Weeks Of Sickness Absence Research Articles

Leisure-Time Physical Activity to Reduce Risk of Long-Term Sickness Absence Across Diverse Subgroups in the Working Population-A Prospective Cohort Study of 68,000 Participants.

There is a dearth of knowledge regarding the relationship between engaging in moderate and vigorous physical activity and long-term sickness absence (LTSA), particularly among various population subgroups such as individuals of different ages or body mass indices. We aimed to evaluate the prospective associations of moderate and vigorous leisure-time physical activity with the risk of LTSA in the general working population. A prospective cohort study with a 2-year register follow-up was conducted, where 68,222 representative workers from Denmark completed a questionnaire about work environment, lifestyle, and health. Data on LTSA (≥6 consecutive weeks of sickness absence) were obtained from the Danish Register for Evaluation of Marginalization. We used Cox regression for the statistical analysis, adjusting for relevant confounding factors. We also performed age- and BMI-stratified analyses. In the fully adjusted model, 2 to 4hours per week of moderate activity (hazard ratios [HR] = 0.87; 95% CI, 0.77 to 0.99) and ≥2hours per week of vigorous activity reduced LTSA risk compared with no physical activity. However, 2 to 4hours per week of vigorous activity (HR = 0.84; 95% CI, 0.76 to 0.91) provided the greatest risk reduction. In the total sample, the complete absence of vigorous activity was associated with increased risk of LTSA (HR = 1.13; 95% CI, 1.05 to 1.22). In stratified analyses, the results were consistent for workers <50years (HR = 1.14; 95% CI, 1.03 to 1.26), ≥50years (HR = 1.13; 95% CI, 1.02 to 1.26), and those with a BMI ≥ 25 (HR = 1.16; 95% CI, 1.06 to 1.28). The complete absence of moderate activity was not associated with LTSA. Vigorous leisure-time physical activity appears to be more important than moderate activity to prevent LTSA.

The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence

BackgroundThe ‘physical activity paradox’ advocates that leisure physical activity (PA) promotes health while high occupational PA impairs health. However, this paradox can be explained by methodological limitations of the previous studies—self-reported PA measures, insufficient adjustment for socioeconomic confounding or not addressing the compositional nature of PA. Therefore, this study investigated if we still observe the PA paradox in relation to long-term sick absence (LTSA) after adjusting for the abovementioned limitations.MethodsTime spent on moderate-to-vigorous physical activity (MVPA) and remaining physical behaviors (sedentary behavior, standing, light PA and time in bed) at work and in leisure was measured for 929 workers using thigh accelerometry and expressed as isometric log-ratios (ilrs). LTSA was register-based first event of ≥6 consecutive weeks of sickness absence during 4-year follow-up. The association between ilrs and LTSA was analyzed using a Cox proportional hazards model adjusted for remaining physical behaviors and potential confounders, then separately adjusting for and stratifying by education and type of work.ResultsDuring the follow-up, 21% of the workers experienced LTSA. In leisure, more relative MVPA time was negatively associated with LTSA (20% lower risk with 20 min more MVPA, p = 0.02). At work, more relative MVPA time was positively associated with LTSA (15% higher risk with 20 min more MVPA, p = 0.02). Results remained unchanged when further adjusted for or stratified by education and type of work.ConclusionThese findings provide further support to the ‘PA paradox’.

Screening instruments for predicting return to work in long-term sickness absence.

