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PubMed2004

Swedish Council on Technology Assessment in Health Care (SBU). Chapter 8. Sick leave due to coronary artery disease or stroke.

The assessment of the literature on sick-leave with cardiovascular diseases include only studies with sufficient scientific quality. These studies describe sick leave following stroke, myocardial infarction, coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI). We found limited scientific evidence for the following results: After stroke, more than half of the patients of working age returned to work (RTW) during the first year following onset (higher rate for the younger patients). The consequences of brain damage, e.g. impaired ADL ability or cognitive capacity, play an important role in this respect. Also after myocardial infarction most patients RTW. PCI is a milder coronary artery intervention than CABG and RTW is more rapid. However, in the long run there are no differences in sick leave. People at higher ages or with physically demanding jobs return to work to a lesser degree. An international comparison shows that the duration of sick leave due to these conditions in Sweden is longer than in other countries although there is no scientific evidence to support this practice. It appears that the interest in research on sick leave in patients with cardiovascular diseases has waned in recent years. Developments in acute cardiological care should inspire renewed scientific involvement in this area of research.

Absenteeism↗
PubMed2006

Sick leave as a predictor of job loss in patients with chronic arthritis.

OBJECTIVES: To study the occurrence and duration of sick leave as potential risk factors for permanent job loss after 24 months among 112 individuals with chronic arthritis and a disease related problem at work. METHODS: Data collection was embedded in a multicentre randomised controlled trial in which the cost-effectiveness of a multidisciplinary job retention vocational rehabilitation programme for employees with chronic arthritis and a disease related problem at work was compared to usual outpatient care. Sick leave (complete or partial) was defined as absenteeism reported to the employer and permanent job loss as receiving a full work disability pension or unemployment. The association between sick leave at baseline and job loss after 24 months was investigated by multivariate logistic regression analysis, including those variables that were univariately significantly associated with job loss after 24 months. RESULTS: At baseline, 60 of the 112 subjects (54%) were on sick leave, with a mean duration of 18.7 weeks, in half of these patients the sick leave was complete. After 24 months, 26 of the 112 patients (23%) had lost their job. The presence of complete sick leave (OR 4.74, 95% CI 1.86-12.07) and the depression score of the hospital anxiety and depression scale (OR 1.18, 95% CI 1.02-1.36) were significantly and independently associated with job loss after 2 years follow-up. CONCLUSION: The occurrence of complete sick leave was found to be an independent risk factor for job loss in patients with chronic arthritis who have a disease related problem at work.

Adult↗
PubMed2003

Sick leave analysis among self-employed Dutch farmers.

BACKGROUND: Agriculture is one of the most physically demanding and risky industries. Aim The objective of this study was to provide baseline data on the diagnoses, occurrence and duration of sick leave of self-employed Dutch farmers. METHOD: A database of 22 807 sick leave claims of 12 627 farmers during the period 1994-2001 was analysed. RESULTS: Most of the claims (61%) were for musculo-skeletal injuries and disorders. The mean cumulative incidence (CI) was 10.2 claims per year per 100 farmers and did not change over time. However, it varied per agricultural sector and per age category, being lowest in arable farming and in the youngest age category and highest in mushroom farming and in the oldest age category. The duration of sick leave depended both on diagnosis and age category: the slowest recovery from sick leave was seen in farmers with respiratory diseases and farmers in the oldest age category. CONCLUSION: The results make it easier to identify groups of farmers to be targeted to prevent sick leave. To reduce the occurrence of sick leave in agriculture, the strategy should be to prevent musculo-skeletal injuries and disorders. Furthermore, a sector-specific approach is recommended, so that preventive actions can be focused on working conditions-specifically on workload and work safety. Efforts to shorten the duration of sick leave will also be valuable to obtain a reduction of sick leave.

Adult↗
PubMed1999

[Sick-listed persons think job adjustments might reduce sick-leave].

