Risk Of Sickness Absence Research Articles

Job demands, job resources and long‐term sickness absence in the Danish eldercare services: a prospective analysis of register‐based outcomes

To investigate associations between psychosocial job demands, job resources and cases of registered long-term sickness absence among nursing staff in the eldercare services. Research has shown that psychosocial work environment exposures predict sickness absence in healthcare settings. However, only few studies have longitudinally investigated associations between specific job demands and job resources and risk of long-term sickness absence. Questionnaire data were collected in 2004 and 2005 among all employees in the eldercare services in 35 Danish municipalities and were followed in a National register on payment of sickness absence compensation for a 1-year follow-up period (N = 7921). Three psychosocial job demands - emotional demands, quantitative demands and role conflicts - and three job resources - influence, quality of leadership and team climate - were investigated to predict risk of sickness absence for eight or more consecutive weeks in the follow-up period. Data were analysed using Cox proportional hazards model. A percentage of 6·5 of the respondents were absent for eight or more consecutive weeks during follow-up. The analyses showed that emotional demands, role conflicts, influence, quality of leadership and team climate were significantly associated with risk of long-term sickness absence. In an analysis with mutual adjustment for all job demands and job resources, influence constituted the strongest predictor of long-term sickness absence (negative association). Job demands and job resources are significantly associated with risk of long-term sickness absence. Interventions aimed at improving the psychosocial work environment may, therefore, contribute towards preventing long-term sickness absence in the eldercare services.

014 How do musculoskeletal pain, avoidant coping and sickness absence relate to each other?

BackgroundMusculoskeletal pain is common and causes extensive sickness absence and work disability in many industrialised countries. The prevalence of musculoskeletal morbidity increases by decreasing socio-economic position and it appears that...

Allergic rhinitis alone or with asthma is associated with an increased risk of sickness absences

The aim of the study is to examine the risk of sickness absence in public sector employees with allergic rhinitis or asthma or both conditions combined. This is a prospective cohort study of 48,296 Finnish public sector employees. Data from self-reported rhinitis and asthma were obtained from survey responses given during either the 2000-2002 or 2004 periods. Follow-up data on sickness absences for the public sector employees surveyed were acquired from records kept by the employers. During the follow-up, mean sick leave days per year for respondents were 17.6 days for rhinitis alone, 23.8 days for asthma alone and 24.2 days for both conditions combined. Respondents with neither condition were absent for a mean of 14.5 days annually. The impact of asthma and rhinitis combined on the risk of sick leave days was marginal compared to asthma alone (RR 1.1; 95% CI 1.0-1.3). In the subgroup analysis (those with current asthma or allergy medication), the risk ratio for medically certified sickness absence (>3 days) was 2.0 (95% CI 1.9-2.2) for those with asthma and rhinitis combined. Rhinitis, asthma and both these conditions combined increased the risk of days off work.

Recurrence of sickness absence due to common mental disorders

PurposeCommon mental disorders (CMDs) are an important cause of work disability. Although CMDs are known to have high recurrence rates, little is known about the recurrence of sickness absence due to CMDs. This study examines the recurrence risk of sickness absence due to CMDs.MethodsA cohort of 9,904 employees with a sickness absence due to CMDs, working in the Dutch Post or Telecommunication company, was studied over a 7-year period. Recurrence was defined as the start of at least one new episode of sickness absence with CMDs after complete return to work for at least 28 days. The recurrence density (RD) of sickness absence with CMDs was calculated per 1,000 person-years.ResultsOf the 9,904 employees with a first absence due to CMDs 1,925 (19%) had a recurrence, 90% of recurrences occurred within 3 years. The RD of sickness absence due to CMDs was 84.5 employees per 1,000 person-years (95% CI = 80.7–88.3). The RD of sickness absence due to CMDs was similar in women and in men. In men, depressive symptoms were related to higher recurrence of sickness absence due to CMDs than distress symptoms and adjustment disorders. In women, no difference by diagnostic category was found.ConclusionsEmployees with a previous episode of sickness absence with CMDs are at increased risk of recurrent sickness absence with CMDs. Relapse prevention consultations are recommended for a period of 3 years after return to work.

