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PubMed1998

Population based case-control study of sick leave in postmenopausal women before diagnosis of hyperparathyroidism.

OBJECTIVE: To analyse sick leave in women at risk of primary hyperparathyroidism before its diagnosis. DESIGN: Case-control study nested within a screened cohort of postmenopausal women. Cases were women with hyperparathyroidism without prior knowledge of their disease and no traditional symptoms or complications. Controls were women from the screened population without hyperparathyroidism. SETTING: Population based screening within a Swedish community. SUBJECT: 48 case-control pairs of women aged 55-70 years. MAIN OUTCOME MEASURE: Sick leave during the 5 years before diagnosis. RESULTS: Total duration of sickness benefits was longer in the cases than controls, and this discrepancy included sick leave on full time or half time and for periods of longer than a week. Cases had an increased risk of sick leave more than half of the investigated time compared with controls (odds ratio 12). Doctors' certificates showed that the overrepresented sick leave in the cases related mainly to cardiovascular diseases. CONCLUSION: Asymptomatic mild primary hyperparathyroidism in postmenopausal women is accompanied by a previously unrecognised morbidity, which has consequences for clinical management of the disorder and its impact on the health economy.

Aged↗
PubMed2006

A prediction rule for shoulder pain related sick leave: a prospective cohort study.

BACKGROUND: Shoulder pain is common in primary care, and has an unfavourable outcome in many patients. Information about predictors of shoulder pain related sick leave in workers is scarce and inconsistent. The objective was to develop a clinical prediction rule for calculating the risk of shoulder pain related sick leave for individual workers, during the 6 months following first consultation in general practice. METHODS: A prospective cohort study with 6 months follow-up was conducted among 350 workers with a new episode of shoulder pain. Potential predictors included the results of a physical examination, sociodemographic variables, disease characteristics (duration of symptoms, sick leave in the 2 months prior to consultation, pain intensity, disability, comorbidity), physical activity, physical work load, psychological factors, and the psychosocial work environment. The main outcome measure was sick leave during 6 months following first consultation in general practice. RESULTS: Response rate to the follow-up questionnaire at 6 months was 85%. During the 6 months after first consultation 30% (89/298) of the workers reported sick leave. 16% (47) reported 10 days sick leave or more. Sick leave during this period was predicted in a multivariable model by a longer duration of sick leave prior to consultation, more shoulder pain, a perceived cause of strain or overuse during regular activities, and co-existing psychological complaints. The discriminative ability of the prediction model was satisfactory with an area under the curve of 0.70 (95% CI 0.64-0.76). CONCLUSION: Although 30% of all workers with shoulder pain reported sick leave during follow-up, the duration of sick leave was limited to a few days in most workers. We developed a prediction rule and a score chart that can be used by general practitioners and occupational health care providers to calculate the absolute risk of sick leave in individual workers with shoulder pain, which may help to identify workers who need additional attention. The performance and applicability of our model needs to be tested in other working populations with shoulder pain to enable valid and reliable use of the score chart in everyday practice.

Disability Evaluation↗
PubMed2005

Do patients with different psychiatric diagnoses require different strategies for certifying sick leave? - first indications from a prospective study.

AIM: To analyze the relationship between duration of prior certified sick leave and the course of symptom severity in a prospective study. METHODS: The severity of psychiatric symptoms was assessed in 109 patients of a psychosomatic/psychotherapeutic polyclinic. Using a basic patient documentation and the Symptom-Check-List SCL-90-R, sociodemographic information, diagnosis, symptom duration, and duration of sick leave were assessed at admission and four to six months later. Intra-individual difference scores were calculated for each patient to assess changes in the severity of psychiatric symptoms. RESULTS: A highly significant interaction between the course of symptom severity, duration of prior sick leave, and diagnostic group was found with two-factorial analysis of variance (F=2.888; P>/=0.01). At the second assessment, patients with anxiety disorders and longer sick leave showed a higher degree of deterioration in symptoms compared with anxiety patients with shorter or no prior sick leave. The patients with depression disorders and long certified sick leave achieved a higher degree of improvement in symptoms compared with depressive patients with shorter or no prior certified sick leave. CONCLUSION: Different diagnostic groups of psychiatric patients require different strategies for certifying sick leave.

