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PubMed1984

Effect of occlusal treatment on sick leaves in TMJ dysfunction patients with head and neck symptoms.

The aim of the study was to test the effect of occlusal treatment on sick leaves utilized in clinically diagnosed TMJ dysfunction patients who had had sick leaves for head and neck symptoms. The patient population differed clearly from a typical TMJ dysfunction clientele. Qualitative statistical analysis disclosed a significant reduction in sick leaves granted in the treatment group (n = 28). The result was corroborated by quantitative statistical analysis. No change was observed in the control group (n = 25). The changes in the number of days on sick leave and in the signs of dysfunction during the follow-up year showed a tendency to covariation. Since there was little reason to suspect that the placebo effect would have been greater in the treatment group than in the control group, it was concluded that the occlusal treatment could have eliminated some of the causes for sick leaves.

Absenteeism↗
PubMed1999

Psychosocial correlates of long-term sick-leave among patients with musculoskeletal pain.

We studied the associations between psychosocial variables and sick-leave among patients with musculoskeletal pain. Patients (n = 586) seeking care to relieve their pain at health care and physiotherapy centres, completed a questionnaire about such variables as clinical characteristics (e.g. pain intensity), psychological well-being (e.g. burnout, depression) and coping strategies. The results show that the patients who had been on sick-leave for >30 days (n = 217), were significantly more often divorced, immigrants, blue-collar workers and less educated than the rest of the sample. Compared with the rest of the patients, they rated their pain as significantly more severe, frequent, complex and functionally impairing. They reported using more pain medication and tranquillizers, and having undergone more somatic treatments. These patients also showed higher scores on job strain, more symptoms of burnout, anxiety/depression and posttraumatic stress reactions, and poorer coping capacity. Logistic regression analyses revealed that an index related to perceived disability was a major predictor of sick-leave within the group. After controlling for possible confounders, multivariate regression analyses showed that the strongest predictors of the disability index were symptoms of burnout and posttraumatic stress reactions. The results confirm that emotional distress, coping style and perceived disability are associated with sick-leave, after controlling for pain parameters and sociodemographic variables. The high levels of emotional distress and the poor coping capacity reported by the patients with a long history of absence due to illness suggest that cognitive behavioural interventions ought to be integrated in the treatment of musculoskeletal pain.

Adaptation, Psychological↗
PubMed1997

Psychosocial characteristics of a group of males with ischemic heart disease and extended sick leave.

A number of studies have been published indicating that psychosocial distress provides a significant predictor for outcome and even mortality among post-myocardial infarction patients. In this study medical and psychosocial characteristics were examined in a group of males with ischemic heart disease (IHD) still on extended sick leave (23.4 months +/- 17.5) after a cardiac event compared with a matched control group with considerably shorter sick leave time (2.7 months +/- 0.8). Twelve men with IHD and extended sick leave were referred from the Regional Social Insurance Office and, after informed consent, were enrolled in the study. The matched controls were recruited from the Sahlgrenska University Hospitals out-patient Heart Clinic. The two groups underwent medical examination including estimation of ejection fraction and ergometer bicycle stress test. Blood samples were drawn for analysis of blood lipids. Psychosocial characteristics were studied by a self-administrative, reliable, valid and sensitive questionnaire. The two groups were comparable on matched variables. Significant differences were found between the groups concerning: memory, emotional control, sleeping habits, daily life, leisure time, sexual life, physical capacity and general health status. A factor analysis revealed an inferior functioning in the group with extended sick leave concerning the social, somatic, and control factor. It is concluded that differences in psychosocial characteristics are present in males with ischemic heart disease and with extended sick leave after a cardiac event, compared to a group with 'normal' sick leave time, suggestive of a need for further studies concerning these characteristics and an implementation of this knowledge in rehabilitation programmes.

Adaptation, Psychological↗
PubMed2006

Risk factors for sick leave due to musculoskeletal disorders among self-employed Dutch farmers: a case-control study.

