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PubMed2004

Swedish Council on Technology Assessment in Health Care (SBU). Chapter 9. Consequences of being on sick leave.

The possible consequences of sick leave can be measured at different levels in society. This chapter focuses on the consequences from the perspective of the sick-listed individual. Sick leave may have both positive and negative consequences for the individual, e.g. regarding disease, health, working life, social life, lifestyle, and emotional aspects. Some of these factors have been investigated in different studies. However, scientific evidence is insufficient since there are too few studies on the consequences of sickness absence and disability pension. The lack of relevant studies is the most striking observation from the review of studies on the consequences of being sick listed.

Absenteeism↗
PubMed2004

Occupational stress and incidence of sick leave in the Belgian workforce: the Belstress study.

CONTEXT: Sick leave is a major problem in public health. The Karasek demands/control/social support/strain (JDCS) model has been largely used to predict a wide range of health outcomes and to a lesser extent sickness absence. STUDY OBJECTIVE: The aim of the study was to test the predictive power of the JDCS model in relation with one year incidence of sick leave in a large cohort of workers. DESIGN AND SETTING: Cohort study conducted between 1994 and 1998 in 25 companies across Belgium. PARTICIPANTS: A total of 20 463 workers aged 35 to 59 years were followed up for sick leave during one year after the baseline survey. OUTCOMES: The outcomes were a high sick leave incidence, short spells (>/=7 days), long spells (>/=28 days), and repetitive spells of sickness absence (>/=3 spells/year). MAIN RESULTS: Independently from baseline confounding variables, a significant association between high strained jobs with low social support and repetitive spells of sickness absence was observed in both sexes with odds ratios of 1.32 (99% CI, 1.04 to 1.68) in men and 1.61 (99% CI, 1.13 to 2.33) in women. In men, high strained jobs with low social support was also significantly associated with high sick leave incidence, and short spells of sick leave with odds ratios of 1.38 (99% CI, 1.16 to 1.64) and 1.22 (99% CI, 1.05 to 1.44) respectively. CONCLUSIONS: Perceived high strain at work especially combined with low social support is predictive of sick leave in both sexes of a large cohort of the Belgian workforce.

Adult↗
PubMed2005

Self-estimated life situation in patients on long-term sick leave.

OBJECTIVE: To analyse the influence of long-term sick leave on patients' life situation. DESIGN AND SUBJECTS: Cross-sectional study based on 1350 individuals with a consecutive sick leave period of 12-18 months. Half were still on sick leave, half were no longer sick-listed. METHODS: A total of 862 participants answered a postal questionnaire including 24 questions on consequences of their sick leave on daily life. Results were analysed by gender, age and type of sick leave diagnosis. Associations between consequences and return to work were analysed by multiple logistic regression. RESULTS AND CONCLUSION: Negative effects of long-term sick leave were particularly related to leisure activities, sleep and psychological well-being. A reduced alcohol intake was more prevalent than increased consumption. Among individuals with psychiatric diagnoses the consequences were polarized, with few persons unaffected, while the effects were more unipolar and negative in other diagnostic groups. Women experienced positive consequences more often than men, attributed to relationships with children and partner, sleep and psychological well-being. Improved sleep was associated with return to work, particularly among older individuals. Negative consequences on life situation are far more common than positive consequences among patients on long-term sick leave. Benefits as well as adverse effects differ depending on diagnosis, age and gender.

Adult↗
PubMed2003

Take some days off, why don't you? Endogenous sick leave and pay.

This is a model of endogenous sick leave in the presence of endemic infectious diseases. The prevalence rate elasticity with respect to sick leave is unity, when workers are paid their marginal product, and firms profit maximise. Full information contracts yield a compensating higher wage to the sick than to the healthy workers. Sick leave pay is greater than the healthy working wage. The contracted sick leave period falls with: the external disease transmission, the productivity of the ill, the discomfort when ill on sick leave and reductions in the work discomfort of the ill. Full insurance breaks down under asymmetric information, where implicit contract firms may offer more sick leave than profit maximising firms with the same payment schedule.

Absenteeism↗
PubMed2005

Health-related and work-related aspects associated with sick leave: a comparison of chronically ill and non-chronically ill workers.

