Are environmental characteristics in the municipal eldercare, more closely associated with frequent short sick leave spells among employees than with total sick leave: a cross-sectional study

PubMed Central

2013-01-01

Background It has been suggested that frequent-, short-term sick leave is associated with work environment factors, whereas long-term sick leave is associated mainly with health factors. However, studies of the hypothesis of an association between a poor working environment and frequent short spells of sick leave are few and results are inconsistent. Therefore, we aimed to explore associations between self-reported psychosocial work factors and workplace-registered frequency and length of sick leave in the eldercare sector. Methods Employees from the municipal eldercare in Aarhus (N = 2,534) were included. In 2005, they responded to a work environment questionnaire. Sick leave records from 2005 were dichotomised into total sick leave days (0–14 and above 14 days) and into spell patterns (0–2 short, 3–9 short, and mixed spells and 1–3 long spells). Logistic regression models were used to analyse associations; adjusted for age, gender, occupation, and number of spells or sick leave length. Results The response rate was 76%; 96% of the respondents were women. Unfavourable mean scores in work pace, demands for hiding emotions, poor quality of leadership and bullying were best indicated by more than 14 sick leave days compared with 0–14 sick leave days. For work pace, the best indicator was a long-term sick leave pattern compared with a non-frequent short-term pattern. A frequent short-term sick leave pattern was a better indicator of emotional demands (1.62; 95% CI: 1.1-2.5) and role conflict (1.50; 95% CI: 1.2-1.9) than a short-term non-frequent pattern. Age (= < 40 / >40 years) statistically significantly modified the association between the 1–3 long-term sick leave spell pattern and commitment to the workplace compared with the 3–9 frequent short-term pattern. Conclusions Total sick leave length and a long-term sick leave spell pattern were just as good or even better indicators of unfavourable work factor scores than a frequent short-term sick leave pattern. Scores in commitment to the workplace and quality of leadership varied with sick leave pattern and age. Thus, different sick leave measures seem to be associated with different work environment factors. Further studies on these associations may inform interventions to improve occupational health care. PMID:23764253

Mood, anxiety, and alcohol use disorders and later cause-specific sick leave in young adult employees.

PubMed

Torvik, Fartein Ask; Reichborn-Kjennerud, Ted; Gjerde, Line C; Knudsen, Gun Peggy; Ystrom, Eivind; Tambs, Kristian; Røysamb, Espen; Østby, Kristian; Ørstavik, Ragnhild

2016-08-03

Mental disorders strongly influence work capability in young adults, but it is not clear which disorders that are most strongly associated with sick leave, and which diagnoses that are stated on the sick leave certificates. Better knowledge of the impairments associated with different mental disorders is needed for optimal planning of interventions and prioritization of health services. In the current study, we investigate the prospective associations between eight mood, anxiety, and alcohol use disorders, and later sick leave granted for mental, somatic, or any disorder. Lifetime mental disorders were assessed by structured diagnostic interviews in 2,178 young adults followed for eight years with registry data on sick leave. Relative risk ratios were estimated for the associations between each mental disorder and the different forms of sick leave. All included diagnoses were associated with later sick leave. In adjusted analyses, major depressive disorder and generalized anxiety disorder were the strongest predictors of sick leave granted for mental disorders, whereas social anxiety disorder and specific phobia were the strongest predictors of sick leave granted for somatic disorders. Specific phobia and major depressive disorder had the highest attributable fractions for all-cause sick leave. Mood and anxiety disorders constituted independent risk factors for all cause sick leave, whereas alcohol use disorders seemed to be of less importance in young adulthood. Disorders characterised by distress were most strongly associated with sick leave granted for mental disorders, whereas disorders characterised by fear primarily predicted sick leave granted for somatic conditions. A large part of all sick leave is related to specific phobia, due to the high prevalence of this disorder. The impairment associated with this common disorder may be under-acknowledged, and it could decrease work capacity among individuals with somatic disorders. This disorder has good treatment response and may be overlooked as a target for interventions aimed at prevention of sick leave.

Absence and leave; sick leave. Final rule.

PubMed

2010-12-03

The U.S. Office of Personnel Management is issuing final regulations on the use of sick leave and advanced sick leave for serious communicable diseases, including pandemic influenza when appropriate. We are also permitting employees to substitute up to 26 weeks of accrued or accumulated sick leave for unpaid Family and Medical Leave Act (FMLA) leave to care for a seriously injured or ill covered servicemember, as authorized under the National Defense Authorization Act for Fiscal Year 2008, including up to 30 days of advanced sick leave for this purpose. Finally, we are reorganizing the existing sick leave regulations to enhance reader understanding and administration of the program.

[Disability leave and sick leave in Spain. 2016 legislative update].

PubMed

Vicente-Herrero, María Teófila; Terradillos-García, María Jesús; Capdevila-García, Luisa M; Ramírez-Íñiguez de la Torre, María Victoria; Aguilar-Jiménez, Encarna; Aguado-Benedí, María José; López-González, Angel Arturo; Torres-Alberich, José Ignacio

2018-01-01

In Spanish, the concepts of discapacidad (disability leave) and incapacidad (sick leave) jointly refer to the impairment of a person due to injuries, diseases or deficiencies that limit their activity in a social, personal or occupational field. However, this common link does not imply that both concepts are the same. Statistical data from INE (Instituto Nacional de Estadística: Statistic National Institute) show that Spain had in 2015 3.85 million persons with a disability (59.8% were women). Statistical data from 2015 from INSS (Instituto Nacional de Seguridad Social: Social Security National Institute) show high levels in the number of processes and in workers affected by temporary sick leave, with social costs to the social security system. Both concepts have been updated: about disability leave, Law 39/2006 adjusted terminology by avoiding the use of concepts with discriminating or pejorative connotation. Regarding sick leave, the Ley General de Seguridad Social (General Social Security Law)has been amended and came into effect in January, 2016. It is necessary to know and distinguish these aspects for a better administrative management, and a more oriented information to the affected patient.

Sick Leave and Factors Influencing Sick Leave in Adult Patients with Atopic Dermatitis: A Cross-Sectional Study.

PubMed

van Os-Medendorp, Harmieke; Appelman-Noordermeer, Simone; Bruijnzeel-Koomen, Carla; de Bruin-Weller, Marjolein

2015-03-27

Little is known about the prevalence of sick leave due to atopic dermatitis (AD). The current literature on factors influencing sick leave is mostly derived from other chronic inflammatory diseases. This study aimed to determine the prevalence of sick leave due to AD and to identify influencing factors. A cross-sectional study was carried out in adult patients with AD. sick leave during the two-week and one-year periods, socio-demographic characteristics, disease severity, quality of life and socio-occupational factors. Logistic regression analyses were used to determine influencing factors on sick leave over the two-week period. In total, 253 patients were included; 12% of the patients had to take sick leave in the last two weeks due to AD and 42% in the past year. A higher level of symptom interference (OR 1.26; 95% CI 1.13-1.40) or perfectionism/diligence (OR 0.90; 95% CI 0.83-0.96) may respectively increase or decrease the number of sick leave days. Sick leave in patients with AD is a common problem and symptom interference and perfectionism/diligence appeared to influence it. Novel approaches are needed to deal with symptoms at work or school to reduce the amount of sick leave due to AD.

Structured functional assessments in general practice increased the use of part-time sick leave: a cluster randomised controlled trial.

PubMed

Osterås, Nina; Gulbrandsen, Pål; Kann, Inger Cathrine; Brage, Søren

2010-03-01

A method for structured functional assessments of persons with long-term sick leave was implemented in a cluster randomised controlled trial in general practice. The aim was to analyse intervention effects on general practitioner (GP) sick-listing practice and patient sick leave. 57 GPs were randomly assigned to an intervention or a control group. The intervention group GPs learned the method at a 1-day workshop including teamwork and role-playing. The control group GPs were requested to assess functional ability as usual during the 8 months intervention period in 2005. Outcome measures included duration of patient sick leave episodes, GP prescription of part-time sick leave, active sick leave, and vocational rehabilitation. This data was extracted from a national register. The GPs in the intervention group prescribed part-time sick leave more often (p < 0.01) and active sick leave less often (p = 0.04) than the control group GPs during the intervention period. There was no intervention effect on duration of patient sick leave episodes or on GP prescription of vocational rehabilitation. Implementing structured functional assessments in general practice made the GPs capable to assess functional ability of persons with long-term sick leave in a standardised and explicit manner. The intervention GPs' sick-listing practice was changed as they prescribed more part-time and less active sick leave compared to the control group GPs. As a result, more intervention GP patients returned to part-time work compared to control GP patients. No intervention effect was seen on duration of patient sick leave episodes or on prescription of vocational rehabilitation.

Sick leave patterns among 5-year cancer survivors: a registry-based retrospective cohort study.

PubMed

Torp, Steffen; Nielsen, Roy A; Gudbergsson, Sævar B; Fosså, Sophie D; Dahl, Alv A

2012-09-01

The aims of this study were to observe the sick leave rates of cancer survivors for five consecutive years following a first lifetime diagnosis of invasive cancer and to identify socio-demographic and clinical predictors of sick leave taken in the fifth year after diagnosis. This registry study comprised 2,008 Norwegian individuals (18-61 years old) with their first lifetime diagnosis of invasive cancer in 1999 and alive in 2004 and a cancer-free control group (n = 3,240) matched by sex, age, educational level, and employment status in 1998. Sick leave was defined as at least one sick leave period >16 days within the year in question. A total of 75 % of the long-term cancer survivors (LTCSs) took sick leave within the first 12 months after their diagnosis. The sick leave rate stabilized at a slightly higher level in the following 4 years compared to the year before diagnosis, with approximately 23 % of the male and 31 % of the female LTCSs taking sick leave. Being single with children, having low education, working in health and social work sector, or having taken sick leave the year before diagnosis (1998) predicted the sick leave taken 5 years after diagnosis (2004) among LTCSs. Compared to the controls, LTCSs with rectal, lymphogenic, breast, or "other" types of cancer had significantly higher sick leave rates 5 years after diagnosis. Socio-demographic factors explained more of the variance in sick leave than did clinical factors. Employed LTCSs struggle with their ability to work 5 years after diagnosis. More research is needed to identify factors that would promote LTCSs' health and ability. A socioeconomic and work environmental perspective seems necessary for achieving effective occupational rehabilitation and preventing sick leave among LTCSs.

Sick Leave and Factors Influencing Sick Leave in Adult Patients with Atopic Dermatitis: A Cross-Sectional Study

PubMed Central

van Os-Medendorp, Harmieke; Appelman-Noordermeer, Simone; Bruijnzeel-Koomen, Carla; de Bruin-Weller, Marjolein

2015-01-01

Background: Little is known about the prevalence of sick leave due to atopic dermatitis (AD). The current literature on factors influencing sick leave is mostly derived from other chronic inflammatory diseases. This study aimed to determine the prevalence of sick leave due to AD and to identify influencing factors. Methods: A cross-sectional study was carried out in adult patients with AD. Outcome measures: sick leave during the two-week and one-year periods, socio-demographic characteristics, disease severity, quality of life and socio-occupational factors. Logistic regression analyses were used to determine influencing factors on sick leave over the two-week period. Results: In total, 253 patients were included; 12% of the patients had to take sick leave in the last two weeks due to AD and 42% in the past year. A higher level of symptom interference (OR 1.26; 95% CI 1.13–1.40) or perfectionism/diligence (OR 0.90; 95% CI 0.83–0.96) may respectively increase or decrease the number of sick leave days. Conclusion: Sick leave in patients with AD is a common problem and symptom interference and perfectionism/diligence appeared to influence it. Novel approaches are needed to deal with symptoms at work or school to reduce the amount of sick leave due to AD. PMID:26239345

Sick-leave decisions for patients with severe subjective health complaints presenting in primary care: A cross-sectional study in Norway, Sweden, and Denmark

PubMed Central

2013-01-01

Abstract Objectives The primary objective of this study was to explore whether general practitioners (GPs) in Norway, Sweden, and Denmark make similar or different decisions regarding sick leave for patients with severe subjective health complaints (SHC). The secondary objective was to investigate if patient diagnoses, the reasons attributed for patient complaints, and GP demographics could explain variations in sick leave decisions. Design A cross-sectional study. Method Video vignettes of GP consultations with nine different patients. Subjects 126 GPs in Norway, Sweden, and Denmark. Setting Primary care in Norway, Sweden, and Denmark. Main outcome measure Sick leave decisions made by GPs. Results “Psychological” diagnoses in Sweden were related to lower odds ratio (OR) of granting sick leave than in Norway (OR = 0.07; 95% CI = 0.01–0.83) Assessments of patient health, the risk of deterioration, and their ability to work predicted sick leave decisions. Specialists in general medicine grant significantly fewer sick leaves than non-specialists. Conclusion Sick-leave decisions made by GPs in the three countries were relatively similar. However, Swedish GPs were more reluctant to grant sick leave for patients with “psychological” diagnoses. Assessments regarding health-related factors were more important than diagnoses in sick-leave decisions. Specialist training may be of importance for sick-leave decisions. PMID:24164371

Multiple transitions in sick leave, disability benefits, and return to work. - A 4-year follow-up of patients participating in a work-related rehabilitation program.

PubMed

Oyeflaten, Irene; Lie, Stein Atle; Ihlebæk, Camilla M; Eriksen, Hege R

2012-09-06

Return to work (RTW) after long-term sick leave can be a long-lasting process where the individual may shift between work and receiving different social security benefits, as well as between part-time and full-time work. This is a challenge in the assessment of RTW outcomes after rehabilitation interventions. The aim of this study was to analyse the probability for RTW, and the probabilities of transitions between different benefits during a 4-year follow-up, after participating in a work-related rehabilitation program. The sample consisted of 584 patients (66% females), mean age 44 years (sd = 9.3). Mean duration on various types of sick leave benefits at entry to the rehabilitation program was 9.3 months (sd = 3.4)]. The patients had mental (47%), musculoskeletal (46%), or other diagnoses (7%). Official national register data over a 4-year follow-up period was analysed. Extended statistical tools for multistate models were used to calculate transition probabilities between the following eight states; working, partial sick leave, full-time sick leave, medical rehabilitation, vocational rehabilitation, and disability pension; (partial, permanent and time-limited). During the follow-up there was an increased probability for working, a decreased probability for being on sick leave, and an increased probability for being on disability pension. The probability of RTW was not related to the work and benefit status at departure from the rehabilitation clinic. The patients had an average of 3.7 (range 0-18) transitions between work and the different benefits. The process of RTW or of receiving disability pension was complex, and may take several years, with multiple transitions between work and different benefits. Access to reliable register data and the use of a multistate RTW model, makes it possible to describe the developmental nature and the different levels of the recovery and disability process.

Multiple transitions in sick leave, disability benefits, and return to work. - A 4-year follow-up of patients participating in a work-related rehabilitation program

PubMed Central

2012-01-01

Background Return to work (RTW) after long-term sick leave can be a long-lasting process where the individual may shift between work and receiving different social security benefits, as well as between part-time and full-time work. This is a challenge in the assessment of RTW outcomes after rehabilitation interventions. The aim of this study was to analyse the probability for RTW, and the probabilities of transitions between different benefits during a 4-year follow-up, after participating in a work-related rehabilitation program. Methods The sample consisted of 584 patients (66% females), mean age 44 years (sd = 9.3). Mean duration on various types of sick leave benefits at entry to the rehabilitation program was 9.3 months (sd = 3.4)]. The patients had mental (47%), musculoskeletal (46%), or other diagnoses (7%). Official national register data over a 4-year follow-up period was analysed. Extended statistical tools for multistate models were used to calculate transition probabilities between the following eight states; working, partial sick leave, full-time sick leave, medical rehabilitation, vocational rehabilitation, and disability pension; (partial, permanent and time-limited). Results During the follow-up there was an increased probability for working, a decreased probability for being on sick leave, and an increased probability for being on disability pension. The probability of RTW was not related to the work and benefit status at departure from the rehabilitation clinic. The patients had an average of 3.7 (range 0–18) transitions between work and the different benefits. Conclusions The process of RTW or of receiving disability pension was complex, and may take several years, with multiple transitions between work and different benefits. Access to reliable register data and the use of a multistate RTW model, makes it possible to describe the developmental nature and the different levels of the recovery and disability process. PMID:22954254

Early Effects of the San Francisco Paid Sick Leave Policy

PubMed Central

Colla, Carrie H.; Dow, William H.; Dube, Arindrajit; Lovell, Vicky

2014-01-01

Objectives. We examined employers’ responses to San Francisco, California’s 2007 Paid Sick Leave Ordinance. Methods. We used the 2009 Bay Area Employer Health Benefits Survey to describe sick leave policy changes and the policy’s effects on firm (n = 699) operations. Results. The proportion of firms offering paid sick leave in San Francisco grew from 73% in 2006 to 91% in 2009, with large firms (99%) more likely to offer sick leave than are small firms (86%) in 2009. Most firms (57%) did not make any changes to their sick leave policy, although 17% made a major change to sick leave policy to comply with the law. Firms beginning to offer sick leave reported reductions in other benefits (39%), worse profitability (32%), and increases in prices (18%) but better employee morale (17%) and high support for the policy (71%). Many employers (58%) reported some difficulty understanding legal requirements, complying administratively, or reassigning work responsibilities. Conclusions. There was a substantial increase in paid sick leave coverage after the mandate. Employers reported some difficulties in complying with the law but supported the policy overall. PMID:24432927

Determinants of sick-leave duration: a tool for managers?

PubMed

Flach, Peter A; Krol, Boudien; Groothoff, Johan W

2008-09-01

To provide managers with tools to manage episodes of sick-leave of their employees, the influence of factors such as age, gender, duration of tenure, working full-time or part-time, cause and history of sick-leave, salary and education on sick-leave duration was studied. In a cross-sectional study, data derived from the 2005 sick-leave files of a Dutch university were examined. Odds ratios of the single risk factors were calculated for short spells (or=91 days) of sick-leave. Next, these factors were studied in multiple regression models. Age, gender, duration of employment, cause and history of sick-leave, salary and membership of scientific staff, studied as single factors, have a significant influence on sick-leave duration. In multiple models, this influence remains for gender, salary, age, and history and cause of sick-leave. Only in medium or long spells and regarding the risk for a long or an extended spell do the predictive values of models consisting of psychological factors, work-related factors, salary and gender become reasonable. The predictive value of the risk factors used in this study is limited, and varies with the duration of the sick-leave spell. Only the risk for an extended spell of sick-leave as compared to a medium or long spell is reasonably predicted. Factors contributing to this risk may be used as tools in decision-making.

Workers not Paid for Sick Leave after Implementation of the New York City Paid Sick Leave Law.

PubMed

Hall, Gerod Sharper; Walters, Sarah; Wimer, Christopher; Levanon Seligson, Amber; Maury, Matthew; Waldfogel, Jane; Gould, L Hannah; Lim, Sungwoo

2018-02-01

This study examined factors associated with being paid for sick leave after implementation of the New York City (NYC) paid sick leave law. A random sample of NYC residents was surveyed by telephone multiple times over a 2-year period. Participants (n = 1195) reported socio-demographics, awareness of the law, income, work hours per week, and payment for sick time off work. In the year after implementation of the law, part-time workers were significantly more likely to attend work while sick than full-time workers (relative risk = 1.25, 95% CI = 1.1, 1.4). Seventy percent of workers who missed work due to illness (n = 249) were paid for sick leave. Part-time workers, respondents not aware of the benefit (30% of workers), and workers without a college degree were the least likely to be paid for sick days. More than one third (37%) of persons not paid for sick leave worked in retail, food service, or health care. Although 70% of respondents were paid for sick leave after implementation of the law, part-time workers and workers with low education were least likely to access the benefit and more likely to work while sick. The disparity in paid sick leave may have public health consequences as many persons not paid for sick leave had occupations that carry a high risk of disease transmission to others.

Sick leave during pregnancy: a longitudinal study of rates and risk factors in a Norwegian population.

PubMed

Dørheim, S K; Bjorvatn, B; Eberhard-Gran, M

2013-04-01

To describe the prevalence of, reasons given for, and factors associated with sick leave during pregnancy. Longitudinal, population-based descriptive study. Akershus University Hospital, Norway. All women scheduled to give birth at the hospital (November 2008 to April 2010). Consenting women were handed a questionnaire at the routine ultrasound check at 17 weeks of gestation. Women returning this questionnaire received a second questionnaire at 32 weeks of gestation. Multiple logistic regression analyses were performed to examine associations with somatic, psychiatric and social factors. Rates and duration of sick leave. By 32 weeks of gestation, 63.2% of the 2918 women included were on sick leave, and 75.3% had been on sick leave at some point during their pregnancy. Pelvic girdle pain and fatigue/sleep problems were the main reasons given for sick leave. Being on sick leave in all trimesters was strongly associated with hyperemesis, exercising less than weekly, chronic pain before or during pregnancy, infertility treatment (all P < 0.001); younger maternal age, conflicts in the workplace (both P < 0.01); multiparity, previous depression, insomnia and lower education (all P < 0.05). Sick leave was associated with elective caesarean section and higher infant birthweight (P < 0.01). Adjustment of the work situation was associated with 1 week shorter duration of sick leave. Most women receive sick leave during pregnancy, but sick leave might not be caused by pregnancy alone. Previous medical and psychiatric history, work conditions and socio-economic factors need to be addressed to understand sick leave during pregnancy. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Parental availability for the care of sick children.

