Risk Factor For Sickness Absence Research Articles

Joint associations of psychological distress and working conditions with sickness absence in Finland

Abstract Background Psychological distress has increased remarkably, especially among younger age groups, during the last years. Both psychological distress and exposure to strenuous working conditions are known risk factors for sickness absence (SA). We examined whether psychological distress and working conditions are jointly associated with SA periods of 1-7 days and 8+ days among young and midlife Finnish employees. Methods We linked survey data from the Helsinki Health Study cohort from 2017 (response rate 51.5%) with the employer’s SA register for the City of Helsinki, Finland (82% consented to the linkage; n = 3949, 80% women, age 19-39 years). Mean follow-up time was 2.1 years. We calculated rate ratios (RR) and 95% confidence intervals (CI) for SA periods of 1-7 days and 8+ days using negative binomial regression models among participants with and without psychological distress, and with and without exposure to strenuous working conditions. Psychological distress was measured with the emotional wellbeing subscale of RAND-36 (cut-off 60 points). Working conditions included physical and mental strenuousness of work and hours per day spent in heavy physical work. Results Participants with psychological distress and exposure to strenuous working conditions had the highest age- and gender-adjusted RRs for SA periods of ≥ 8 days (physically strenuous work: RR: 2.38, CI: 1.97-2.88; mentally strenuous work: RR: 2.08, CI: 1.72-2.53; ≥3 h per day spent in physical work: RR: 2.48, CI: 2.01-3.06), the interactions being additive. The associations were weaker for SA periods of 1-7 days. Adjusting for marital and employment status, education, alcohol use, smoking and body mass index only slightly attenuated these associations. Conclusions Psychological distress and exposure to strenuous working conditions were additively associated with SA. Both individual- and workplace-related risk factors for SA are important to be considered when planning preventive actions. Key messages • Young and early midlife Finnish employees with simultaneous psychological distress and exposure to strenuous working conditions had the highest rates of SA periods, the interactions being additive. • Both psychological distress and exposure to strenuous physical and mental working conditions should be considered when planning preventive actions to reduce employees’ SA.

Identifying pain profiles in employees including work-related factors and pain perceptions: a cross-sectional study in Belgian companies

ObjectivesStudies usually investigate a limited number or a predefined combinations of risk factors for sickness absence in employees with pain. We examined frequently occurring combinations across a wide range of...

Mental disorders in judicial workers: analysis of sickness absence in a cohort study.

To analyze risk factors for sickness absence due to mental disorders among judicial workers in Bahia, Brazil. Retrospective cohort with follow-up from 2011 to 2016 with 2,660 workers of a judicial sector in Bahia, Brazil. The main outcome measures were survival curves estimated for the independent variables using the Kaplan-Meier product limit estimator and risk factors for the first episode of sickness absence calculated based on the Cox regression model. The survival estimate of the population of this study for the event was 0.90 and from the Cox model the risk factors for the first episode of sickness absence due to mental disorders were: female (HR = 1.81), occupation of magistrate (HR = 1.80), and age over 30 years old (HR = 1.84). In addition, the risk for new cases of sickness absence among women reached 4.0 times the risk for men, in 2015. The estimated relative risks of sickness absence and the observed survival reduction behavior over time add information to the literature on sociodemographic and occupational factors associated with sickness absence due to mental disorders in the public sector. These results highlight the need for further research to more precisely identify vulnerable groups at risk of preventable mental health-related sickness absence in the workplace, better identify the workplace organizational factors that contribute to these disorders as well as studies on the effectiveness of workplace interventions to improve mental health among judicial and other public sectors workers.