Multiple somatic symptoms are common and may cause prolonged sickness absence (SA) and unsuccessful return to work (RTW). To compare three instruments and their predictive and discriminative abilities regarding RTW. A longitudinal cohort study of participants recruited from two municipal job centres, with at least 8 weeks of SA. The instruments used were the Symptom Check List of somatic distress (SCL-SOM) (score 0-48 points), the Bodily Distress Syndrome Questionnaire (BDSQ) (0-120 points) and the one-item self-rated health (SRH) (1-5 points). The instruments' predictive value was explored in a time-to-event analysis. Different cut-points were analysed to find the highest number of correctly classified RTW cases, identified in a register on public transfer payments. The study involved 305 subjects. The adjusted relative risk regarding prediction of RTW was 0.89 [95% confidence interval (CI) 0.83-0.95], 0.89 (95% CI 0.83-0.95) and 0.78 (95% CI 0.70-0.86) per 5-, 10- and 1-point increase in the SCL-SOM, BDSQ and SRH, respectively. After mutual adjustment for the three instruments, only the prediction of RTW from SRH remained statistically significant 0.81 (95% CI 0.72-0.92). The highest sensitivity (86%) was found by SRH at the cut-point ≤5, at which 62% were correctly classified. All three instruments predicted RTW, but only SRH remained a significant predictor after adjustment for the SCL-SOM and BDSQ. The SRH provides an efficient alternative to more time-consuming instruments such as SCL-SOM or BDSQ for estimating the chances of RTW among sickness absentees.

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

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

Occupational mechanical exposures and reoperation after first-time inguinal hernia repair: a prognosis study in a male cohort

The aim of this study was to evaluate exposure-response relationships between occupational mechanical exposures and risk of reoperation after inguinal hernia repair. Using register information, we identified all men born in Denmark 1938-1988, who had their first inguinal hernia repair 1998-2008, and who were 18-65 years old and active in the labour market at the time of surgery. The Danish Hernia Database provided information on repairs and reoperations. We used registered occupational codes and a job exposure matrix based on experts' ratings to estimate total load lifted per day, frequency of heavy lifting, and number of hours per day spent standing/walking. We also obtained register information on sickness absence. Multivariable Cox regression analysis was used. The cohort comprised 34,822 patients. We did not reveal exposure-response relationships between occupational mechanical exposures and the hazard ratio (HR) of reoperation. The percentage of patients with >2 weeks of sickness absence within 8 weeks after surgery increased with total load lifted per day from 15 to 53%. Longer sickness absence was associated with an increased HR of reoperation, but within strata of sickness absence, we found no increase in the HR of reoperation with increasing exposures. We did not find indications that the HR of reoperation was related to occupational mechanical exposures, even after accounting for a potential protective effect of sickness absence. Hence, the exposure-related prolonged duration of sickness absence could not be explained by exposure-related complications that led to reoperation.

Will sick leave after a counselling intervention prevent later burnout? A 3-year follow-up study of Norwegian doctors

Burnout and mental distress in working doctors increase the risk for both suboptimal treatment of patients and negative health consequences for the doctors. Doctors have low rates of sickness absence and are reluctant to seek help, especially for mental distress. We examined whether a spell of sickness absence after a counselling intervention could predict reduction in emotional exhaustion among doctors at work 3 years later. A 3-year follow up after a counselling intervention for burnout at the Resource Centre Villa Sana in Norway in 2003-05 was completed by 184/227 doctors. Self-report assessments were administered at baseline, 1-, and 3-years. The effect of number of weeks of sickness absence on reduction in emotional exhaustion among doctors working 3 years after the intervention was assessed by linear regression. Of the 184 doctors completing assessment, 149 were working at 3-year follow up. Emotional exhaustion (scale 1-5) was significantly reduced at follow up (from 3.00±0.96 to 2.37±0.79, p<0.001). The number of weeks of sickness absence after the intervention was a significant positive predictor of this reduction (β=0.31, p<0.001), also after including sex, age, neuroticism, reduction of work hours, and other forms for treatment in the model. The number of weeks of sickness absence after a counselling intervention for burnout had a positive predictive effect on reduction in emotional exhaustion among doctors at work 3 years later. Sick leave thus seems to "prevent" later burnout, which can be of importance both for their patients and for the doctors themselves.

