced by mother’s age at birth, educational level, occupation, income and family composition. Conclusions The study was the first to provide evidence about an interrelation between birth order and sickness absence, utilising diagnose information and family fixed effects methods. A clear birth order pattern was observed for these main causes, but not for a residual group that consisted of other miscellaneous causes. Higher birth order was found associated with a higher risk of sickness absence, and particularly so for mental disorders and muscoloskeletal disorders in women. The underlying mechanisms behind these associations constitute an avenue for future research. Key messages • Using sibling fixed effects, the study was the first to analyse if sickness absence by main cause is associated with birth order in working ages. • First-born siblings were the least likely to be sick because of mental or musculoskeletal disorders, and the associations were notably more accentuated for women than men.

Work Ability and Quality of Life in Patients with Rheumatoid Arthritis.

Background. Reduced work participation has social implications (sickness absence, economic impact) and consequences for the individual patient (impoverishment, depression, limited social interaction). As patients with rheumatoid arthritis (RA) are more likely to experience job loss and/or at-work productivity loss and are at higher risk of sickness absence and, ultimately, permanent work productivity, consideration should be given to the association between work productivity or partial work capacity and quality of life (QoL). The aim of the study was to assess the relationship between QoL and the risk of work disability, as well as to estimate the risk of a future event and identify factors affecting the risk of work disability in RA inpatients. Material and methods. This cross-sectional study included 142 inpatients (65 male) aged 47 (38–58) years, who met the established criteria for a diagnosis of RA and treatment with biologic drugs. Only standardized tools were used to examine the patients: WHOQOL-BREF, MFIS and AS-WIS. Results. An analysis of the QoL scores on the WHOQOL-BREF demonstrated that the patients’ QoL was lowest in the physical health domain and highest in the social relationships domain. The median WHOQOL-BREF total score in the group studied was 62.8, which indicates a moderate QoL. The median total score for the risk of work disability (AS-WIS) was 10.1, which indicates that the level of risk of work disability in the patients was higher than the average level reported in the literature. A multivariate analysis showed that the following were significant independent determinants of a higher risk of work disability: low QoL in the WHOQOL-BREF physical health (β = 0.961; p = 0.029) and psychological health (β = 1.752; p = 0.002) domains, being in a relationship (β = 0.043; p = 0.005) and the use of opioids for pain (β = 3.054; p = 0.012). Conclusions. RA patients presented with moderate QoL, moderate fatigue (MFIS) and high risk of disability (AS-WIS). There is an association between a high risk of work disability and lower QoL, especially in the physical and psychological health domains. The lower the QoL in those domains, the higher the risk of work disability. The identification of factors increasing the risk of work disability will help in planning tailored interventions to improve at-work productivity loss and thus prevent work disability.

Musculoskeletal Health Climate Is a Prognostic Determinant of Sickness Absence Among Female Eldercare Workers: A Prospective Cohort Study.

The present study investigated the association between musculoskeletal health climate, that is, the shared perceptions among workers concerning musculoskeletal health, and sickness absence. Questionnaire data on two domains of musculoskeletal health climate, perceived management priority (PMP) and pain acceptance at work (PAW), were collected at baseline. Data on sickness absence were extracted at 1-year follow-up. Data were analyzed using negative binomial multivariable regression. The final study population comprised 390 female eldercare workers. Compared with participants with low PMP scores, participants with high PMP scores had lower risk of sickness absence (incidence rate ratio, 0.6; 95% confidence interval, 0.4-0.9). Participants with high PAW scores had higher risk of sickness absence than participants with low PAW scores (incidence rate ratio, 1.4; 95% confidence interval, 0.9-2.2). The results showed an association between the musculoskeletal health climate and sickness absence.