In the 1990's, improving the follow-up of sick-listed patients with a focus on job adjustments has been a priority in Norwegian social policy. In a study of 1,000 consecutive sick-listed patients (14 days or more) with a musculoskeletal or mental disorder as primary diagnosis, we asked 499 randomly selected sick-listed patients about their opinion on whether adjustments in their job situation might reduce their need for sick-leave in the current episode or in the future. 161 useful questionnaires were returned. Nearly 30% replied that job adjustments might bring down his or her current sick-leave, and 40% thought that job adjustments might reduce future needs for sick-leaves. One in four were of the opinion that they might return to work immediately if job adjustments were made. Among those who knew about job adjustments which had in fact been implemented at their place of work, there were no significant differences in the estimates of potential reductions by age, sex, diagnosis or occupation, with the exception that young women who worked in places where such adjustments had been made, had little belief in the potential of such adjustments. We may conclude that in the sick-listed patients' own opinion, job adjustments have a considerable potential for cutting down the number of working days lost by sickness. The Norwegian "active sick-leave" scheme is suitable and might be used more.

Adult↗
PubMed2004

Obesity, body fat distribution and incidence of sick leave in the Belgian workforce: the Belstress study.

OBJECTIVES: In many studies, obesity has been associated with morbidity or mortality, but only a few have studied the relation between obesity and sick leave. Our aim is to analyse the independent effects of both adiposity and body fat distribution in relation to the 1-y incidence of sick leave in a large cohort of male and female workers covering a variety of occupations, taking into account a wide range of socio-demographic, behavioural and bioclinical variables. DESIGN AND SETTING: The baseline survey of the Belstress study was conducted in 25 companies across Belgium between 1994 and 1998. A cohort of 20 463 workers (15 557 males and 4906 females) aged 35-59 y was followed for absenteeism during 1 y. The 75th percentile of the distribution of the total annual sickness days was used as a cutoff to classify the workers with a high 1-y incidence rate of sick leave. The relation between sick leave and both obesity and body fat distribution assessed by the body mass index (BMI) and the waist circumference, respectively, was analysed by multivariate logistic regression models. RESULTS: Using a backward procedure based on the likelihood ratio, we found central abdominal fatness to be an independent predictor of sick leave in both genders (high sick-leave incidence and long spells), but not BMI. In men, the odds ratios was 1.31 (99% CI 1.12-1.52, P<0.0001) and in women it ranged from 1.32 (99% CI 1.03-1.70, P=0.005) to 1.47 (99% CI 1.14-1.90, P<0.0001). Two baseline covariables, respiratory problems and perceived health, are confounders or mediators. CONCLUSIONS: In this study, body fat distribution was associated with a high annual sick-leave incidence and long spells of sickness absence. If this link is reversible, employers may benefit from programs aiming at the prevention and treatment of central obesity.

Adipose Tissue↗
PubMed1977

Sick leave--honour or expediency?

Experience has shown that doctors tend to be overgenerous when awarding sick leave. Quite rightly their first consideration is their patient, but frequently too little thought is given to the overall effect that excessive absence because of illness may have have on the patient, on the company in which he works, and on the country as a whole. Economically, these effects may be profound. A tempered industrial viewpoint is put forward and South African law regarding sick leave is outlined. A plea is made to doctors to safeguard their sick leave notes, prescription pads or letterhead paper, to award sick leave on merit, giving legible sick leave notes containing the necessary information, and to the profession not to overlook the wider aspects of the matter.

Absenteeism↗
PubMed1992

The epidemiology of sick leave in an urban population in Malmö, Sweden.