PubMed

Heymann, S J; Earle, A; Egleston, B

1996-08-01

Parents have always played a critical role in the care of sick children. Although parents' roles remain crucial to children's health, parental availability has declined during the past half century. The percentage of women with preschool children who work has risen almost fivefold in 45 years from 12% in 1947 to 58% in 1992. The percentage of women in the paid work force with school-aged children has almost tripled in the same period, from 27.3% to 75.9%. Research has examined the effects of a variety of parental work conditions on children. However, past research has not examined how working conditions affect the ability of parents to care for their sick children. In this article, we examine how often the children of working parents get sick and whether parents receive enough paid leave to care for their sick children. This analysis makes use of two national surveys, which provide complementary information regarding the care of sick children. The National Longitudinal Survey of Youth is a longitudinal survey of a nationally representative probability sample of 12,686 men and women; the National Medical Expenditure Survey is a panel survey of 34,459 people. First, we estimated the family illness burden. Second, we looked in detail at the number of days of sick leave mothers had. Third, we examined whether mothers who had sick leave had it consistently during a 5-year period. Finally, we conducted a logistic regression to determine what factors were significant predictors of both lacking sick leave. More than one in three families faced a family illness burden of 2 weeks or more each year. Yet, 28% of mothers had sick leave none of the time they were employed between 1985 and 1990. Employed mothers of children with chronic conditions had less sick leave than other employed mothers. Thirty-six percent of mothers whose children had chronic conditions had sick leave none of the time they were employed. Although 20% of working parents who did not live in poverty lacked sick leave, 38% of parents who did live in poverty lacked sick leave. The problem is also more marked for nonwhite parents. Although 23% of working white parents lacked paid sick leave, 31% of nonwhite parents lacked sick leave. One in six families that lacked sick leave had to cover for more than 4 weeks of family illness during the year. In 1993, the US Congress passed the Family and Medical Leave Act (FMLA). However, by limiting the medical leave to the care of major illnesses, primarily those requiring hospitalization, the FMLA does not address the majority of children's sick care needs. For the common childhood illnesses that are not covered by the FMLA, employed parents often must rely on their sick leave if they are to care for their sick children themselves. Yet, we found that many employed parents lack sick leave. This is particularly true of parents of children with chronic conditions and poor and minority families.

Sick leave before and after the age of 65 years among those in paid work in Sweden in 2000 or 2005: a register-based cohort study.

PubMed

Farrants, Kristin; Kjeldgård, Linnea; Marklund, Staffan; Head, Jenny; Alexanderson, Kristina

2018-02-01

Objective With pressure for older people to remain in work, research is needed on how people aged over 65 years fare in the labour market. However, few studies have focused on sick leave among older workers, especially those over the standard retirement age. This study investigated changes in sick-leave patterns among people aged over 65 years still in work. Methods All individuals in Sweden who turned 65 years old in 2000 or 2005 were followed from 1995 to 2010. The mean number of sick-leave days per year was measured for those who remained in paid work past the age of 65 years. Results Those over 65 years still working had fewer sick-leave days before the age of 65 years than those who retired. They also had fewer sick-leave days after 65 years than before. There were fewer socioeconomic differences after 65 years than before, but these differences were greater for workers over 65 years in the 2005 cohort. Conclusions Although there were more people over 65 years in paid work in 2005, sick-leave days and socioeconomic differences in sick leave were lower in this age group. Sick-leave days and socioeconomic differences in sick leave were greater in the 2005 cohort.

Swedish Council on Technology Assessment in Health Care (SBU). Chapter 6. Sickness absence due to back and neck disorders.

PubMed

Hansson, Tommy; Jensen, Irene

2004-01-01

The scientific evidence on the causes for sick leave attributed to back and neck disorders was reviewed. Categories were established for acute, recurring, and chronic problems based on the duration of the sick leave period. Forty-eight articles were found to be relevant, whereof two were of high quality and 26 were of medium or low quality. Quality was assessed exclusively in relation to the aim of this systematic review. The results reveal limited published research on causes for sick leave from back and neck disorders. The generalisability of the findings is also limited since most of the subjects were men and employees in manufacturing industries. Women, white-collar workers, employees in the public sector (care, social services, schools, etc) were underrepresented in the studies. Hence, these groups and areas should be studied further to verify conclusions and enhance knowledge about the causes for sick leave from back and neck disorders. The following factors were found to have consistent, but limited, support as regards their influence on the risk for sick leave due to back and neck disorders: (a) heavy physical workload, bent or twisted working position, and low work satisfaction increases the risk for short-term and long-term sick leave; (b) specific back diagnoses and previous sick leave due to back disorders increases the risk for short-term and long-term sick leave; (c) female gender, smoking, exposure to vibration, and deficient social support were not found to significantly increase the risk for short-term and long-term sick leave; (d) self-reported pain and functional impairments were associated with a high risk for long-term sick leave; (e) longer employment periods reduced the risk for short-term sick leave; (f) perceived demands at work did not influence short-term sick leave; (g) female gender and higher age increases the risk for disability pension.

Occupational injuries and sick leaves in household moving works.

PubMed

Hwan Park, Myoung; Jeong, Byung Yong

2017-09-01

This study is concerned with household moving works and the characteristics of occupational injuries and sick leaves in each step of the moving process. Accident data for 392 occupational accidents were categorized by the moving processes in which the accidents occurred, and possible incidents and sick leaves were assessed for each moving process and hazard factor. Accidents occurring during specific moving processes showed different characteristics depending on the type of accident and agency of accidents. The most critical form in the level of risk management was falls from a height in the 'lifting by ladder truck' process. Incidents ranked as a 'High' level of risk management were in the forms of slips, being struck by objects and musculoskeletal disorders in the 'manual materials handling' process. Also, falls in 'loading/unloading', being struck by objects during 'lifting by ladder truck' and driving accidents in the process of 'transport' were ranked 'High'. The findings of this study can be used to develop more effective accident prevention policy reflecting different circumstances and conditions to reduce occupational accidents in household moving works.

[Teacher sick leave: Prevalence, duration, reasons and covariates].

PubMed

Vercambre-Jacquot, M-N; Gilbert, F; Billaudeau, N

2018-02-01

Absences from work have considerable social and economic impact. In the education sector, the phenomenon is particularly worrying since teacher sick leave has an impact on the overall performance of the education system. Yet, available data are scarce. In April-June 2013, 2653 teachers responded to a population-based postal survey on their quality of life (enquête Qualité de vie des enseignants, MGEN Foundation/Ministry of education, response rate 53 %). Besides questions on work environment and health, teachers were asked to describe their eventual sick leave(s) since the beginning of the school year: duration, type and medical reasons. Self-reported information was reinforced by administrative data from ministerial databases and weighted to be extrapolated to all French teachers. Tobit models adjusted for individual factors of a private nature were used to investigate different occupational risk factors of teacher sick leave, taking into account both the estimated effect on the probability of sick leave and the length of it. More than one in three teachers (36 %) reported having had at least one day of sick leave since the beginning of the school year. Respiratory/ENT diseases were the leading reason for sick leave (37 %). However, and because sick leave duration depended on the underlying health problem, such diseases came in third place among justifications of sick leave days (14 %), far behind musculoskeletal problems (27 %) and neurological and psychological disorders (25 %). Tobit models suggested that some occupational factors significantly associated with the risk of sick leave may represent promising preventive targets, including high psychological demand, workplace violence and unfavorable socio-environmental context. Our study provides objective evidence about the issue of sick leave among French teachers, highlighting the usefulness of implementing actions to minimize its weight. To this end, the study findings point-out the importance of considering not only the probability of sick leave, but also its duration. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Sick leave patterns as predictors of disability pension or long-term sick leave: a 6.75-year follow-up study in municipal eldercare workers

PubMed Central

Stapelfeldt, Christina Malmose; Nielsen, Claus Vinther; Andersen, Niels Trolle; Krane, Line; Borg, Vilhelm; Fleten, Nils; Jensen, Chris

2014-01-01

Objectives The aim was to study whether a workplace-registered frequent short-term sick leave spell pattern was an early indicator of future disability pension or future long-term sick leave among municipal eldercare workers. Setting The municipal healthcare sector in the city of Aarhus, which is the second largest city in Denmark. Participants All elder care employees who worked the entire year of 2004 in the municipality of Aarhus, Denmark (N=2774). The employees’ sick leave days during 2004 were categorised into: 0–2 and 3–17 short (1–7 days) spells, 2–13 mixed short and long (8+ days) spells and long spells only. Student workers (n=180), employees who were absent due to maternal/paternal leave (n=536) and employees who did not work the entire year of 2004 (n=1218) were not included. Primary outcome Disability pension and long-term sick leave (≥8 weeks) were subsequently identified in a National register. The cumulative incidence proportion as a function of follow-up weeks was estimated using the Kaplan-Meier curve. The relative cumulative incidence (RR) of experiencing events within 352 weeks was analysed in a generalised linear regression model using the pseudo values method adjusted for age, occupation, unfavourable work factors and sick leave length. Results A frequent short-term and a mixed sick leave pattern showed RRs of being granted a disability pension of 2.08 (95% CI 1.00 to 4.35) and 2.61 (95% CI 1.33 to 5.12) compared with 0–2 short spells. The risk of long-term sick leave was significantly increased for all sick leave patterns compared with 0–2 short spells. Adding sick leave length to the models attenuated all RRs and they became non-significant. Conclusions Sick leave length was a better indicator of future workability than spell frequency. Preventive actions should target employees engaged in homecare. The more sick leave days the greater the preventive potential seems, irrespective of spell frequency. PMID:24508850

The association between body mass index status and sick leave and the role of emotional exhaustion-a mediation analysis among a representative sample of dutch employees.

PubMed

Proper, Karin I; Koppes, Lando L J; Meijer, Sanne; Bemelmans, Wanda J E

2013-10-01

To investigate the associations between body mass index (BMI) and sick leave, and the mediating role of emotional exhaustion. Data were collected from a large survey among Dutch employees (n = 35,022). The causal pathway approach consisting of four regression analyses was applied. In women, moderate overweight and obesity were associated with higher sick leave; in men, obesity, but not moderate overweight, was associated with higher sick leave. Obese workers were at increased risk for emotional exhaustion. Emotional exhaustion was also associated with higher sick leave rates. Adjustment for emotional exhaustion in the association between BMI and sick leave hardly changed the effect size and significance remained. The association between BMI status and sick leave can be explained partially by the presence of emotional exhaustion. Workplace health promotion initiatives should take this into account.

Methods of Reducing Sick Leave Abuse. An ERS Information Aid.

ERIC Educational Resources Information Center

Stemnock, Suzanne K.

A perennial concern to educational administrators is the abuse of sick leave by school employees. Numerous suggestions have been offered for reducing the abuse of sick leave both within education and industry. This publication reviews 12 research studies that evaluate plans for reducing sick leave abuse among various categories of employees. Also…

Sickness absence due to otoaudiological diagnoses and risk of disability pension: a nationwide Swedish prospective cohort study.

PubMed

Friberg, Emilie; Jansson, Catarina; Mittendorfer-Rutz, Ellenor; Rosenhall, Ulf; Alexanderson, Kristina

2012-01-01

Hearing difficulties are a large public health problem. Knowledge is scarce regarding risk of disability pension among people who have been sickness absent due to these difficulties. A cohort including all 4,687,756 individuals living in Sweden in 2005, aged 20-64, and not on disability or old-age pension, was followed through 2009. Incidence rate ratios (RR) of disability pension with 95% confidence intervals (CI) were estimated using Cox proportional hazard models. In multivariable models, individuals who had a sick-leave spell due to otoaudiological diagnoses in 2005 had a 1.52-fold (95% CI: 1.43-1.62) increased risk of being granted a disability pension compared to individuals on sick leave due to other diagnoses. Hearing and tinnitus sick-leave diagnoses were associated with risk of disability pension: RR 3.38, 95% CI: 3.04-3.75, and 3.30, 95% CI: 2.95-3.68, respectively. No association was observed between sick leave due to vertigo diagnoses and disability pension whereas otological diagnoses and no sick leave were inversely associated with risk of disability pension compared to non-otoaudiological sick-leave diagnoses. Sick leave due to otoaudiological diagnoses was positively associated with risk of disability pension due to otoaudiological diagnoses and sick leave due to a tinnitus diagnosis was also associated with risk of disability pension due to mental diagnoses. The risk of disability pension among individuals with hearing or tinnitus sick-leave diagnoses was highest in the age group 35-44. Moreover, men had a slightly higher risk. This large cohort study suggests an increased risk of disability pension among those with sickness absence due to otoaudiological diagnoses, particularly hearing and tinnitus diagnoses, compared to those with sickness absence due to non-otoaudiological diagnoses.

Adverse outcomes of sick leave due to mental disorders: A prospective study of discordant twin pairs.

PubMed

Mather, Lisa; Blom, Victoria; Bergström, Gunnar; Svedberg, Pia

2017-10-01

The aim of this study was to investigate whether sick leave due to different mental disorders increased the risk of reoccurring sick-leave, disability pension and unemployment, taking genetics and shared environment into account. This register-based cohort study contains 2202 discordant twin pairs 18-64 years old, where one twin had sick leave due to a mental disorder 2005-2006. The end of the sick-leave spell was the start of follow-up for both twins. The twins were followed up for reoccurring sick-leave, disability pension and unemployment (> 180 days in a year), until December 2012. Analyses were censored for disability pension, death, emigration and old-age pension. Cox proportional hazards models with time-varying covariates were used to calculate hazard ratios with 95% confidence intervals (CI). Those with sick leave due to mental disorders had a 3.64 (CI: 3.24-4.08) times higher risk of reoccurring sick-leave within the first two years; after that, hazard ratios were attenuated and explained by genetic factors. The first year, they had 12.24 (CI: 8.11-18.46) times the risk of disability pension. The risk was attenuated but remained at 2.75 (CI: 2.07-3.65) after one year. The risk of unemployment was 1.99 (CI: 1.72-2.31) during the whole follow-up period. The risk of unemployment and disability pension was lower for those with stress-related than other mental disorders, this was less clear for recurrent reoccuring sick-leave. Sick leave due to mental disorders increased the risk of reoccurring sick-leave within two years, disability pension and unemployment, independent of genetics and shared environment.

Decisions on sick leave certifications for acute airways infections based on vignettes: A cross-sectional survey of GPs in Norway and Poland

PubMed Central

Halvorsen, Peder A.; Wennevold, Katrine; Fleten, Nils; Muras, Magdalena; Kowalczyk, Anna; Godycki-Cwirko, Maciek; Melbye, Hasse

2011-01-01

Objective To explore whether frequency and duration of sick-leave certification for acute airway infections differ between general practitioners (GPs) in Poland and Norway. Design Cross-sectional survey. Setting Educational courses for GPs. Intervention We used a questionnaire with four vignettes presenting patients with symptoms consistent with pneumonia, sinusitis, common cold, and exacerbation of chronic obstructive pulmonary disease (COPD), respectively. For each vignette GPs were asked whether they would offer a sick-leave note, and if so, for how many days. Subjects Convenience samples of GPs in Poland (n = 216) and Norway (n = 171). Main outcome measures Proportion of GPs offering a sick-leave certificate. Duration of sick-leave certification. Results In Poland 100%, 95%, 87%, and 94% of GPs would offer sick leave for pneumonia, sinusitis, common cold, and exacerbation of COPD, respectively. Corresponding figures in Norway were 97%, 83%, 60%, and 90%. Regression analysis adjusting for the GPs' sex, speciality, experience, and workload indicated that relative risks for offering sick leave (Poland versus Norway) were 1.16 (95% CI 1.07–1.26) for sinusitis and 1.50 (1.28–1.75) for common cold. Among GPs who offered sick leave for pneumonia, sinusitis, common cold, and exacerbation of COPD, mean duration was 8.9, 7.5, 5.1, and 6.9 days (Poland) versus 6.6, 4.3, 3.1, and 6.1 days (Norway), respectively. In regression analyses the differences between the Polish and Norwegian samples in duration of sick leave were statistically significant for all vignettes. A pattern of offering sick leave for three, five, seven, 10, or 14 days was observed in both countries. Conclusion In the Polish sample GPs were more likely to offer sick-leave notes for sinusitis and common cold. GPs in Poland offered sick leaves of longer duration for pneumonia, sinusitis, common colds, and exacerbation of COPD compared with GPs in the Norwegian sample. PMID:21323635

The association between pelvic girdle pain and sick leave during pregnancy; a retrospective study of a Norwegian population.

PubMed

Malmqvist, Stefan; Kjaermann, Inger; Andersen, Knut; Økland, Inger; Larsen, Jan Petter; Brønnick, Kolbjørn

2015-10-05

The incidence of pelvic girdle pain (PGP) in pregnancy is wide ranged depending on definition, the utilised diagnostic means, and the design of the studies. PGP during pregnancy has negative effects on activities of daily living and causes long sick leave, which makes it a major public health issue. Our objectives were to explore the frequency of sick leave in pregnancy due to PGP, assess the relationship between different types of pain-related activities of daily living, examine physical workload, type of work in relation to sick leave, and to explore factors that make women less likely to take sick leave for PGP. All women giving birth at the maternity ward of Stavanger University Hospital, Norway, were asked to participate and complete a questionnaire on demographic features, PGP, pain-related activities of daily living, sick leave in general and for PGP, frequency of exercising before and during pregnancy. Drawings of pelvic girdle and low back area were used for the localization of pain. PGP intensity was then rated retrospectively on a numerical rating scale. Non-parametric tests, multinomial logistic regression and sequential linear regression analysis were used in the statistical analysis. PGP is a frequent and major cause of sick leave during pregnancy among Norwegian women, which is also reflected in activities of daily living as measured with scores on all Oswestry disability index items. In the multivariate analysis of factors related to sick leave and PGP we found that work satisfaction, problems with lifting and sleeping, and pain intensity were risk factors for sick leave. In addition, women with longer education, higher work satisfaction and fewer problems with sitting, walking and standing, were less likely to take sick leave in pregnancy, despite the same pain intensity as women being on sick leave. A coping factor in pregnant women with PGP was discovered, most likely dependant on education, associated with work situation and/or work posture, which decreases sick leave. We recommend these issues to be further examined in a prospective longitudinal study since it may have important implications for sick leave frequency during pregnancy.

[Costs and sick leave due to chikungunya in the Instituto Mexicano del Seguro Social in Guerrero, Mexico].

PubMed

Vázquez-Cruz, Irene; Juanico-Morales, Guillermina; Sánchez-Ramos, Apolinar; Morales-Sánchez, Ofelia de Jesúis

2018-01-01

Chikungunya fever (CHIK) generally causes temporary sick leave, affecting groups of productive age, which represents a significant economic impact from the labor point of view. The objective was to estimate costs of disability due to chikungunya in the Instituto Mexicano del Seguro Social (IMSS) in Guerrero, Mexico. Cost assessment of working population from IMSS in Guerrero who met the definition of case for CHIK and took sick leave, which was registered in the Original Disability Certificates (OCI, according to its initials in Spanish) processed from January to April, 2015. Paid sick days were multiplied by the current minimum wage of the municipality of Acapulco (geographical area A, general = $ 70.10: seventy pesos with 10 cents per day]). Of all the OCIs, 31.5% (38 271/12 062) met the criteria for CHIK with a total of 41 197 prescribed days and 14 941 paid sick days with an estimated cost of 2 397 393.40 pesos (two million, three hundred and ninety seven thousand, three hundred and ninety three dollars and forty cents). Sick leaves increase the costs in health systems. These costs increase as increases the number of days granted. The average number of days granted is consistent with the information published in different articles.

Subjective health complaints, functional ability, fear avoidance beliefs, and days on sickness benefits after work rehabilitation - a mediation model.

PubMed

Øyeflaten, Irene; Opsahl, Jon; Eriksen, Hege R; Braathen, Tore Norendal; Lie, Stein Atle; Brage, Søren; Ihlebæk, Camilla M; Breivik, Kyrre

2016-05-23

Long-term sick leave and withdrawal from working life is a concern in western countries. In Norway, comprehensive inpatient work rehabilitation may be offered to sick listed individuals at risk of long-term absence from work. Knowledge about prognostic factors for work outcomes after long-term sick leave and work rehabilitation is still limited. The aim of this study was to test a mediation model for various hypothesized biopsychosocial predictors of continued sick leave after inpatient work rehabilitation. One thousand one hundred fifty-five participants on long-term sick leave from eight different work rehabilitation clinics answered comprehensive questionnaires at arrival to the clinic, and were followed with official register data on sickness benefits for 3 years. Structural equation models were conducted, with days on sickness benefits after work rehabilitation as the outcome. Fear avoidance beliefs for work mediated the relation between both musculoskeletal complaints and education on days on sickness benefits after work rehabilitation. The relation between musculoskeletal complaints and fear avoidance beliefs for work was furthermore fully mediated by poor physical function. Previous sick leave had a strong independent effect on continued sick leave after work rehabilitation. Fear avoidance beliefs for work did not mediate the small effect of pseudoneurological complaints on continued sick leave. Poor coping/interaction ability was neither related to continued sick leave nor fear avoidance beliefs for work. The mediation model was partly supported by the data, and provides some possible new insight into how fear avoidance beliefs for work and functional ability may intervene with subjective health complaints and days on sickness benefits after work rehabilitation.

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

PubMed

Kaerlev, Linda; Jacobsen, Lene B; Olsen, Jørn; Bonde, Jens Peter

2004-01-01

The authors sought to describe risk indicators of long-term sick leave during pregnancy among hospital employees. 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%). 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. 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.

Psychosocial and organizational risk factors for doctor-certified sick leave: a prospective study of female health and social workers in Norway.

PubMed

Aagestad, Cecilie; Tyssen, Reidar; Johannessen, Håkon A; Gravseth, Hans Magne; Tynes, Tore; Sterud, Tom

2014-09-29

Doctor-certified sick leave differs substantially across sectors, and among health and social workers, in particular, there is an increased risk. Previous studies have shown that work environmental factors contribute to sick leave. Hence, the identification of specific organizational and psychosocial risk factors for long- term sick leave, taking into account potential confounding related to mechanical risk factors such as lifting and awkward body postures, will be of importance in the work of prevention. A randomly drawn population sample of Norwegian residents was interviewed about working conditions in 2009 (n = 12,255; response rate 60.9%). Female health and social care workers (n = 925) were followed in a national registry for subsequent sickness absence during 2010. The outcome of interest was doctor-certified sick leave of 21 days or more (long-term sick leave). Eleven work-related psychosocial and organizational factors were evaluated. In total, 186 persons (20.1%) were classified with subsequent long-term sick leave. After thoroughly adjusting for competing explanatory variables, the most consistent predictors for long-term sick leave were violence and threats of violence (OR = 1.67; 95% CI 1.14-2.45). The estimated population attributable risk for violence and threats of violence was 13%. The present study among female health and social care workers revealed a substantial relationship between self-reported violence and threats of violence and subsequent long- term sick leave.