Patient Overcrowding in Hospital Wards as a Predictor of Diagnosis-Specific Mental Disorders Among Staff

Hospital ward patient overcrowding has been hypothesized to increase psychiatric morbidity among staff, but it is unknown whether the association is specific to depressive disorders. This study examined whether patient overcrowding in hospital wards predicts diagnosis-specific mental disorders among staff. A 2-year prospective cohort study was conducted, in which the extent of hospital ward overcrowding was determined using routinely recorded patient bed occupancy rates between 2003 and 2004 and linked to sickness absence for 5,166 nurses and physicians in 203 somatic illness wards in 16 Finnish acute-care hospitals. Medically certified long-term (> 9 days) sickness absence spells in 2004 and 2005 with physician-determined diagnosis (based on ICD-10 criteria) were obtained from the register of the Social Insurance Institution of Finland. Cox proportional hazard models for recurrent events adjusted for sex, age, occupation, type and length of employment contract, hospital district, and specialty showed that health professionals working in wards with a patient occupancy level 10 percentage units above the optimal during a 1-year period experienced twice the risk of sickness absence due to depressive disorders (HR = 1.95; 95% CI, 1.18-3.24) relative to colleagues working in wards with optimal or below-occupancy levels. No significant association was found for diagnoses of severe stress and adjustment disorders or other psychiatric disorders. Chronic workload, as expressed by patient overcrowding in hospital wards, is associated with the onset of depressive disorders among staff.

Work Arrangements, Physical Working Conditions, and Psychosocial Working Conditions as Risk Factors for Sickness Absence: Bayesian Analysis of Prospective Data

To determine which work arrangements, physical working conditions, and psychosocial working conditions are important risk factors for sickness absence. Survey data on working conditions collected among the employees of the City of Helsinki during 2000 to 2002 (N = 6503, response rate 67%) were linked to the employer's sickness absence records for the subsequent 3 years. First occurrences of short-term (1-3 days), intermediate (4-14 days), and long-term (15 days or more) sickness absence episodes were examined by the use of proportional hazards models with Bayesian model averaging. Working overtime decreased the risk of short-term sickness absence by 19%. Heavy physical work load and hazardous exposures were consistently associated with increased sickness absence episodes of all lengths. The risk of intermediate and long-term absence episodes was increased by 24% to 28% per one standard deviation increase in physical work load. Low job control in women and job dissatisfaction in men increased the risk of sickness absence episodes of all lengths. Heavy physical work load and hazardous exposures had the strongest associations with sickness absence. Furthermore, low job control in women and job dissatisfaction in men were consistently associated with increased risk of sickness absence. Systematic differences in risk factors for absence episodes of different lengths were not found.

The predictive capacity of declared musculoskeletal disorder at pre-employment screening

This study was undertaken at a major UK airport in response to management concerns about levels of sickness absence and impaired work capacity in the security department in order to investigate the possibility of achieving reductions through changes in pre-employment screening procedures. To determine the predictive capacity of a declared musculoskeletal disorder (MSD) at pre-employment screening. This study was based on the pre-employment health declarations of security workers. Work outcomes measured included sickness absence rates (including total and MSD-related absence), work restriction and ill-health retirement rates. Pre-employment questionnaires (PEQs) were analysed for 594 individuals who joined as security staff from 1993-2002. Those who declared an MSD were compared with those who did not using data from the human resources department and the occupational health records. Subjects who disclosed MSDs at pre-employment had significantly higher rates of subsequent total absence, MSD-related absence and work restrictions compared with those who did not. Potential confounders included sex, smoking, age and years in employment. Pre-employment health screening can predict subsequent work outcomes. It is suggested that greater scrutiny is applied to declarations of an MSD at pre-employment screening in the potentially adverse manual handling environment of airport security work and that more advice is given to management about future risks of sickness absence and impaired work capacity.