Reduction in sickness absence in patients with rheumatoid arthritis receiving adalimumab: data from a German noninterventional study

The aim of this noninterventional study (NIS) was to analyze the changes in sickness absence, disease activity, and functional capacity in employed rheumatoid arthritis (RA) patients during adalimumab treatment. RA patients receiving adalimumab according to label instructions (40 mg every other week) were evaluated at regular intervals in a multicenter prospective NIS. Patients provided information on sickness absence in the 12 months preceding treatment initiation (baseline) and at months 6 and 12. Disease activity was assessed by the Disease Activity Score using 28 joints, and physical function was assessed via the Hannover Functional Ability Questionnaire, a patient self-questionnaire comparable with the Health Assessment Questionnaire-Disability Index. We present data on 1,157 patients who were employed (part time or full time) at baseline. Patients were categorized by the length of sickness absence at baseline. At baseline, patients with absences of 6 weeks or more in the previous year (n = 226 [19.5%]) accounted for 77% of the documented weeks of sickness absence, and patients with absences of more than 12 weeks (n = 98 [8.5%]) accounted for 54% of sickness absence weeks. During 12 months of adalimumab treatment, disease activity decreased, functional capacity improved, and sickness absence was reduced. The greatest decrease in sickness absence was observed in patients with more than 12 weeks of sick leave in the year prior to adalimumab therapy. These patients also showed gains in function comparable with those observed in other employed patients. We conclude that sustaining and improving functional capacity represent the key to preservation of work capability.

Using administrative sickness absence data as a marker of future disability pension: the prospective DREAM study of Danish private sector employees

Objectives:The aim of this study was to examine duration of sickness absence as a risk marker for future disability pension among all private sector employees in Denmark 1998–2004.Methods:All private sector...

Multilevel Analysis of Individual and Contextual Factors as Predictors of Return to Work

The objective of this study was to examine if individual and contextual levels of work environment factors predict return to work (RTW). Baseline data from 52 workplaces was linked to a national absence register. Four hundred twenty-eight persons with more than 2 weeks of sickness absence during a 2-year period were identified. Follow up was 1 year to examine three RTW outcomes. Multilevel logistic and Poisson regression models were used. At the individual level, significant associations were found between one psychosocial and four physical factors and RTW within 4 weeks. Two physical factors predicted RTW within 1 year. Two psychosocial and two physical factors significantly prolonged duration of sickness absence. No significant contextual level risk factors were found. At the individual level, both the psychosocial and physical work environment factors are important independent predictors of RTW.

Sickness absence with low-back, shoulder, or neck diagnoses: An 11-year follow-up regarding gender differences in sickness absence and disability pension

Background: There is very little knowledge on the long-term outcomes of sickness absence. The aim was to investigate sickness absence and disability pensions over 11 years in a cohort of young persons initially long-term sick listed with back, neck, or shoulder diagnoses. Method: A prospective population-based cohort study of all 213 individuals in the Municipality of Linköping, Sweden, who in 1985 were aged 25–34 and had at least one new sick-leave spell &gt; 28 days with such diagnoses. Main results: More women (61%) than men fulfilled the inclusion criteria. In 1996, 22% of the cohort (14% of the men, 26% of the women) had been granted disability pension; 76% of these individuals with musculoskeletal and the rest with psychiatric diagnoses. Partial disability pension was granted to 59% of the women, 17% of the men. Women were more often granted temporary disability pension than men. Conclusions: This proved to be a high-risk group for disability pension. There were large and somewhat unexpected gender differences regarding incidence and type of disability pension. It has been debated how soon physicians should be concerned about the risk of long-term disability regarding these diagnoses; at four or eight weeks of sickness absence – our results support the former, at least for women.

Sickness absence due to occupational dermatoses in a prefabrication construction factory.

In a study of sickness absence due to occupational dermatoses among 360 construction workers in a prefabrication construction factory in 1984, we found 3 workers with allergic contact dermatitis from chromate in cement who required medical leave. There were 5 sickness absence spells due to occupational dermatoses and the number of days lost due to occupational dermatoses was 53 days for the year. This averaged out at 0.01 spells per worker per year, 0.15 days per worker per year and 15 days per spell. It appeared that the number of workers requiring sickness absence from occupational dermatoses was low, but that those with the condition required about 2 weeks of sickness absence. Allergic contact dermatitis from chromate in cement appeared to be the only occupational dermatosis causing sickness absence in the factory.