Changes in sick-leave diagnoses over eleven years in a cohort of young adults initially sick-listed due to low back, neck, or shoulder diagnoses.

PubMed

Festin, Karin; Alexanderson, Kristina

2009-05-01

To study future general and diagnoses-specific sickness absence and disability pension among young adults who were initially on long-term sick-leave due to back, neck, or shoulder diagnoses. Eleven-year prospective cohort study. All 213 adults in a Swedish municipality who, in 1985, were in the age range 25-34 years and had begun a spell of sick-leave lasting > or = 28 days with low back, neck, or shoulder diagnoses. For the time-period 1985-96, data regarding the dates and diagnoses for all periods of sick-leave, and the dates of disability pension, emigration, and death were obtained. Numbers of days of sick-leave and disability pension were analysed separately for each of the 11 years in relation to the number of days at risk for such benefits. The cohort members were on sick-leave or disability pension for 25% of all days at risk during the 11 years of follow-up. A large difference in the number of sick-leave days between the 22% of subjects who were later granted disability pension and the others was already apparent during the first 2 years. During the entire period, up to 21% of the sick-leave days for women and 24% for men entailed psychiatric diagnoses. This cohort of young adults, initially off sick for 4 weeks due to back, neck, or shoulder diagnoses, also had a high level of sickness absence in the subsequent 11 years with other diagnoses.

Office design's impact on sick leave rates.

PubMed

Bodin Danielsson, Christina; Chungkham, Holendro Singh; Wulff, Cornelia; Westerlund, Hugo

2014-01-01

The effect of office type on sickness absence among office employees was studied prospectively in 1852 employees working in (1) cell-offices; (2) shared-room offices; (3) small, (4) medium-sized and (5) large open-plan offices; (6) flex-offices and (7) combi-offices. Sick leaves were self-reported two years later as number of (a) short and (b) long (medically certified) sick leave spells as well as (c) total number of sick leave days. Multivariate logistic regression analysis was used, with adjustment for background factors. A significant excess risk for sickness absence was found only in terms of short sick leave spells in the three open-plan offices. In the gender separate analysis, this remained for women, whereas men had a significantly increased risk in flex-offices. For long sick leave spells, a significantly higher risk was found among women in large open-plan offices and for total number of sick days among men in flex-offices. A prospective study of the office environment's effect on employees is motivated by the high rates of sick leaves in the workforce. The results indicate differences between office types, depending on the number of people sharing workspace and the opportunity to exert personal control as influenced by the features that define the office types.

Benefits and Harms of Sick Leave: Lack of Randomized, Controlled Trials

ERIC Educational Resources Information Center

Axelsson, Inge; Marnetoft, Sven-Uno

2010-01-01

The aim of this study was to try to identify those randomized controlled trials that compare sick leave with no sick leave or a different duration or degree of sick leave. A comprehensive, systematic, electronic search of Clinical Evidence, the Cochrane Library and PubMed, and a manual search of the Campbell Library and a journal supplement was…

Paid Sick Leave and Nonfatal Occupational Injuries

PubMed Central

Pana-Cryan, Regina; Rosa, Roger

2012-01-01

Objectives. We examined the association between US workers’ access to paid sick leave and the incidence of nonfatal occupational injuries from the employer’s perspective. We also examined this association in different industries and occupations. Methods. We developed a theoretical framework to examine the business value of offering paid sick leave. Data from the National Health Interview Survey were used to test the hypothesis that offering paid sick leave is associated with a reduced incidence of occupational injuries. We used data on approximately 38 000 working adults to estimate a multivariate model. Results. With all other variables held constant, workers with access to paid sick leave were 28% (95% confidence interval = 0.52, 0.99) less likely than workers without access to paid sick leave to be injured. The association between the availability of paid sick leave and the incidence of occupational injuries varied across sectors and occupations, with the greatest differences occurring in high-risk sectors and occupations. Conclusions. Our findings suggest that, similar to other investments in worker safety and health, introducing or expanding paid sick leave programs might help businesses reduce the incidence of nonfatal occupational injuries, particularly in high-risk sectors and occupations. PMID:22720767

[Risk factors for absenteeism due to sick leave in the petroleum industry].

PubMed

Oenning, Nágila Soares Xavier; Carvalho, Fernando Martins; Lima, Veronica Maria Cadena

2014-02-01

To identify risk factors for absenteeism among workers with sick leave in an oil company. A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave. To identify risk factors for absenteeism among workers with sick leave in an oil company. A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave.

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

PubMed

Folgerø, I S; Larsen, S

1991-09-10

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.

Age-, sex-, and diagnosis-specific incidence rate of medically certified long-term sick leave among private sector employees: The Japan Epidemiology Collaboration on Occupational Health (J-ECOH) study.

PubMed

Nishiura, Chihiro; Nanri, Akiko; Kashino, Ikuko; Hori, Ai; Kinugawa, Chihiro; Endo, Motoki; Kato, Noritada; Tomizawa, Aki; Uehara, Akihiko; Yamamoto, Makoto; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Imai, Teppei; Okino, Akiko; Miyamoto, Toshiaki; Sasaki, Naoko; Tomita, Kentaro; Nagahama, Satsue; Kochi, Takeshi; Eguchi, Masafumi; Okazaki, Hiroko; Murakami, Taizo; Shimizu, Chii; Shimizu, Makiko; Kabe, Isamu; Mizoue, Tetsuya; Sone, Tomofumi; Dohi, Seitaro

2017-12-01

Long-term sick-leave is a major public health problem, but data on its incidence in Japan are scarce. We aimed to present reference data for long-term sick-leave among private sector employees in Japan. The study population comprised employees of 12 companies that participated in the Japan Epidemiology Collaboration on Occupational Health Study. Details on medically certified sick-leave lasting ≥30 days were collected from each company. Age- and sex-specific incidence rate of sick-leave was calculated for the period of April 2012 to March 2014. A total of 1422 spells in men and 289 in women occurred during 162,989 and 30,645 person-years of observation, respectively. The three leading causes of sick-leave (percentage of total spells) were mental disorders (52%), neoplasms (12%), and injury (8%) for men; and mental disorders (35%), neoplasms (20%), and pregnancy-related disease (14%) for women. Incidence rate of sick-leave due to mental disorders was relatively high among men in their 20s-40s but tended to decrease with age among women. Incidence rate of sick-leave due to neoplasms started to increase after age 50 in men and after age 40 in women, making neoplasms the leading cause of sick-leave after age 50 for women and after age 60 for men and the second leading cause after age 40 for women and after age 50 for men. Pregnancy-related disease was the second leading cause of sick-leave among women aged 20-39 years. These results suggest that mental disorder, neoplasms, and pregnancy-related disease are the major causes of long-term sick-leave among private sector employees in Japan. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Early identification in primary health care of people at risk for sick leave due to work-related stress - study protocol of a randomized controlled trial (RCT).

PubMed

Holmgren, Kristina; Sandheimer, Christine; Mårdby, Ann-Charlotte; Larsson, Maria E H; Bültmann, Ute; Hange, Dominique; Hensing, Gunnel

2016-11-25

Early identification of persons at risk of sickness absence due to work-related stress is a crucial problem for society in general, and primary health care in particular. Tho date, no established method to do this exists. This project's aim is to evaluate whether systematic early identification of work-related stress can prevent sickness absence. This paper presents the study design, procedure and outcome measurements, as well as allocation and baseline characteristics of the study population. The study is a two-armed randomized controlled trial with follow-up at 3, 6 and 12 months. Non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers (PHCC) were eligible to participate. At baseline work-related stress was measured by the Work Stress Questionnaire (WSQ), combined with feedback at consultation, at PHCC. The preventive intervention included early identification of work-related stress by the WSQ, GP training in the use of WSQ, GP feedback at consultation and finding suitable preventive measures. A process evaluation was used to explore how to facilitate future implementation and structural use of the WSQ at the PHCC. The primary outcome to compare the preventive sick leave intervention by the general practitioner (GP) versus treatment as usual is sick leave data obtained from the Swedish Social Insurance Agency register. Early screening for sick leave due to work-related stress makes it possible not only to identify those at risk for sick leave, but also to put focus on the patient's specific work-related stress problems, which can be helpful in finding suitable preventive measures. This study investigates if use of the WSQ by GPs at PHCCs, combined with feedback at consultation, prevents future sickness absence. ClinicalTrials.gov. Identifier: NCT02480855 . Registered 20 May 2015.

Sick leave among people in paid work after age 65: A Swedish population-based study covering 1995, 2000, 2005 and 2010.

PubMed

Farrants, K; Marklund, S; Kjeldgård, L; Head, J; Alexanderson, K

2018-05-01

Extending working life into older age groups is discussed in many countries. However, there is no knowledge about how this affects rates of sick leave. The aim of this work was to investigate rates of sick leave among people in paid work after retirement age and if such rates have changed over time. Swedish nationwide register data on people aged >65 years and living in Sweden in 1995, 2000, 2005 and 2010 were analysed. All people with a sufficiently high work income to be eligible for public sick leave benefits were included. The proportions in paid work and compensated rates of sick leave for people aged 66-70 and ≥71 were analysed by sex, educational level, country of birth, living area, and employment type and sector. The percentage of people in paid work at ages 66-70 years increased from <10% in 1995 to 24% in 2010 and among those aged ≥71 years from 2.7% in 1995 to 3.5% in 2010. The rates of sick leave among working people aged 66-70 years were 3.3% in 1995 and 2.4% in 2010 and for people aged ≥71 years the rates of sick leave were 2.2% in 1995 and 0.2% in 2010. Women had higher rates of sick leave than men in 2005 and 2010, but lower in 1995 and 2000. In 2010, the rates of sick leave were similar between employees and the self-employed, and higher among employees in the public sector than among employees in the private sector. Rates of sick leave among workers aged >65 years were lower in 2010 than in 1995, despite much higher rates of labour market participation in 2010.

The work ability index and single-item question: associations with sick leave, symptoms, and health--a prospective study of women on long-term sick leave.

PubMed

Ahlstrom, Linda; Grimby-Ekman, Anna; Hagberg, Mats; Dellve, Lotta

2010-09-01

This study investigated the association between the work ability index (WAI) and the single-item question on work ability among women working in human service organizations (HSO) currently on long-term sick leave. It also examined the association between the WAI and the single-item question in relation to sick leave, symptoms, and health. Predictive values of the WAI, the changed WAI, the single-item question and the changed single-item question were investigated for degree of sick leave, symptoms, and health. This cohort study comprised 324 HSO female workers on long-term (>60 days) sick leave, with follow-ups at 6 and 12 months. Participants responded to questionnaires. Data on work ability, sick leave, health, and symptoms were analyzed with regard to associations and predictability. Spearman correlation and mixed-model analysis were performed for repeated measurements over time. The study showed a very strong association between the WAI and the single-item question among all participants. Both the WAI and the single-item question showed similar patterns of associations with sick leave, health, and symptoms. The predictive value for the degree of sick leave and health-related quality of life (HRQoL) was strong for both the WAI and the single-item question, and slightly less strong for vitality, neck pain, both self-rated general and mental health, and behavioral and current stress. This study suggests that the single-item question on work ability could be used as a simple indicator for assessing the status and progress of work ability among women on long-term sick leave.

Short rest between shift intervals increases the risk of sick leave: a prospective registry study.

PubMed

Vedaa, Øystein; Pallesen, Ståle; Waage, Siri; Bjorvatn, Bjørn; Sivertsen, Børge; Erevik, Eilin; Svensen, Erling; Harris, Anette

2017-07-01

The purpose of this study was to use objective registry data to prospectively investigate the effects of quick returns (QR, <11 hours of rest between shifts) and night shifts on sick leave. A total of 1538 nurses (response rate =41.5%) answered questionnaires on demographics and personality and provided consent to link this information to registry data on shift work and sick leave from employers' records. A multilevel negative binomial model was used to investigate the predictive effect of exposure to night shifts and QR every month for 1 year, on sick leave the following month. Exposure to QR the previous month increased the risk for sick leave days (incidence rate ratio (IRR)=1.066, 95% CI 1.022 to 1.108, p<0.01) and sick leave spells (IRR=1.059, 95% CI 1.025 to 1.097, p<0.001) the following month, whereas night shifts did not. 83% per cent of the nurses experienced QR within a year, and on average they were exposed to 3.0 QR per month (SD=1.6). Personality characteristics associated with shift work tolerance (low on morningness, low on languidity and high on flexibility) were not associated with sick leave, and did not moderate the relationship between QR and sick leave. We found a positive linear relationship between QR and sick leave. Avoiding QR may help reduce workers' sick leave. The restricted recovery opportunity associated with QR may give little room for beneficial effects of individual characteristics usually associated with shift work tolerance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

75 FR 75363 - Absence and Leave; Sick Leave

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-03

... diseases, including pandemic influenza when appropriate. We are also permitting employees to substitute up..., including pandemic influenza when appropriate, by permitting the use of sick leave and advanced sick leave... and procedures developed in planning for a pandemic influenza and provided references to a substantial...

Expectations and illness perceptions as predictors of benefit recipiency among workers with common mental disorders: secondary analysis from a randomised controlled trial

PubMed Central

Løvvik, Camilla; Shaw, William; Øverland, Simon; Reme, Silje Endresen

2014-01-01

Objective Common mental disorders (CMDs) are among the leading causes of sick leave, and more knowledge on factors related to work participation and return-to-work (RTW) in CMDs is needed. The aim of this study was to investigate RTW-expectations and illness perceptions as predictors of benefit recipiency in CMDs. Design Study participants were enrolled in a randomised controlled trial and reported CMDs as a main obstacle for work participation. Three prespecified subgroups were included: people at risk of going on sick leave, people on sick leave (>3 weeks) or people on long-term benefits. Baseline questionnaire data and registry data at baseline and 6 months were used to investigate predictors of benefit recipiency at 6-month follow-up. Benefit recipiency included sickness benefits, disability pension, work assessment allowance and unemployment benefits. Results In this study, uncertain and negative RTW-expectations were strong predictors of benefit recipiency at 6 months follow-up. Illness perceptions predicted benefit recipiency in the unadjusted model, but not in the fully adjusted model. In the subgroup on sick leave, uncertain and negative RTW-expectations predicted benefit recipiency, while in the subgroup of people at risk of going on sick leave, negative RTW-expectations predicted benefit recipiency. In the subgroup on long-term benefits, only female gender predicted benefit recipiency. Conclusions For people with CMDs, uncertain and negative RTW-expectations predict later benefit recipiency, and expectations seem particularly important for those at risk of or on sick leave. For those at risk of sick leave, benefit recipiency at follow-up denoted a transition onto sick leave or long-term benefit, while those on sick leave had remained so or were receiving long-term benefits. Addressing RTW-expectations in occupational healthcare services or vocational rehabilitation might be beneficial in early stages or even prior to a sick leave episode. Trial registration http://www.clinicaltrials.gov, NCT01146730. PMID:24589824

Four-year incidence of sick leave because of neck and shoulder pain and its association with work and lifestyle.

PubMed

Alipour, Akbar; Ghaffari, Mostafa; Shariati, Batoul; Jensen, Irene; Vingard, Eva

2009-02-15

Four-year prospective cohort study. To find the incidence of sick leave because of neck and shoulder pain (NSP) in industrial workers, and its association with work and lifestyle risk factors. Longitudinal studies to investigate NSP incidence and risk factors are rare, and even fewer have been conducted in middle- and low-income countries. After inviting all full-time employees of an Iranian car manufacturing company with 18,031 employees to participate in a baseline study, they were followed for 4 years. New episodes of sick leave because of NSP have been calculated based on sickness absence registration between the years 2003 and 2007. The incidence was compared for participants and nonparticipants. The association between sick leave, physical, and psychosocial risk factors at work, and previous self-reported NSP, was calculated for the remaining population of baseline participants (12,184 employees) during a 4-year follow-up. During a 4-year follow-up of study subjects for the remaining participants of the baseline study, the incidence of sick leave was 0.8% (98 sick leave cases in 12,184 employees). For nonparticipants this incidence was 4.2% (130 cases in 3127 employees). In the final regression model for sick leave cases, the remaining factors for potential physical risk factors were repetitive work and sitting positions at work; for psychosocial factors unattractive work was the only significant remaining factor. The incidence of NSP based on sick leave is definitely very low compared with previous studies in high-income countries. This incidence varies between participants and nonparticipants. Risk factors for sick leave differ from risk factors for self-reported pain. A young population, job security, the insurance system, different health behaviors, and healthy worker bias, are all factors that may affect the results, and sick-leave as an outcome must be interpreted with more caution in middle- and low-income countries.

Work reintegration after long-term sick leave: domains of influence on co-workers' ability to be supportive.

PubMed

Petersen, Kirsten Schultz; Labriola, Merete; Nielsen, Claus Vinther; Larsen, Eva Ladekjær

2016-09-01

The purpose of the study is to identify domains of influence on co-workers' ability to be supportive of returning worker during the work reintegration (WR) process. An ethnographic study design was chosen involving fieldwork at four different workplaces, at an emergency care service, a waste disposal company and at two nursing homes. Qualitative methods for inquiry were used including participant observation, individual- and group interviews of 30 participants. Data were coded and analysed according to a grounded theory approach. Four themes were identified related to domains of influence on co-workers' ability to be supportive of returning worker during the WR process: (1) organisation of work and level of interaction; (2) disruption of work routines, (3) relationship with returning worker and (4) attitudes towards sick leave. The WR process after long-term sick leave is not only influenced by the WR's arrangements made, but also by the co-workers' responses to the process. Work arrangements not only affect the returning worker's ability to return-to-work (RTW) successfully, but also the co-workers' ability to be supportive and their ability to take active part in the process. Implications for Rehabilitation The process of WR after long-term sick leave involves interaction with co-workers. Domains of influence is in the co-workers' perspective influencing their ability to be supportive during reintegration of a returning worker. Future WR management could benefit from integrating the conditions for co-worker support. We encourage co-workers to be involved in the RTW planning, monitoring and evaluation with particular focus on how the WR arrangements are influencing their work and their ability to be supportive.

Risk factors for absenteeism due to sick leave in the petroleum industry

PubMed Central

Oenning, Nágila Soares Xavier; Carvalho, Fernando Martins; Lima, Veronica Maria Cadena

2014-01-01

OBJECTIVE To identify risk factors for absenteeism among workers with sick leave in an oil company. METHODS A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. RESULTS Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. CONCLUSIONS In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave. PMID:24789643

Sick leave in Sweden before and after total joint replacement in hip and knee osteoarthritis patients.

PubMed

Stigmar, Kjerstin; Dahlberg, Leif E; Zhou, Caddie; Jacobson Lidgren, Helena; Petersson, Ingemar F; Englund, Martin

2017-04-01

Background and purpose - Little is know about patterns of sick leave in connection with total hip and knee joint replacement (THR and TKR) in patients with osteoarthritis (OA). Patients and methods - Using registers from southern Sweden, we identified hip and knee OA patients aged 40-59 years who had a THR or TKR in the period 2004-2012. Patients who died or started on disability pension were excluded. We included 1,307 patients with THR (46% women) and 996 patients with TKR (56% women). For the period 1 year before until 2 years after the surgery, we linked individual-level data on sick leave from the Swedish Social Insurance Agency. We created a matched reference cohort from the general population by age, birth year, and area of residence (THR: n = 4,604; TKR: n = 3,425). The mean number of days on sick leave and the proportion (%) on sick leave 12 and 24 months before and after surgery were calculated. Results - The month after surgery, about 90% of patients in both cohorts were on sick leave. At the two-year follow-up, sick leave was lower for both cohorts than 1 year before surgery, except for men with THR, but about 9% of the THR patients and 12-17% of the TKR patients were still sick-listed. In the matched reference cohorts, sick leave was constant at around 4-7% during the entire study period. Interpretation - A long period of sick leave is common after total joint replacement, especially after TKR. There is a need for better knowledge on how workplace adjustments and rehabilitation can facilitate the return to work and can postpone surgery.

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

PubMed Central

Moreau, M; Valente, F; Mak, R; Pelfrene, E; de Smet, P; De Backer, G; Kornitzer, M

2004-01-01

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. PMID:15143121

Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints.

PubMed

Bot, Sandra D M; Terwee, Caroline B; van der Windt, Daniëlle A W M; van der Beek, Allard J; Bouter, Lex M; Dekker, Joost

2007-08-01

To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. In the subgroup of patients who scored high on the pain copying scale "worrying" the hazard ratio of sick leave was 1.32 (95% CI 1.07-1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale "worrying" (adjusted HR=0.17, 95%-CI 0.04-0.72). Other work-related risk factors were not significantly related to sick leave. Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results.

Local mandate improves equity of paid sick leave coverage: Seattle's experience.

PubMed

Romich, Jennifer L

2017-01-11

Paid sick leave allows workers to take time off work for personal or family health needs, improving health and potentially limiting infectious diseases. The U.S. has no national sick leave mandate, and many American workers - particularly those at lower income levels - have no right to paid time off for their own or family members' health needs. This article reports on outcomes of a local mandate, the City of Seattle Paid Sick and Safe Time Ordinance, which requires certain employers to provide paid sick leave to eligible workers. Survey collectors contacted a stratified random sample of Seattle employers before the Ordinance went into effect and one year later. Pre- and post- analysis draws on responses to survey items by 345 employers who were subject to the paid sick leave mandate. Awareness of the policy and provision of paid leave grew significantly over the year after the Ordinance was enacted. More employers offered leave to full-time workers (80.8 to 93.9%, p < .001) and part-time workers (47.1 to 66.7%, p < .001) with particularly large increases in the hospitality sector, which includes food workers (coverage of any hospitality employee: 27.5 to 85.0%, p < .001). Absent a federal policy, local paid sick time mandates can increase paid sick leave coverage, an important social determinant of health.

Assessing predictors of intention to prescribe sick leave among primary care physicians using the theory of planned behaviour.