Do psychosocial work environment factors measured with scales from the Copenhagen Psychosocial Questionnaire predict register-based sickness absence of 3 weeks or more in Denmark?

To analyse the predictive validity of 18 psychosocial work environment scales from the Copenhagen Psychosocial Questionnaire version II (COPSOQ II) with regard to risk of sickness absence. The study population consisted of 3188 wage earners (52% women) from a representative sample of Danish residents. Participants received the long version of the COPSOQ II in autumn and winter 2004-2005, including 18 psychosocial work environment scales from the domains ''Demands at work'', ''Work organization and job contents'', and ''Interpersonal relations and leadership''. The study endpoint was register-based sickness absence of 3 weeks or more in the 1-year period following completion of the COPSOQ II. Associations between COPSOQ scales at baseline and sickness absence at follow-up were analysed with Cox proportional hazards models, adjusted for age, gender, prevalence of a health problem at baseline, and occupational grade. Sickness absence during follow-up was predicted by a one standard deviation increase on the scales of cognitive demands (hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.00-1.37), emotional demands (HR 1.28, 95% CI 1.10-1.50), and role conflicts (HR 1.32, 95% CI 1.15-1.52). After applying adjustment for multiple testing, the effect of emotional demands and of role conflict remained statistically significant, but not the effect of cognitive demands. Selected psychosocial work environment factors from the COPSOQ predict register-based sickness absence in the Danish workforce.

Effectiveness of a Targeted Occupational Health Intervention in Workers with High Risk of Sickness Absence: Baseline Characteristics and Adherence as Effect Modifying Factors in a Randomized Controlled Trial

Introduction In a recently published randomized controlled trial (RCT), a targeted occupational health (OH) intervention was found effective in an intention-to-treat analysis in controlling sickness absence among workers with high risk of sickness absence, compared to usual care. We performed an exploratory subgroup analysis in order to detect possible effect modifiers and mediators. Methods Age, gender, working status, severity of physical impairment, depression score, self-rated working ability, co-morbidity, and sickness absence characteristics in the previous 12 months were identified as potential effect modifiers (n = 382). We conducted regression analyses with the potential effect modifiers and a mediator (treatment attendance as intended) as explanatory variables. The difference of sickness absence days during the previous year and the follow-up year was the dependent variable. Results The intervention was especially effective in the subgroups of workers who were certain that they will not be able to continue working in their current job due to health-related reasons (−74 days; 95% CI −105 to −43), had co-morbidities (−22.5 days; 95% CI −35.5 to −9.5), or severe physical impairment at work (−17.5 days; 95% CI −28.5 to −6.5). A modifying effect of age, gender, working status, depressive symptoms, or prior sickness absence on the effectiveness of this OH intervention was not found. Conclusions This targeted OH intervention seems especially suitable for workers who consider that they are no longer able to continue working due to health reasons and have high level of physical impairment or co-morbidities. The findings from these exploratory analyses should be tested in future RCTs.

Self-reported exhaustion: a possible indicator of reduced work ability and increased risk of sickness absence among human service workers

The aim of this study was to assess the construct and predictive validity of a new instrument for self-rating of stress-related Exhaustion Disorder (s-ED). Public healthcare workers and social insurance officers, 85% females, were included (N = 2,683) in a longitudinal study. The s-ED instrument, based on clinical criteria for Exhaustion Disorder, was used at baseline to classify participants into three categories: non-s-ED, light/moderate s-ED and pronounced s-ED. Other assessments include burnout, anxiety, depression and work ability. Sick leave at follow-up after 2 years was defined as 14 days of ongoing sick leave (SA14) or a period of 60 days of sick leave during the last 12 months (SA60). Associations at baseline were expressed as prevalence ratios, and adjusted relative risks (RR) were calculated using Cox regression. At baseline, 16% reported s-ED. Scores of depression, anxiety and burnout and the rate of poor work ability increased with increasing severity of s-ED. Self-reported exhaustion at baseline increased the risk of reporting sickness absence at follow-up; pronounced s-ED RR 2.7; CI 1.8-4.0 for SA14 and RR 3.4; CI 2.3-5.2 for SA60. Self-rated ED corresponded well to established scales for mental health, indicating sufficient construct validity. Individuals reporting s-ED at baseline were more likely to report sickness absence at follow-up, confirming its predictive properties. The s-ED instrument may be a useful tool for occupational health services in identifying human service workers at risk of having or developing a potentially disabling stress-related mental illness.