P036 Gout and work participation in British adults: findings from the Health and Employment After Fifty study

Abstract Background/Aims The prevalence of gout is increasing in the UK and gout is the most common inflammatory arthritis among men aged 40 and older. As well as acute and chronic musculoskeletal manifestations, it is also associated with cardiometabolic disease and renal impairment. Given its risk factors and associated morbidities, it has potential to significantly impact work ability, but this has received little attention to date. Methods Data came from the Health and Employment After Fifty (HEAF) study, a cohort of 8134 men and women recruited in 2013-14 when aged 50-64. Consenting participants also agreed to data linkage to their Clinical Practice Research Datalink (CPRD) primary care records. Participants were coded as having gout if they had at least 2 CPRD records diagnosing/treating gout at any time before the baseline questionnaire. Annual follow-up questionnaires enquired about jobs altered mainly or partly because of health reasons which was coded as health-related job loss (HRJL). Other outcomes assessed were: any sickness absence in past 12 months (vs no sickness absence); prolonged sickness absence (defined as > 20 days of sickness absence in past 12 months vs less than 20 days); and any sickness absence because of musculoskeletal pain (vs no sickness absence because of musculoskeletal pain). Participants with gout who were in paid work at baseline were individually matched by sex and age (within 1 year) with 3 participants also working but without a diagnosis of gout. Associations between having gout and a subsequent work outcome were explored with multilevel logistic regression with random intercept, to account for the repeated measures for each participant, and results expressed as ORs with 95%CIs. Results Of the 7673 HEAF participants who consented to CPRD data linkage, 149 (1.9%) were classified with gout. The proportion of participants in work at baseline was similar among those with gout (73.8%) and without gout (67.9%). Participants with gout were mostly men, average age 58 years. Gout participants were more likely than controls to be: obese, previous smokers, heavy drinkers, to report fair/poor self-rated health (SRH) and to have prevalent hypertension as compared with those without gout. After adjustment for age, sex, time of follow-up, BMI, alcohol, and SRH, having gout was significantly associated with any sickness absence (OR = 2.68 95%CI 1.58,4.54) and musculoskeletal sickness absence (OR = 2.50 95%CI 1.15,5.43) but no association was seen with HRJL or prolonged sickness absence. Conclusion Gout was an independent risk factor for sickness absence but not health related job loss. As the impact of sickness absence associated with gout is likely to increase with rising disease prevalence and an older workforce, there is need to explore whether improved management of hyperuricaemia and gout can improve work outcomes. Disclosure S. D'Angelo: None. K. Walker-Bone: None. N. Goodson: None.

Office design, telework from home, and self-certified sickness absence: A cross-sectional study of main and moderating effects in a nationally representative sample.

This study aimed to investigate (i) the main effects of office design and access to telework from home (TWFH) on self-certified sickness absence and (ii) the moderating effects of access to TWFH on the relationship between office design and self-certified sickness absence. The study used cross-sectional survey data from a nationally representative sample from Norway (N=4329). Research objectives were investigated with negative binomial hurdle models, adjusting for age, gender, education level, leadership responsibility, and time spent on office work. Moderating effects of TWFH were evaluated with pairwise comparisons and plots of estimated marginal means. In adjusted models, employees in conventional open-plan offices [odds ratio (OR) 1.32, 95% confidence interval (CI) 1.13-1.54] had significantly higher odds of sickness absence than employees in private offices. Employees with access to TWFH (OR 0.86, 95% CI 0.74-0.99) had significantly lower odds of sickness absence than employees with no access. Among employees with access to TWFH, those in conventional open-plan offices had significantly higher predicted probability of self-certified sickness absence than those in private offices (z=4.41, P<0.0001). There were no significant differences between office designs among employees who did not have access to TWFH. There were no significant main or moderating effects on the number of sickness absence episodes in adjusted models. The current study identifies conventional open-plan offices as a potential risk factor for sickness absence. While access to TWFH may be a protective factor overall, it amplified - rather than attenuated - differences in sickness absence between employees in private offices and conventional open-plan offices.

Poor psychosocial job conditions increase sickness absence: evidence from the PATH Through Life Mid-Aged Cohort

ObjectivesEvidence is mounting that poor psychosocial job conditions increase sickness absence, but there is a need for further rigorous prospective research to isolate the influence of psychosocial job quality from...

Does occupational forward bending of the back increase long-term sickness absence risk? A 4-year prospective register-based study using device-measured compositional data analysis.