PubMed

Swarna Nantha, Yogarabindranath; Wee, Lei Hum; Chan, Caryn Mei-Hsien

2018-01-16

Providing sickness certification is a decision that primary care physicians make on a daily basis. The majority of sickness certification studies in the literature involve a general assessment of physician or patient behaviour without the use of a robust psychological framework to guide research accuracy. To address this deficiency, this study utilized the Theory of Planned Behaviour (TPB) to specifically gauge the intention and other salient predictors related to sickness certification prescribing behaviour amongst primary care physicians. A cross-sectional study was conducted among N = 271 primary care physicians from 86 primary care practices throughout two states in Malaysia. Questionnaires used were specifically developed based on the TPB, consisting of both direct and indirect measures related to the provision of sickness leave. Questionnaire validity was established through factor analysis and the determination of internal consistency between theoretically related constructs. The temporal stability of the indirect measures was determined via the test-retest correlation analysis. Structural equation modelling was conducted to determine the strength of predictors related to intentions. The mean scores for intention to provide patients with sickness was low. The Cronbach α value for the direct measures was good: overall physician intent to provide sick leave (0.77), physician attitude towards prescribing sick leave for patients (0.77) and physician attitude in trusting the intention of patients seeking sick leave (0.83). The temporal stability of the indirect measures of the questionnaire was satisfactory with significant correlation between constructs separated by an interval of two weeks (p < 0.05). Attitudes and subjective norms were identified as important predictors in physician intention to provide sick leave to patients. An integrated behavioural model utilizing the TPB could help fully explain the complex act of providing sickness leave to patients. Findings from this study could assist relevant agencies to facilitate the creation of policies that may help regulate the provision of sickness leave and alleviate the work burden of sickness leave tasks faced by physicians in Malaysia.

Cost-effectiveness of a workplace intervention for sick-listed employees with common mental disorders: design of a randomized controlled trial

PubMed Central

van Oostrom, Sandra H; Anema, Johannes R; Terluin, Berend; de Vet, Henrica CW; Knol, Dirk L; van Mechelen, Willem

2008-01-01

Background Considering the high costs of sick leave and the consequences of sick leave for employees, an early return-to-work of employees with mental disorders is very important. Therefore, a workplace intervention is developed based on a successful return-to-work intervention for employees with low back pain. The objective of this paper is to present the design of a randomized controlled trial evaluating the cost-effectiveness of the workplace intervention compared with usual care for sick-listed employees with common mental disorders. Methods The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are on sick leave for 2 to 8 weeks with common mental disorders. The workplace intervention will be compared with usual care. The workplace intervention is a stepwise approach that aims to reach consensus about a return-to-work plan by active participation and strong commitment of both the sick-listed employee and the supervisor. Outcomes will be assessed at baseline, 3, 6, 9 and 12 months. The primary outcome of this study is lasting return-to-work, which will be acquired from continuous registration systems of the companies after the follow-up. Secondary outcomes are total number of days of sick leave during the follow-up, severity of common mental disorders, coping style, job content, and attitude, social influence, and self-efficacy determinants. Cost-effectiveness will be evaluated from the societal perspective. A process evaluation will also be conducted. Discussion Return-to-work is difficult to discuss in the workplace for sick-listed employees with mental disorders and their supervisors. Therefore, this intervention offers a unique opportunity for the sick-listed employee and the supervisor to discuss barriers for return-to-work. Results of this study will possibly contribute to improvement of disability management for sick-listed employees with common mental disorders. Results will become available in 2009. Trial registration ISRCTN92307123 PMID:18194525

Partial sick leave associated with disability pension: propensity score approach in a register-based cohort study

PubMed Central

Kausto, Johanna; Solovieva, Svetlana; Virta, Lauri J; Viikari-Juntura, Eira

2012-01-01

Objectives To support sustainability of the welfare society enhanced work retention is needed among those with impaired work ability. Partial health-related benefits have been introduced for this target. The aim was to estimate the effects of partial sick leave on transition to disability pension applying propensity score methods. Design Register-based cohort study. Setting Sample from the national sickness insurance registers representative of the Finnish working population (full-time workers) with long-term sickness absence due to musculoskeletal disorders, mental disorders, traumas or tumours. Participants All recipients of partial or full sickness benefit whose sick leave period had ended between 1 May and 31 December 2007 were included. The sample was limited to four most prevalent diagnostic groups—mental and musculoskeletal disorders, traumas and tumours. The total sample consisted of 1047 subjects on partial sick leave (treatment group) and 28 380 subjects on full sick leave (control group). A subsample (1017 and 25 249 subjects, respectively) was formed to improve the comparability of the two groups. Outcome measures A three-category measure and a binary measure for the occurrence of disability pension on the last day of 2008 were computed. Results Partial sickness benefit reduced the risk (change in absolute risk) of full disability pension by 6% and increased the risk of partial disability pension by 8% compared with full sick leave. The effects did not differ markedly for the two main diagnostic groups of musculoskeletal and mental disorders. In men, the use of full disability pension was reduced by 10% with a 5% increase in the use of partial disability pension, while in women the effects were close to those of the total sample. Conclusions Our findings suggest that combining work with partial sick leave may provide one means to increase work retention at population level. The use of partial sick leave could be encouraged among men. PMID:23144260

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

PubMed

Bernklev, Tomm; Jahnsen, Jørgen; Henriksen, Magne; Lygren, Idar; Aadland, Erling; Sauar, Jostein; Schulz, Tom; Stray, Njål; Vatn, Morten; Moum, Bjørn

2006-05-01

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). 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. 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. 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.

Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints

PubMed Central

Terwee, Caroline B.; van der Windt, Daniëlle A. W. M.; van der Beek, Allard J.; Bouter, Lex M.; Dekker, Joost

2007-01-01

Objectives To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Methods Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. Results In the subgroup of patients who scored high on the pain copying scale “worrying” the hazard ratio of sick leave was 1.32 (95% CI 1.07–1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale “worrying” (adjusted HR = 0.17, 95%-CI 0.04–0.72). Other work-related risk factors were not significantly related to sick leave. Conclusions Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results. PMID:17410376

Determinants for return to work among sickness certified patients in general practice.

PubMed

von Celsing, Anna-Sophia; Svärdsudd, Kurt; Eriksson, Hans-G; Björkegren, Karin; Eriksson, Margaretha; Wallman, Thorne

2012-12-14

Long-term sickness absence is one of the main risk factors for permanent exit out of the labour market. Early identification of the condition is essential to facilitate return to work. The aim of this study was to analyse possible determinants of return to work and their relative impact. All 943 subjects aged 18 to 63 years, sickness certified at a Primary Health Care Centre in Sweden from 1 January until 31 August 2004, were followed up for three years. Baseline information on sex, age, sick leave diagnosis, employment status, extent of sick leave, and sickness absence during the year before baseline was obtained, as was information on all compensated days of sick leave, disability pension and death during follow-up. Slightly more than half the subjects were women, mean age was 39 years. Half of the study population returned to work within 14 days after baseline, and after three years only 15 subjects were still on sick leave. In multivariate proportional hazards regression analysis the extent of previous sick leave, age, being on part-time sick leave, and having a psychiatric, musculoskeletal, cardiovascular, nervous disease, digestive system, or injury or poisoning diagnosis decreased the return to work rate, while being employed increased it. Marital status, sex, being born in Sweden, citizenship, and annual salary had no influence. In logistic regression analyses across follow-up time these variables altogether explained 88-90% of return to work variation. Return to work was positively or negatively associated by a number of variables easily accessible in the GP's office. Track record data in the form of previous sick leave was the most influential variable.

Work-related psychosocial events as triggers of sick leave--results from a Swedish case-crossover study.

PubMed

Hultin, Hanna; Hallqvist, Johan; Alexanderson, Kristina; Johansson, Gun; Lindholm, Christina; Lundberg, Ingvar; Möller, Jette

2011-03-23

Although illness is an important cause of sick leave, it has also been suggested that non-medical risk factors may influence this association. If such factors impact on the period of decision making, they should be considered as triggers. Yet, there is no empirical support available.The aim was to investigate whether recent exposure to work-related psychosocial events can trigger the decision to report sick when ill. A case-crossover design was applied to 546 sick-leave spells, extracted from a Swedish cohort of 1430 employees with a 3-12 month follow-up of new sick-leave spells. Exposure in a case period corresponding to an induction period of one or two days was compared with exposure during control periods sampled from workdays during a two-week period prior to sick leave for the same individual. This was done according to the matched-pair interval and the usual frequency approaches. Results are presented as odds ratios (OR) with 95% confidence intervals (CI). Most sick-leave spells happened in relation to acute, minor illnesses that substantially reduced work ability. The risk of taking sick leave was increased when individuals had recently been exposed to problems in their relationship with a superior (OR 3.63; CI 1.44-9.14) or colleagues (OR 4.68; CI 1.43-15.29). Individuals were also more inclined to report sick on days when they expected a very stressful work situation than on a day when they were not under such stress (OR 2.27; CI 1.40-3.70). Exposure to problems in workplace relationships or a stressful work situation seems to be able to trigger reporting sick. Psychosocial work-environmental factors appear to have a short-term effect on individuals when deciding to report sick.

Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial.

PubMed

Viikari-Juntura, Eira; Kausto, Johanna; Shiri, Rahman; Kaila-Kangas, Leena; Takala, Esa-Pekka; Karppinen, Jaro; Miranda, Helena; Luukkonen, Ritva; Martimo, Kari-Pekka

2012-03-01

The purpose of this study was to assess the effects of early part-time sick leave on return to work (RTW) and sickness absence among patients with musculoskeletal disorders. A randomized controlled trial was conducted in six occupational health units of medium- and large-size enterprises. Patients aged 18-60 years with musculoskeletal disorders (N=63) unable to perform their regular work were randomly allocated to part- or full-time sick leave. In the former group, workload was reduced by restricting work time by about a half. Remaining work tasks were modified when necessary, as specified in a "fit note" from the physician. The main outcomes were time to return to regular work activities and sickness absence during 12-month follow-up. Time to RTW sustained for ≥4 weeks was shorter in the intervention group (median 12 versus 20 days, P=0.10). Hazard ratio of RTW adjusted for age was 1.60 [95% confidence interval (95% CI) 0.98-2.63] and 1.76 (95% CI 1.21-2.56) after further adjustment for pain interference with sleep and previous sickness absence at baseline. Total sickness absence during the 12-month follow-up was about 20% lower in the intervention than the control group. Compliance with the intervention was high with no discontinuations of part-time sick leave due to musculoskeletal reasons. Early part-time sick leave may provide a faster and more sustainable return to regular duties than full-time sick leave among patients with musculoskeletal disorders. This is the first study to show that work participation can be safely increased with early part-time sick leave.

Work and health, a blind spot in curative healthcare? A pilot study.

PubMed

Lötters, Freek J B; Foets, Marleen; Burdorf, Alex

2011-09-01

Most workers with musculoskeletal disorders on sick leave often consult with regular health care before entering a specific work rehabilitation program. However, it remains unclear to what extent regular healthcare contributes to the timely return to work (RTW). Moreover, several studies have indicated that it might postpone RTW. There is a need to establish the influence of regular healthcare on RTW as outcome; "Does visiting a regular healthcare provider influence the duration of sickness absence and recurrent sick leave due to musculoskeletal disorders?". A cohort of workers on sick leave for 2-6 weeks due to a-specific musculoskeletal disorders was followed for 12 months. The main outcomes for the present analysis were: duration of sickness absence till 100% return to work and recurrent sick leave after initial RTW. Cox regression analyses were conducted with visiting a general health practitioner, physical therapist, or medical specialist during the sick leave period as independent variables. Each regression model was adjusted for variables known to influence health care utilization like age, sex, diagnostic group, pain intensity, functional disability, general health perception, severity of complaints, job control, and physical load at work. Patients visiting a medical specialist reported higher pain intensity and more functional limitations and also had a worse health perception at start of the sick leave period compared with those not visiting a specialist. Visiting a medical specialist delayed return to work significantly (HR = 2.10; 95%CI 1.43-3.07). After approximately 8 weeks on sick leave workers visiting a physical therapist returned to work faster than other workers. A recurrent episode of sick leave during the follow up quick was initiated by higher pain intensity and more functional limitations at the moment of fully return to work. Visiting a primary healthcare provider during the sickness absence period did not influence the occurrence of a new sick leave period. Despite the adjustment for severity of the musculoskeletal disorder, visiting a medical specialist was associated with a delayed full return to work. More attention to the factor 'labor' in the regular healthcare is warranted, especially for those patients experiencing substantial functional limitations due to musculoskeletal disorders.

[Work absenteeism in Chile according to the type of work place].

PubMed

Mesa, Francisco R; Kaempffer, Ana María

2004-09-01

The issue of medically justified work absenteeism has a great relevance in Chile at the present moment. To analyze sick leaves among people working in hospitals, mines, automotive industry and universities. Analysis of 14 thesis and research papers about absenteeism in Chile. The incapacity rate (number of days with sick leave per worker per year, the frequency rate (number of sick leaves per year per worker) and the severity rate (mean duration of sick leaves) were calculated. The diseases causing the highest rates of absenteeism were also recorded. The mean age of the studied populations was 36 years old and the most common diseases causing absenteeism were respiratory, rheumatologic and trauma. Hospital workers had the highest incapacity rate with 14.3 days of sick leave per worker per year, followed by mining industry with 12 days, automotive industry with 7.1 days and universities with 6 days. In Chile, respiratory diseases are the main cause of sick leaves and hospital workers have the highest incapacity rate.

Comparison of sick leave patterns between Norway and Denmark in the health and care sector: a register study.

PubMed

Krane, Line; Fleten, Nils; Stapelfeldt, Christina M; Nielsen, Claus Vinther; Jensen, Chris; Johnsen, Roar; Braaten, Tonje

2013-11-01

Sickness absence is of considerable concern in both Norway and Denmark. Labour Force Surveys indicate that absence in Norway is about twice that in Denmark and twice that of the mean reported by the Organisation for Economic Co-operation and Development. This study compares absence patterns according to age, percentage of employment, and occupation between municipal employees in the health and care sectors in two municipalities in Norway and Denmark. Data recorded in the personnel registers of the municipalities of Kristiansand, Norway and Aarhus, Denmark were extracted for the years 2004 and 2008, revealing 3498 and 7751 employee-years, respectively. We calculated absence rates together with number of sick leave episodes, and their association with the above-mentioned covariates. Gender-specific comparative descriptive statistics and negative binomial regression analysis were performed. The sickness absence rate in women was 11.3% in Norway (95% confidence interval [CI] 11.2-11.4) and 7.0% in Denmark (95% CI 7.0-7.1) whereas mean number of sick leave episodes among women was 2.4 in Denmark, compared to 2.3 in Norway (p = 0.02). Young employees in Denmark had more sick leave episodes than in Norway. Proportion of absentees was higher in Denmark compared to Norway (p < 0.0001). The finding of that more employees in Denmark have more frequent, but shorter sick leave episodes compared to Norway, for whatever reasons, may indicate that more frequent sick leaves episodes prevent higher sick leaves rates.

School neighborhood disadvantage as a predictor of long-term sick leave among teachers: prospective cohort study.

PubMed

Virtanen, Marianna; Kivimäki, Mika; Pentti, Jaana; Oksanen, Tuula; Ahola, Kirsi; Linna, Anne; Kouvonen, Anne; Salo, Paula; Vahtera, Jussi

2010-04-01

This ongoing prospective study examined characteristics of school neighborhood and neighborhood of residence as predictors of sick leave among school teachers. School neighborhood income data for 226 lower-level comprehensive schools in 10 towns in Finland were derived from Statistics Finland and were linked to register-based data on 3,063 teachers with no long-term sick leave at study entry. Outcome was medically certified (>9 days) sick leave spells during a mean follow-up of 4.3 years from data collection in 2000-2001. A multilevel, cross-classified Poisson regression model, adjusted for age, type of teaching job, length and type of job contract, school size, baseline health status, and income level of the teacher's residential area, showed a rate ratio of 1.30 (95% confidence interval: 1.03, 1.63) for sick leave among female teachers working in schools located in low-income neighborhoods compared with those working in high-income neighborhoods. A low income level of the teacher's residential area was also independently associated with sick leave among female teachers (rate ratio = 1.50, 95% confidence interval: 1.18, 1.91). Exposure to both low-income school neighborhoods and low-income residential neighborhoods was associated with the greatest risk of sick leave (rate ratio = 1.71, 95% confidence interval: 1.27, 2.30). This study indicates that working and living in a socioeconomically disadvantaged neighborhood is associated with increased risk of sick leave among female teachers.

No physician gender difference in prescription of sick-leave certification: A retrospective study of the Skaraborg Primary Care Database

PubMed Central

Starzmann, Karin; Hjerpe, Per; Dalemo, Sofia; Björkelund, Cecilia; Boström, Kristina Bengtsson

2012-01-01

Objective The primary objective was to investigate how physicians’ gender and level of experience affects the rate and length of sick-leave certificate prescription. The secondary objective was to study the physicians’ gender and professional experience in relation to the diagnoses on the certificates. Design Retrospective, cross-sectional study of computerized medical records from 24 health care centres in 2005. Setting Primary care in Sweden. Subjects Primary care physicians (n = 589) and patients (n = 88 780) aged 18–64 years. Main outcome measures Rate and duration of sick leave certified by different categories of physicians and for different diagnoses and gender of patients. Results Sick leave was certified in 9.0% (musculoskeletal (3%) and psychiatric (2.3%) diagnoses were most common) of all contacts and the mean duration was 32.2 days. Overall there was no difference between male and female physicians in the sick-leave certification prescription rate (9.1% vs. 9.0%) or duration of sick leave (32.1 vs. 32.6 days). The duration of sick leave was associated with the physician's level of professional experience in general practice (GPs (Distriktläkare) 37, GP trainees (ST-läkare) 26, interns (AT-läkare) 20 and locum (vikarier) 19 days, p < 0.001). Conclusion Contrary to earlier studies we found no difference in sick-leave certification prescription rate and length between male and female physicians. PMID:22348513

Strong support for relocation to other work tasks: A cross-sectional study of attitudes to sickness insurance regulations in Sweden.

PubMed

Hensing, G; Holmgren, K; Rohdén, H

2015-01-01

Profound changes are taking place in the Swedish welfare state. The general population's attitudes are important insofar changes will be perceived as fair and effective to become implemented. The aim was to study attitudes to the strictness of the sick-leave rules, relocation to other work tasks after 3 months of sick leave and applications for new jobs after 6 months of sick leave. Eligible for this questionnaire study were 1,140 individuals aged 19 to 64 years. Their attitudes were analyzed in relation to age, gender, political ideology and health status. Health status was measured as sick-leave experiences, self-reported health and level of symptoms. Showed that 42% considered the sick-leave rules to be too strict, 60% found relocation to other work tasks to be good while 35% found that applications for new work were good. In logistic regression analyses, high sick-leave experience was associated with increased odds of finding the sick-leave rules too strict and disagreement with relocation to other work tasks or application for new jobs. In conclusion, strong support was found for relocation to other work tasks with the present employer. Earlier research on returning to work has found workplace interventions to be efficient. From a policy perspective it seems relevant to promote such interventions given the strong public opinion in their favor.

The Growing Costs and Burden of Family Caregiving of Older Adults: A Review of Paid Sick Leave and Family Leave Policies.

PubMed

Chen, Mei-Lan

2016-06-01

Many family caregivers of older adults suffer from a high burden of care and struggle with the balance of jobs and caregiving tasks. However, the United States is the only developed country without paid sick leave policies for all workers and their families. The purpose of this article is to review the federal Family and Medical Leave Act (FMLA) and empirical studies about paid sick policy, propose policy recommendations, and provide a starting point for future research. The result has shown that the FMLA only applies to certain employees and the provided leave is unpaid under the act. Working women, Latinos, low-wage workers, and less-educated employees are less likely to access paid sick leave and family leave. Obviously, social injustice exists in the FMLA and paid sick leave policies. This article proposes that the Family and Medical Leave Act coverage should be expanded to protect all workers, especially for primary family caregivers of older adults, regardless of family relationships. Also, paid sick and family leave laws should be passed, and requirements to contribute to a family-friendly workplace added to relieve the growing burden of family caregiving of older adults. Policy recommendations including the exemplar of the San Francisco Paid Sick Leave Ordinance, and suggestions for more comprehensive policies are proposed for federal, state, or/and city legislation. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sick-leave track record and other potential predictors of a disability pension. A population based study of 8,218 men and women followed for 16 years

PubMed Central

Wallman, Thorne; Wedel, Hans; Palmer, Edward; Rosengren, Annika; Johansson, Saga; Eriksson, Henry; Svärdsudd, Kurt

2009-01-01

Background A number of previous studies have investigated various predictors for being granted a disability pension. The aim of this study was to test the efficacy of sick-leave track record as a predictor of being granted a disability pension in a large dataset based on subjects sampled from the general population and followed for a long time. Methods Data from five ongoing population-based Swedish studies was used, supplemented with data on all compensated sick leave periods, disability pensions granted, and vital status, obtained from official registers. The data set included 8,218 men and women followed for 16 years, generated 109,369 person years of observation and 97,160 sickness spells. Various measures of days of sick leave during follow up were used as independent variables and disability pension grant was used as outcome. Results There was a strong relationship between individual sickness spell duration and annual cumulative days of sick leave on the one hand and being granted a disability pension on the other, among both men and women, after adjustment for the effects of marital status, education, household size, smoking habits, geographical area and calendar time period, a proxy for position in the business cycle. The interval between sickness spells showed a corresponding inverse relationship. Of all the variables studied, the number of days of sick leave per year was the most powerful predictor of a disability pension. For both men and women 245 annual sick leave days were needed to reach a 50% probability of transition to disability. The independent variables, taken together, explained 96% of the variation in disability pension grantings. Conclusion The sick-leave track record was the most important predictor of the probability of being granted a disability pension in this study, even when the influences of other variables affecting the outcome were taken into account. PMID:19368715

Sickness absence in the private sector of Greece: comparing shipyard industry and national insurance data.