Difficulties detaching psychologically from work among German teachers: prevalence, risk factors and health outcomes within a cross-sectional and national representative employee survey

BackgroundTeachers often face high job demands that might elicit strong stress responses. This can increase risks of adverse strain outcomes such as mental and physical health impairment. Psychological detachment has been suggested as a recovery experience that counteracts the stressor-strain relationship. However, psychological detachment is often difficult when job demands are high. The aims of this study were, first, to gain information on the prevalence of difficulties detaching from work among German teachers, second, to identify potential person-related/individual (i.e., age, sex), occupational (e.g., tenure, leadership position), and work-related (e.g., overload, cognitive, emotional, and physical demands) risk factors and, third, to examine relationships with mental and physical health impairment and sickness absence.MethodsA secondary analysis of cross-sectional data from a national and representative survey of German employees was conducted (BIBB/BAuA Employment Survey 2018). For the analyses data from two groups of teachers (primary/secondary school teachers: n = 901, other teachers: n = 641) were used and compared with prevalence estimates of employees from other occupations (n = 16,266).ResultsPrimary/secondary school teachers (41.5%) and other teachers (30.3%) reported more difficulties detaching from work than employees from other occupations (21.3%). Emotional demands and deadline/performance pressure were the most severe risk factors in both groups of teachers. In the group of primary/secondary school teachers multitasking demands were further risk factors for difficulties to detach from work whereas support from colleagues reduced risks. In both groups of teachers detachment difficulties can be linked to an increase in psychosomatic and musculoskeletal complaints and, additionally, to a higher risk of sickness absence among primary/secondary school teachers.ConclusionsDifficulties detaching from work are highly prevalent among German teachers. In order to protect them from related risks of health impairment, interventions are needed which aim at optimizing job demands and contextual resources (i.e., work-directed approaches) or at improving coping strategies (i.e., person-directed approaches).

Systematic Review and Dose-Response Meta-Analysis on the Relationship Between Alcohol Consumption and Sickness Absence.

Alcohol consumption (AC) may cause workplace absence, but the findings of individual studies vary markedly. To date, no dose-response meta-analysis (DRMA) of the relationship between AC and sickness absence (SA) has been completed. This paper aims to estimate the dose-response relationship between AC and the risk of SA based on published observational studies. We used DRMA and modelling to investigate the effects of varying doses of AC (including heavy episodic drinking (HED)) onSA. The meta-analysis included 21 studies (12 cohort studies and 9 cross-sectional). It showed that HED, risky (20-40g of alcohol/day) and high-risk (>40g of alcohol/day) drinkers had an elevated risk of SA when compared with light-to-moderate drinkers for both sexes. Those who abstained from alcohol had a higher risk of SA than those who drink moderately. Our results indicate that risky, high-risk drinking and HED may increase the risk of absenteeism. The implementation of population-based strategies may be appropriate to address the burdens of alcohol-related SA. Additionally, economic evaluations of alcohol policies should incorporate their impacts on SA. However, the current literature has substantial limitations, relying on modestly designed studies from just a few settings and more studies are needed-especially those that measure abstention in more nuancedways.

Sickness absence among privately employed white-collar workers: A total population study in Sweden.

Background: Knowledge about sickness absence (SA) and disability pension (DP) among privately employed white-collar workers is very limited. Aims: This study aimed to explore SA and DP among privately employed white-collar women and men using different measures of SA to investigate differences by branch of industry, and to analyse the association between sociodemographic factors and SA. Methods: This was a population-based study of all 1,283,516 (47% women) privately employed white-collar workers in Sweden in 2012, using register data linked at the individual level. Several different measures of SA and DP were used. Logistic regression was used to investigate associations of sociodemographic factors with SA. Results: More women than men had SA (10.9% women vs. 4.5% men) and DP (1.8% women vs. 0.6% men). While women had a higher risk of SA than men and had more SA days per employed person, they did not have more SA days per person with SA than men. The risk of SA was higher for women (odds ratio (OR)=2.54 (95% confidence interval (CI) 2.51–2.58)), older individuals (OR age 18–24 years=0.58 (95% CI 0.56–0.60); age 55–64 years OR=1.43 (95% CI 1.40–1.46) compared to age 45–54 years), living in medium-sized towns (OR=1.05 (95% CI 1.03–1.06)) or small towns/rural areas (OR=1.13 (95% CI 1.11–1.15)), with shorter education than college/university (OR compulsory only=1.64 (95% CI 1.59–1.69); OR high school=1.38 (95% CI 1.36–1.40)), born outside the EU25 (OR=1.23 (95% CI 1.20–1.27)) and singles with children at home (OR=1.33 (95% CI 1.30–1.36)). Conclusions: SA and DP among privately employed white-collar workers were lower than in the general population. SA prevalence, length and risk varied by branch of industry, sex and other sociodemographic factors, however, depending on the SA measure used.