OBJECTIVES: Our aims were to study to what extent chronically ill workers (CIWs) take more sick leave than non-chronically ill workers (NCIWs) and to explore which health-related and work-related aspects are associated with the sick leave patterns of the two groups. METHODS: A questionnaire on work, health and sick leave was sent to all employees of a university in The Netherlands (response: 49.1%). Analyses were conducted for 444 CIWs and 1,347 NCIWs. Odds ratios (ORs) were calculated to quantify the contribution of being chronically ill to sick leave in general, frequent sick leave, prolonged sick leave, and present sick leave. The contributions of health-related and work-related aspects to sick leave were investigated by multiple logistic regression analyses for both CIWs and NCIWs separately. RESULTS: CIWs showed significantly increased ORs for general, frequent, prolonged and present sick leave when compared with NCIWs. Fatigue, emotional exhaustion and perceived health complaints showed stronger associations with sick leave for both CIWs and NCIWs than various work-related aspects. Workers of 46 years of age and older showed less sick leave than workers under the age of 36. Male respondents and scientific personnel showed less frequent sick leave than the other respondents, and so did respondents working more than 40 h a week, compared with part-timers. The final regression models explained 8%-16% of the variance in sick leave. CONCLUSIONS: CIWs take two to three times more and longer sick leave than NCIWs. Health-related aspects are more strongly associated with sick leave than work-related aspects for both CIWs and NCIWs. Sick leave patterns were, nevertheless, only partly explained by health-related and work-related aspects. In any case, future studies of sick leave should certainly take the presence of chronic disease into account as an important determinant of sick leave.

Adult↗
PubMed1998

Psychiatric disorders as a factor in sick-leave due to other diagnoses. A general population-based study.

BACKGROUND: The aim was to analyse the role of psychiatric disorders in sick-leave in different sick-leave diagnoses. METHOD: A stratified population-based sample of women (n = 292) in Göteborg were interviewed, and diagnoses were made according to DSM-III-R. Sick-leave data, including diagnoses, were obtained for two years. RESULTS: Women with psychiatric disorders had an increased number of sick-leave spells and sick-leave days in all the sick-leave diagnostic groups. The largest differences between the two groups of women were found in mental disorders, diseases of the locomotor system and gastro-intestinal diseases. The association between psychiatric disorders and sick-leave was strongest in older age groups. CONCLUSIONS: Unrecognised psychiatric disorders associated with an increased number of medical complaints and visits can be an important factor in the increase in sick-leave.

Absenteeism↗
PubMed2005

Prognostic factors for duration of sick leave due to low-back pain in dutch health care professionals.

BACKGROUND: Information on prognostic factors for duration of sick leave due to low-back pain (LBP) is growing. In this prospective cohort study prognostic factors for duration of sick leave and course of disability were identified in a very early stage of sick leave due to LBP in an occupational health care setting. METHODS: A total of 615 workers calling in sick from work due to LBP at an occupational health service (OHS) of one institution completed a questionnaire. Duration of follow-up was 26 weeks. Prognostic factors were identified by means of Cox regression analysis and multiple linear regression analysis, and explained variance was calculated. RESULTS: Median time to first return to work (RTW) was 5 days (Inter Quartile Range (IQR) = 2-12). Median time to lasting return to work (LRTW) was 6 days (IQR = 3-13). The final model for delayed RTW included self-reported expected duration of sick-leave, treatment by GP or specialist, care-seeking, diminished mobility, and the interaction between care-seeking and diminished mobility. The final model for LRTW included: self-reported expected duration of sick-leave, treatment by GP or specialist, care-seeking, the interaction between the self-reported expected duration of sick-leave and seeking care at OHS, complaints due to job stress, diminished mobility, and the interactions between expected duration of more then 10 days and seeking OP care and diminished mobility. Median total days on sick leave (TDSL) was 6 days (IQR = 3-13 days). The final model for TDSL included: age, expected duration of sick leave, treatment by GP or medical specialist, seeking OP care, complaints due to physical load, and diminished mobility. Explained variance (R2) of these models ranged from 30 to 35%. CONCLUSIONS: Poor prognosis for duration of sick leave can be identified by means of a simple questionnaire administered on the first day of sick leave. Workers at high risk for longer duration of sick leave (all outcomes) expected to stay off work longer, were already being treated by a MD, sought OP care, and had diminished mobility. In case of delayed LRTW workers reported job stress as a possible cause of sick leave. Interactions were found in both RTW and LRTW between care-seeking and diminished mobility and in LRTW between expected duration of sick leave and seeking OP care. Older age increased TDSL with borderline significance.

Adult↗
PubMed2006

[Quality of medical diagnosis in sick leave certificates for non-occupational diseases and injuries].