Forward bending of the back is common in many jobs and a risk factor for sickness absence. However, this knowledge is based on self-reported forward bending that is generally imprecise. Thus, we aimed to investigate the dose-response relation between device-measured forward bending at work and prospective register-based risk of long-term sickness absence (LTSA). At baseline, 944 workers (93% from blue-collar jobs) wore accelerometers on their upper back and thigh over 1-6 workdays to measure worktime with forward bending (>30˚ and >60˚) and body positions. The first event of LTSA (≥6 consecutive weeks) over a 4-year follow-up were retrieved from a national register. Compositional Cox proportional hazard analyses were used to model the association between worktime with forward bending of the back in an upright body position and LTSA adjusted for age, sex, body mass index (BMI), occupational lifting/carrying, type of work, and, in an additional step, for leisure time physical activity (PA) on workdays. During a mean worktime of 457 minutes/day, the workers on average spent 40 and 10 minutes on forward bending >30˚ and >60˚ in the upright position, respectively. Five more minutes forward bending >30˚ and >60˚ at work were associated with a 4% [95% confidence interval (CI) 1.01-1.07] and 8% (95% CI 1.01-1.16) higher LTSA risk, respectively. Adjustment for leisure-time PA did not influence the results. We found a dose-response association between device-measured forward bending of the back and prospective LTSA risk. This knowledge can be integrated into available feasible methods to measure forward bending of the back for improved workplace risk assessment and prevention.

Is work–life interference a risk factor for sickness absence? A longitudinal study of the Swedish working population

BackgroundWhile there is increasing literature on the health effects of work–life interference, few studies have investigated the relationship between a direct measure of work–life interference and objective sickness absence measures. The aim of this study is to investigate whether work–life interference is a risk factor for subsequent long-term sickness absence (LTSA).MethodsData were derived from the Swedish Longitudinal Occupational Survey of Health 2010, 2012, 2014 and 2016. Data were linked to register data on LTSA (having at least one continuous period of medically certified sick leave exceeding 14 days) the following 2 years after each data collection wave. We applied generalized estimating equations, odds ratios (ORs) and 95% confidence intervals (CIs). The sample included 15 244 individuals (43.1% men and 56.9% women). Nearly a fifth of the sample (18.7%, n = 1110) started at least one period of LTSA at any point between 2010 and 2018.ResultsWork–life interference was found to be a risk factor for subsequent LTSA (OR = 1.55; 95% CI = 1.44–1.67) even when adjusting for relevant factors including general health (OR = 1.39; 95% CI = 1.29–1.51). We found no significant moderating effect of gender.ConclusionThe results of this study indicate that work–life interference is a risk factor for subsequent LTSA for working men and women in Sweden.

Length of exposure to long working hours and night work and risk of sickness absence: a register-based cohort study

BackgroundThere is inconsistent evidence that long working hours and night work are risk factors for sickness absence, but few studies have considered variation in the length of exposure time window as a potential source of mixed findings. We examined whether the association of long working hours and night work with sickness absence is dependent on the length of exposure to the working hour characteristics.MethodsWe analysed records of working hours, night work and sickness absence for a cohort of 9226 employees in one hospital district in Finland between 2008 and 2019. The exposure time windows ranged from 10 to 180 days, and we used Cox’s proportional hazards models with time-dependent exposures to analyse the associations between working-hour characteristics and subsequent sickness absence.ResultsLonger working hours for a period of 10 to 30 days was not associated with the risk of sickness absence whereas longer working hours for a period of 40 to 180 days was associated with a lower risk of sickness absence. Irrespective of exposure time window, night work was not associated with sickness absence.ConclusionsIt is important to consider the length of exposure time window when examining associations between long working hours and sickness absence, whereas the association between night work and sickness absence is not similarly sensitive to exposure times.

Risks of COVID-19 by occupation in NHS workers in England

ObjectiveTo quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020–31 July 2020) of the pandemic in England.MethodsWe used pseudonymised data on 902 813 individuals...