Working time characteristics and long-term sickness absence among Danish and Finnish nurses: A register-based study

BackgroundWorking time regimes in Denmark and Finland share many similarities such as nursing personnel working in highly irregular shift systems. Yet, there are also differences for example in policy on when and how the employers are compensated for sickness absence. ObjectiveWe aimed to investigate the association between different working hour characteristics and long-term sickness absence and whether these associations differed within various age groups in two large datasets of nursing personnel from Denmark and Finland. DesignBased on objective payroll data we used Poisson regression models to calculate incidence rate ratios with 95% confidence intervals to prospectively assess the risk of long-term sickness absence in relation to annual working hour characteristics. The analyses were adjusted for age, sex, short-term sickness absence, and weekly working hours. Setting(s)Danish and Finnish nursing personnel. Participants31,729 Danish and 6970 Finnish nursing personnel with ≥ 0.5 Whole-Time Equivalent, registered in the database ≥ 1 year, 18–67 years of age with less than 30 days sickness absence in baseline year 2008. MethodsWorking hour characteristics were assessed for 2008: time of day; day; evening; night. Duration of shift; long shifts (9–12 h); very long shifts (12–24 h); quick returns (< 11 h between two shifts); long weeks (> 40 h/week); very long weeks (> 48 h/week); and consecutive night shifts (≥ 5 night shifts). Long-term sickness absence was assessed as first incidence of 30 or more consecutive days off in 2009–2015. ResultsThe Danish data showed having evening work or five or more consecutive night shifts were associated with higher risk of long-term sickness absence. When excluding pregnant women, night work was also associated to higher risk of sickness absence. When stratifying on age groups, we observed a lower risk of sickness absence in the youngest age groups and a higher risk among the oldest. The Finnish results showed a higher risk of sickness absence when working nights, longs shifts, quick returns, and long work weeks. When stratifying on age groups, the results showed similar tendencies as the Danish. ConclusionsThe results show that the scheduling of working hours is likely to affect the risk of long-term sickness absence and that the risk differs in different age groups. No consistent picture was found for the results from Denmark and Finland. Differences may be due to contextual differences thus comparison of risk of sickness absence in relation to working hours between countries should be performed with caution.Tweetable abstract: A recent study from Denmark and Finland shows higher risk for long sickness absence among nurses with five or more consecutive night shifts

Psychosocial Stressors at Work and the Risk of Sickness Absence Due to a Diagnosed Mental Disorder