OBJECTIVE: To evaluate the quality of medical diagnosis in the sick leave certificate. DESIGN: Retrospective, observational study. SETTING: Castelldefels Primary Care Centre, Barcelona, Spain. MEASUREMENTS AND INTERVENTIONS: 205 sick leave episodes of patients reported as non-occupational diseases and injuries were analyzed. The diagnosis of the sick leave certificate was checked against the clinical report carried out by the same physician who made out the sick leave certificate. To assess the quality of medical diagnosis, sensitivity, positive predictive value and the percentage of positive agreement were calculated. The variability of these indicators was also assessed according to the duration of the sick leave episode. RESULTS: Simple agreement between the diagnoses of the sick leave certificate and the clinical report was 92%. The sensitivity of the sick leave certificate in relation to the clinical report by diagnostic group ranged from 75% to 97%; positive predictive value, from 81% to 100%; and the percentage of positive agreement, from 86% to 97%. Short-term sick leave episodes (< or =15 days) had lower values than long-term sick leave (>15 days). CONCLUSIONS: Our findings confirm that the quality of diagnosis on the sick leave certificate is high. The availability of more medical information about the reasons for the sick leave episode does not modify the quality of the diagnosis substantially.

Diagnostic Techniques and Procedures↗
PubMed2005

Sick leave in workers with asthma and COPD: the role of attitudes, perceived social norms and self efficacy.

We investigated associations of sick leave in 165 workers with asthma and COPD with three components of the Model of Planned Behavior (MPB): attitudes, social norms towards sick leave, and perceived control over sick leave and over health complaints. All participants underwent lung-function tests and completed questionnaires on sick leave, and on the MPB-components. Differences were calculated between high and low sick leave (frequency and duration) for the total group of asthma and COPD and separately for asthma and COPD. The most relevant variable within each MPB-component was selected for multivariate analysis. In the total group and in the group with asthma, low sick leave was associated with more perceived control over fatigue. In COPD, the attitude 'finding the negative consequences of sick leave more unpleasant' was associated with high sick leave. It was concluded that similarities exist in a population of asthma and COPD patients, but that different MPB-components play a role in sick leave in asthma and COPD. Perceived control over health complaints is more important in asthma than in COPD. Attitudes towards sick leave appear to be more important in COPD patients.

Absenteeism↗
PubMed1986

Smoking and excess sick leave in a department of health.

Average number of sick leave hours per month taken by smoking and nonsmoking employees of Missouri's Department of Health were examined. During a 20-month period 97 smokers took 5.3 hours per month sick leave, whereas 309 nonsmokers took 4.3 hours, a 23% difference. Excess sick leave was taken by smokers regardless of their sex, marital status, or age group. Smokers who were male, unmarried, or older took 22% to 38% more sick leave than their nonsmoking counterparts. It was estimated that for excess sick leave only, the smokers cost the department $11,931 per year. Using total cost figures developed by Weiss yielded an estimated excess cost of $510,802 per year.

Absenteeism↗
PubMed2005

Significant resources needed for return to work after sick leave.

There are increasing numbers of people on long-term sick leave, especially with stress-related ill health and musculoskeletal disorders. The main purpose of this study is to, early on in the sick leave, find predictors of individual resources for a return to work. The study group consists of women and men on sick leave compared with reference groups of healthy persons. A questionnaire was used regarding diagnosis given on the doctor's certificate, self-reported symptoms, residential area, education, and kind of work. It also contained open questions about consequences in daily life and beliefs about future. Checklists concerning life satisfaction, sense of coherence, locus of control, coping resources and sick leave information over a four-year period have been used. Significant differences between the study group and the reference groups were found, relating to sense of coherence, locus of control, life satisfaction and coping resources. More than half of the study group were still on sick leave at a two-year follow-up. Important predictive factors turned out to be: previous sick leave, own belief about future and self-reported symptoms.

Adaptation, Psychological↗
PubMed2003

Relation between sick leave and selected exposure variables among women semiconductor workers in Malaysia.