Adaptation, Psychological↗
PubMed2006

Dose-response relation between physical activity and sick leave.

OBJECTIVE: To investigate the dose-response relation between moderate and vigorous physical activity and sick leave in a working population. METHODS: Data were used from three large Dutch databases: two continuous, cross sectional surveys among a representative sample of the Dutch population and one prospective cohort study. A distinction was made between duration, frequency and intensity of physical activity. The outcome measure was the number of days of sick leave. Analyses of variance were used to compare sick leave (in days) for workers with different amounts of physical activity, in particular workers meeting the physical activity recommendations v those who did not. Linear and logistic regression analyses were used to obtain effect estimates in the prospective cohort study, with the generalised estimating equation (GEE) method. RESULTS: No relation was found between moderate physical activity and sick leave. In two databases, workers meeting the recommendation of vigorous physical activity (active at a vigorous level for at least three times a week) had significantly less sick leave: more than one day over two months and more than four days over a year. The duration of vigorous physical activity was not associated with sick leave. CONCLUSION: Physical activity at a vigorous intensity level for at least three times a week, as in the CDC/ACSM recommendation, has a positive effect on sick leave.

Adult↗
PubMed1997

Sick-leave among women and the role of psychiatric disorder.

The aim was to assess sick-leave among women in relation to psychiatric disorder. A stratified population-based sample of women in Gothenburg were interviewed and diagnoses were made according to DSM-III-R. Sick-leave data was obtained for a ten year period. Women with psychiatric disorder had higher rates of sick-leave, compared to women without such disorders, in analyses taking into account age, socio-economic status, physical health, marital status and motherhood. Presence of psychiatric and physical illness were both independently associated with higher sick-leave. Highest sick-leave was found among those with a combination of psychiatric and physical morbidity. Psychiatric disorder is an important factor in sick-leave among women, especially regarding length of absence.

Adult↗
PubMed2000

Is asthma underestimated as a cause of sick leave?

Public interest needs to be focused on the economic burden of asthma on society because of the increasing prevalence of the condition. Asthma is common in individuals of working age and sick leave is an important health-economic issue. In the present study we looked at the prevalence of asthma in a sick leave register. Individuals on sick leave due to asthma, individuals on sick leave due to any other respiratory disorder or symptom and individuals on sick leave due to non-respiratory conditions were included in a questionnaire based study. Individuals in the register diagnosed with asthma could be classified as current asthmatics or possible asthmatics in respectively 94% and 99% of the cases. They were also ex-smokers to a greater extent than the other groups, which was more pronounced in males. However, individuals on sick leave due to 'any other respiratory disorder' could be classified as current asthmatics or possible asthmatics in respectively 19% and 30% of the cases. The corresponding figures in the group on sick leave due to 'other diagnoses' were 7% and 10%. Hence, there is evidence that asthma is an under-reported diagnosis and this must be taken into consideration when sick leave registers are used in health-economic studies.

Adolescent↗
PubMed1999

The effect of vocational rehabilitation on later sick leave.

PURPOSE: The aim of this study was to examine the effect of vocational rehabilitation on later sick leave for employed and unemployed people on long-term sick leave. METHOD: The study was based on long-term sick-leave cases initiated during 1992-1994 in Stockholm, Sweden. Of 1704 cases, 383 (321 employed and 62 unemployed) underwent vocational rehabilitation. These were individually matched with sick-leave cases not undergoing rehabilitation, using the variables age, sex, diagnoses and employment status. RESULTS: The hypotheses were (1) that people who underwent rehabilitation, both employed and unemployed, would have less later sick leave than those who did not, and (2) that rehabilitation would affect employed people more than unemployed people. These hypotheses were only partly supported. CONCLUSIONS: The results indicate that vocational rehabilitation has a positive effect regarding later sick leave only for unemployed men. For unemployed women the effect is negative and for those employed, both men and women, rehabilitation has no demonstrable effect.