The epidemiology of sick leave was studied in the city of Malmö, Sweden, (230,000 inhabitants). Every current and completed sick-leave episode during the year of 1985 was collected for 124,411 persons aged 16 to 65, who were registered with the National Health insurance scheme in 1985. Absence rate, absence incidence, absence prevalence and absence duration were analyzed in relation to age, sex, marital status, nationality, income and place of residence. Absence rate (mean value) in the total population was 25.5 days with a median of three days. The absence rate increased by age. High absence rates were seen for females, single people and some immigrant groups. This was even true for residential areas characterized by a higher proportion of single-person households and households on social welfare, of unemployed and people with a low income and a foreign background. The absence rate gives limited information as to the epidemiology of sick leave. Through adding absence incidence, absence prevalence and absence duration it was possible to get a more comprehensive picture of the phenomenon. Sex-differences in absence rate for instance were mainly explained by differences in absence incidence and prevalence, while differences in absence rate regarding nationality were explained by differences in absence duration. This is an important step towards a better understanding of the factors behind sick leave.

Absenteeism↗
PubMed1996

[Sick leave for pregnant women in the municipality of Fjend 1987-1990].

All of 417 pregnancies in 1987-1990 in a rural community were retrospectively evaluated with emphasis on age, parity, previous spontaneous or induced abortion, occupation during pregnancy and sick leave from work. No difference was found in prevalence of sick leave between the employed women and the unemployed. Thirty-five percent of the women experienced sick leave at some time during pregnancy. The greatest single diagnostic group was pelvic insufficiency, which accounted for 33.5% of all days of sick leave up to the 32nd week of gestation. The incidence of pelvic insufficiency was high: 76 in 1000 deliveries. This may in part be due to a change in diagnostic criteria. Logistic regression analysis revealed that being a multipara was associated with a significantly higher risk of sick leave in the present pregnancy. Furthermore, being employed as a nurse, a shop assistant, a seamstress or a factory worker was associated with a significantly higher risk of sick leave during pregnancy in comparison with employment as a secretary. When investigating relationships between occupational conditions and the outcome of pregnancy, sick leave during pregnancy because of the same conditions may interfere significantly.

Adult↗
PubMed1993

Precursors of repeated short-term sick-leave: an empirical review of some background, job and well-being characteristics.

The aim of the study was to search for bivariate associations between on the one hand samples of background, job-related and well-being characteristics, and on the other hand longitudinally recorded sick-leave in individuals with repeated short-term sick-leave. Out of altogether 123 subjects included, 113 self-rated their well-being at the onset of, and 88 also after, a supportive programme. The well-being rating covered experience of treatment by other people, reservation, loneliness, inferiority, tension, vulnerability, guilt, security and indolence. Socio-demographic and job-related characteristics and attitudes were registered and declared at the initial contact. Correlations between these separate sets of independent variables, and sick-leave occasions and days in each of the two years following the contact were computed. There was an almost complete lack of covariation between background variables and sick-leave. Neither did job-related characteristics correlate. Only an expressed wish for a job change was vaguely associated with more absence days, but not with more spells. In striking contrast, a convincing consistent longitudinal pattern between self-rated well-being and sick-leave behaviour emerged. The poorer the well-being, the greater the subsequent sick-leave. Yet, a major part of the sick-leave variance remained unexplained. Accordingly, other etiological factors may still interact with well-being in the comprehensive setting behind the sick-leave behaviour.(ABSTRACT TRUNCATED AT 250 WORDS)

Absenteeism↗
PubMed2003

Sick-leave certificates granted to psychiatric outpatients with major depression.

We investigated to what extent and for what reasons depressive outpatients are given certificates for sick-leaves and whether there are particular factors associated with the given sick-leaves. Our retrospective case note study was based on 213 adult psychiatric outpatients with first-time documented DSM-III-R major depression. Several sociodemographic, clinical, and treatment characteristics were detected during the follow-up of 3 months' medical care. This information was related to official registers of granted sick-leave certificates with a follow-up time of 30 months for the study patients. Sick-leave certificates were granted to 61% of patients. The mean duration of time off work due to documented illness was 142 days. Eighty-seven percent of the total sum of sick-leave days was for depressive disorders. Living with someone else, being employed, and early recognition of the illness were associated with the granted sick-leaves.

