When does absenteeism make a difference for disease management programs?

A three-level model is proposed to simultaneously examine the effects of daily exposure to air pollution and individual risk factors on health outcomes without aggregating over subjects or time. We used a logistic transition model with random effects to take into account heterogeneity and overdispersion of the observations. A distributed lag structure for pollution has been included, assuming that the event on day t for a subject depends on the levels of air pollution for several preceding days. We illustrate this proposed model via detailed analysis of the effect of air pollution on school absenteeism based on data from the Southern California Children's Health Study.

Absenteeism↗

PubMed2005

Temporary employment and health: a review.

OBJECTIVES: We aimed to review evidence on the relationship between temporary employment and health, and to see whether the association is dependent on outcome measure, instability of employment, and contextual factors. METHOD: We systematically searched for studies of temporary employment and various health outcomes and critically appraised 27 studies. RESULTS: The review suggests higher psychological morbidity among temporary workers compared with permanent employees. According to some studies, temporary workers also have a higher risk of occupational injuries but their sickness absence is lower. Morbidity may be higher in temporary jobs with high employment instability and in countries with a lower number of temporary workers and unemployed workers. CONCLUSIONS: The evidence indicates an association between temporary employment and psychological morbidity. The health risk may depend on instability of temporary employment and the context. Confounding by occupation may have biased some of the studies. Additional research to clarify the role of employment instability, hazard accumulation, and selection is recommended.

Absenteeism↗

PubMed2005

Alcohol, stress-related factors, and short-term absenteeism among urban transit operators.

Transit operators, relative to workers in many other occupations, experience high levels of work-related stress, as documented through neuroendocrine elevations on the job vis-a-vis resting states (J Occup Health Psychol. 1998;3:122-129). Previous research suggests that self-reported job stress is associated with higher levels of alcohol consumption among transit operators (Alcohol Clin Exp Res. 2000;24:1011-1019) and with absenteeism (Working Environment for Local Public Transport Personnel, Stockholm: Swedish Work Environmental Fund, 1982; Work Stress. 1990;4:83-89). The purpose of this study was to examine the interrelationships between alcohol use, stress-related factors (stressful life events, job stressors, and burnout), and short-term absenteeism among a multiethnic cohort of urban transit operators. Self-reported measures of alcohol, stress-related factors, and short-term absenteeism were obtained from a sample (n=1,446) of San Francisco municipal transit operators who participated in the 1993-1995 Municipal Railway Health and Safety Study. Multivariate logistic regression analyses showed that absenteeism among drinkers was associated with risk for alcohol dependence [odds ratio (OR)=2.46, heavy drinking (OR=1.87), alcohol-related harm (OR=2.17), increased drinking since becoming a transit operator (OR=1.74), and having any problem drinking indicator (OR=1.72). The association between absenteeism and stress-related factors varied by gender and drinking status. Final multivariate models among drinkers indicated that among males, problem drinking (OR=1.82), stressful life events (OR=1.62), and job burnout (OR=1.22) were independently associated with elevated odds of absenteeism. Among female drinkers, only stressful life events (OR=5.17) was significantly associated with elevated odds of absenteeism. Findings suggest that workplace interventions that address both individual and environmental stressors are most likely to have a positive impact on health-related outcomes, including problem drinking, thereby reducing absenteeism.

Absenteeism↗