Adult↗
PubMed2006

Experiences within the process of sick leave.

The aim of this study was to explore what individuals who have been on sick leave experienced as important in the process of returning to work, moving to long-term sick leave, or receiving a disability pension. Grounded Theory was used for interpreting interviews with 15 people who had been on sick leave four years previously. In the results four ideal types were crystallized which are presented in the form of vignettes. The ideal types were discussed focusing on occupational life using the Model of Human Occupation and the theories of Sense of Coherence and Status Passage. The study provided a deeper understanding of people's experiences during the process of their sick leave. Valuable predictors for re-entry into work or disability retirement were: individual mental resources; clear or unclear diagnosis; how long had been spent in the sick-leave process; and personal belief in an ability to work in the future. The interventions and support given by professionals and the social environment, the balance and sense of coherence in life, and participation in the sick leave process were also important. The idealtypes found could be helpful to professionals working in this field in deepening their understanding of the clients.

Persons with Disabilities↗
PubMed2004

Worksite health promotion using individual counselling and the effectiveness on sick leave; results of a randomised controlled trial.

AIMS: To investigate the effectiveness of a worksite health promotion programme by individual counselling on sick leave. METHODS: Three municipal services of Enschede, the Netherlands, participated in this trial. A total of 299 civil servants were measured at baseline and were randomised by cluster into the intervention (n = 131) or the control group (n = 168). During nine months, subjects in the intervention group received a total of seven consultations, particularly aimed at increasing their physical activity level and improving their dietary habits. Both the intervention and the control subjects received written information as to several lifestyle factors. Sick leave data regarding the nine month intervention period (from May until January) were collected from each municipal service's personnel department. In addition, sick leave data concerning the nine month period pre- and post-intervention were collected. Sick leave data were analysed using multilevel analysis. RESULTS: For both groups, the mean sick leave rate during the intervention increased compared to before the intervention. After the intervention period, the control group increased even more (from 22.9 to 27.6 days), whereas the intervention group slightly decreased (from 21.5 to 20.5 days). Median values of sick leave rate decreased for both groups. No statistically significant intervention effect was found. In both groups, the mean sick leave frequency slightly decreased over time (intervention effects were not significant). CONCLUSIONS: Results showed no significant effect of individual counselling on sick leave. Continued research investigating the effectiveness of this individual counselling programme on several health related outcomes is useful to clarify the trend observed in sick leave.

Adult↗
PubMed1998

Shift work and sick leave.

OBJECTIVE: Shift workers working nights are known to have higher morbidity from certain illnesses than day workers. This study examined episodes of certified sick leaves of day workers and shift workers in a large industrial plant to examine whether slowly rotating shift work leads to increased risk of sick leave. METHODS: In a case-base design more than 11000 episodes of sick leave, lasting more than 3 days, were obtained from the sick-leave files of a chemical plant in Norway. The diagnoses were grouped into 5 categories according to information on their work schedules. The workers included in the study were divided into 3 groups. They worked slowly rotating 3 shifts, 2 shifts without night work, and daytime schedules. RESULTS: For all the diagnoses the shift workers and day workers were evenly distributed among the cases and the referents, the odds ratios ranging from 0.8 to 1.2. The risk of sick leave did not change with the number of years in shift work. There was a higher risk of sick leave with musculoskeletal diagnoses among the 2-shift workers. CONCLUSIONS: In this study shift workers did not have a higher risk of sick leave for diseases that, in previous studies, have been shown to be related to shift and night work. Although bias may be present in the study, the results are in line with those of previous studies, and they suggest that even certified sick leaves are not a valid proxy for morbidity.

Adult↗
PubMed1998

Occupational factors affecting sick leave attributed to low-back pain.