BACKGROUND: In Dutch agriculture, musculoskeletal disorders are a main cause of sick leave. Among self-employed insured farmers, neck, shoulder, upper extremity, and back disorders accounted for 30% of the claims for sick leave of less than 1 year This case-control study set out to identify and quantify risk factors for sick leave due to musculoskeletal disorders among self-employed Dutch farmers. METHODS: Sick leave, claimed at an insurance company from 1998 to 2001 for back (SL-BP, n = 198) or neck/shoulder/upper extremity trouble (SL-EXT, n = 89) was analyzed; the controls did not file any claim in this period (n = 816). RESULTS: Multivariate analysis showed that risk factors for SL-BP were increased age (OR = 1.06 per year, CI = 1.04-1.09), body mass index (BMI) >27 (OR = 1.93, CI = 1.2-3.2), smoking (OR = 1.90, CI = 1.2-2.9), former pain (OR = 3.28, CI = 2.1-5.1), tractor driving >1,000 hr/year (OR = 2.44, CI = 1.0-6.4), and "high work pace and workload" (OR = 1.59, CI = 1.0-2.4). SL-EXT was associated with pig (OR = 3.63, CI = 1.4-9.7), mushroom (OR = 6.14, CI = 1.4-27.2), or dairy/pig farming (OR = 4.56, 1.1-19.5), while age (OR = 1.10, CI = 1.06-1.14), smoking (OR = 1.79, CI = 1.0-3.2), and former pain (OR = 3.37, CI = 1.9-6.1) were also contributing. CONCLUSIONS: Prevention of sick leave of self-employed farmers should focus on life style (obesity, smoking), reducing older farmers' exposure to physical load, exposure to long-term tractor driving. Specific attention should be paid to animal and mushroom farmers.

Adult↗
PubMed2002

High prevalence of obesity in asthmatic patients on sick leave.

Obesity and asthma are common chronic diseases in the industrialised world. The aim of the present study was to investigate a possible relationship between asthma and obesity among persons on sick leave due to respiratory disorder. The diagnosis of asthma (n = 237) was made in a three-stage model (questionnaire, telephone interview and clinical examination) in persons on sick leave due to any respiratory disorder. Persons on sick leave due to non-specific spinal pain, (n = 1231) and a general population sample (n = 5092) were used as references. Obesity (body mass index > 30 kg/m2) was found in 20.7% of the asthmatic patients on sick leave compared with 13.7% in the non-specific pain patients on sick leave and in 6.5% of the controls (P < 0.001). It is not clear whether the increased prevalence of obesity among asthmatics reflects a true increase in asthma in obese persons or whether asthma-like symptoms occur because of obesity. Weight reduction schemes and weight maintenance programmes should be important components in treatment and rehabilitation plans for persons with asthma.

Absenteeism↗
PubMed1992

Certified sick leave and work load. A case referent study among nurses.

A case-referent study assessed the association of medically certified sick leave from work with some occupational characteristics: hospital, care unit, and two work-load indices (patients' average length-of-stay, and nurse-patient ratio). Study participants were nurses from seven general hospitals in Quebec City, who had been employed for at least 6 months at the time of study. Cases (n = 1165) experienced at least one episode of medically certified sick leave between January 1, 1984 and May 31, 1987. Referents (n = 1165) were chosen from subjects who had no such leave and were matched to cases on the basis of dates on which sick leave occurred. Occupational data were collected from employment records and administrative files. Analysis was conducted using multiple logistic regression. Statistically significant associations were found between sick leave and one hospital, two care units, and nurse-patient ratio among head nurses. These odds ratios were independent of length of service in the hospital or in the actual job assignment. The study supports the pertinence of using certified sick leave as a nonspecific indicator of health outcomes.

Absenteeism↗
PubMed2000

The impact of pituitary adenoma on morbidity. Increased sick leave and disability retirement in a cross-sectional analysis of Swedish national data.