The role of sickness absence diagnosis for the risk of future inpatient- or specialized outpatient care in a Swedish population-based twin sample

BackgroundStudies of consequences of sickness absence such as health and well-being have been rare whereas risk factors for sickness absence have been studied extensively. This study assumed the consequences of sickness absence would differ by diagnostic group or by patient care type. The aim was to investigate sickness absence due to various diagnosis groups as a predictor for subsequent inpatient- and specialized outpatient care while controlling for familial confounding.MethodsWe utilized the register data of 69,552 twin individuals between 16 and 80 years of age (48% women). The first incident sickness absence spell, from baseline year 2005, including diagnosis of sickness absence was our primary exposure of interest and we followed them until the first incident inpatient- and specialized outpatient care episode with main diagnosis code or until 31.12.2013.ResultsA total of 7464 incident sickness absence spells took place (11%), 42% had inpatient care and 83% specialized outpatient care (mean follow-up time 3.2 years, SD 3.1 years). All the main sickness absence diagnosis groups were associated with increased risk of future care in comparison to no sickness absence. Controlling for confounders attenuated the associations in magnitude but with retaining direction, and we could not confirm an effect of familial factors.ConclusionsSickness absence predicts both inpatient- and specialized outpatient care and the association is universal across diagnosis groups. The lower survival time and incidence rates of inpatient than specialized outpatient care point towards severity of diseases assumption. This finding was also universal across sickness absence diagnosis groups.

Risk factors for sick leave in Brazilian oil industry workers.

Studies point to a complex and multifactorial aetiology for sickness absence, but there is still insufficient evidence on how occupational and non-occupational risk factors contribute to this phenomenon. This study aimed to identify occupational and non-occupational factors related to sickness absence in oil industry workers, as well as their population attributable fractions (PAF). A retrospective cohort study of 2028 oil industry workers was conducted in the state of Bahia, Brazil, between January 1, 2012 and December 31, 2016. Study data were obtained from workers´ medical register. The dependent variable was the first event of sick leave for five or more days, and the independent variables were gender, age, years of work, type of work activity, level of education, work schedule, awkward working postures, body mass index, smoking, physical activity and alcohol consumption. Cox regression analysis identified risk factors to the outcome and PAF were calculated. Being female (HR 1.79), being older (HR 1.44), non-graduated ones (HR 1.44), being of operational staff (HR 1.18), overweight (HR 1.13), obesity (HR 1.39), smoking (HR 1.61) and former smoking (HR 1.30) were risk factors for sickness absence in this cohort. Of all sickness absence in the study population, 6% could be attributed to overweight, 10% to obesity, and 8% to smoking. To prevent sick leave, we recommend programs focused on combating smoking and encouraging healthy habits, aiming at weight control and the prevention of chronic diseases. Population attributable fractions point that a universal approach, aimed at the total population will be more cost-effective than health promotion programmes restricted for high-risk populations.

Impact of Workplace Conflicts on Self-Reported Medically Certified Sickness Absence in Latvia.

Sickness absence is one of the most important working population health indicators. It is a complex phenomenon that is investigated by health care and occupational health specialists, economists, and work psychologists. Sickness absence is used as a predictor for morbidity and mortality, but besides the health status of an individual, sickness absence is influenced by demographic, socio-economic factors, and work environment factors. Conflicts at work are a common psychosocial risk factor that can affect sickness absence. The aim of the study was to investigate the association between different types of workplace conflict and self-reported medically certified sickness absence using cross-sectional survey data pooled from four periodic national surveys—Work conditions and risks in Latvia (2006–2018). The sample is representative of the working population of Latvia, as respondents were randomly drawn from different regions and industries. In total, the study sample (n = 8557) consisted of employees between 16 and 80 years old (average 42.8 +/− 12.6) of which 46.2% were males and 53.8% were females. Researchers used the computer-assisted personal interviewing (CAPI) method for collecting data. The association between workplace conflicts and sickness absence was analysed by using binomial logistic regression and calculated as odds ratios (OR) with 95% confidence intervals (CI), with adjustment for gender, age, education and survey year. The risk of sickness absence was higher among women (OR = 1.24, CI 1.13–1.35), employees aged 25–44 years old and employees with higher income. Controlling for socio-demographic factors and survey year, the odds of sickness absence increased significantly for all types of workplace conflict analysed. The strongest association with sickness absence was related to conflicts between managers and employees (OR = 1.51, CI 1.37–1.66) and conflicts between groups of employees (OR = 1.45, CI 1.31–1.61). Conflicts between employees and with customers also increased the odds of sickness absence (OR = 1.39, CI 1.27–1.52 and OR = 1.11, CI 1.01–1.23, respectively). Our findings suggest that tailored interventions at a company level for reducing workplace conflicts as risk factors of sickness absence are required. Those should focus on the improvement of managers’ leadership and human resource management skills.