OBJECTIVES: The purpose of this study was to determine the occupational factors that cause workers to take sick leave attributed to low-back pain. METHODS: Twice, with a 24-month interval, 117 white- and 189 blue-collar employees from 2 metal industry companies completed a questionnaire on recurrent low-back pain and exposure to potential risk factors (biomechanical loads, physical environment, psychosocial factors) at work. Sick leave was monitored for the period between the questionnaires. RESULTS: Low-back pain was predicted by exposure to harmful biomechanical loads among both white- and blue-collar workers [odds ratio (OR) 4.1 and 4.7, respectively), stress among white-collar workers (OR 2.4), and draft among blue-collar workers (OR 2.3). The take-up of sick leave was predicted by exposure to harmful biomechanical loads [rate ratio (RR) 1.7]; for sick leaves attributed to low-back pain the rate ratio was 3.1. Lack of recognition and respect at work predicted sick leave attributed to low-back pain (RR 2.0), but not sick leave attributed to other disorders. CONCLUSIONS: Recurrent low-back pain is preceded by reports of harmful biomechanical loads at work among white- and blue-collar workers, by stress among white-collar workers and by draft among blue-collar workers. The environmental and psychosocial factors under study did not modify the relation between biomechanical loads and recurrent low-back pain. Sick leave attributed to back disorders is preceded by exposure to biomechanical loads at work and by a lack of recognition and respect at work among blue-collar workers. Biomechanical loading seems to be the most important occupational factor predicting both recurrent low-back pain and sick leave attributed to back disorders. Lack of recognition and respect at work appear to affect sick leave attributed to back disorders.

Adolescent↗
PubMed2006

Reducing sick leave by minimal postal intervention: a randomised, controlled intervention study.

BACKGROUND: The lack of efficient medical interventions for combating increasing sickness absence rates has lead to the introduction of alternative measures initiated by the Norwegian National Insurance Service or at workplaces. AIM: To determine whether minimal postal intervention had any effect on the length of sick leave. METHODS: Randomised, controlled trial with a one year follow up in Northern Norway in 1997 and 1998; 990 consecutive newly sick-listed persons with musculoskeletal or mental disorders were studied. Within the intervention group, 495 eligible sick-listed persons received a general information letter and a questionnaire as their sick leave passed 14 days. Possible intervention effects were analysed by survival analysis of the probability of returning to work within one year, and logistic regressions with benefits at one year as the dependent variable. RESULTS: The overall reduction of 8.3 (95% CI -22.5 to 6.0) calendar days in mean length of sick leaves in the intervention group compared to controls, was not statistically significant. However, intervention significantly reduced length of sick leaves in subgroups with mental disorders, and with rheumatic disorders and arthritis, and overall for sick leaves lasting 12 weeks or more. Young people with low back pain showed an adverse effect to intervention. The overall relative risk of receiving benefits due to sickness after one year in the intervention group was 0.69 (95% CI 0.51 to 0.93) compared to controls. CONCLUSION: The results should encourage employers, insurance institutions, and authorities to initiate challenges as questions on the length of sick leave and possible modified work measures, during the first few weeks of sick leave, for at least some groups of sick-listed persons.

Absenteeism↗
PubMed2003

Reduction in sick leave and costs to society of patients with Meniere's disease after treatment of temporomandibular and cervical spine disorders: a controlled six-year cost-benefit study.