OBJECTIVE: To quantify sick leave and medical retirement for the year 1989 in adults with a history of nonsecreting pituitary adenoma. DESIGN AND SETTING: A cross-sectional analysis of official Swedish data from 1989 was performed. Sick leave and disability pension data for these patients were obtained from the Swedish National Social Insurance Board, which also supplied information on sick leave taken by an age- and gender-matched control population of 5121 individuals. Uptake of disability pensions and the reasons for drawing these pensions in the study group were compared with national statistics. STUDY POPULATION: A group of 809 eligible adults with nonsecreting pituitary adenoma was identified from the national cancer registry. MAIN OUTCOME MEASURES AND RESULTS: Almost a quarter of the patients with a history of pituitary adenoma had retired due to ill health (23.8%); this was twice the figure expected from national statistics (11.5%). Similar results were obtained when men and women were considered separately. Some patients (17%) had received disability pensions before the diagnosis of pituitary adenoma, but the majority (75%) retired on medical grounds at least 1 year after their diagnosis. The reasons for early retirement in the study group were largely related to the diagnosis of pituitary adenoma (e.g. neoplasm, endocrine disorders), but there was some evidence of an increase in the number of disability pensions awarded because of diseases of the nervous system and sensory organs. Patients with a history of pituitary adenoma took significantly more sick leave in 1989 than those in the control group (mean 40.2 vs 24.0 days), and this significant difference applied to both sexes. CONCLUSIONS: A cross-sectional analysis of Swedish national data from 1989 showed excess morbidity, relative to reference data, in patients with a history of nonsecreting pituitary adenoma. Suboptimal conventional hormone replacement therapy and untreated growth hormone deficiency might to some extent explain the increased morbidity found in the present study.

Adenoma↗
PubMed1998

Validity and reliability of self-reported retrospectively collected data on sick leave related to musculoskeletal diseases.

OBJECTIVES: The aim was to study the reliability and validity of retrospective data, collected by self-report, on sick leave related to musculoskeletal diseases. METHODS: The study groups consisted of 66 and 306 subjects, for the reliability and validity studies, respectively. They were all part of a wider study of risk factors for musculoskeletal disorders, the REBUS study, conducted in Stockholm in 1993. Reliability was tested using a test-retest design regarding self-reported sick leave related to musculoskeletal diseases in 1970-1993. The validity study comprised the period 1990-1994. Self-reported and registered sick-leave data related to musculoskeletal diseases were collected and analyzed regarding concordance. Data about current musculoskeletal disorders and different work-related conditions were collected and analyzed regarding possible effect- and exposure-dependent misclassification. RESULTS: The test-retest reliability study showed the percentage of agreement to be between 0.88 and 0.97, and the kappa values were between 0.73 and 0.93. The validity study of the concordance between the self-reported and registered data showed high agreement and specificity, but the sensitivity was sometimes lower. All the kappa values exceeded 0.50. No effect- or exposure-dependent misclassification was found. CONCLUSIONS: The validity of retrospectively collected self-reported sick-leave data was sufficient for use as a measure of musculoskeletal morbidity in the analyses of associations with work-related conditions. Because of the relatively low sensitivity, such data will underestimate the prevalence of sick leave and should not be used for surveys of morbidity.

Female↗
PubMed2006

Risk factors for new episodes of sick leave due to neck or back pain in a working population. A prospective study with an 18-month and a three-year follow-up.

OBJECTIVES: To identify risk factors for new episodes of sick leave due to neck or back pain. METHODS: This prospective study comprised an industrial population of 2187 employees who were followed up at 18 months and 3 years after a comprehensive baseline measurement. The potential risk factors comprised physical and psychosocial work factors, health-related and pain-related characteristics and lifestyle and demographic factors. The response rate at both follow-ups was close to 73%. RESULTS: At the 18-month follow-up, 151 participants reported at least one episode of sick-listing due to neck or back pain during the previous year. Risk factors assessed at baseline for sick leave due to neck or back pain at the follow-up were blue-collar work, back pain one or several times during the previous year, 1-99 days of cumulative sickness absence during the previous year (all causes except neck or back pain), uncertainty of one's own working ability in 2 years' time and the experience of few positive challenges at work. After 3 years, 127 participants reported at least one episode of sick leave due to back or neck pain during the year previous to follow-up. The risk factors for this pain-related sick leave were blue-collar work, several earlier episodes of neck pain, no everyday physical activities during leisure time (cleaning, gardening and so on), lower physical functioning and, for blue-collar workers separately, repetitive work procedures. CONCLUSION: The most consistent risk factors for new episodes of sick leave due to neck or back pain found during both the follow-ups were blue-collar work and several earlier episodes of neck or back pain assessed at baseline. Preventive efforts to decrease sick leave due to neck or back pain may include measures to increase the occurrence of positive challenges at work and to minimise repetitive work procedures. An evidence-based secondary prevention of neck and back pain including advice to stay active is also warranted.