Mental health problems are associated with considerable occupational, medical, social, and economic burdens. Psychosocial stressors at work have been associated with a higher risk of mental disorders, but the risk of sickness absence due to a diagnosed mental disorder, indicating a more severe condition, has never been investigated in a systematic review and meta-analysis. To synthesize the evidence of the association of psychosocial stressors at work with sickness absence due to a diagnosed mental disorder among adult workers. Seven electronic databases (MEDLINE, Embase, PsycInfo, Web of Science, CINAHL, Sociological Abstracts, and International Bibliography of the Social Sciences), 3 gray literature databases (Grey Literature Report, WHO-IRIS and Open Grey), and the reference lists of all eligible studies and reviews were searched in January 2017 and updated in February 2019. Only original prospective studies evaluating the association of at least 1 psychosocial stressor at work from the 3 most recognized theoretical models were eligible: the job demand-control-support model, including exposure to job strain (high psychological demands with low job control); effort-reward imbalance model; and organizational justice model. Study selection was performed in duplicate by blinded independent reviewers. Among the 28 467 citations screened, 23 studies were eligible for systematic review. This meta-analysis followed the PRISMA and MOOSE guidelines. Data extraction and risk of bias evaluation, using the Risk of Bias in Nonrandomized Studies-Interventions tool, were performed in duplicate by blinded independent reviewers. Data were pooled using random-effect models. Sickness absence due to a mental disorder with a diagnosis obtained objectively. A total of 13 studies representing 130 056 participants were included in the 6 meta-analyses. Workers exposed to low reward were associated with a higher risk of sickness absence due to a diagnosed mental disorder compared with nonexposed workers (pooled risk ratio [RR], 1.76 [95% CI, 1.49-2.08]), as were those exposed to effort-reward imbalance (pooled RR, 1.66 [95% CI, 1.37-2.00]), job strain (pooled RR, 1.47 [95% CI, 1.24-1.74]), low job control (pooled RR, 1.25 [95% CI, 1.02-1.53]), and high psychological demands (pooled RR, 1.23 [95% CI, 1.04-1.45]). This meta-analysis found that workers exposed to psychosocial stressors at work were associated with a higher risk of sickness absence due to a mental disorder. A better understanding of the importance of these stressors could help physicians when evaluating their patients' mental health and work capacity.

BMI and Labor Market Participation: A Cohort Study of Transitions Between Work, Unemployment, and Sickness Absence.

This study aimed to test the hypotheses that individuals with obesity are at higher risk of unemployment and sickness absence and have a lower chance of getting employed compared with individuals with normal weight. Data on weight and height were collected at baseline from 87,796 participants in the Danish National Health Survey 2010. Participants were then followed in national registers for 5 years. Outcome measures were transitions from employment to unemployment and sickness absence and the transitions from unemployment or sickness absence to employment. Data were analyzed by Cox proportional hazards models adjusted for potential confounders. Hazard ratios for unemployment were 1.18 (95% CI: 1.10-1.26) for individuals with obesity and 1.27 (95% CI: 1.14-1.41) for individuals with severe obesity compared with individuals with normal weight. Participants with obesity also had a higher risk of sickness absence. Additionally, participants with obesity who were unemployed at baseline had a lower chance of becoming employed compared with participants with normal weight. Obesity was associated with a higher risk of unemployment and sickness absence compared with individuals with normal weight. Additionally, obesity was associated with a lower chance of employment.

Occupational Class Differences in Long-Term Sickness Absence Due to Breast Cancer during 2005-2013: A Population-Based Study among Finnish Women.

Breast cancer is the most common cancer among women in Western countries with clear socioeconomic differences. Higher occupational class is associated with higher breast cancer incidence but with better survival from the disease, whereas lower occupational class is associated with higher risk of sickness absence. We are not aware of previous studies examining changes over time in occupational class differences in sickness absence due to breast cancer. This paper focuses on occupational class differences in the incidence and duration of sickness absence due to breast cancer over the period of 2005–2013. Age-adjusted occupational class differences in the cumulative incidence and duration of sickness absence due to breast cancer were calculated utilising a nationally representative 70% random sample of employed Finnish women aged 35–64 years (yearly N varying between 499,778 and 519,318). The results show that higher occupational class was associated with higher annual cumulative incidence of sickness absence due to breast cancer. Lower occupational class was associated with longer duration of absence. Occupational class differences in both cumulative incidence and duration of absence remained broadly stable. As a conclusion, these results suggest that measures should be targeted particularly to promotion of work capacity among employees with breast cancer in lower occupational classes.