PubMed

Alexopoulos, Evangelos C; Merekoulias, Georgios; Tanagra, Dimitra; Konstantinou, Eleni C; Mikelatou, Efi; Jelastopulu, Eleni

2012-04-01

Approximately 3% of employees are absent from work due to illness daily in Europe, while in some countries sickness absence exceeds 20 days per year. Based on a limited body of reliable studies, Greek employees in the private sector seem to be absent far less frequently (<5 days/year) compared to most of the industrialized world. The aim of this study was to estimate the levels of sickness absence in the private sector in Greece, using shipyard and national insurance data. Detailed data on absenteeism of employees in a large shipyard company during the period 1999-2006 were utilized. National data on compensated days due to sickness absence concerning all employees (around 2 million) insured by the Social Insurance Institute (IKA, the largest insurance scheme in Greece) were retrieved from the Institute's annual statistical reports for the period 1987-2006. Sick-leave days per employee and sick-leave rate (%) were calculated, among other indicators. In the shipyard cohort, the employment time loss due to sick leave was 1%. The mean number of sick-leave days per employee in shipyards ranged between 4.6 and 8.7 and sick-leave rate (sickness absenteeism rate) varied among 2% and 3.7%. The corresponding indicators for IKA were estimated between 5 and 6.3 sick-leave days per insured employee (median 5.8), and 2.14-2.72% (median 2.49%), respectively. Short sick-leave spells (<4 days) may account at least for the 25% of the total number of sick-leave days, currently not recorded in national statistics. The level of sickness absence in the private sector in Greece was found to be higher than the suggested by previous reports and international comparative studies, but still remains one of the lowest in the industrialized world. In the 20-years national data, the results also showed a 7-year wave in sickness absence indexes (a decrease during the period 1991-1997 and an increase in 1998-2004) combined with a small yet significant decline as a general trend. These observations deserve detailed monitoring and could only partly be attributed to the compensation and unemployment rates in Greece so other possible reasons should be explored.

Sickness Absence in the Private Sector of Greece: Comparing Shipyard Industry and National Insurance Data

PubMed Central

Alexopoulos, Evangelos C.; Merekoulias, Georgios; Tanagra, Dimitra; Konstantinou, Eleni C.; Mikelatou, Efi; Jelastopulu, Eleni

2012-01-01

Approximately 3% of employees are absent from work due to illness daily in Europe, while in some countries sickness absence exceeds 20 days per year. Based on a limited body of reliable studies, Greek employees in the private sector seem to be absent far less frequently (<5 days/year) compared to most of the industrialized world. The aim of this study was to estimate the levels of sickness absence in the private sector in Greece, using shipyard and national insurance data. Detailed data on absenteeism of employees in a large shipyard company during the period 1999–2006 were utilized. National data on compensated days due to sickness absence concerning all employees (around 2 million) insured by the Social Insurance Institute (IKA, the largest insurance scheme in Greece) were retrieved from the Institute’s annual statistical reports for the period 1987–2006. Sick-leave days per employee and sick-leave rate (%) were calculated, among other indicators. In the shipyard cohort, the employment time loss due to sick leave was 1%. The mean number of sick-leave days per employee in shipyards ranged between 4.6 and 8.7 and sick-leave rate (sickness absenteeism rate) varied among 2% and 3.7%. The corresponding indicators for IKA were estimated between 5 and 6.3 sick-leave days per insured employee (median 5.8), and 2.14–2.72% (median 2.49%), respectively. Short sick-leave spells (<4 days) may account at least for the 25% of the total number of sick-leave days, currently not recorded in national statistics. The level of sickness absence in the private sector in Greece was found to be higher than the suggested by previous reports and international comparative studies, but still remains one of the lowest in the industrialized world. In the 20-years national data, the results also showed a 7-year wave in sickness absence indexes (a decrease during the period 1991–1997 and an increase in 1998–2004) combined with a small yet significant decline as a general trend. These observations deserve detailed monitoring and could only partly be attributed to the compensation and unemployment rates in Greece so other possible reasons should be explored. PMID:22690189

Partner relationships and long-term sick leave among female workers: consequences and impact on dimensions of health and return to work.

PubMed

Dellve, Lotta; Ahlborg, Tone

2012-12-01

Few efforts have been made to prospectively identify resources and obstacles outside work that may predict regained work ability and return to work when workers are on sick leave. This study investigates the association between partner relationships and sick leave. Our research questions were as follows: (i) What is the influence of sick leave, pain, stress and domestic strain on the quality of the dyadic partner relationship?, and (ii) What is the influence of the partner and social relationship on pain, stress, work ability, self-rated health and return to work? A cohort of female workers (n = 225) on long-term sick leave (>60 days), all in a partner relationship, at 6-month intervals completed a questionnaire based on the Quality of Dyadic Relationship (QDR) instrument, the Interview Schedule of Social Interaction (ISSI), the Work Ability Index (WAI) and the Copenhagen Psychosocial Questionnaire (COPSOQ). Univariate and multivariate analyses of baseline and prospective data were performed. The results showed that decreased partner relationship quality was related to having major responsibility for household work despite being on sick leave, having pain and having decreased social integration. Among younger individuals on sick leave, a reduction in the quality of the partner relationship was shown already at the first (6-month) follow-up, while among middle-aged women, such a reduction was seen only at the 12-month follow-up. No dimensions of partner relationship quality at baseline were related to dimensions of return to work, either as a resource or as an obstacle. Consequently, our results show that a good relationship does not keep the woman from returning to work. Having main responsibility for household work, which implies domestic strain while on sick leave, predicts lower partner relationship quality. The practical implications are that healthcare professionals treating women on sick leave should emphasize the importance of keeping a social network as well as making sufficient adjustments at home for the relationship quality to be safeguarded. Special attention should be given to the young woman on sick leave as being on sick leave seems to influence her partner relationship considerably. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

Sick leave and the impact of job-to-job mobility on the likelihood of remaining on the labour market--a longitudinal Swedish register study.

PubMed

Nordström, Karin; Ekberg, Kerstin; Hemmingsson, Tomas; Johansson, Gun

2014-04-03

Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave. In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20-60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n>3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration. Women with more than 180 days' sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999. The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation.

Legislative change enabling use of early part-time sick leave enhanced return to work and work participation in Finland.

PubMed

Viikari-Juntura, Eira; Virta, Lauri J; Kausto, Johanna; Autti-Rämö, Ilona; Martimo, Kari-Pekka; Laaksonen, Mikko; Leinonen, Taina; Husgafvel-Pursiainen, Kirsti; Burdorf, Alex; Solovieva, Svetlana

2017-09-01

Objectives The aim of the study was to assess the effectiveness of the use of part-time sick leave at the early (first 12 weeks) stage of work disability due to mental disorder or musculoskeletal disease on sustained return to work (RTW) and overall work participation. Methods In a nation-wide register-based quasi-experimental study, we compared sustained RTW (ie, ≥28 consecutive days at work) and 2-year work participation between the part- and full-time sickness absence (SA) benefit groups (N=1878 in each group) using propensity-score matching. Persons who received partial or full SA benefit due to musculoskeletal diseases or mental disorders between January 1, 2010 and December 31, 2011 were eligible as cases or controls, respectively. Results A higher proportion showed sustained RTW after part- compared to full-time sick leave [absolute risk difference 8.0%, 95% confidence interval (95% CI) 5.3-10.9]. Moreover, the proportion of time at work was at a 10.5% higher level in the part- compared to full-time sick leave group. The prevalence of full disability retirement was almost three-fold among the full- compared to part-time sick leave group, whereas partial disability retirement was 4.5-fold more prevalent in the part- compared to full-time sick leave group. Conclusions The use of part-time sick leave during the first three months of SA enhances RTW and overall work participation during two years among persons with mental disorders and musculoskeletal diseases. The prescription of part-time sick leave can be recommended at an early stage of work disability.

Modeling the cost of influenza: the impact of missing costs of unreported complications and sick leave

PubMed Central

2010-01-01

Background Estimating the economic impact of influenza is complicated because the disease may have non-specific symptoms, and many patients with influenza are registered with other diagnoses. Furthermore, in some countries like Norway, employees can be on paid sick leave for a specified number of days without a doctor's certificate ("self-reported sick leave") and these sick leaves are not registered. Both problems result in gaps in the existing literature: costs associated with influenza-related illness and self-reported sick leave are rarely included. The aim of this study was to improve estimates of total influenza-related health-care costs and productivity losses by estimating these missing costs. Methods Using Norwegian data, the weekly numbers of influenza-attributable hospital admissions and certified sick leaves registered with other diagnoses were estimated from influenza-like illness surveillance data using quasi-Poisson regression. The number of self-reported sick leaves was estimated using a Monte-Carlo simulation model of illness recovery curves based on the number of certified sick leaves. A probabilistic sensitivity analysis was conducted on the economic outcomes. Results During the 1998/99 through 2005/06 influenza seasons, the models estimated an annual average of 2700 excess influenza-associated hospitalizations in Norway, of which 16% were registered as influenza, 51% as pneumonia and 33% were registered with other diagnoses. The direct cost of seasonal influenza totaled US$22 million annually, including costs of pharmaceuticals and outpatient services. The annual average number of working days lost was predicted at 793 000, resulting in an estimated productivity loss of US$231 million. Self-reported sick leave accounted for approximately one-third of the total indirect cost. During a pandemic, the total cost could rise to over US$800 million. Conclusions Influenza places a considerable burden on patients and society with indirect costs greatly exceeding direct costs. The cost of influenza-attributable complications and the cost of self-reported sick leave represent a considerable part of the economic burden of influenza. PMID:21106057

School environment as predictor of teacher sick leave: data-linked prospective cohort study

PubMed Central

2012-01-01

Background Poor indoor air quality (IAQ) and psychosocial problems are common in schools worldwide, yet longitudinal research on the issue is scarce. We examined whether the level of or a change in pupil-reported school environment (IAQ, school satisfaction, and bullying) predicts recorded sick leaves among teachers. Methods Changes in the school environment were assessed using pupil surveys at two time points (2001/02 and 2004/05) in 92 secondary schools in Finland. Variables indicating change were based on median values at baseline. We linked these data to individual-level records of teachers’ (n = 1678) sick leaves in 2001–02 and in 2004–05. Results Multilevel multinomial logistic regression models adjusted for baseline sick leave and covariates showed a decreased risk for short-term (one to three days) sick leaves among teachers working in schools with good perceived IAQ at both times (OR = 0.6, 95% CI: 0.5-0.9), and for those with a positive change in IAQ (OR = 0.6, 95% CI: 0.4-0.9), compared to teachers in schools where IAQ was constantly poor. Negative changes in pupil school satisfaction (OR = 1.8, 95% CI: 1.1-2.8) and bullying (OR = 1.5, 95% CI: 1.0-2.3) increased the risk for short-term leaves among teachers when compared to teachers in schools where the level of satisfaction and bullying had remained stable. School environment factors were not associated with long-term sick leaves. Conclusions Good and improved IAQ are associated with decreased teacher absenteeism. While pupil-related psychosocial factors also contribute to sick leaves, no effect modification or mediation of psychosocial factors on the association between IAQ and sick leave was observed. PMID:22966903

School environment as predictor of teacher sick leave: data-linked prospective cohort study.

PubMed

Ervasti, Jenni; Kivimäki, Mika; Kawachi, Ichiro; Subramanian, S V; Pentti, Jaana; Oksanen, Tuula; Puusniekka, Riikka; Pohjonen, Tiina; Vahtera, Jussi; Virtanen, Marianna

2012-09-11

Poor indoor air quality (IAQ) and psychosocial problems are common in schools worldwide, yet longitudinal research on the issue is scarce. We examined whether the level of or a change in pupil-reported school environment (IAQ, school satisfaction, and bullying) predicts recorded sick leaves among teachers. Changes in the school environment were assessed using pupil surveys at two time points (2001/02 and 2004/05) in 92 secondary schools in Finland. Variables indicating change were based on median values at baseline. We linked these data to individual-level records of teachers' (n = 1678) sick leaves in 2001-02 and in 2004-05. Multilevel multinomial logistic regression models adjusted for baseline sick leave and covariates showed a decreased risk for short-term (one to three days) sick leaves among teachers working in schools with good perceived IAQ at both times (OR = 0.6, 95% CI: 0.5-0.9), and for those with a positive change in IAQ (OR = 0.6, 95% CI: 0.4-0.9), compared to teachers in schools where IAQ was constantly poor. Negative changes in pupil school satisfaction (OR = 1.8, 95% CI: 1.1-2.8) and bullying (OR = 1.5, 95% CI: 1.0-2.3) increased the risk for short-term leaves among teachers when compared to teachers in schools where the level of satisfaction and bullying had remained stable. School environment factors were not associated with long-term sick leaves. Good and improved IAQ are associated with decreased teacher absenteeism. While pupil-related psychosocial factors also contribute to sick leaves, no effect modification or mediation of psychosocial factors on the association between IAQ and sick leave was observed.

Long Sick Leave after Orthopaedic Inpatient Rehabilitation: Treatment Failure or Relapse?

ERIC Educational Resources Information Center

Mangels, Marija; Schwarz, Susanne; Worringen, Ulrike; Holme, Martin; Rief, Winfried

2011-01-01

We investigated whether short-term versus long-term sick leave after orthopaedic inpatient rehabilitation can be predicted by initial assessment information, the clinical status at discharge, or whether the follow-up interval is crucial for later sick leave. We examined 214 patients from an orthopaedic rehabilitation hospital at admission,…

Demographic trends of sick leave absenteeism among civil service employees at a federal agency from 2004 to 2012.

PubMed

Gajewski, Kim; Burris, Dara; Spears, D Ross; Sullivan, Kevin; Oyinloye, Oluremi; McNeil, Carrie; Meechan, Paul; Warnock, Eli; Trapp, Jonathan; Decker, K C; Chapman, Sandy

2015-03-01

To investigate the associations between demographic variables and sick leave use. We analyzed sick leave use among civil servants at a federal agency (FA) from 2004 to 2012 by demographic and FA-specific variables. We used a mixed methods approach and type III analysis to build a descriptive model of sick leave proportions and demographic variables. Sick absenteeism usage varied significantly (variation of greater than one sick day per year) by sex, Emergency Operations Center response tier, length of service at the FA, age, and general schedule pay grade level. Our final descriptive model contained age, sex, response tier and an interaction term between age and sex. Future studies should examine these associations on smaller time scales, perhaps breaking the data down by month or day of the week.

The influence of lifestyle and gender on sickness absence in Brazilian workers

PubMed Central

2014-01-01

Background Despite an increasing body of knowledge concerning gender and lifestyle factors as determinants of sickness absence in well-developed countries, the relationship between these variables has not been elucidated in emerging economic power countries, where the burden of non-communicable diseases is particularly high. This study aimed to analyze the relationships among lifestyle-related factors and sick leave and to examine whether gender differences in sickness absence can be explained by differences in socio-demographic, work and lifestyle-related factors among Brazilian workers. Methods In this longitudinal study with a one year follow-up among 2.150 employees of a Brazilian airline company, sick leave was the primary outcome of interest. Independent variables collected by interview at enrolment in the study were gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity and smoking). In addition, the risk for coronary heart disease was determined based on measurement of blood pressure, total cholesterol and glucose levels. The total number of days on sick leave during 12 months follow-up was available from the company register. Logistic regression analysis was used to determine the influence of socio-demographic, type of work and lifestyle-related factors on sick leave. Results Younger employees, those with lower educational level, those who worked as air crew members and those with higher levels of stress were more likely to have sick leave. Body mass index and level of physical activity were not associated with sick leave. After adjustment by socio-demographic variables, increased odds for 10 or more days of sick leave were found in smokers (OR = 1.51, CI = 1.05-2.17), and ex-smokers (OR = 1.45, CI = 1.01-2.10). Women were more likely to have 10 or more days of sick leave. Gender differences were reduced mainly when adjusted for type of work (15%) and educational level (7%). Conclusions The higher occurrence of sick leave among women than among men was partly explained by type of work and educational level. Our results suggest that type of work, a stressful life, and smoking are important targets for health promotion in this study population. PMID:24708760

Paid Sick Leave and Risks of All-Cause and Cause-Specific Mortality among Adult Workers in the USA

PubMed Central

2017-01-01

Background: The USA is one of only a few advanced economies globally that does not guarantee its workers paid sick leave. While there are plausible reasons why paid sick leave may be linked to mortality, little is known empirically about this association. Methods: In a pooled USA nationally-representative longitudinal sample of 57,323 working adults aged 18–85 years from the National Health Interview Surveys 2000–2002, paid sick leave was examined as a predictor of all-cause and cause-specific mortality. Multivariate Cox proportional hazards models were used to estimate the impact of paid sick leave on mortality. Results: Having paid sick leave through one’s job was associated with 10% (hazards ratio, HR = 0.90; 95% CI = 0.81–0.996; p = 0.04), 14% (HR = 0.86; 95% CI = 0.74–0.99; p = 0.04), and 22% (HR = 0.78; 95% CI = 0.65–0.94; p = 0.01) significantly lower hazards of all-cause mortality after mean follow-up times of 11.1, 6.5, and 4.5 years, respectively. This study further identified associations of paid sick leave with 24% (HR = 0.76; 95% CI = 0.59–0.98; p = 0.03), and 35% (HR = 0.65; 95% CI = 0.44–0.95; p = 0.03) lower hazards of dying from heart diseases and unintentional injuries, respectively. Conclusions: To the author’s knowledge, this study provides the first empirical evidence on the linkages between paid sick leave and mortality and supports protective effects, particularly against heart diseases and unintentional injuries. The most salient association corresponded to a lag period of just less than five years. Social policies that mandate paid sick leave may help to reduce health inequities and alleviate the population burden of mortality among working adults in the USA. PMID:29048337

Diagnoses have the greatest impact on variation in sick-leave certification rate among primary-care patients in Sweden: A multilevel analysis including patient, physician and primary health-care centre levels.

PubMed

Starzmann, Karin; Hjerpe, Per; Dalemo, Sofia; Ohlsson, Henrik; Björkelund, Cecilia; Bengtsson Boström, Kristina

2015-11-01

The aims of this study were to determine and evaluate simultaneously the importance of factors known to influence sick-leave certification such as the sick leave-related diagnoses, the patients' socio-economic status, and characteristics of the physicians. Computerised medical records from 24 public primary health-care centres (PHCC) were used in a multilevel logistic regression analysis at three levels: patients (n=64,354; sex, age, socio-economic status, workplace factors and diagnoses), physicians (n=574; sex and level of experience) and PHCC (n=24). The variation of sick-leave certification at each level was the outcome. Most of the variation was attributed to the patient level and only 3.5% to the physician and 1.2% to the PHCC levels. Among the patient characteristics, psychiatric diagnoses (mostly acute stress) had the highest odds ratio (OR) for sick leave (OR=16.0; 95% confidence interval [CI] 15-17.2), followed by musculoskeletal diagnoses (OR=6.1; 95% CI 5.8-6.5). Other factors with increased OR were low education (OR=1.7; 95% CI 1.6-1.8), use of social allowance (OR=1.4; 95% CI 1.2-1.7) and certain workplaces (manufacture and health and social care). Being older was not associated with increased certified sick leave. The greatest variation in sick-leave certification rate was seen at the patient level, specifically psychiatric diagnoses. Socio-economic factors increasing the risk for sick-leave certification were education, social allowance and occupations in manufacture and caregiving. Understanding the impact of the different factors that influence certified sick leave is important both for targeted interventions in order to facilitate patients' return to work. © 2015 the Nordic Societies of Public Health.

Work-related psychosocial events as triggers of sick leave - results from a Swedish case-crossover study

PubMed Central

2011-01-01

Background Although illness is an important cause of sick leave, it has also been suggested that non-medical risk factors may influence this association. If such factors impact on the period of decision making, they should be considered as triggers. Yet, there is no empirical support available. The aim was to investigate whether recent exposure to work-related psychosocial events can trigger the decision to report sick when ill. Methods A case-crossover design was applied to 546 sick-leave spells, extracted from a Swedish cohort of 1 430 employees with a 3-12 month follow-up of new sick-leave spells. Exposure in a case period corresponding to an induction period of one or two days was compared with exposure during control periods sampled from workdays during a two-week period prior to sick leave for the same individual. This was done according to the matched-pair interval and the usual frequency approaches. Results are presented as odds ratios (OR) with 95% confidence intervals (CI). Results Most sick-leave spells happened in relation to acute, minor illnesses that substantially reduced work ability. The risk of taking sick leave was increased when individuals had recently been exposed to problems in their relationship with a superior (OR 3.63; CI 1.44-9.14) or colleagues (OR 4.68; CI 1.43-15.29). Individuals were also more inclined to report sick on days when they expected a very stressful work situation than on a day when they were not under such stress (OR 2.27; CI 1.40-3.70). Conclusions Exposure to problems in workplace relationships or a stressful work situation seems to be able to trigger reporting sick. Psychosocial work-environmental factors appear to have a short-term effect on individuals when deciding to report sick. PMID:21429193

The actions of the social insurance agency regarding long-term sickness absentees before and after a medical assessment--a study of 384 case files.

PubMed

Marklund, Staffan; Lundh, Göran; Gustafsson, Klas; Linder, Jürgen; Svedberg, Pia; Alexanderson, Kristina

2015-01-01

The purpose of this article is to investigate actions taken by the Social Insurance Agency (SIA) for long-term sickness absentees and possible associations of this with future sick leave or disability pension. For 384 long-term sickness absentees who had had a multidisciplinary medical assessment (MMA) during 2001-2006, three types of data were obtained: (1) case file information about SIA actions, (2) suggested rehabilitation measures from the MMA and (3) sickness absence and disability pension data. Most individuals had been subject to a range of actions by the SIA. Sixty percent had been invited to a coordination meeting, and half of those who assessed by the MMA for vocational rehabilitation were approved to get it by the SIA. Few SIA actions were associated with full or partial return to work. Although the studied individuals had been on sick leave for a long time, the number of SIA actions related to vocational rehabilitation was limited and came late in the sick-leave spell. The information from the MMA was often not used as a basis for further SIA action and seldom resulted in return to work. The positive MMA views on the potential of vocational rehabilitation were not met by SIA actions. Suggestions on vocational rehabilitation from a medical assessment was in many cases not used by the social insurance agency in relationship to long-term sickness absentees. Active rehabilitation measures by the social insurance agency were few and came late in the sickness absence process. Few of the activities taken by the social insurance agency enhanced return to work.

Systematic co-operation between employer, occupational health service and social insurance office: a 6-year follow-up of vocational rehabilitation for people on sick-leave, including economic benefits.