Absenteeism↗
PubMed2006

Sick leave is related to frequencies of migraine and non-migrainous headache--The HUNT Study.

The aim of this large, cross-sectional, population-based study was to examine the association between sick leave and headache. Between 1995 and 1997, all 92 566 adults in Nord-Trøndelag County in Norway were invited to participate in a health survey. Out of 73 327 invited individuals <67 years old, a total of 38 192 (52%) responded to questions about headache, work situation and sick leave during the past year. Associations between sick leave, headache and migraine included were assessed in multivariate analyses, estimating prevalence odds ratios (ORs) with 95% confidence intervals (CIs). There was an increasing prevalence of sick leave with increasing frequency of migraine and non-migrainous headache. The prevalence of sick leave >8 weeks during the past year was more than three times higher among individuals with headache >14 days per month (20%) compared with those without headache (6%). The results may indicate that better treatment of individuals with chronic headache may have beneficial economic implications.

Adult↗
PubMed2003

Sick leave certification: a unique perspective on frequency and duration of episodes - a complete record of sickness certification in a defined population of employees in Malta.

BACKGROUND: In Malta, sickness certificates are needed from the first day of illness, and are issued by family physicians (FPs) either employed by the government primary health care system, self-employed in private practice, or employed by an employer for this purpose alone. The latter system, when applied by the employer, is compulsory. In order to contribute to the debate on the role of the FP in this context, electronic data collected by a group of company-employed FPs was used to study the phenomenon of sickness certification. This database is a complete record of the selected employees' sick leave certification during the study period. METHODS: Data collected by company-employed FPs from a defined population was used: all employees of selected Maltese companies served by a group of FPs. The database included episode-based data from home visits over three years (01/01/1997 - 31/12/1999), by 9 company-appointed FPs regarding 421 employees of five companies. RESULTS: 3015 episodes of sickness absenteeism, with an average duration of 2.9 days, were documented. Employees who did intensive manual work had relatively higher rates. Furthermore, a relatively higher incidence of work injury, sprains and strains, anxiety and depression and low back pain as found in manual workers, and in male workers. This trend was shown to be statistically significant. CONCLUSIONS: The frequency of sick-leave certification in Malta is comparable to that in other European countries, but the average duration of certificates is much less than reported in other studies that generally did not include data on short-term illness and certification. This has important implications on future research in the field. A number of common disorders were found to be significantly more prevalent causes of sickness certification in manual workers, amongst them anxiety and depression.

Absenteeism↗
PubMedDate not supplied

[Relationship of sick leave before treatment to severity of symptoms and treatment outcome in in-patients with anxiety disorders].

The aim of this study is to explore whether or not being already on sick leave at admission to a psychosomatic clinic indicates a higher level of severity of symptoms in patients with anxiety disorders, and whether or not this has an impact on therapy outcome. We examined 194 in-patients at 8 psychosomatic clinics upon admission and discharge by interview and psychometric testing. Being on sick leave before admission proved to be an indicator for higher global symptom distress as well as a higher severity of anxiety symptoms. Treatment duration was longer for the sick leave group than for the patients that had not been on sick leave, but each group experienced the same degree of change in pre-and-post treatment symptoms. We conclude that sick leave before admission does give information about illness severity and need of treatment in patients with anxiety disorders.

Adult↗
PubMed1998

Sick leave and disability pension among passenger car occupants injured in urban traffic.