Is combining human service work with family caregiving associated with additional odds of emotional exhaustion and sickness absence? A cross-sectional study based on a Swedish cohort

PurposeThe aim of the study is to examine to what extent human service work and family caregiving is associated with emotional exhaustion and sickness absence, and to what extent combining human service work and family caregiving is associated with additional odds.MethodsData were derived from participants in paid work from the Swedish Longitudinal Occupational Survey of Health, year 2016 (n = 11 951). Logistic regression analyses were performed and odds ratios and 95% confidence intervals estimated for the association between human service work and family caregiving, respectively, as well as combinations of the two on one hand, and emotional exhaustion and self-reported sickness absence on the other hand. Interaction between human service work and family caregiving was assessed as departure from additivity with Rothman’s synergy index.ResultsHuman service work was not associated with higher odds of emotional exhaustion, but with higher odds of sickness absence. Providing childcare was associated with higher odds of emotional exhaustion, but lower odds of sickness absence, and caring for a relative was associated with higher odds of both emotional exhaustion and sickness absence. There was no indication of an additive interaction between human service work and family caregiving in relation to neither emotional exhaustion nor sickness absence.ConclusionsWe did not find support for the common assumption that long hours providing service and care for others by combining human service work with family caregiving can explain the higher risk of sickness absence or emotional exhaustion among employees in human service occupations.

Use of TETRA personal radios and sickness absence in the Airwave Health Monitoring Study of the British police forces

BackgroundTerrestrial Trunked Radio (TETRA) is used for radiocommunications among the British police forces. ObjectivesTo investigate association of personal radio use and sickness absence among police officers and staff from the Airwave Health Monitoring Study. MethodsParticipant-level sickness absence records for 26 forces were linked with personal radio use for 32,102 participants. We used multivariable logistic regression to analyse TETRA usage in year prior to enrolment and sickness absence (lasting more than 7 or 28 consecutive days) in the following year and a zero-inflated negative binomial model for analyses of number of sickness absence episodes of any duration (‘spells’) over the same period. In secondary analyses, we looked at an extended period of observation among a sub-cohort with linked data over time, using Cox proportional hazards regression. ResultsMedian personal radio use (year prior to enrolment) was 29.7 min per month (interquartile range 7.5, 64.7) among users. In the year following enrolment there were 25,655 sickness absence spells among 15,248 participants. There were similar risks of sickness absence lasting more than seven days among users and non-users, although among users risk was higher with greater use, odds ratio = 1.04 (95% confidence interval [CI] 1.02 to 1.06) per doubling of radio use. There was no association for sickness absence of more than 28 days. For sickness absence spells, risk was lower among users than non-users (incidence rate ratio = 0.91; 95% CI 0.75 to 1.11), again with higher risk among users for greater radio use. There was no association between radio use and sickness absence in secondary analyses. DiscussionThere were similar or lower risks of sickness absence in TETRA radio users compared with non-users. Among users, the higher risk of sickness absence with greater radio use may reflect working pattern differences among police personnel rather than effects of radiofrequency exposure.

Relational justice, economic fluctuations, and long-term sickness absence: a multi-cohort study

Objectives Previous studies mainly based on the public sector show that organizational justice is associated with a lower risk of sickness absence (SA). The purpose of this study is to analyze this association with multi-cohort data from different employment sectors and to discover whether the association varies according to the general economic context or financial situation of the workplace. Methods Cross-sectional Finnish Quality of Work Life surveys from 1997, 2003, and 2008 were combined with data on long-term SA obtained from the Finnish Social Security Institution. The associations between SA periods in the three years following each survey and perceived relational justice, general economic context, and the perceived financial situation of the workplace were analyzed with negative binomial regression. Results Higher level of relational justice was statistically significantly associated with lower rate of SA after controlling for baseline health, but not after controlling for job control and job demands. An interaction was found with relational justice and the financial situation of the workplace. Higher level of relational justice was related to a lower risk of SA when the financial situation of the workplace was stable, but there was a higher risk of SA when the financial situation was insecure. Conclusions The association between relational justice and a lower risk of SA is in line with previous studies when the financial situation of the workplace is stable. In unstable economic conditions, employees may have the courage to take sick leave when they are ill if they are fairly treated by their supervisor.