PubMed

Kärrholm, Jenny; Ekholm, Karolina; Ekholm, Jan; Bergroth, Alf; Ekholm, Kristina Schüldt

2008-08-01

To evaluate the effects of systematic co-operation among municipal employees on the number of sick-leave days per month and the type of benefit granted by the Social Insurance Office. A further aim was to evaluate the economic consequences for society. A 6-year follow-up study with a matched-pairs design. Days on sick-leave were calculated for each subject one year before the intervention started and yearly for the following 6-year period. Statistical mixed-model analysis was used. The economic benefit of the intervention was estimated as the increased production stemming from fewer days on sick-leave. Sixty-four employees on long-term sick-leave were individually matched with controls from another Social Insurance Office in a county with a socioeconomic structure similar to that of the study group. The study group had 5.7 fewer days on sick-leave per month and person over the 6-year period (p=0.003). The estimated average economic benefit of the intervention was euro36,600 per person over the 6-year period. In conclusion, those who received systematic co-operation in vocational rehabilitation had fewer days on sick-leave than their "treatment-as-usual" peers. This effect persisted over 6 years, generating substantial net economic gains for society.

Profiling the U.S. Sick Leave Landscape: Presenteeism among Females.

PubMed

Susser, Philip; Ziebarth, Nicolas R

2016-12-01

To profile the sick leave landscape in the United States. The 2011 Leave Supplement of the American Time Use Survey. Bivariate and multivariate analyses to identify (i) employees without sick pay coverage and (ii) employees who attend work sick. Sixty-five percent of full-time employees have sick pay coverage. Coverage rates are below 20 percent for employees with hourly wages below $10, part-time employees, and employees in the hospitality and leisure industry. Each week, up to 3 million U.S. employees go to work sick. Females, low-income earners, and those aged 25 to 34 years have a significantly elevated risk of presenteeism behavior. © Health Research and Educational Trust.

Influenza in workplaces: transmission, workers’ adherence to sick leave advice and European sick leave recommendations

PubMed Central

Tomba, Gianpaolo Scalia; de Blasio, Birgitte Freiesleben

2016-01-01

Background: Knowledge about influenza transmission in the workplace and whether staying home from work when experiencing influenza-like illness can reduce the spread of influenza is crucial for the design of efficient public health initiatives. Aim: This review synthesizes current literature on sickness presenteeism and influenza transmission in the workplace and provides an overview of sick leave recommendations in Europe for influenza. Methods: A search was performed on Medline, Embase, PsychINFO, Cinahl, Web of Science, Scopus and SweMed to identify studies related to workplace contacts, -transmission, -interventions and compliance with recommendations to take sick leave. A web-based survey on national recommendations and policies for sick leave during influenza was issued to 31 European countries. Results: Twenty-two articles (9 surveys; 13 modelling articles) were eligible for this review. Results from social mixing studies suggest that 20–25% of weekly contacts are made in the workplace, while modelling studies suggest that on average 16% (range 9–33%) of influenza transmission occurs in the workplace. The effectiveness of interventions to reduce workplace presenteeism is largely unknown. Finally, estimates from studies reporting expected compliance with sick leave recommendations ranged from 71 to 95%. Overall, 18 countries participated in the survey of which nine (50%) had issued recommendations encouraging sick employees to stay at home during the 2009 A(H1N1) pandemic, while only one country had official recommendations for seasonal influenza. Conclusions: During the 2009 A(H1N1) pandemic, many European countries recommended ill employees to take sick leave. Further research is warranted to quantify the effect of reduced presenteeism during influenza illness. PMID:27060594

Influenza in workplaces: transmission, workers' adherence to sick leave advice and European sick leave recommendations.

PubMed

Edwards, Christina Hansen; Tomba, Gianpaolo Scalia; de Blasio, Birgitte Freiesleben

2016-06-01

Knowledge about influenza transmission in the workplace and whether staying home from work when experiencing influenza-like illness can reduce the spread of influenza is crucial for the design of efficient public health initiatives. This review synthesizes current literature on sickness presenteeism and influenza transmission in the workplace and provides an overview of sick leave recommendations in Europe for influenza. A search was performed on Medline, Embase, PsychINFO, Cinahl, Web of Science, Scopus and SweMed to identify studies related to workplace contacts, -transmission, -interventions and compliance with recommendations to take sick leave. A web-based survey on national recommendations and policies for sick leave during influenza was issued to 31 European countries. Twenty-two articles (9 surveys; 13 modelling articles) were eligible for this review. Results from social mixing studies suggest that 20-25% of weekly contacts are made in the workplace, while modelling studies suggest that on average 16% (range 9-33%) of influenza transmission occurs in the workplace. The effectiveness of interventions to reduce workplace presenteeism is largely unknown. Finally, estimates from studies reporting expected compliance with sick leave recommendations ranged from 71 to 95%. Overall, 18 countries participated in the survey of which nine (50%) had issued recommendations encouraging sick employees to stay at home during the 2009 A(H1N1) pandemic, while only one country had official recommendations for seasonal influenza. During the 2009 A(H1N1) pandemic, many European countries recommended ill employees to take sick leave. Further research is warranted to quantify the effect of reduced presenteeism during influenza illness. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association.

Sick-leave and help seeking among rescue workers after the terror attacks in Norway, 2011.

PubMed

Gjerland, Astrid; Pedersen, May Janne Botha; Ekeberg, Øivind; Skogstad, Laila

2015-12-01

Several studies have addressed psychological problems after terror attacks, especially among victims. Fewer have addressed possible health consequences among rescue workers involved with terror attacks. This study's aim was to investigate the levels of sick-leave and psychological help seeking among rescue workers involved in the terror attacks in Norway on July 22, 2011, and to identify associations between sick-leave and background-, exposure- and work-related variables. This cross-sectional study included five groups of professional rescue personnel and one group of unaffiliated volunteers. The questionnaire was distributed approximately 10 months after the terror attacks, with a response rate of 61.3 % (N = 1790). A total of 9.7 % of participants self-reported sick-leave. The rate varied from 2.4 % among police officers to 14.5 % among unaffiliated volunteers, p < .001. There were 0.0-1.2 % of the professionals who were on sick-leave for more than 2 weeks and 5.5 % among the unaffiliated volunteers. More unaffiliated volunteers (42.6 %) and psychosocial personnel (16.3 %) consulted a psychologist or psychiatrist compared to other groups (3-9 %), p < .001. General healthcare providers (OR 6.1), psychosocial personnel (OR 6.3) and unaffiliated volunteers (OR 5.7) were associated with sick-leave, together with unwanted stress reactions (OR 1.6) and starting work on July 22 (OR 1.6). A small minority of professional rescue workers reported sick-leave for more than 2 weeks, and few had sought psychological help. Unaffiliated volunteers reported more stress symptoms, longer sick-leave duration and more psychological help seeking. This group may benefit from more support.

Association between Sick Leave Prescribing Practices and Physician Burnout and Empathy

PubMed Central

2015-01-01

Objectives To investigate the association between sick leave prescription and physician burnout and empathy in a primary care health district in Lleida, Spain. Methods This descriptive study included 108 primary care doctors from 22 primary care centers in Lleida in 2014 (183,600 patients). Burnout was measured with the Maslach Burnout Inventory and empathy with the Jefferson Scale of Physician Empathy. The reliability of the instruments was measured by calculating Cronbach’s alpha and normal distribution was analyzed using the Kolmogorov-Smirnov-Lilliefors and χ2 tests. Burnout and empathy scores were analyzed by age, sex, and place of work (urban vs rural). Sick leave data were obtained from the Catalan Health Institute. Results High empathy was significantly associated with low burnout. Neither empathy nor burnout were significantly associated with sick leave prescription. Conclusion Sick leave prescription by physicians is not associated with physicians' empathy or burnout and may mostly depend on prescribing guidelines. PMID:26196687

Trends of absenteeism in Croatia: a longitudinal study from 2000 to 2012.

PubMed

Ban-Toskić, Nataša; Tabak, Vesna; Tiljak, Hrvoje

2014-12-01

The aim of this article is to determine the trends in absenteeism from 2000 to 2012 in Croatia and to examine if the observed trends could be related to the regulations implemented to keep the absenteeism on low level. In Croatia only family doctors keep the responsibility for sick leave and were always been targeted by many regulations to keep absenteeism on appropriate level. A study was observational and retrospective based on the official CHIF data available from the web-page. Although the average number of sick leave days had been bisected (from 30.58 to 15.08 days per patient) sick leave rate only slightly fell down (from 3.32% to 3.11%). It seems that the restrictive measures did not significantly affect the number of sick leave cases. Such a results and other European research studies indicates that without reduction of the institutional rights there will be no reducing of sick leave rates.

Meaning of work and the returning process after breast cancer: a longitudinal study of 56 women.

PubMed

Lilliehorn, Sara; Hamberg, Katarina; Kero, Anneli; Salander, Pär

2013-06-01

An increasing number of women survive breast cancer and a majority return to work. However, findings based on mean values may conceal individual processes that need to be better understood to discuss meaningful rehabilitation. The purpose of this study is to describe the sick-leave pattern of a group of Swedish women with primary breast cancer but foremost to explore their ideas about what motivates and discourages their return to work. Fifty-six women were repeatedly interviewed over a period of 18-24 months. Interview sections that clearly illustrated the women's experiences and ideas about work were categorized using the comparative similarities-differences technique. The average length of sick leave was 410 days (range 0-942). Six months after the first day of sick leave, 29% worked at least their previous service grade. At 12 months, 55% and at 18 months 57% did so. Those treated with chemotherapy had in average more than twice as large sick leave as those who did not. Three categories emerged. 'Motives for not returning to work' consists of four subcategories: 'I'm still too fragile to return to work'; 'My workplace is a discouraging place'; 'I took an opportunity to pause' and 'I've lost the taste for work'. 'Motives for returning' consists of two sub-categories: 'Work generates and structures my everyday life' and 'I miss my workplace'. Finally, 'Transition in work approach' reflects a changed approach to work. The meaning of work varies over time, but first and foremost work was regarded as an important part of the healing process as it restores the disruption of everyday life. Guidelines cannot be reduced to a linear relationship with biomedical variables but the individual context of everyday life must be considered. © 2012 Nordic College of Caring Science.

Approaches for predicting long-term sickness absence. Re: Schouten et al. "Screening manual and office workers for risk of long-term sickness absence: cut-off points for the Work Ability Index".

PubMed

van Amelsvoort, Ludovic Gpm; Jansen, Nicole W H; Kant, I Jmert

2015-05-01

We read with much interest the article of Schouten et al (1) on identifying workers with a high risk for future long-term sickness absence using the Work Ability Index (WAI). The ability to identify high-risk workers might facilitate targeted interventions for such workers and, consequently, can reduce sickness absence levels and improve workers' health. Earlier studies by both Tamela et al (2), Kant et al (3), and Lexis et al (4) have demonstrated that such an approach, based on the identification of high-risk workers and a subsequent intervention, can be effectively applied in practice to reduce sickness absence significantly. The reason for our letter on Schouten et al's article is twofold. First, by including workers already on sick leave in a study predicting long-term sick leave will result in an overestimation of the predictive properties of the instrument and biased predictors, especially when also the outcome of interest is included as a factor in the prediction model. Second, we object to the use of the term "screening" when subjects with the condition screened for are included in the study. Reinforced by the inclusion of sickness absence in the prediction model, including workers already on sick leave will shift the focus of the study findings towards the prediction of (re)current sickness absence and workers with a below-average return-to-work rate, rather than the identification of workers at high risk for the onset of future long-term sickness absence. The possibilities for prevention will shift from pure secondary prevention to a mix of secondary and tertiary prevention. As a consequence, the predictors of the model presented in the Schouten et al article can be used as a basis for tailoring neither preventive measures nor interventions. Moreover, including the outcome (sickness absence) as a predictor in the model, especially in a mixed population including workers with and without the condition (on sick leave), will result in biased predictors and an overestimation of the predictive value. A methodological approach of related issues is provided in the works of Glymour et al (5) and Hamilton et al (6). This phenomenon is even more clearly illustrated by the predictive properties of the workability index, as described by Alavinia et al (7, page 328), which reported that "when adjusted for individual characteristics, lifestyle factors, and work characteristics, two dimensions of the WAI were significant predictors for both moderate and long durations of sickness absence: (i) the presence of sickness absence in the past 12 months prior to the medical examination and (ii) experienced limitations due to health problems." So, when applied to the study by Schouten et al (1), this means that most of the predictive value would be related to the factors "sickness absence in the past 12 months". In addition, we object to the use of the term "screening" in the Schouten et al study as it includes workers with the intended outcome (long-term sickness absence). One can identify three separate aims to study the longitudinal association between risk factors and subsequent long-term sickness absence: (i) to establish causal risk factors for long-term sickness absence, often to find clues for primary preventive strategies (beyond the scope here); (ii) to identify high-risk workers who are still at work and might benefit from an intervention before sickness absence occurs (secondary prevention); and (iii) to identify workers on sick leave who might suffer a below-average return-to-work rate or have a high risk for the recurrence of (long-term) sickness absence and might benefit from intensification or optimization of the return-to-work process (tertiary prevention). In this light, one needs to separate screening instruments from predictive instruments and reserve the term "screening" for the situation as defined by Wilson and Junger (8, page 7): "The object of screening for disease is to discover those among the apparently well who are in fact suffering from disease" (ie, situations of secondary prevention). This means that, when applying this definition on long-term sickness absence under the precondition that the individuals are still at work, screening enables the identification of high-risk individuals in the early "stages" of a "disease" that can progress into long-term sickness absence. In the case of the Schouten et al study, the population at risk, as derived from their predictive instrument, consists of workers with and without sickness absence, and as such excludes the use of the term "screening" in this case. To conclude, we have substantiated that, in addition to correct usage of the term "screening", careful selection of the study population, predictors and most importantly the aim of the predictive model are essential in the process of developing predictive instruments aimed at identifying workers at high risk of long-term sickness absence. Two fundamentally different approaches are possible. One approach aims at identifying workers on sick leave with either a below-average chance to return to work an/or a high risk for a successive episode of long-term sickness absence. From a methodological and practical point of view, such an instrument should be developed and validated among workers already on sick leave. A second approach aims at identifying workers who are still at work but at high risk for future long-term sickness absence. To develop and validate such an instrument, a study sample where workers already on sick leave are excluded is a prerequisite. Such instruments fit in a pro-active approach of preventing future sickness absence, where an early intervention can be offered to those workers with an increased risk for future sickness absence.

How do line managers experience and handle the return to work of employees on sick leave due to work-related stress? A one-year follow-up study.

PubMed

Ladegaard, Yun; Skakon, Janne; Elrond, Andreas Friis; Netterstrøm, Bo

2017-08-28

To examine how line managers experience and manage the return to work process of employees on sick leave due to work-related stress and to identify supportive and inhibiting factors. Semi-structured interviews with 15 line managers who have had employees on sick leave due to work-related stress. The grounded theory approach was employed. Even though managers may accept the overall concept of work-related stress, they focus on personality and individual circumstances when an employee is sick-listed due to work-related stress. The lack of a common understanding of stress creates room for this focus. Line managers experience cross-pressure, discrepancies between strategic and human-relationship perspectives and a lack of organizational support in the return to work process. Organizations should aim to provide support for line managers. Research-based knowledge and guidelines on work-related stress and return to work process are essential, as is the involvement of coworkers. A commonly accepted definition of stress and a systematic risk assessment is also important. Cross-pressure on line managers should be minimized and room for adequate preventive actions should be provided as such an approach could support both the return to work process and the implementation of important interventions in the work environment. Implication for rehabilitation Organizations should aim to provide support for line managers handling the return to work process. Cross-pressure on line managers should be minimized and adequate preventive actions should be provided in relation to the return to work process. Research-based knowledge and guidelines on work-related stress and return to work are essential. A common and formal definition of stress should be emphasized in the workplace.

General practitioners' experiences with sickness certification: a comparison of survey data from Sweden and Norway

PubMed Central

2012-01-01

Background In most countries with sickness insurance systems, general practitioners (GPs) play a key role in the sickness-absence process. Previous studies have indicated that GPs experience several tasks and situations related to sickness certification consultations as problematic. The fact that the organization of primary health care and social insurance systems differ between countries may influence both GPs' experiences and certification. The aim of the present study was to gain more knowledge of GPs' experiences of sickness certification, by comparing data from Sweden and Norway, regarding frequencies and aspects of sickness certification found to be problematic. Methods Statistical analyses of cross-sectional survey data of sickness certification by GPs in Sweden and Norway. In Sweden, all GPs were included, with 3949 (60.6%) responding. In Norway, a representative sample of GPs was included, with 221 (66.5%) responding. Results Most GPs reported having consultations involving sickness certification at least once a week; 95% of the GPs in Sweden and 99% of the GPs in Norway. A majority found such tasks problematic; 60% of the GPs in Sweden and 53% in Norway. In a logistic regression, having a higher frequency of sickness certification consultations was associated with a higher risk of experiencing them as problematic, in both countries. A higher rate of GPs in Sweden than in Norway reported meeting patients wanting a sickness certification without a medical reason. GPs in Sweden found it more problematic to discuss the advantages and disadvantages of sick leave with patients and to issue a prolongation of a sick-leave period initiated by another physician. GPs in Norway more often worried that patients would go to another physician if they did not issue a certificate, and a higher proportion of Norwegian GPs found it problematic to handle situations where they and their patient disagreed on the need for sick leave. Conclusions The study confirms that many GPs experience sickness absence consultations as problematic. However, there were differences between the two countries in GPs' experiences, which may be linked to differences in social security regulations and the organization of GP services. Possible causes and consequences of national differences should be addressed in future studies. PMID:22375615

Sick leave and the impact of job-to-job mobility on the likelihood of remaining on the labour market - a longitudinal Swedish register study

PubMed Central

2014-01-01

Background Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave. Methods In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20–60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n > 3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration. Results Women with more than 180 days’ sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999. Conclusions The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation. PMID:24694029

A prospective study of psychosocial work characteristics and long sick leave of Japanese male employees in multiple workplaces.

PubMed

Ishizaki, Masao; Kawakami, Norito; Honda, Ryumon; Yamada, Yuichi; Nakagawa, Hideaki; Morikawa, Yuko

2013-01-01

The aim of this study was to identify psychosocial work characteristics associated with long sick leave in a large population of male Japanese employees in multiple workplaces. We examined various psychosocial work characteristics (job overload, job control, supervisor support, coworker support, support by family and friends, role ambiguity, role conflict, intragroup conflict and intergroup conflict) of employees in six factories at the base line. We then conducted a follow-up survey on the recorded long sick leaves of ≥ 30 continuous days taken by the employees due to any medical condition. We found 574 cases of long sick leave out of 15,531 subjects during an average 5.07-yr follow-up. The results showed that high supervisor support was significantly associated with a decrease in the hazard ratio (HR) of long sick leave after adjustment for several confounding factors (95%CI; 0.69-0.97). High role ambiguity also tended to increase HR, but without reaching significance (95%CI; 0.99-1.41). The results suggest that supervisor support in the workplace may be important to reduce long sick leave in Japanese male employees.

The influence of household work and of having children on sickness absence among publicly employed women in Sweden.

PubMed

Voss, Margaretha; Josephson, Malin; Stark, Stefan; Vaez, Marjan; Alexanderson, Kristina; Alfredsson, Lars; Vingård, Eva

2008-08-01

To investigate whether family obligations influence the risk of sickness absence among female municipal employees in Sweden. A 1-year prospective cohort study of 1464 female municipal employees <50 years of age in Sweden in 2000 was conducted using questionnaire responses and absence data from the employers' personnel records. The relative risk of having children <16 years of age in the home, marital status, household work, financial situation, working hours and work-family conflicts for repeated sick-leave spells (>or=4 spells) and long-term sickness absence (>or=28 days) were calculated by applying Poisson regression models. Women reporting financial strain or work-family conflicts were at elevated risk for long-term sickness absence. Having children was not a risk factor for repeated sick-leave spells or long-term sickness absence among married/cohabiting women. Single women with children had a two-fold greater risk of repeated sick-leave spells than single women without children. The findings suggest that the combination of gainful employment and children does not influence the risk of repeated sick-leave spells or long-term sickness absence among married/cohabiting publicly employed women. However, this was not true for single women with children, which indicates that their circumstances are particularly strained.

LEAVE OF ABSENCE PRACTICES IN SOUTH DAKOTA SCHOOLS--SCHOOL YEAR 1964-65.

ERIC Educational Resources Information Center

South Dakota Education Association, Pierre.

IN ADDITION TO SCHOOL POLICIES RELATING TO TEACHER LEAVES OF ABSENCE IN SOUTH DAKOTA, STATE BY STATE SUMMARIES OF EDUCATIONAL LEGISLATION REGARDING SICK LEAVE, MATERNITY LEAVE, AND SABBATICAL LEAVE ARE PRESENTED IN THIS DOCUMENT. OF THE 228 RESPONDING SCHOOLS IN SOUTH DAKOTA, 215 REPORTED EXISTING SICK LEAVE POLICIES. THE MAJORITY OF RESPONDING…

Downsizing of staff is associated with lowered medically certified sick leave in female employees.

PubMed

Theorell, T; Oxenstierna, G; Westerlund, H; Ferrie, J; Hagberg, J; Alfredsson, L

2003-09-01

To determine whether changes in number of staff in work sites are associated with medically certified sick leave among employees with an increased risk of developing cardiovascular disease. The 5720 employees (aged 18-65) were from the WOLF study of cardiovascular risk factors in working men and women in greater Stockholm during the years 1992-95. From the medical examination a cardiovascular score was calculated for each participant. The WOLF study base was linked to a Statistics Sweden registry of economic and administrative activities. Sick leave spells lasting for at least 15 days during the calendar year following downsizing/expansion were identified for each subject. In multiple logistic regression an increased likelihood of having no medically certified sick leave (15 days or more) was found in women during the year following both downsizing and expansion. These analyses were adjusted for age and cardiovascular score. A high cardiovascular risk score reduced the likelihood of having no medically certified sick leave. The inclusion of psychosocial work environment variables did not change the results markedly. Separate analyses of women with and without high cardiovascular score showed that downsizing had a more pronounced effect on reduced long term sick leave among those with high than among those without low cardiovascular score. There were no consistent findings in men. There is evidence of a reduction of long term sick leave in women after downsizing and this is particularly evident among those with high cardiovascular score.