AIMS: To determine the relation between sick leave and selected exposure variables among women semiconductor workers. METHODS: This was a cross sectional survey of production workers from 18 semiconductor factories. Those selected had to be women, direct production operators up to the level of line leader, and Malaysian citizens. Sick leave and exposure to physical and chemical hazards were determined by self reporting. Three sick leave variables were used; number of sick leave days taken in the past year was the variable of interest in logistic regression models where the effects of age, marital status, work task, work schedule, work section, and duration of work in factory and work section were also explored. RESULTS: Marital status was strongly linked to the taking of sick leave. Age, work schedule, and duration of work in the factory were significant confounders only in certain cases. After adjusting for these confounders, chemical and physical exposures, with the exception of poor ventilation and smelling chemicals, showed no significant relation to the taking of sick leave within the past year. Work section was a good predictor for taking sick leave, as wafer polishing workers faced higher odds of taking sick leave for each of the three cut off points of seven days, three days, and not at all, while parts assembly workers also faced significantly higher odds of taking sick leave. CONCLUSION: In Malaysia, the wafer fabrication factories only carry out a limited portion of the work processes, in particular, wafer polishing and the processes immediately prior to and following it. This study, in showing higher illness rates for workers in wafer polishing compared to semiconductor assembly, has implications for the governmental policy of encouraging the setting up of wafer fabrication plants with the full range of work processes.

Adult↗
PubMed1996

Economic consequences of sick-leave and early retirement in obese Swedish women.

OBJECTIVES: To describe the pattern of sick-leave and disability pension in an obese sample and to estimate the Incremental, indirect cost due to sick-leave and early retirement for the obese fraction of the Swedish female population. DESIGN: A retrospective study of sick-leave and disability pension in health examined obese subjects was performed. The indirect cost of obesity in Sweden was estimated from reported and recorded sick-leave and disability pension in the sample and from the estimated prevalence of obesity in the country. SUBJECTS: 1298 obese persons aged 30-59 y. The mean age was 46 years. The mean body mass Index was 39 kg/m2 (range 28-68). SETTING: The obese subjects were recruited from eight counties in Sweden. RESULTS: As compared to the general Swedish population the obese subjects had 1.5-1.9 times higher sick-leave during one year. Twelve percent of the obese women had disability pension while the corresponding figure in the general population was 5%. The incremental cost of sick-leave and disability pensions attributable to obesity was 3.6 billion SEK during one year, which is equivalent to about 300 million USD per million female adult population. The total cost for sick-leave and disability pension due to absence from work for the obese fraction of the Swedish female population was 10.5 billion SEK during one year. CONCLUSION: Obesity represents a major health problem with significant economic implications for the society. Approximately 10 percent of the total cost of loss of productivity due to sick-leave and disability pensions in women may be related to obesity and obesity-related diseases.

Adult↗
PubMedDate not supplied

Reducing sick leave costs by shortening waiting periods for elective surgery.

Some sick leave of patients waiting for elective surgery could be avoided if these patients were treated with less delay. One way of achieving this is to give priority to patients on sick leave. Problems of fairness that such a policy would raise might be solved by assuring that part of the production gains stemming from avoided sick leave were used to increase treatment capacity to benefit all patients, including those not on sick leave. Another way to reduce sick leave due to waiting time is to increase supply temporarily and reduce treatment backlog without changing priorities among patient groups. If treatment thresholds are unaffected, such a temporary increase in supply will relieve all later patients of some of their waiting and render a production gain that may exceed marginal costs. If treatment thresholds are lowered as a result of waiting time's being reduced, there will still be production gains in patients benefiting by the temporary increase in supply, but in this situation the gains may cover only part of marginal costs.

Absenteeism↗
PubMed2005

Predictors of changes in sick leave in workers with asthma: a follow-up study.

OBJECTIVE: The aim of this prospective study was to investigate predictors of 1-year changes in sick leave in workers with asthma. METHODS: The initial cohort consisted of 111 workers with asthma. One-hundred and one participants completed the follow-up after 1 year. Self-reported sick leave over the past 12 months was reported at baseline and at follow-up. At the start of this study, all participants completed questionnaires on adaptation to functional limitations, psychosocial variables, working conditions, lung function characteristics, disease history characteristics, health complaints and functional limitations, and person characteristics ('potential predictors'). Three multivariate logistic regression models were calculated, with an increase in sick leave, a decrease in sick leave, and stable high sick leave as dependent (outcome) variables, and the potential predictors as independent (explanatory) variables. RESULTS: An increase in sick leave was predicted by a lower level of education and perceiving more functional limitations in activities of daily life. A decrease in sick leave was predicted by spending all energy at work less often and perceiving fewer health complaints in social activities (adaptation criteria 4 and 5). Stable high sick leave was predicted by less job satisfaction, perceiving more support from the employer and perceiving more health complaints in social activities (adaptation criterion 5). Lung function characteristics, or disease history characteristics were not predictive for changes in sick leave in any of the groups. CONCLUSION: We conclude that adaptation to functional limitations played a major role in changes in sick leave in workers with asthma. Lung function characteristics hardly played a role.