Health-related behaviours and sickness absence from work

Objectives:To compare associations of health-related behaviours with self-certified and medically confirmed sickness absence, and to examine whether these associations can be explained by psychosocial and physical working conditions and occupational...

The impact of physical activity on sickness absence

The aim of this study was to examine whether the volume and intensity of physical activity are associated with subsequent sickness absence spells of different lengths, and how much of these associations can be explained by socioeconomic position, body mass index (BMI) and physical health functioning. Baseline data were collected by questionnaire surveys in 2000-2002 among 40-60-year-old employees of Helsinki City (n=6465, 79% women). Sickness absence data were derived from the employer's registers (mean follow-up time 3.9 years). Associations of physical activity with shorter (< or =14 days) and longer (>14 days) sickness absence spells were examined, using Poisson's regression analysis. The volume of physical activity was weakly and somewhat inconsistently associated with sickness absence. However, men and women who were vigorously active systematically had reduced risk of sickness absence, whereas the same volume of moderately intensive physical activity did not reduce the risk of sickness absence. Adjusting for BMI and in particular physical health functioning attenuated these associations, after which the associations lost statistical significance. The results suggest that vigorous physical activity is associated with sickness absence and may contribute to better work ability.

Self-reported noise exposure as a risk factor for long-term sickness absence

Self-reported noise exposure is on the rise in Denmark. Little is known, however, about the social consequences, including sickness absence, of noise exposure. The aim of this paper was to investigate the association between self-reported noise exposure and long-term sickness absence. The association was investigated using the Cox proportional hazards model to analyze outcomes in Danish register data on the basis of Danish survey data (5357 employees aged 18-69 in 2000). The analyses showed that self-reported noise exposure was significantly associated with long-term sickness absence for both men and women when adjusting for demographic factors and health behavior. After further adjustment for physical workload at work the association between noise exposure and sickness absence disappeared for women, but not for men. Men that reported to be exposed to loud noise between one-quarter and three-quarters of their time at work had an increased risk of 43% (CI: 10-85%) for sickness absence of two weeks or longer compared to men that reported never to be exposed to loud noise. Men that reported to be little/rarely exposed to loud noise had an increased risk of 37% (CI: 7-76%). Men that reported to be exposed to loud noise more than three-quarters of their time at work did not have an increased risk of sickness absence. This latter result might be due a healthy worker effect and/or more frequent use of hearing protection in this group. Along with evidence from previous studies these results provide further support for an association between occupational noise exposure and sickness absence.

PREVALENCE OF MUSCULOSKELETAL COMPLAINTS AMONG DENTISTS IN SOME EGYPTIAN CITIES

Background: Musculoskeletal complaints represent a significant occupational health issue in dentistry. In Egypt , data about the prevalence and risk factors of this problem are little. The aim of the study was to assess the prevalence of musculoskeletal (MSK) complaints among dentists in some Egyptian cities ,evaluate the influence of personalcharacteristics, physical and psychological risk factors at work and health status on the occurrence of MSK complaints and to detect the association between MSK complaints and other contributing factors in the development of sickness absence among dentists. Methods: A self-administered questionnaire was distributed to a random sample of 350 dentists in 3 cities of Egypt (Cairo , Al-mehalla El-kobra and El-mansoura).The questionnaire involved information on the respondent’s individual characteristics, job history, physical and psychosocial risk factors at work, general health status, and theoccurrence of musculoskeletal complaints.Results: Occupational neck and low-back pain were the most prevalent MSK complaintsamong dentists in the past 12 months in Egypt (75.1% and 58.5%, respectively). On the other hand low-back pain was the most prevalent chronic MSK complaints (11.4%) followed by chronic neck pain (7.4%). The occurrence of MSK pain was associated with at least one work- related physical load. Especially important was awkwardposture followed by improper workplace ergonomics, prolonged static posture, and repetitive movements .High job demands were associated with shoulder and hand/wrist complaints (OR= 2.26 and 2.17, respectively) . In this study, 27.4% of the respondents reported sickness absence . Chronic low-back pain was the only complaint thatincreased the risk of sickness absence (OR= 4.83). BMI >30, age > 40 years, perceived moderate general health, need for recovery and basic education were significant contributing factors for sickness absence. Conclusions: MSK complaints are a significant occupational health problem among dentists in some Egyptian cities. Interaction of physical load, psychosocial load, general health conditions, and personal criteria in developing the MSK pain require integratedpreventive strategies to minimize their impacts.