Pregnancy-related sickness absence among employed women in a Swedish county.

PubMed

Alexanderson, K; Hensing, G; Carstensen, J; Bjurulf, P

1995-06-01

The objective of this study was to analyze the variation of pregnancy-related sickness absence among employed women according to age, occupation, and degree of male-female domination within occupations. Data from a prospective study of all new sick-leave spells exceeding 7 d in 1985 and 1986 in the county of Ostergötland, Sweden, were related to the population at risk, through the Swedish Medical Birth Register. The subjects included in the analysis were all 7000 employed women that gave birth in 1985 and 1986, of which some 3000 were sick-listed at least once with pregnancy-related diagnoses. There was little difference in the pregnancy-related sickness absence between the age groups. The age-standardized rate for sick leaves involving pregnancy-related diagnoses differed substantially between occupations. Women in the metal industry had the highest rates; those employed in administration, banking, and insurance had the lowest. White-collar occupations generally had lower rates and blue-collar occupations higher rates, with some exceptions (eg, in saw mills, farming, and the chemical industry). Gender-integrated occupations had the lowest sick-leave rate, while extremely male-dominated jobs had the highest. The latter association remained after adjustment for occupational area. There were considerable differences between occupational groups in the rates of sick leaves involving pregnancy-related diagnoses. Some differences were related to physical load of the jobs being done, but not all. It seems important to consider also male-female domination within a job with respect to such sick leaves.

Improving return-to-work after childbirth: design of the Mom@Work study, a randomised controlled trial and cohort study.

PubMed

Stomp-van den Berg, Suzanne G M; van Poppel, Mireille N M; Hendriksen, Ingrid J M; Bruinvels, David J; Uegaki, Kimi; de Bruijne, Martine C; van Mechelen, Willem

2007-03-29

Many women suffer from health problems after giving birth, which can lead to sick leave. About 30% of Dutch workers are on sick leave after maternity leave. Structural contact of supervisors with employees on maternity leave, supported by early medical advice of occupational physicians, may increase the chances of return-to-work after maternity leave. In addition, to understand the process of sick leave and return-to-work after childbirth it is important to gain insight into which factors hinder return-to-work after childbirth, as well, as which prognostic factors lead to the development of postpartum health complaints. In this paper, the design of the Mom@Work study is described. The Mom@Work study is simultaneously a randomised controlled trial and a cohort study. Pregnant women working for at least 12 hours a week at one of the 15 participating companies are eligible to participate. The supervisors of these pregnant employees are randomised at 35 weeks pregnancy into the intervention group or control group. During maternity leave, supervisors in the intervention group contact their employee six weeks after delivery using a structured interview. When employees do not expect to return to their jobs at the end of their scheduled maternity leave due to health problems, the supervisor offers early support of the occupational physician. Supervisors in the control group have no structural contact with their employees during maternity leave. Measurements take place at 30 weeks pregnancy and at 6, 12, 24 and 52 weeks postpartum. In addition, cost data are collected. For the RCT, primary outcome measures are sick leave and return-to-work, and secondary outcome measures are costs, health, satisfaction with intervention and global feelings of recovery. Outcome measures for the cohort are pregnancy-related pelvic girdle pain, fatigue and depression. Finally, a number of prognostic factors for return-to-work and for the development of complaints will be measured. The Mom@Work study will provide important information about return-to-work of employees after giving birth. Results will give insight in prognosis of postpartum sick leave and complaints. Also, the role of supervisors and occupational physicians in successful return-to-work after childbirth will be clarified.

A multi-state model for sick-leave data applied to a randomized control trial study of low back pain.

PubMed

Lie, Stein Atle; Eriksen, Hege R; Ursin, Holger; Hagen, Eli Molde

2008-05-01

Analysing and presenting data on different outcomes after sick-leave is challenging. The use of extended statistical methods supplies additional information and allows further exploitation of data. Four hundred and fifty-seven patients, sick-listed for 8-12 weeks for low back pain, were randomized to intervention (n=237) or control (n=220). Outcome was measured as: "sick-listed'', "returned to work'', or "disability pension''. The individuals shifted between the three states between one and 22 times (mean 6.4 times). In a multi-state model, shifting between the states was set up in a transition intensity matrix. The probability of being in any of the states was calculated as a transition probability matrix. The effects of the intervention were modelled using a non-parametric model. There was an effect of the intervention for leaving the state sick-listed and shifting to returned to work (relative risk (RR)=1.27, 95% confidence interval (CI) 1.09- 1.47). The nonparametric estimates showed an effect of the intervention for leaving sick-listed and shifting to returned to work in the first 6 months. We found a protective effect of the intervention for shifting back to sick-listed between 6 and 18 months. The analyses showed that the probability of staying in the state returned to work was not different between the intervention and control groups at the end of the follow-up (3 years). We demonstrate that these alternative analyses give additional results and increase the strength of the analyses. The simple intervention did not decrease the probability of being on sick-leave in the long term; however, it decreased the time that individuals were on sick-leave.

Determinants of sick-leave length: still limited to diagnosis elements.

PubMed

Lévy, Yvan; Denis, Angélique; Fassier, Jean-Baptiste; Kellou, Nadir; Schott, Anne-Marie; Letrilliart, Laurent

2017-12-01

Sickness certification implies that a health problem impairs ability to work. However, its assessment is seldom performed by physicians. Our objective was, therefore, to assess the specific influence of functional and environmental limitations on the length of sick-leave prescriptions. We conducted a cross-sectional study in French general teaching practices and recorded 353 initial sick-leave certifications. For each of them, the functional and environmental limitations were collected using the ATCIF questionnaire, derived from the International Classification of Functioning. Data analysis was based on a linear regression multivariate model. Among the functional limitations, "pain" was the main body function impairment (22% of impairments) and "mobility" the main activity limitation (48%). An environmental barrier was identified in 39% of sick-listed patients, mainly relating to "products and technology" (20%), which refers to workplace factors. The prescription was longer in cases of activity limitations relating to "mobility" and in cases of environmental barriers relating to "products and technology". The multivariate model explained 27% of the variability of sick-leave length through diagnosis elements and only 7% through functional and contextual elements. In sick-leave prescription, a functional and contextual approach, in addition to the traditional diagnosis-based approach, could better support patients' shared understanding and follow-up, and accountability towards health authorities. Implication for Rehabilitation Although sickness certification implies that a health problem impairs ability to work, decision on sick-leave length in general practice is primarily based on diagnosis. A more functional and contextual approach could better support patients' and other health professionals' shared understanding and follow-up, and accountability towards health authorities. Such evolution requires a change of paradigm in medical education, and the way of reasoning of healthcare professionals.

Partial sick leave--review of its use, effects and feasibility in the Nordic countries.

PubMed

Kausto, Johanna; Miranda, Helena; Martimo, Kari-Pekka; Viikari-Juntura, Eira

2008-08-01

Partial sick leave and partial sickness benefits are currently available in Sweden, Norway, Denmark, and Finland. The literature was reviewed to determine their use, describe their recipients, find evidence of their effects, and explore attitudes towards and experiences with their use. Eight databases were searched. National sickness absence statistics and other relevant sources were also reviewed. Of the sickness benefits, partial benefits accounted for approximately one-fifth in Norway, less than 10% in Denmark, and over a third in Sweden. In Finland, partial sick leave was seldom used during the first year (2007) of benefit availability. Few peer-reviewed studies on its effects were identified, and scientific evidence was scarce. Its acceptance was good in all four countries. Most of the recipients were women and over 45 years of age. Studies of its feasibility seem congruent in reporting hindrances due to inflexible work arrangements and poor collaboration between actors. More research and more rigorous study designs are needed to determine whether partial sick leave is feasible and beneficial in keeping those with reduced work ability in worklife.

Paid Sick Leave and Job Stability

PubMed Central

Hill, Heather D.

2013-01-01

A compelling, but unsubstantiated, argument for paid sick leave legislation is that workers with leave are better able to address own and family member health needs without risking a voluntary or involuntary job separation. This study tests that claim using the Medical Expenditure Panel Survey and regression models controlling for a large set of worker and job characteristics, as well as with propensity score techniques. Results suggest that paid sick leave decreases the probability of job separation by at least 2.5 percentage points, or 25%. The association is strongest for workers without paid vacation leave and for mothers. PMID:24235780

Psychoeducation to facilitate return to work in individuals on sick leave and at risk of having a mental disorder: protocol of a randomised controlled trial.

PubMed

Pedersen, Pernille; Søgaard, Hans Jørgen; Yde, Bjarne Frostholm; Labriola, Merete; Nohr, Ellen A; Jensen, Chris

2014-12-17

Sickness absence due to poor mental health is a common problem in many Western countries. To facilitate return to work, it may be important to identify individuals on sick leave and at risk of having a mental disorder and subsequently to offer appropriate treatment. Psychoeducation alone has not previously been used as a return to work intervention, but may be a promising tool to facilitate return to work. Therefore, the aim of the study is to evaluate the effectiveness of psychoeducation designed specifically to facilitate return to work for individuals on sick leave and at risk of having a mental disorder. The psychoeducation was a supplement to the various standard offers provided by the job centres. The study is a randomised controlled trial, in which individuals on sick leave either receive psychoeducation and standard case management or standard case management alone. Participants were individuals with mental health symptoms, who had been on sick leave from part-time or full-time work or unemployment for about 4-8 weeks. The psychoeducational intervention was group-based and the course consisted of 2 hour sessions once a week for 6 weeks. The course was given by psychiatric nurses, a psychologist, a social worker, a physiotherapist and a person who had previously been on sick leave due to mental health problems. The sessions focused on stress and work life, and the purpose was to provide individuals on sick leave the skills to understand and improve their mental functioning.The primary outcome is the duration of sickness absence measured by register data. Secondary outcomes include psychological symptoms, mental health-related quality of life, and locus of control. These outcomes are measured by questionnaires at the start of the intervention and at 3 and 6 months follow-up. On the basis of this trial, the effect of psychoeducation for individuals on sick leave and at risk of having a mental disorder will be studied. The results will contribute to the continuing research on sickness absence and mental health. It will primarily show whether psychoeducation can lead to faster and sustainable return to work. Clinical Trial.gov NCT01637363. Registered 6 July 2012.

Organizational return to work support and sick leave duration: a cohort of Spanish workers with a long-term non-work-related sick leave episode.

PubMed

Sampere, Maite; Gimeno, David; Serra, Consol; Plana, Manel; Martínez, José Miguel; Delclos, George L; Benavides, Fernando G

2011-06-01

To analyze the association between organizational support and time to return to work (RTW) in workers with long-term non-work-related sick leave. Cohort participants were 571 workers, with a non-work-related sick leave episode of more than 15 days, recruited during the first visit in a health insurance company (mutua). Workers completed a baseline questionnaire regarding organizational RTW support measures and were followed until the end of the episodes. Return to work and time to RTW were established on the basis of the mutua's register. Multivariate Cox regression models were used. Workers in companies with an overall high organizational RTW support returned to work earlier. This effect was mainly due to workers in companies that provided specific RTW programs. Our findings suggest that companies play an important role in facilitating RTW for workers with long-term non-work-related sick leave episodes.

Living with uncertainty: a Swedish qualitative interview study of women at home on sick leave due to premature labour.

PubMed

Höglund, Eva; Dykes, Anna-Karin

2013-05-01

to highlight the experiences of pregnant women, experiencing preterm labour, being on sick leave at home and how they handled their daily life. qualitative, descriptive using open interviews. 10 antenatal clinics in the south of Sweden. 15 pregnant women who were on sick leave for premature labour. four categories were identified: how to interpret unpredictable contractions in the uterus? Having concern regarding premature labour of their child, handling the new situation and finding a balance, and from work to sick leave. to be on sick leave for premature contractions can be compared with enduring a situation of inactivity. The woman finds herself in a stressful situation which she must learn to handle this and find a balance. it appears that supportive information offers the women in premature labour the opportunity of increased participation and responsibility which thereby positively affects her well-being. Copyright © 2012 Elsevier Ltd. All rights reserved.

Waterborne outbreak of gastroenteritis: effects on sick leaves and cost of lost workdays.

PubMed

Halonen, Jaana I; Kivimäki, Mika; Oksanen, Tuula; Virtanen, Pekka; Virtanen, Mikko J; Pentti, Jaana; Vahtera, Jussi

2012-01-01

In 2007, part of a drinking water distribution system was accidentally contaminated with waste water effluent causing a gastroenteritis outbreak in a Finnish town. We examined the acute and cumulative effects of this incidence on sick leaves among public sector employees residing in the clean and contaminated areas, and the additional costs of lost workdays due to the incidence. Daily information on sick leaves of 1789 Finnish Public Sector Study participants was obtained from employers' registers. Global Positioning System-coordinates were used for linking participants to the clean and contaminated areas. Prevalence ratios (PR) for weekly sickness absences were calculated using binomial regression analysis. Calculations for the costs were based on prior studies. Among those living in the contaminated areas, the prevalence of participants on sick leave was 3.54 (95% confidence interval (CI) 2.97-4.22) times higher on the week following the incidence compared to the reference period. Those living and working in the clean area were basically not affected, the corresponding PR for sick leaves was 1.12, 95% CI 0.73-1.73. No cumulative effects on sick leaves were observed among the exposed. The estimated additional costs of lost workdays due to the incidence were 1.8-2.1 million euros. The prevalence of sickness absences among public sector employees residing in affected areas increased shortly after drinking water distribution system was contaminated, but no long-term effects were observed. The estimated costs of lost workdays were remarkable, thus, the cost-benefits of better monitoring systems for the water distribution systems should be evaluated.

Estimating influenza-related sick leave in Norway: was work absenteeism higher during the 2009 A(H1N1) pandemic compared to seasonal epidemics?

PubMed

de Blasio, B F; Xue, Y; Iversen, B; Gran, J Michael

2012-08-16

The impact of influenza on work absenteeism is poorly documented. We used data from the national registry and Norway Post AS (>14,000 employees) to explore sickness absence patterns from 2005/06 through 2009/10 in Norway. Annually, an estimated 2.868% (mean 95% confidence interval (CI): 2.405-4.820%) of the working population obtained sick leave for influenza, of whom 0.915% (mean 95% CI: 0.453-1.590%) had diagnoses for other respiratory illnesses with influenza as underlying cause. In the 2009/10 pandemic season, the absence rate increased 1.5-fold, mainly due to a 73% increase in influenza-diagnosed sick leaves. At Norway Post AS, absence related to seasonal influenza accounted for 0.351% (mean 95% CI: 0.126-0.704%) of total person-days annually (excluding parental care absence), of which 32-43% were estimated to be self-certified. Medically certified sick leave increased 1.3-fold in the pandemic season to 0.458% (95% CI: 0.176-0.856), while self-certified sick leave remained at a level typical for seasonal influenza. We found a significant four-fold increase in work loss to care for sick children, 0.048% (95% CI: 0.031-0.070%) of person-days, compared with 0.012% (95% CI: 0.004-0.028%) in 2008/09. In conclusion, GP-certified and parental care work absence were higher in the pandemic season. More studies are needed to quantify the burden of self-certified sick leave.

The association between shift work and sick leave: a systematic review

PubMed Central

van Drongelen, Alwin; Holte, Kari Anne; Labriola, Merete; Lund, Thomas; van Mechelen, Willem; van der Beek, Allard J

2012-01-01

Shift work is associated with a number of negative health outcomes, although it is not known whether it is associated with sick leave. This systematic review therefore aimed to determine whether an association exists between shift work and sick leave. A systematic literature search was conducted in six databases on observational studies. Two reviewers independently selected relevant articles and appraised methodological quality. Data extraction was performed independently by review couples. Articles were categorised according to shift work characteristics and summarised using a levels of evidence synthesis. In total, the search strategy yielded 1207 references, of which 24 studies met the inclusion criteria. Nine studies were appraised as high quality and used in the levels of evidence synthesis. Two high quality longitudinal studies found a positive association between fixed evening shifts and longer sick leave for female healthcare workers. The evidence was assessed as strong. Evidence was inconclusive for rotating shifts, shift work including nights, for fixed night work, and for 8-hour and 12-hour shifts. The association found between evening work and sick leave in female healthcare workers implies that the association between shift work and sick leave might be schedule and population specific. To study the association further, more high quality studies are necessary that assess and adjust for detailed shift work exposure. PMID:22767871

Sick leave and disability pension before and after diagnosis of multiple sclerosis.

PubMed

Landfeldt, Erik; Castelo-Branco, Anna; Svedbom, Axel; Löfroth, Emil; Kavaliunas, Andrius; Hillert, Jan

2016-12-01

Multiple sclerosis (MS) is associated with considerable morbidity and serious disability, but little is known of the long-term impact of the disease on work ability. To assess sick leave (short-term absence) and disability pension (long-term absence) before and after diagnosis of MS. Patients with MS in Sweden were identified in a nationwide disease-specific register and matched with general population controls. Sick leave and disability pension were measured before and after index (i.e. the MS diagnosis date). The final sample comprised 6092 patients and 60,345 controls (mean age 39 years; 70% female). The mean annual prevalence of sick leave ranged from 12% the first year after index to 23% after 11 years among patients and from 13% to 13% among controls. Corresponding estimates for disability pension were 12% and 55% for patients and 7% and 9% for controls. Significant differences in sick leave were observed up to 15 years before index and 3 years for disability pension. Patients with MS in Sweden have elevated levels of sick leave and disability pension up to 15 years before disease diagnosis. Our results highlight the burden of disease on affected patients and society and underscore the substantial unmet medical need. © The Author(s), 2016.

Risk of sick leave and disability pension in working-age women and men with knee osteoarthritis.

PubMed

Hubertsson, Jenny; Petersson, Ingemar F; Thorstensson, Carina A; Englund, Martin

2013-03-01

To investigate sick leave and disability pension in working-age subjects with knee osteoarthritis (OA) compared with the general population. Population-based cohort study: individual-level inpatient and outpatient Skåne Health Care Register data were linked with data from the Swedish Social Insurance Agency. In 2009 all working-age (16-64 years) Skåne County residents who in 1998-2009 had been diagnosed with knee OA (International Classification of Diseases-10 code M17) were identified and their sick leave and disability pension in 2009 related to those of the general working-age population (n=789 366) standardised for age. 15 345 working-age residents (49.6% women) with knee OA were identified. Compared with the general population, the RR (95% CI) of having had one or more episodes of sick leave during the year was 1.82 (1.73 to 1.91) for women and 2.03 (1.92 to 2.14) for men with knee OA. The corresponding risk for disability pension was 1.54 (1.48 to 1.60) for women and 1.36 (1.28 to 1.43) for men with knee OA. The annual mean number of sick days was 87 for each patient with knee OA and 57 for the general population (age- and sex-standardised). Of all sick leave and disability pension in the entire population, 2.1% of days were attributable to knee OA or associated comorbidity in the patients with knee OA (3.1% for sick leave and 1.8% for disability pension). Subjects with doctor-diagnosed knee OA have an almost twofold increased risk of sick leave and about 40-50% increased risk of disability pension compared with the general population. About 2% of all sick days in society are attributable to knee OA.

Effect of peer-based low back pain information and reassurance at the workplace on sick leave: a cluster randomized trial.

PubMed

Odeen, Magnus; Ihlebæk, Camilla; Indahl, Aage; Wormgoor, Marjon E A; Lie, Stein A; Eriksen, Hege R

2013-06-01

To evaluate whether information and reassurance about low back pain (LBP) given to employees at the workplace could reduce sick leave. A Cluster randomized controlled trial with 135 work units of about 3,500 public sector employees in two Norwegian municipalities, randomized into two intervention groups; Education and peer support (EPS) (n = 45 units), education and "peer support and access to an outpatient clinic" (EPSOC) (n = 48 units), and a control group (n = 42 units). Both interventions consisted of educational meetings based on a "non-injury model" and a "peer adviser" appointed by colleagues. Employees in the EPSOC group had access to an outpatient clinic for medical examination and further education. The control group received no intervention. The main outcome was sick leave based on municipal records. Secondary outcomes were self-reported pain, pain related fear of movement, coping, and beliefs about LBP from survey data of 1,746 employees (response rate about 50 %). EPS reduced sick leave by 7 % and EPSOC reduced sick leave by 4 % during the intervention year, while sick leave in the control group was increased by 7 % during the same period. Overall, Rate Ratios (RR) were statistically significant for EPSOC (RR = .84 (C.I = 0.71-.99) but not EPS (RR = .92 (C.I = 0.78-1.09)) in a mixed Poisson regression analysis. Faulty beliefs about LBP were reduced in both intervention groups. Educational meetings, combined with peer support and access to an outpatient clinic, were effective in reducing sick leave in public sector employees.

Paid sick leave is associated with fewer ED visits among US private sector working adults.

PubMed

Bhuyan, Soumitra S; Wang, Yang; Bhatt, Jay; Dismuke, S Edward; Carlton, Erik L; Gentry, Dan; LaGrange, Chad; Chang, Cyril F

2016-05-01

The United States (US) is the only developed country that does not guarantee short-term or longer-term paid sick leave. This study used a multiyear nationally representative database to examine the association between availability of paid sick leave and frequency of emergency department (ED) use among US private sector employees. We used the National Health Interview Survey data (2012-2014). The final study sample consists of 42,460 US adults between 18 and 64years of age and working in nongovernmental private sector. Our results suggest that availability of paid sick leave is significantly associated with lower likelihood of ED use, for both moderate (1-3 times/year) and repeated users (4 or more times/year). After controlling for confounding factors, respondents with paid sick leave are 14% less likely to be moderate ED users (adjusted odds ratio, 0.86; 95% CI, 0.79-0.93) and 32% less likely to be repeated ED users (adjusted odds ratio, 0.68; 95% CI, 0.50-0.91). Although expansion of health insurance coverage under the Affordable Care Act has not been shown to reduce utilization of high cost health care services such as the ED, our study suggests other factors such as the availability of paid sick leave may do so, by allowing patients to seek care through other more cost-effective mechanisms (eg, primary care providers). To reduce ED utilization, health policymakers should consider alternative reforms including paid sick leave. Copyright © 2016 Elsevier Inc. All rights reserved.