Adult↗
PubMed1997

Reduction of sick leave for lumbar back and posterior pelvic pain in pregnancy.

STUDY DESIGN: In this prospective, consecutive, controlled cohort study, the authors analyzed the impact of a differentiated, individual-based treatment program on sick leave during pregnancy for women experiencing lumbar back or posterior pelvic pain during pregnancy. OBJECTIVE: To identify patients with pain early in pregnancy and, by means of individual information and differentiated physiotherapy, reduce sick leave during pregnancy. SUMMARY OF BACKGROUND DATA: Sick leave for back pain during pregnancy is common, and treatment programs have been aimed at reducing pain, for that reason. In Sweden, the average sick leave due to back pain during pregnancy is 7 weeks. METHODS: All pregnant women who attended a specific antenatal clinic and experienced lumbar back or posterior pelvic pain were included in an intervention group, and results were compared with women in a control group from another antenatal clinic. RESULTS: The intervention group comprised 54 women, compared with 81 women in the control group. Thirty-three women were on sick leave for an average of 30 days in the intervention group versus 45 women for an average of 54 days in the control group (P < 0.001). The reduction in sick leave reduced insurance costs by approximately $53,000 U.S. CONCLUSIONS: Sick leave for lumbar back and posterior pelvic pain in the intervention group was significantly reduced with the program, and the program was cost effective.

Cohort Studies↗
PubMed2003

Sick leave and professional assistance for multiple sclerosis individuals in Västerbotten County, northern Sweden.

The aims of this study of a cross-sectional multiple sclerosis (MS) population in Västerbotten County, northern Sweden, were to estimate the prevalence of sick leave, professional assistance and housing; to study risk factors for sick leave; and to estimate the odds for sick leave in comparison with the general population of the county. The consequences of MS-related incapacity on the socioeconomic factors studied were considerable. Almost half (45%) of prevalent MS cases aged 18-64 years were fully sick listed and only one-third (35%) were not sick listed at all. Every fourth individual in the prevalence population received professional assistance, and 9% were living in care homes or special apartments for the disabled. Multiple logistic regression analysis identified the Expanded Disability Status Scale (EDSS) as the strongest predictor of sick leave. The time from symptom onset to full sick leave leading to temporary or permanent disability pension was significantly shorter for cases with progressive onset, higher age at onset and in males. The risk of full sick leave due to MS was six times higher than in the general population.

Adolescent↗
PubMed2002

A study of indoor carbon dioxide levels and sick leave among office workers.

BACKGROUND: A previous observational study detected a strong positive relationship between sick leave absences and carbon dioxide (CO2) concentrations in office buildings in the Boston area. The authors speculated that the observed association was due to a causal effect associated with low dilution ventilation, perhaps increased airborne transmission of respiratory infections. This study was undertaken to explore this association. METHODS: We conducted an intervention study of indoor CO2 levels and sick leave among hourly office workers employed by a large corporation. Outdoor air supply rates were adjusted periodically to increase the range of CO2 concentrations. We recorded indoor CO2 concentrations every 10 minutes and calculated a CO2 concentration differential as a measure of outdoor air supply per person by subtracting the 1-3 a.m. average CO2 concentration from the same-day 9 a.m. - 5 a.m. average concentration. The metric of CO2 differential was used as a surrogate for the concentration of exhaled breath and for potential exposure to human source airborne respiratory pathogens. RESULTS: The weekly mean, workday, CO2 concentration differential ranged from 37 to 250 ppm with a peak CO2 concentration above background of 312 ppm as compared with the American Society of Heating, Refrigeration and Air-conditioning Engineers (ASHRAE) recommended maximum differential of 700 ppm. We determined the frequency of sick leave among 294 hourly workers scheduled to work approximately 49,804.2 days in the study areas using company records. We found no association between sick leave and CO2 differential CONCLUSIONS: The CO2 differential was in the range of very low values, as compared with the ASHRAE recommended maximum differential of 700 ppm. Although no effect was found, this study was unable to test whether higher CO2 differentials may be associated with increased sick leave.