Sickness Absence Among Female Employees With Migraine and Co-Existing Conditions

This prospective cohort study examined the risk of sickness absence among 27,127 female public-sector employees by status of migraine and co-existing conditions. A baseline survey was used to assess chronic disorders and demographic factors. Information on sickness absence in the 3 years following the survey was obtained from employers' registers. Migraine was related to 5.4 extra sickness absence days per person-year, with the corresponding figures being 14.6 and 6.1 for depression and respiratory disorders, respectively. After adjusting for age, marital status, socioeconomic status and presence of depression or respiratory disorders, employees with migraine had a 1.21 (95% confidence interval 1.18, 1.24) times higher risk of self-certified sickness absence episodes (< or = 3 days) than did those without migraine. The corresponding excess risk for medically certified absence episodes (> 3 days) was 1.15 (1.12, 1.19). Among employees with depression or respiratory disorders, secondary migraine was associated with an increased risk of sickness absence episode of 1.15 to 1.23. These findings suggest that migraine is associated with increased risk of recorded sickness absence independent of depression and respiratory disorders.

The influence of household work and of having children on sickness absence among publicly employed women in Sweden

To investigate whether family obligations influence the risk of sickness absence among female municipal employees in Sweden. A 1-year prospective cohort study of 1464 female municipal employees <50 years of age in Sweden in 2000 was conducted using questionnaire responses and absence data from the employers' personnel records. The relative risk of having children <16 years of age in the home, marital status, household work, financial situation, working hours and work-family conflicts for repeated sick-leave spells (>or=4 spells) and long-term sickness absence (>or=28 days) were calculated by applying Poisson regression models. Women reporting financial strain or work-family conflicts were at elevated risk for long-term sickness absence. Having children was not a risk factor for repeated sick-leave spells or long-term sickness absence among married/cohabiting women. Single women with children had a two-fold greater risk of repeated sick-leave spells than single women without children. The findings suggest that the combination of gainful employment and children does not influence the risk of repeated sick-leave spells or long-term sickness absence among married/cohabiting publicly employed women. However, this was not true for single women with children, which indicates that their circumstances are particularly strained.

Effectiveness of a Preventive Coaching Intervention for Employees at Risk for Sickness Absence Due to Psychosocial Health Complaints: Results of a Randomized Controlled Trial

To assess the effectiveness of a preventive coaching intervention on sickness absence due to psychosocial health complaints and on general well being of employees. Employees at risk for sickness absence were identified and randomized. The intervention group received the preventive coaching program; the control group received usual care. Primary outcome measure of the trial is sickness absence due to psychosocial health complaints; secondary outcome measures are related to general well being, such as psychological distress, fatigue, and coping. No effect of coaching on self-reported sickness absence due to psychosocial health complaints was found. The intervention group reported statistically significant improved health, declined psychological distress, less burnout, less need for recovery, and an increased satisfaction with life. This study shows that the coaching intervention primarily has an effect on general well being of employees.