This study compares the frequency of sick leave between the three-year period after and the three-year period before coordinated treatment of temporomandibular and cervical spine disorders in 24 patients (ten males and 14 females) diagnosed with Meniere's disease. The frequency of sick leave for the patients was also compared with the frequency of sick leave in a control group from the population. A cost-benefit analysis was made regarding the costs to society of sick leave related to the treatment costs of the patients. In a previous study the same patients were treated for their severe signs and symptoms of temporomandibular and cervical spine disorders, and they reported a substantial reduction in their vertigo, non-whirling dizziness, tinnitus, feeling of fullness in the ear, pain in the face and jaws, pain in the neck and shoulders, and headache. The number of days of sick leave and the year the patient began to receive disability pension due to the symptoms of Meniere's disease were obtained from the National Health Insurance Service in Sweden. Two of the patients received disability pension benefits due to Meniere's disease 17 years prior to their normal retirement pension. A third patient received disability pension for another reason and two were receiving a retirement pension. Data on the remaining 19 patients showed a considerable reduction in number of days of sick leave during the three-year period after coordinated treatment (270 days) compared with the three-year period before the treatment (1,536 days). The control subjects used a total of 14 days sick leave for the same symptoms during the same six-year period. Vertigo (nine days) was the dominant cause followed by pain in the neck and shoulders, and headache. The reduction in sick leave for the 19 nonretired patients and the treatment costs for the 24 patients can be used for a simple cost-benefit calculation for the subgroup of nonretired patients. During the first three years after treatment the reduction in sick leave was on average 66.6 days for each of the 19 nonretired patients. Within the limits of this study, it can be concluded that the costs to society for sick leave and disability pension due to Meniere's disease are substantial. A coordinated treatment of temporomandibular and cervical spine disorders appears to substantially reduce these costs.

Adult↗
PubMed2004

Long-term sick leave and its risk factors during pregnancy among Danish hospital employees.

AIM: The authors sought to describe risk indicators of long-term sick leave during pregnancy among hospital employees. METHODS: A register-based study was undertaken of 4,852 female hospital employees aged 20-45 years from the second largest hospital in Denmark during 1995-99 based on job titles, working time, sick leave, and births combined with a survey among a total of 773 women who had been pregnant during their employment (response rate 85%). RESULTS: Altogether 236 (31%) were on sick leave for at least 10% of their scheduled work time during their latest pregnancy and 169 (22%) had been absent at least 20% of the time. The pregnant women had an average sickness absence of 6.1 days per month, non-pregnant women 0.95 days per month. Sick leave was more frequent in late than in early gestation. Women employed as nursing aides or hospital orderlies, launderers, and nurses had more sick leave days than other hospital employees. Part-time work, previous sickness absence not related to pregnancy, and previous chronic back pain were risk factors for long-term sick leave as were much walking or standing, long working days, high work level, little practical support from supervisors and colleagues, low job control, much lifting and night or shift work. Sick leave was unrelated to family size, support from the family and number of working years. CONCLUSION: Long-term sick leave during pregnancy was frequent and to some extent predictable. Efforts should be made to organize work for pregnant women in a manner that optimizes their health and well-being.

Absenteeism↗
PubMedDate not supplied

Diabetes mellitus in middle-aged people is associated with increased sick leave: the BELSTRESS study.

In a prospective study of the association between self-reported diabetes mellitus and sick leave from work, 21,149 men and women, aged 35-59 years, participated. Prevalence of diabetes was obtained by questionnaire. Sick leave was prospectively obtained from departments of human resources in the year after the baseline survey. Outcome variables related to duration of sick leave, repetitive absences, and long absences of at least seven consecutive days. In gender-specific multivariate analyses the relation between diabetes and sick leave was studied independent of age, body mass index, physical activity, alcohol intake, education, job title, and smoking habit. Prevalence rates of self reported diabetes were 2.8% and 2.2% in men and women, respectively. For each outcome variable a significant association between diabetes and sick leave was observed. Significant associations were found between diabetes and duration of sick leave and repetitive absences in men. In women a similar trend was observed for duration, and a significant association was found for repetitive absences.

Adult↗
PubMed2006

Relationship between sick leave, unemployment, disability, and health-related quality of life in patients with inflammatory bowel disease.