Occupational and non-occupational risk factors of sickness absence due to a shoulder lesion

ObjectivesTo determine the associations of lifestyle factors and cumulative physical workload exposures with sickness absence (SA) due to a shoulder lesion and to calculate their population attributable fractions (PAF).MethodsOur nationally...

Associations of sickness absence for pain in the low back, neck and shoulders with wider propensity to pain

ObjectivesTo explore the association of sickness absence ascribed to pain at specific anatomical sites with wider propensity to musculoskeletal pain.MethodsAs part of the CUPID (Cultural and Psychosocial Influences on Disability)...

Does lifestyle matter for sickness absence?

Does lifestyle matter for sickness absence?

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.

NIPSA: a new scale for measuring non-illness predictors of sickness absence

ObjectivesWe describe the development and initial validation of a new scale for measuring non-illness factors that are important in predicting occupational outcomes, called the NIPSA (non-illness predictors of sickness absence)...

Disentangling the link between Honesty-Humility and detrimental workplace behaviors: The role of ethical leadership and organizational justice

Organizational justice perceptions have been suggested to be associated with symptoms of mental health but the nature of the association is unknown due to reporting bias (measurement error related to response style and reversed causality). In this study, we used prospective design and long-term (>9 days) sickness absence with psychiatric diagnosis as the outcome measure. Participants were 21 221 Finnish public sector employees (the participation rate at baseline in 2000–2002 68%), who responded to repeated surveys of procedural and interactional justice in 2000–2004 along with register data on sickness absence with a diagnosis of depression or anxiety disorders (822 cases). Results from logistic regression analyses showed that a one-unit increase in self-reported and work-unit level co-worker assessed interactional justice was associated with a 25–32% lower odds of sickness absence due to anxiety disorders. These associations were robust to adjustments for a variety of potential individual-level confounders including chronic disease (adjusted OR for self-reported interactional justice 0.77, 95% CI 0.65–0.91) and were replicated using co-worker assessed justice. Only weak evidence of reversed causality was found. The results suggest that low organizational justice is a risk factor for sickness absence due to anxiety disorders.

Workplace bullying and sickness absence: a systematic review and meta-analysis of the research literature.

The association between workplace bullying and sickness absence remains unclear. This paper presents a systematic review and meta-analysis of research on the association. We conducted a systematic review and meta-analysis of published primary studies on workplace bullying and sickness absence. Studies based on prospective design or registry data on sickness absence were included. Cross-sectional studies with self-reported sickness absence were excluded. Seventeen primary studies were included in the review, sixteen originated from the Nordic countries and fifteen included registry data on sickness absence. All but one study found that exposure to workplace bullying was associated with increased risk of sickness absence. A meta-analysis of ten independent studies showed that exposure to bullying increased the risk of sickness absence (odds ratio 1.58, 95% CI 1.39-1.79). Five studies included variables that moderated the association between bullying and absenteeism. None of the studies included mediating variables. No studies examined sickness absence as a risk factor for later exposure to bullying. Following the GRADE guidelines, the evidence for an association between bullying and sickness absence is moderate. Workplace bullying is a risk factor for sickness absence, but the mechanisms to explain this relationship are not sufficiently described. It is unclear whether sickness absence predicts later exposure to bullying. While, the methodological quality of the reviewed studies was high, the knowledge base is small. There is a need for more research on how and when bullying is related to sickness absence and the possible bidirectional relationships involved.