STUDY DESIGN: A follow-up cohort study of passenger car occupants injured in car crashes in an urban area in Sweden. OBJECTIVES: To analyze the injuries, injury events, and long-term consequences of injuries in car crashes. SUMMARY OF BACKGROUND DATA: The consequences of car crashes usually are described in terms of the number of people injured, the severity of injuries, or the number of inpatient days. Certain types of crash injuries can results in long-term sick leave and granting of disability pension. The increased socioeconomic significance of these outcomes is not always indicated by analysis of commonly used variables. METHODS: Two hundred fifty-five passenger car occupants aged 16-64 years who were injured in car crashes in urban traffic were analyzed in terms of length of sick leave and receipt of disability pension. RESULTS: Strain of the cervical spine was the most common type of injury (55%, 141 injuries), and these injuries accounted for 82% of all sick leave taken within 2.5 years after the injury event. Injury to the cervical spine in 16 of 18 cases resulted in long-term sick leave or dependence on disability pension. The most common injury mechanism was rear-end collisions (39%). This type of crash resulted in 64% of all sick-leave days within 2.5 years after the injury event. Twelve out of 18 injured people on long-term sick leave or receiving disability pension had been in cars struck from behind. CONCLUSIONS: It is important to include long-term consequences in the form of sick leave and disability pension when describing the consequences of different types of car crashes and injuries.

Accidents, Traffic↗
PubMed2005

Health status, its perceptions, and effect on return to work and recurrent sick leave.

STUDY DESIGN: Prospective cohort study with 1-year follow-up. OBJECTIVES: The purpose of this study is to describe the improvement in several health outcomes during sick leave resulting from musculoskeletal disorders and in the first months after return to work (RTW), and to evaluate the personal and work-related factors associated with these health outcomes, in order to provide some insight in the timing of RTW. SUMMARY OF BACKGROUND DATA: Although improvements in pain perception and functional disability appear to be associated with time of RTW, little is known about the required improvement enabling RTW, the additional health improvement after RTW, and whether the health status at the time of RTW is associated with the probability of a recurrence of sick leave. METHODS: Workers were included when on sickness absence between 2 to 6 weeks due to musculoskeletal disorders. Self-administered questionnaires at baseline, after RTW, and at 12-month follow-up were used to collect information on changes in symptom status, functional status, and general health. RESULTS: All health outcomes were improved significantly at the time of RTW, whereas perceived pain, functional disability, and physical health also improved significantly in the first months after RTW. Previous sick leave 12 months before study entry was significantly associated with the level of functional disability and general health at time of RTW and also predictive for recurrence of sickness absence. Personal and work-related factors showed little, if any, association with health status at RTW and improvement thereafter. CONCLUSIONS: Being fully recovered is not a stipulation for regaining work activities. We hypothesize that workers with musculoskeletal disorders may need additional medical guidance shortly after RTW, especially those with a history of sick leave.

Adult↗
PubMed2002

Blind faith? The effects of promoting active sick leave for back pain patients: a cluster-randomized controlled trial.

STUDY DESIGN: A cluster-randomized controlled trial. OBJECTIVE: To evaluate the effects of two strategies to increase the use of active sick leave (ASL) among patients with low back pain (LBP) on improved return to work and quality of life. SUMMARY OF BACKGROUND DATA: Active sick leave is an option provided by the Norwegian National Insurance Administration that enables employees to return to modified duties at the workplace with 100% of normal wages. A proactive implementation strategy increased the use of ASL for LBP patients from 11.5% to 17.7% compared with a passive intervention and a control group ( = 0.006). METHODS: Sixty-five municipalities were randomly assigned to a passive intervention, a proactive intervention, or a control group. The interventions, which were designed to improve the use of ASL, were targeted at patients on sick leave for LBP for more than 16 days (n = 6179), their general practitioners, employers, and local insurance officers. The main outcome measures were the average number of days off work, the proportion of patients returning to work within 1 year, and self-reported quality of life while on sick leave. RESULTS: The median number of days on sick leave was similar in the proactive intervention group (70 days), the passive intervention group (68 days), and the control group (71 days) ( = 0.8). The proportion of patients returning to work before 50 weeks was also similar in the proactive (89%), passive (89.5%), and control groups (89.1%). Response rates for the questionnaires that were sent to patients were low (38%), and no significant differences were observed across the three groups for quality of life or patient satisfaction. CONCLUSIONS: It is not likely that efforts to increase the use of ASL will result in measurable economic benefits or improved health outcomes at the population level. The benefits of ASL for individual patients with LBP are not known.