Can a poor psychosocial work environment and insufficient organizational resources explain the higher risk of ill-health and sickness absence in human service occupations? Evidence from a Swedish national cohort.

The aim of this study was to investigate differences in burnout, self-rated health (SRH) and sickness absence between human service occupations (HSOs) and other occupations, and whether they can be attributed to differences in psychosocial work environment and organizational resources. Data were derived from the Swedish Longitudinal Occupational Survey of Health, an approximately representative sample of the Swedish working population ( n = 4408). Employment in HSOs, psychosocial work environment and organizational resources in 2012 predicted relative risks of sickness absence, burnout and suboptimal SRH in 2014 using modified Poisson regressions. The psychosocial work factors' and organizational resource variables' relative importance were estimated by adding them to the models one by one, and with population attributable fractions (PAFs). Employment in HSOs was associated with a higher risk of sickness absence and the risk was explained by psychosocial and organizational factors, particularly high emotional demands, low work-time control and exposure to workplace violence. Employment in HSOs was not associated with burnout after sociodemographic factors were adjusted for, and furthermore not with SRH. A lower risk of suboptimal SRH was found in HSOs than in other occupations with equivalent psychosocial work environment and organizational resources. PAFs indicated that psychosocial work environment and organizational resource improvements could lead to morbidity reductions for all outcomes; emotional demands were more important in HSOs. HSOs had higher risks of sickness absence and burnout than other occupations. The most important work factors to address were high emotional demands, low work-time control, and exposure to workplace violence.

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 absence diagnoses among abstainers, low-risk drinkers and at-risk drinkers: consideration of the U-shaped association between alcohol use and sickness absence in four cohort studies.

AimsTo estimate differences in the strength and shape of associations between alcohol use and diagnosis‐specific sickness absence.DesignA multi‐cohort study. Participants (n = 47 520) responded to a survey on alcohol use at two time‐points, and were linked to records of sickness absence. Diagnosis‐specific sickness absence was followed for 4–7 years from the latter survey.Setting and participantsFrom Finland, we had population cohort survey data from 1998 and 2003 and employee cohort survey data from 2000–02 and 2004. From France and the United Kingdom, we had employee cohort survey data from 1993 and 1997, and 1985–88 and 1991–94, respectively.MeasurementsWe used standard questionnaires to assess alcohol intake categorized into 0, 1–11 and > 11 units per week in women and 0, 1–34 and > 34 units per week in men. We identified groups with stable and changing alcohol use over time. We linked participants to records from sickness absence registers. Diagnoses of sickness absence were coded according to the International Classification of Diseases. Estimates were adjusted for sex, age, socio‐economic status, smoking and body mass index.FindingsWomen who reported drinking 1–11 units and men who reported drinking 1–34 units of alcohol per week in both surveys were the reference group. Compared with them, women and men who reported no alcohol use in either survey had a higher risk of sickness absence due to mental disorders [rate ratio = 1.51, 95% confidence interval (CI) = 1.22–1.88], musculoskeletal disorders (1.22, 95% CI = 1.06–1.41), diseases of the digestive system (1.35, 95% CI = 1.02–1.77) and diseases of the respiratory system (1.49, 95% CI = 1.29–1.72). Women who reported alcohol consumption of > 11 weekly units and men who reported alcohol consumption of > 34 units per week in both surveys were at increased risk of absence due to injury or poisoning (1.44, 95% CI = 1.13–1.83).ConclusionsIn Finland, France and the United Kingdom, people who report not drinking any alcohol on two occasions several years apart appear to have a higher prevalence of sickness absence from work with chronic somatic and mental illness diagnoses than those drinking below a risk threshold of 11 units per week for women and 34 units per week for men. Persistent at‐risk drinking in Finland, France and the United Kingdom appears to be related to increased absence due to injury or poisoning.

Sociodemographic Differences Between Alcohol Use and Sickness Absence: Pooled Analysis of Four Cohort Studies.