Adult↗
PubMed2005

Sick leave aboard--a one-year descriptive study among crew on a passenger ship.

OBJECTIVES: To study crew sick leave aboard and medical sign-off during one year (2004) among crew on a passenger ship doing worldwide cruising. Methods - Patient data were registered continuously during the year and reviewed afterward. RESULTS: There was an average of 612 crew members (22% women) aboard. There were 6378 recorded crew visits (=17.5 per day), 3705 of which directly involved the doctor (=10.2 per day). Four-hundred-and-fifty-one crew were on sick leave aboard for a total of 829 days. One-hundred-and-thirty-eight crew were isolated for a total of 268 days (= 32% of all sick leave) to prevent spreading of gastroenteritis. Among the 142 reported injuries, 77 (54%) led to sick leave on board for a total of 182.5 days (=22% of all sick leave). Fifty-six crew were referred to dentists and 18 to medical specialists in port. Twenty-eight crew were medically signed off, 16 (57%) of them following injuries, and 7 (25%) for pre-existing conditions. Three crew were hospitalized in port prior to repatriation. CONCLUSIONS: Crew consultation rates were high and sick leave rates low. Many factors aboard promoted sick presenteeism, minimized absenteeism, prevented malingering and reduced the length of sick leave. A substantial part of the sick leave was imposed by management and doctor, and if it was up to the crew, the number of sick leave days would have been even lower. The crew was eager to work, and their work morale was high.

Adult↗
PubMed1992

Cigarette smoking and sick leave in an industrial population in Shanghai, China.

A study of cigarette smoking and sick leave was conducted at a large petrochemical complex in Shanghai, China in 1988. Among a random sample of 1856 men the smoking prevalence was 80% with the highest rate (84%) occurring in the age group 25-34 years. Only 53% of smokers and 76% of nonsmokers said they believed smoking was harmful to health and knowledge of which diseases were associated with smoking was poor. Retrospective data were also collected on sick leave in 1986 and 1987. In 1986 13% of men took sick leave and in 1987 12%; the mean duration of sick leave was 3 days per year. In 1986 the odds ratios (OR) for taking sick leave were 2.37 for heavy smokers and 1.45 for light smokers compared to unity for nonsmokers; the corresponding OR for 1987 were 1.70 and 1.28 for heavy and light smokers compared with nonsmokers. Smoking was positively associated with sick leave even after adjustment for age, consumption of alcohol and exposure to chemicals; OR = 1.56 (95% confidence interval (Cl): 1.06-2.31) in 1986 and OR = 1.32 (95% Cl: 0.90-1.95) in 1987. Demonstration of this association even in a young population with low sick leave rates illustrates yet again the adverse effects of smoking on health and the urgent need to reduce the very high prevalence of smoking in China.

Absenteeism↗
PubMed2000

Risk of sick leave associated with outdoor air supply rate, humidification, and occupant complaints.

We analyzed 1994 sick leave for 3,720 hourly employees of a large Massachusetts manufacturer, in 40 buildings with 115 independently ventilated work areas. Corporate records identified building characteristics and IEQ complaints. We rated ventilation as moderate (approximately 25 cfm/person, 12 ls-1) or high (approximately 50 cfm/person, 24 ls-1) outdoor air supply based on knowledge of ventilation systems and CO2 measurements on a subset of work areas, and used Poisson regression to analyze sick leave controlled for age, gender, seniority, hours of non-illness absence, shift, ethnicity, crowding, and type of job (office, technical, or manufacturing worker). We found consistent associations of increased sick leave with lower levels of outdoor air supply and IEQ complaints. Among office workers, the relative risk for short-term sick leave was 1.53 (95% confidence 1.22-1.92) with lower ventilation, and 1.52 (1.18-1.97) in areas with IEQ complaints. The effect of ventilation was independent of IEQ complaints and among those exposed to lower outdoor air supply rates the attributable risk of short-term sick leave was 35%. The cost of sick leave attributable to ventilation at current recommended rates was estimated as $480 per employee per year at Polaroid. These findings suggest that net savings of $400 per employee per year may be obtained with increased ventilation. Thus, currently recommended levels of outdoor air supply may be associated with significant morbidity, and lost productivity on a national scale could be as much as $22.8 billion per year. Additional studies of IEQ impacts on productivity and sick leave, and the mechanisms underlying the apparent association are needed.

Adult↗