Adult↗
PubMed1991

[Duration of sick-leave and the moment of recovery in the hotel industry].

The paper addresses the problem of sick leave in the hotel industry. It was hypothesized that there would be a tendency for granted sick leaves to include weekends, thus imposing an additional financial burden on the hotel in question. A total of 401 medical certificates from a large city hotel were reviewed. According to these certificates one third of the patients regained their health between Sunday and Monday. Of the patients with "short" sick leaves (less than a fortnight), 40% recovered between Sunday and Monday. The average duration of the sick leave for this group was 1.3 days longer than that of the patients whose sick leaves ended on other days of the week. The results are discussed in terms of the ambiguous position of the medical practitioner.

Humans↗
PubMed1999

[Sick leave while on a waiting list].

Evidence suggest that waiting for hospital treatment leeds to unnecessary sick leaves. However, we know little about the extent of the problem. During a six-week period, 1,061 patients attending a total of ten hospital departments for the first time for outpatient treatment or examination received a self-administered questionnaire about sick leaves during the waiting period. 901 patients responded. Great variations were found between the ten departments. The average waiting period was 86 days (32-226 days). 26% (8-61%) of the patients had had a sick leave during the waiting period caused by the disease for which they were seeking treatment; average duration was 48 days (17-89 days); total sick leave for all patients responding in this survey was 11,000 days. Of patients with a sick leave during the waiting period, 44% thought that the examination or treatment which they attended would increase their ability to work, while their doctors were somewhat less optimistic (36%). The study shows that a large proportion of patients on waiting lists for hospital treatment are incapable of work and that cost savings achieved by cutting down waiting period may be considerable.

Adult↗
PubMed2003

[Could sick leaves be reduced by augmenting the knowledge of the general practitioner?].

BACKGROUND: Musculoskeletal disorders account for about 50 % of the cost of sick leaves in Norway. The aim of the study was to evaluate whether it is possible cut down the length of such sick leaves by augmenting the knowledge of these disorders among general practitioners (GPs). MATERIAL AND METHODS: Among GPs in a region of 50 000 inhabitants in Buskerud county, 24 joined a continuous medical education programme on musculoskeletal disorders and received financial compensation for the extra time spent on an extended clinical examination of patients whose sick leave had exceeded 16 days. 41 GPs that did not wish to attend the programme joined the study as a control group. Patients were included over one year and there was a one-year follow-up period. RESULTS: The GPs in the programme had a total of 753 patients who were included in the study; the GPs in the control group had 964. There were no differences between these patient groups with regard to sex, age, occupation and diagnosis, in length of sick leaves, or more permanent disability benefits. Among patients on sick leave of more than one year, 55% had not been referred to a specialist. INTERPRETATION: Augmenting the skills of GPs and giving them incentives to conduct more thorough clinical examinations does not reduce length of sick leaves caused by musculoskeletal disorders.

Adult↗
PubMed1992

[Sick-leave during pregnancy--focusing on textile workers].

In order to illustrate the conditions involved in sick-leave during pregnancy, 593 consecutive parturient women received a questionnaire on the day after delivery. 48% of the pregnant women were certified as sick and 16% were admitted to hospital during pregnancy. The most common reasons for sick-leave were threatening abortion (19%), haemorrhage (18%) and threatening premature delivery (15%). The duration of sick-leave averaged 15 weeks as compared with 7.3 weeks in Denmark as a whole. In the subgroup of textile workers, 71% considered that the work was physically stressing and 70% were certified sick. Compared with all of the other occupationally active women, textile workers were more frequently certified sick, considered that their work was more physically stressing and had more frequently required sick-leave but were more rarely admitted to hospital. Similarly, textile workers had a greater risk for sick-leave on account of threatening abortion, pelvic loosening or pain in the locomotor system.

Adolescent↗