BACKGROUND: The goal of this study was to determine the rate of work disability, unemployment, and sick leave in an unselected inflammatory bowel disease (IBD) cohort and to measure the effect of working status and disability on the patient's health-related quality of life (HRQOL). MATERIALS AND METHODS: All eligible patients were clinically examined and interviewed at the 5-year follow-up visit. In addition, they completed the 2 HRQOL questionnaires, the Short Form-36 Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire validated for use in Norway (N-IBDQ). Data regarding sick leave, unemployment, and disability pension (DP) also were collected. RESULTS: All together, 495 patients were or had been in the workforce during the 5-year follow-up period since diagnosis. Forty-two patients (8.5%) were on DP compared with 8.8% in the background population. Women with Crohn's disease (CD) had the highest probability of receiving DP (24.6%). A total of 58 patients (11.7%) reported they were unemployed at 5 years. This was equally distributed between men and women but was more frequent in patients with ulcerative colitis. Sick leave for all causes was reported in 47% with ulcerative colitis and 53% with CD, whereas IBD-related sick leave was reported in 18% and 23%, respectively. A majority (75%) had been sick <4 weeks, and a relatively small number of patients (25%) contributed to a large number of the total sick leave days. Both unemployment and DP reduced HRQOL scores, but the most pronounced effect on HRQOL was found in patients reporting IBD-related sick leave, measured with SF-36 and N-IBDQ. The observed differences also were highly clinically significant. Multiple regression analysis confirmed that IBD-related sick leave was the independent variable with the strongest association to the observed reduction in HRQOL scores. CONCLUSIONS: Unemployment or sick leave is more common in IBD patients than in the Norwegian background population. The number of patients receiving DP is significantly increased in women with CD but not in the other patient groups. Unemployment, sick leave, and DP are related to the patient's HRQOL in a negative way, but this effect is most pronounced in patients reporting IBD-related sick leave.

Adult↗
PubMed2005

Risk factors for musculoskeletal symptoms and ensuing health care use and sick leave.

STUDY DESIGN: Longitudinal study with a 6-month follow-up. OBJECTIVE: To investigate whether demographic, work-related physical and psychosocial risk factors involved in the occurrence of musculoskeletal symptoms also determine subsequent health care use and sick leave. SUMMARY OF BACKGROUND DATA: Preventing the socioeconomic consequences of disability from musculoskeletal symptoms may be a goal separate from that of eliminating the symptoms themselves; thus, other factors may need to be addressed in intervention. METHODS: A questionnaire provided data on demographics and work-related factors, musculoskeletal symptoms, and ensuing health care use and sick leave among 407 industrial workers. RESULTS: The 12-month prevalence of low back pain (LBP) and neck/upper extremity symptoms was 52% and 56%, respectively. Of those individuals with symptoms at baseline, 68% had a recurrence of LBP, and 62% a recurrence of neck/upper extremity symptoms during a 6-month follow-up. The recurrence of sick leave for a particular musculoskeletal complaint was approximately 30%, while recurrence of health care use was more than 40%. Recurrence of symptoms, health care use, and sick leave were strongly associated with a history of severe symptoms. Physical load, high job strain, and low social support at work determined the occurrence of LBP, related health care use, and sick leave. Older age and living alone were also important risk factors, especially for sick leave. High job strain determined the occurrence of neck/upper extremity symptoms, related health care use, and sick leave. Being female and living alone increased the probability of the occurrence of all 3 endpoints, especially the occurrence of sick leave. CONCLUSIONS: Work-related factors that were associated with the occurrence of musculoskeletal symptoms were quite similar to those associated with health care use and sick leave. However, for LBP, older age and living alone, and, for neck/upper extremity symptoms, living alone and being female more strongly determined whether subjects with these complaints took sick leave. These results imply that prevention strategies aimed at minimizing the risks of the occurrence of work-related musculoskeletal symptoms and prevention programs aimed at reducing sick leave may need to emphasize different sets of risk factors.

Adolescent↗
PubMed1995

Sick leave: taking time off for family.

Sick leave, traditionally, has been for employees alone--a dissatisfying arrangement when the sick person is a family member, not the professional. But one hospital rewrote its rule, extending sick leave to include time off if a spouse or dependent child is ill. The staff likes the hospital's acknowledgment that professionals have important family obligations. Administrators like the high rate at which it's retaining valued personnel.

Budgets↗