We examined differences in sickness absence in relation to at-risk drinking and abstinence, taking into account potential changes in consumption. We used individual-participant data (n = 46,514) from four prospective cohort studies from Finland, France and the UK. Participants responded to a survey on alcohol use at two time points 4-6 years apart, and were linked to records of sickness absence for an ~6-year follow-up after the latter survey. Abstainers were those reporting no alcohol use in either survey. At-risk drinkers at T1 were labelled as 'former', at-risk drinkers at T2 as 'current' and at-risk drinkers at both times as 'consistent' at-risk drinkers. The reference group was low-risk drinkers at both times. Study-specific analyses were stratified by sex and socioeconomic status (SES) and the estimates were pooled using meta-analysis. Among men (n = 17,285), abstainers (6%), former (5%), current (5%) and consistent (7%) at-risk drinkers had an increased risk of sickness absence compared with consistent low-risk drinkers (77%). Among women (n = 29,229), only abstainers (12%) had a higher risk of sickness absence compared to consistent low-risk drinkers (74%). After adjustment for lifestyle and health, abstaining from alcohol was associated with sickness absence among people with intermediate and high SES, but not among people with low SES. The U-shaped alcohol use-sickness absence association is more consistent in men than women. Abstinence is a risk factor for sickness absence among people with higher rather than lower SES. Healthy worker effect and health selection may partly explain the observed differences. In a pooled analysis from four cohort studies from three European countries, we demonstrated a U-shaped association between alcohol use and sickness absence, particularly among men. Abstinence from alcohol was associated with increased sickness absenteeism among both sexes and across socioeconomic strata, except those with low SES.

Labour-market marginalisation after mental disorders among young natives and immigrants living in Sweden

BackgroundThe aim was to investigate the associations between mental disorders and three different measures of labour-market marginalisation, and differences between native Swedes and immigrants.MethodsThe study comprised 1,753,544 individuals, aged 20–35 years, and resident in Sweden 2004. They were followed 2005–2011 with regard to disability pension, sickness absence (≥90 days) and unemployment (≥180 days). Immigrants were born in Western countries (Nordic countries, EU, Europe outside EU or North-America/Oceania), or in non-Western countries (Africa, Asia or South-America). Mental disorders were grouped into seven subgroups based on a record of in- or specialised outpatient health care 2001–2004. Hazard ratios (HRs) with 95% confidence intervals (CIs) were computed by Cox regression models with both fixed and time-dependent covariates and competing risks. We also performed stratified analyses with regard to labour-market attachment.ResultsIndividuals with mental disorders had a seven times higher risk of disability pension, a two times higher risk of sickness absence, and a 20% higher risk of unemployment than individuals without mental disorders. Individuals with personality disorders and schizophrenia/non-affective psychoses had highest risk estimates for having disability pension and long-term sickness absence, while the risk estimates of long-term unemployment were similar among all subgroups of mental disorders. Among persons with mental disorders, native Swedes had higher risk estimates for disability pension (HR:6.6; 95%CI:6.4–6.8) than Western immigrants (4.8; 4.4–5.2) and non-Western immigrants (4.8; 4.4–5.1), slightly higher risk estimates for sickness absence (2.1;2.1–2.2) than Western (1.9;1.8–2.1), and non-Western (1.9;1.7–2.0) immigrants but lower risk estimates for unemployment (1.4;1.3–1.4) than Western (1.8;1.7–1.9) and non-Western immigrants (2.0;1.9–2.1). There were similar risk estimates among sub-regions within both Western and non-Western countries. Stratification by labour-market attachment showed that the risk estimates for immigrants were lower the more distant individuals were from gainful employment.ConclusionsMental disorders were associated with all three measures of labour-market marginalisation, strongest with subsequent disability pension. Native Swedes had higher risk estimates for both disability pension and sickness absence, but lower risk estimates for unemployment than immigrants. Previous labour-market attachment explained a great part of the association between immigrant status and subsequent labour-market marginalisation.