Psychometrics and validation of a screening instrument for sickness absence

Absence from work due to psychosocial health complaints has considerable negative effects for employees, employers and society. A better and more effective strategy would be early identification of employees at risk for psychosocial sickness absence and early intervention to prevent sickness absence as far as possible. To assess psychometric characteristics and the external validation of a recently developed screening instrument, called 'Werkwijzer', for the identification of employees at risk for sickness absence due to psychosocial health complaints. Exploratory factor analysis was applied on items of the instrument. Cronbach's alpha coefficient was used to determine internal consistency of the subscales. Sum scores on the screening instrument were correlated to absenteeism data to determine their potential for predicting sickness absence. Predictive value was investigated, using objective sickness absence data as criterion measure. Sensitivity and specificity rates were calculated for external validation. For both men and women, three interpretable factors were found. Sum scores on the instrument showed low correlations with sickness absence. The association between 'being at risk' (yes/no) and sickness absence (yes/no) was odds ratio (OR) 3.1 (95% CI 1.5-6.5) for men and OR 2.0 (95% CI 1.4-2.7) for women. Sensitivity scores were rather low, whereas specificity scores were remarkably high. The results of this study provide the screening instrument a theoretic and scientific basis. Predictive value is promising, when absence is treated as a dichotomous measure. Sensitivity and specificity were unvarying during the development and validation phases of the instrument.

A protocol improves GP recording of long-term sickness absence risk factors

If general practitioners (GPs) were better informed about patients' risks of long-term sickness absence (LTSA), they could incorporate these risk assessments into their patient management plans and cooperate more with occupational physicians to prevent LTSA. To evaluate the effectiveness of a protocol helping GPs in recording risks of LTSA and in co-operating with occupational physicians (OPs). Twenty-six GPs (co-operating in four groups) in Amsterdam, The Netherlands, participated in a controlled intervention study. Fourteen GPs were the protocol-supported intervention group and twelve GPs were the reference group. Outcome measures were consultations containing work-related information, information about two risk factors for LTSA, referrals to OPs and contacts of OPs with GPs and patients. Outcomes were identified through an electronic search in the GPs' information systems. Entries containing information were independently scored by two investigators. The proportions of patients with consultations documenting LTSA-pertinent items were compared between the groups, accounting for differences at baseline. There was no increase in consultations containing work-related information. Recording of risk factor information increased in the intervention group; the difference was 4.5% [95% CI 1.5-7.6] and 1.8% (95% CI -0.8 to 4.4) for the two risk factors. The referral rate to the OP increased by 2.9% (95% CI 1.2-4.5). There was no effect on contacts of OPs with GPs or with patients. Protocol-supported consultations may lead to a modest increase in information regarding two risk factors for LTSA in GPs' electronic records and to more referrals to OPs.

Occupational burnout and medically certified sickness absence: A population-based study of Finnish employees

Objective Occupational burnout is a common problem in working populations, but its association with sickness absence is poorly understood. The contribution of occupational burnout to medically certified sickness absence was examined in a population-based sample of employees. Methods A representative sample of 3151 Finnish employees aged 30–60 years participated in a comprehensive health study in 2000–2001, including an assessment of physician-diagnosed physical illnesses and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV) mental disorders based on the Composite International Diagnostic Interview. Burnout was measured with the Maslach Burnout Inventory—General Survey. Sickness absences longer than 9 days in 2000–2001 were extracted from a register of the Social Insurance Institution of Finland. Results The occurrence of medically certified sickness absence was more prevalent among employees with burnout than among those without burnout. After adjusting for sociodemographic factors and mental and physical disorders, the odds ratio of sickness absence for severe burnout was 6.9 [95% confidence interval (95% CI)=2.7–17.8] for men and 2.1 (95% CI=1.1–4.0) for women. Among employees with mental or physical disorders, severe burnout was associated with a 7.7-fold risk of sickness absence among men and with a 2.6-fold risk among women. The duration of absence was related to burnout among men with absences, for whom severe burnout accounted for 52 excess sickness absence days during the 2-year period after adjusting for sociodemographic factors, mental disorders, and physical illnesses. Conclusions Severe burnout is associated with a substantial excess risk of medically certified sickness absence among both men and women. This association is independent of prevalent mental disorders and physical illnesses.