Back Pain↗
PubMed1994

[Extension of sick leave for temporary work incapacity of oncology patients].

The paper deals with an analysis of the end results of extension of sick leaves for 558 cancer patients examined by the Oncological Commission of Medical Experts on Disability, Novosibirsk, in 1988-1991. Extension proved effective in 95.9 +/- 0.8%. The number of patients treated while on sick leave can be increased by the Commission decision with a view to giving them courses of chemotherapy. Such patients might work in between courses. Sick leave should be extended for patients with unclear prognosis and high motivation for work. Extension of sick leave rather than dismissal from work--because of disability, stage I, should be granted on humanitarian grounds to grave cases of incurable cancer.

Adult↗
PubMed2001

Influence of pregnancy-related diagnoses on sick-leave data in women aged 16-44.

Data on sickness absence frequently are used as a measure of morbidity and its social consequences in the employed population. The effects of sickness absence, as well as any possible differences in diagnoses among pregnant women as compared the sick leave data among the total population of women in fertile age have so far not been studied. The aim of this study was to investigate the relative contribution of pregnant women to the level of sickness absence, in general and in different diagnostic groups, as well as the extent to which sick-listed pregnant women can be identified through diagnoses on sickness certificates. In a cross-sectional study of all sick leave insured women aged 16-44 years (n = 24,481) in Linköping, Sweden (117,000 inhabitants), data from two population-based research registers were used, one of sickness absence for the whole population, one of sickness absence among pregnant women in the same population and year. Pregnant women (5%) had a significantly higher cumulative incidence of sickness absence (0.64) compared with all women (0.18) and accounted for 20% of the women listed as absent because of sickness. The duration of the sickness absence was also significantly longer among pregnant women, 44.8 days compared with 9.7 days among all women. Practically all diagnoses among pregnant women were related to pregnancy or back pain (93%). When using diagnoses on the sickness certificates, only 46% of all sick-listed pregnant women could be identified, suggesting methodological difficulties in studies on sickness absence. Studies on sickness absence among women of fertile age should also contain information on the proportion of sick-listed pregnant women, as a small proportion of pregnant women may have a deep impact on the results and conclusions among all women.

Adolescent↗
PubMed2006

The relationship of sick leave benefits, employment patterns, and individual characteristics to radiation therapy-related fatigue.

PURPOSE/OBJECTIVES: To examine the relationship among sick leave benefits, employment patterns, individual characteristics, and fatigue in patients receiving radiation therapy. DESIGN: Prospective, longitudinal design. SETTING: A community hospital radiation oncology department. SAMPLE: 77 patients receiving radiation therapy to the breast, chest, head and neck, pelvis, or prostate. All were employed at the time of diagnosis. METHODS: The Piper Integrated Fatigue Model guided the study. The Revised Piper Fatigue Scale (PFS), Brief Fatigue Inventory, and a single-item scale were used to measure five dimensions of subjective fatigue. Sick leave, employment, individual characteristics, and fatigue were measured at baseline, weekly during treatment, and at one month post-treatment. MAIN RESEARCH VARIABLES: Employment patterns, availability of sick leave benefits, and fatigue. FINDINGS: Mean total fatigue scores on the PFS ranged from 0-4.77 at baseline (mean = 0.46, SD = 0.93), 0-8.77 at the completion of treatment (mean = 2.84, SD = 2.40), and 0-4.82 at one month post-treatment (mean = 0.77, SD = 1.20). Side effects, education, living situation, age, treatment site, and work were associated with fatigue along the trajectory of radiation therapy. Study participants who were working at the end of radiation had lower fatigue scores than those who were not. Availability of sick leave benefits was associated with employment patterns during treatment. CONCLUSIONS: Work may have benefits during radiation therapy but may be affected by radiation therapy-related fatigue. IMPLICATIONS FOR NURSING: Management of treatment side effects, including fatigue, may help patients remain in the workforce during radiation.

Adult↗