[Problems in Providing Care to Young Workers with Mental Health Disturbance - A Survey Using of the Cases of Workers Who Had Taken Sick Leave Due to Mental Health Disturbance].

PubMed

Ikegami, Kazunori; Eguchi, Masafumi; Osaki, Yohei; Nakao, Tomo; Nakamoto, Kengo; Hiro, Hisanori

2016-06-01

In this study we discuss the measures of providing care to young workers with mental health disturbance by analyzing the cases of workers who had taken sick leave due to mental health disturbance. We analyzed 36 cases, collected from 11 occupational physicians, of workers who had taken sick leave due to mental health disturbance, and discuss measures for providing care to such young workers. We organized and classified data containing the details of the care provided to the workers and analyzed the main aspects and problems in providing it. We compared two age groups of workers: a below age 30 group, and an age 30 and above group. We observed that occupational nurses were more frequently the primary persons who dealt with workplace consultations in the below age 30 group (before sick leave: 38.9%; during sick leave: 38.9%) compared to the age 30 and above group (before sick leave: 16.7%, during sick leave: 11.1%). Most of the case providers expressed the opinion that a support system is necessary to help the workers return to work and it is an important factor in providing care to workers who have taken sick leave due to mental health disturbance. Coordination with the families of the workers was also important in the below age 30 group. It might be difficult to assign young workers to suitable workplaces or duties because of their inadequate job skills, lack of sufficient experience, and influence of personal factors on mental health. Our results suggest that it is important to provide appropriate care for young workers with mental health disturbance, such as support by occupational nurses, and to strengthen the collaboration between their families and the workplace staff.

[Work ability and gender--physicians' assessment of sick-listed patients].

PubMed

Brage, S; Reiso, H

1999-10-20

Medical assessments might be influenced by the patient's gender and work situation. This article explorers the relationship between physicians' assessments of work ability in sick-listed patients, and gender of the sick-listed and the physicians. We conducted a questionnaire survey among 52 primary care physicians and 442 of their sick-listed full-time employed patients in Aust-Agder county. The relationship between physician assessment of the patients' work ability and gender were analysed by full/part-time sick-leave, new/extended sick-leave, patient's workload, and the physician's gender. Multivariate analyses were done in two-level logistic regression models. 60% of sick-listed women were assessed as having "very much" or "much" reduced work ability, against 71% of sick-listed men (p < 0.01). Women received part-time sickness certification more often than men, 27% vs. 11% (p < 0.001). These relationships were only found for extended sick-leaves, and were significant also after adjustment for physician's gender and patient work-load. Male physicians assessed work ability as more reduced among sick-listed men than among sick-listed women. Primary care physicians assessed work ability as less reduced among women than men. Women more often received part-time sickness certification. Possibly, the physicians' gender influenced their assessment of work ability, but this should be confirmed by more studies.

Work health determinants in employees without sickness absence.

PubMed

Schell, E; Theorell, T; Nilsson, B; Saraste, H

2013-01-01

Working ability is known to be related to good physical condition, clear work tasks, positive feedback and other occupational, organizational and psychosocial factors. In Sweden, high levels of sickness absence are due to stress-related disorders and musculoskeletal pain. To identify work health characteristics in a working population with a large variety of professional skills and occupational tasks. Employers' data on occupation, sickness absence, age and gender in a working population of 11 occupational groups and questionnaire responses regarding work-organization, environment, work stress, pain, health, and socio-demographic factors were collected. Employees with no history of sick-leave were compared with those with a history of sick-leave (1-182 days, mean 25 days). Of 2641 employees, 1961 participated. Those with no history of sick-leave reported less work-related pain, work-related stress, sleep disturbances, worry about their health, 'sick-presenteeism', monotonous work, bent and twisted working positions and exposure to disturbing noise than those with a history of sick-leave (P < 0.001). They also reported better health, support from superiors, having influence on their working hours and evening and week-end working, longer working hours per week (P < 0.001) and more regular physical training (P < 0.01). Socio-demographic factors were less important than gender, and differences in responses between occupational groups were also found. Workers without a history of sick-leave experienced less stress, sleep disturbances, worry about their own health and less neck, shoulder and back pain and more support from their superiors and influence on their working hours.

What factors are most relevant to the assessment of work ability of employees on long-term sick leave? The physicians' perspective.

PubMed

Dekkers-Sánchez, Patricia M; Wind, Haije; Sluiter, Judith K; Frings-Dresen, Monique H W

2013-07-01

To reach insurance physician (IPs) consensus on factors that must be taken into account in the assessment of the work ability of employees who are sick-listed for 2 years. A Delphi study using online questionnaires was conducted from October 2010 to March 2011. One hundred and two insurance physicians reached a consensus on important factors for return to work (RTW) of employees on long-term sick leave; from those factors, the most relevant for the assessment of work ability was determined. From a total of 22 relevant factors considered for the return to work of long-term sick-listed employees, consensus was reached on nine relevant factors that need to be taken into account in the assessment of the work ability of employees on long-term sick leave. Relevant factors that support return to work are motivation, attitude towards RTW, assessment of cognitions and behaviour, vocational rehabilitation in an early stage and instruction for the sick-listed employee to cope with his disabilities. Relevant factors that hinder RTW are secondary gain from illness, negative perceptions of illness, inefficient coping style and incorrect advice of treating physicians regarding RTW. Non-medical personal and environmental factors may either hinder or promote RTW and must be considered in the assessment of the work ability of long-term sick-listed employees. Assessment of work ability should start early during the sick leave period. These factors may be used by IPs to improve the quality of the assessment of the work ability of employees on long-term sick leave.

Sick Leave and Work Participation among Parents of Children with Autism Spectrum Disorder in the Stockholm Youth Cohort: A Register Linkage Study in Stockholm, Sweden

ERIC Educational Resources Information Center

McEvilly, Miranda; Wicks, Susanne; Dalman, Christina

2015-01-01

This population-based register study explored the association between having a child with/without autism spectrum disorder (ASD) and parental sick leave and work participation. Parents of children with ASD living in Stockholm, Sweden in 2006 were more likely to be on sick leave, not in the labor force, or earning low income when compared to…

Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of exhaustion disorder, adjustment disorder, and distress (the Danish IBBIS trial): study protocol for a randomized controlled trial.

PubMed

Poulsen, Rie; Fisker, Jonas; Hoff, Andreas; Hjorthøj, Carsten; Eplov, Lene Falgaard

2017-12-02

Common mental disorders are important contributors to the global burden of disease and cause negative effects on both the individual and society. Stress-related disorders influence the individual's workability and cause early retirement pensions in Denmark. There is no clear evidence that mental health care alone will provide sufficient support for vocational recovery for this group. Integrated vocational and health care services have shown good effects on return to work in other similar welfare contexts. The purpose of the Danish IBBIS (Integreret Behandlings- og BeskæftigelsesIndsats til Sygemeldte) study is to examine the efficacy of (1) a stepped mental health care intervention with individual stress coaching and/or group-based MBSR and (2) an integrated stepped mental health care with individual stress coaching and/or group-based MBSR and vocational rehabilitation intervention for people on sick leave because of exhaustion disorder, adjustment disorder or distress in Denmark. This three-armed, parallel-group, randomized superiority trial is set up to investigate the effectiveness of a stepped mental health care intervention and an integrated mental health care and vocational rehabilitation intervention for people on sick leave because of exhaustion disorder, adjustment disorder or distress in Denmark. The trial has an investigator-initiated multicenter design. Six hundred and three patients will be recruited from Danish vocational rehabilitation centers in four municipalities and randomly assigned into three groups: (1) IBBIS mental health care integrated with IBBIS vocational rehabilitation, (2) IBBIS mental health care and standard vocational rehabilitation, and (3) standard mental health care and standard vocational rehabilitation. The primary outcome is register-based return to work at 12 months. The secondary outcome measures are self-assessed level of depression (BDI), anxiety (BAI), distress symptoms (4DSQ), work- and social functioning (WSAS), and register-based recurrent sickness absence. This study will contribute with knowledge on the consequence of the current organizational separation of health care interventions and vocational rehabilitation regarding the individual's process of returning to work after sick leave because of exhaustion disorder, adjustment disorder or distress. If the effect on return to work, symptom level, and recurrent sick leave is different in the intervention groups, this study can contribute with new knowledge on shared care models and the potential for preventing deterioration in stress symptoms, prolonged sick leave, and recurrent sick leave. ClinicalTrials.gov, registration number: NCT02885519 . Retrospectively registered on 15 August 2016). Participants have been included in the IBBIS trial for distress, adjustment disorder and exhaustion disorder since April 2016.

Activities and sources of income after a period of long-term sick leave--a population-based prospective cohort study.

PubMed

Wikman, Anders; Wiberg, Michael; Marklund, Staffan; Alexanderson, Kristina

2012-09-06

There is limited knowledge about what happens to people after long-term sick leave. The aim of this report was to conduct a prospective study of individuals who were on prolonged sick leave during a particular year, considering their activities and sources of income during subsequent years. To enable comparison of different time periods, we used three cohorts of individuals with different starting years. Using data from national registers, three separate cohorts were constructed that included all people living in Sweden who were 20-64 years of age (>5 million) in the years 1995, 2000 and 2005, respectively. The individual members of the cohorts were classified into the following groups based on their main source of income and activity in 1995-2008: on long-term sick leave, employed, old-age pensioner, long-term unemployed, disability pensioner, on parental leave, social assistance recipient, student allowance recipient, deceased, or emigrated. Most individuals on long-term (> 6 months) sick leave in 1995 were not employed 13 years later. Only 11% of the women and 13% of the men were primarily in employment after 13 years. Instead, a wide range of alternatives existed, for example, many had been granted disability pension, and about 10% of the women and 17% of the men had died during the follow-up period. A larger proportion of those with long-term sick leave were back in employment when 2005 was the starting year for the follow-up. The low future employment rates for people on long-term sick leave may seem surprising. There are several possible explanations for the finding: The disorders these people may have, might have entailed longstanding difficulties on the labor market. Besides, long-term absence from work, no matter what its causes were, might have worsen the chances of further employment. The economic cycles may also have been of importance. The improving labor market during later years seems to have improved the chances for employment among those earlier on long-term sick leave.

The effect of part-time sick leave for employees with mental disorders.

PubMed

Høgelund, Jan; Holm, Anders; Eplov, Lene Falgaard

2012-12-01

Part-time sick leave (PTSL) allows employees on full-time sick leave (FTSL) to resume work at reduced hours. When the partly absent employee's health improves, working hours are increased until the employee is able to work regular hours. Studies have found that PTSL is an effective instrument for reducing sick leave durations for employees with musculoskeletal disorders and for employees on sick leave in general. This is the first published article to document how PTSL affects sick leave durations for employees with mental disorders. The aim is to estimate the effect of PTSL on the duration until returning to regular working hours for employees with mental disorders. We compare this effect to that of PTSL for employees with non-mental disorders ('other disorders'). We use combined survey and register data about 226 employees on long-term sick leave with mental disorders and 638 employees with other disorders. These data contain information about type of disorder, PTSL and FTSL (full-time sick leave) durations, and various background characteristics. We use a mixed proportional hazard regression model that allows us to control for unobserved differences between employees on PTSL and those on FTSL. Our analyses show that PTSL has no effect on the duration until returning to regular working hours for employees with mental disorders. Furthermore, looking at specific disorders such as depression and stress-related conditions, we find no significant effects of PTSL. In contrast, in line with previous research, we find that PTSL significantly reduces the duration until returning to regular working hours for employees with other disorders. The analyses also illustrate the importance of controlling for unobserved differences between employees on PTSL and those on FTSL. Without this control, PTSL significantly reduces the duration until returning to regular working hours. When we control for unobserved characteristics, this effect decreases, and for employees with mental disorders the effect vanishes entirely. The lack of an effect of PTSL for employees with mental disorders needs replication in other studies. If subsequent studies confirm our findings, one should not necessarily conclude that PTSL is an ineffective intervention: PTSL may play a role in combination with other workplace interventions and in combination with person-centred interventions. The study is limited by self-reported data about disorders and a relatively small number of employees with mental disorders. Our findings suggest that while PTSL reduces sick leave durations for employees with other disorders, it does not affect sick leave durations for employees with mental disorders. These results may indicate that PTSL by itself is insufficient for promoting the return to work of employees with mental disorders. Future studies could benefit from larger data sets with disorder information based on medical assessments. In addition to quantitative effect studies, future studies could focus on qualitative workplace mechanisms that may counteract the potential positive effects of PTSL for employees on sick leave with mental disorders.

Emotions and encounters with healthcare professionals as predictors for the self-estimated ability to return to work: a cross-sectional study of people with heart failure.

PubMed

Nordgren, Lena; Söderlund, Anne

2016-11-09

To live with heart failure means that life is delimited. Still, people with heart failure can have a desire to stay active in working life as long as possible. Although a number of factors affect sick leave and rehabilitation processes, little is known about sick leave and vocational rehabilitation concerning people with heart failure. This study aimed to identify emotions and encounters with healthcare professionals as possible predictors for the self-estimated ability to return to work in people on sick leave due to heart failure. A population-based cross-sectional study design was used. The study was conducted in Sweden. Data were collected in 2012 from 3 different sources: 2 official registries and 1 postal questionnaire. A total of 590 individuals were included. Descriptive statistics, correlation analysis and linear multiple regression analysis were used. 3 variables, feeling strengthened in the situation (β=-0.21, p=0.02), feeling happy (β=-0.24, p=0.02) and receiving encouragement about work (β=-0.32, p≤0.001), were identified as possible predictive factors for the self-estimated ability to return to work. To feel strengthened, happy and to receive encouragement about work can affect the return to work process for people on sick leave due to heart failure. In order to develop and implement rehabilitation programmes to meet these needs, more research is needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Using nature-based rehabilitation to restart a stalled process of rehabilitation in individuals with stress-related mental illness.

PubMed

Sahlin, Eva; Ahlborg, Gunnar; Tenenbaum, Artur; Grahn, Patrik

2015-02-09

After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR). Region Västra Götaland (VGR) started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57) and an occupational health service (OHS) model (n = 45). Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process.

Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness

PubMed Central

Sahlin, Eva; Ahlborg, Gunnar; Tenenbaum, Artur; Grahn, Patrik

2015-01-01

After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR). Region Västra Götaland (VGR) started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57) and an occupational health service (OHS) model (n = 45). Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process. PMID:25671775

Increased absenteeism from work among aware and treated hypertensive and hypercholesterolaemic patients.

PubMed

Leynen, Françoise; De Backer, Guy; Pelfrene, Edwin; Clays, Els; Kittel, France; Moreau, Michel; Kornitzer, Marcel

2006-04-01

The 'labelling hypothesis' was introduced on the basis of the observation that labelling subjects with blood pressure elevation as hypertensive was associated with an increase in sickness absence. In the Belstress I study this hypothesis was analysed in the same way for the possible influence on sick leave of labelling persons with elevated cholesterol as hypercholesterolaemic. The Belstress I cohort concerns a sample of more than 16,000 men and 5,000 women at work in 24 Belgian industries in various sectors. Baseline data were collected by questionnaire and clinical examination. Awareness was defined as answering positively to the question 'did a physician ever tell you that your blood pressure/serum cholesterol was too high?' Sick leave data were independently and objectively recorded during 1 year following the screening. Sick leave was treated in a dichotomous way whereby the event was defined as being in the highest quartile of the annual number of days of sick leave (10 days or more for men and 15 days or more for women) or as being in the highest quartile of the annual number of spells of sick leave (two spells or more for both sexes). Gender-specific logistic regression analyses were performed, with adjustment for a large set of covariates. A positive association was observed between both awareness of hypertension and awareness of hypercholesterolaemia and the various definitions of sick leave, in both sexes and after adjustment for different covariates. When dividing up aware subjects into treated versus untreated, we observed in men the highest sick leave incidence in aware and treated hypertensive patients as well as in aware and treated hypercholesterolaemic patients. In women findings were less consistent, probably due to the smaller sample size. When looking at cumulative effects by examining participants with both hypertension and hypercholesterolaemia and their level of awareness for one or both risk factors, a statistically significant gradient was noticed in men, with the highest sick leave incidence, whatever the definition, in men aware for both risk factors, followed by men aware for one. In women the same trends were observed, but no level of statistical significance was reached. Without being able to test the effect of 'labelling' as such, our study provides support for the association between awareness of two different coronary risk factors and incidence of sick leave. Probably a common mechanism is at the base of these findings. Further research is needed, in order to reduce potential negative effects of screening on human wellbeing as well as on productivity.

Effects of Flexitime on Sick Leave, Vacation Leave, Anxiety, Performance, and Satisfaction in a Library Setting.

ERIC Educational Resources Information Center

Saunders, Carol Stoak; Saunders, Russell

1985-01-01

Results of study using pretest and posttest control group design in public university library setting to study impact of flexitime indicate that: satisfaction with promotions decreased with significant effect, sick leaves decreased, average length of vacation leaves increased, and results were mixed on performance and approached significance for…

Cost-effectiveness of an activating intervention by social workers for patients with minor mental disorders on sick leave: a randomized controlled trial.

PubMed

Brouwers, Evelien P M; de Bruijne, Martine C; Terluin, Berend; Tiemens, Bea G; Verhaak, Peter F M

2007-04-01

Sickness absence often occurs in patients with emotional distress or minor mental disorders. In several European countries, these patients are over-represented among those receiving illness benefits, and interventions are needed. The aim of this study was to evaluate the cost-effectiveness of an intervention conducted by social workers, designed to reduce sick leave duration in patients absent from work owing to emotional distress or minor mental disorders. In this Randomized Controlled Trial, patients were recruited by GPs. The intervention group (N = 98) received an activating, structured treatment by social workers, the control group (N = 96) received routine GP care. Sick leave duration, clinical symptoms, and medical consumption (consumption of medical staffs' time as well as consumption of drugs) were measured at baseline and 3, 6, and 18 months later. Neither for sick leave duration nor for clinical improvement over time were significant differences found between the groups. Also the associated costs were not significantly lower in the intervention group. Compared with usual GP care, the activating social work intervention was not superior in reducing sick leave duration, improving clinical symptoms, and decreasing medical consumption. It was also not cost-effective compared with GP routine care in the treatment of minor mental disorders. Therefore, further implementation of the intervention is not justified. Potentially, programmes aimed at reducing sick leave duration in patients with minor mental disorders carried out closer to the workplace (e.g. by occupational physicians) are more successful than programmes in primary care.

Physicians' assessments of work capacity in patients with severe subjective health complaints: a cross-sectional study on differences between five European countries

PubMed Central

Werner, Erik L; Merkus, Suzanne L; Mæland, Silje; Jourdain, Maud; Schaafsma, Frederieke; Canevet, Jean Paul; Weerdesteijn, Kristel H N; Rat, Cédric; Anema, Johannes R

2016-01-01

Objectives A comparison of appraisals made by general practitioners (GPs) in France and occupational physicians (OPs) and insurance physicians (IPs) in the Netherlands with those made by Scandinavian GPs on work capacity in patients with severe subjective health complaints (SHCs). Setting GPs in France and OPs/IPs in the Netherlands gathered to watch nine authentic video recordings from a Norwegian general practice. Participants 46 GPs in France and 93 OPs/IPs in the Netherlands were invited to a 1-day course on SHC. Outcomes Recommendation of sick leave (full or partial) or no sick leave for each of the patients. Results Compared with Norwegian GPs, sick leave was less likely to be granted by Swedish GPs (OR 0.51, 95% CI 0.30 to 0.86) and by Dutch OPs/IPs (OR 0.53, 95% CI 0.37 to 0.78). The differences between Swedish and Norwegian GPs were maintained in the adjusted analyses (OR 0.43, 95% CI 0.23 to 0.79). This was also true for the differences between Dutch and Norwegian physicians (OR 0.55, 95% CI 0.36 to 0.86). Overall, compared with the GPs, the Dutch OPs/IPs were less likely to grant sick leave (OR 0.60, 95% CI 0.45 to 0.87). Conclusions Swedish GPs and Dutch OPs/IPs were less likely to grant sick leave to patients with severe SHC compared with GPs from Norway, while GPs from Denmark and France were just as likely to grant sick leave as the Norwegian GPs. We suggest that these findings may be due to the guidelines on sick-listing and on patients with severe SHC which exist in Sweden and the Netherlands, respectively. Differences in the working conditions, relationships with patients and training of specialists in occupational medicine may also have affected the results. However, a pattern was observed in which of the patients the physicians in all countries thought should be sick-listed, suggesting that the physicians share tacit knowledge regarding sick leave decision-making in patients with severe SHC. PMID:27417198

How Can Supervisors Contribute to the Return to Work of Employees Who have Experienced Depression?

PubMed

Negrini, Alessia; Corbière, Marc; Lecomte, Tania; Coutu, Marie-France; Nieuwenhuijsen, Karen; St-Arnaud, Louise; Durand, Marie-José; Gragnano, Andrea; Berbiche, Djamal

2018-06-01

Background In Western countries, work disability due to depression is a widespread problem that generates enormous costs. Objective The goal of this study was to determine the types and prevalence of supervisor contributions during the different phases of the return-to-work (RTW) process (before and during the sick-leave absence, and during the RTW preparations) of employees diagnosed with depression. Moreover, we sought to determine which contributions actually facilitate employees' RTW, and to identify the work accommodations most frequently implemented by supervisors at the actual time of their employee's RTW. Methods Telephone interviews were conducted in Québec (Canada) with 74 supervisors working with employees who were already back at work or still on sick leave due to depression. A sub-sample of 46 supervisors who had already taken measures to facilitate their employees' RTW was questioned about the work accommodations implemented. Results Most of the supervisors got along well with their employees before their sick leave and 72% stayed in contact with them during their leave. Nearly 90% of the supervisors encouraged their employees to focus primarily on their recovery before their RTW, but 43% pressured their employees to RTW as soon as possible. Cox regression analyses performed for the entire sample revealed that "the supervisors' intention to take measures to facilitate their employees' RTW" was the only significant predictor of the RTW at the time of the interview. The Kaplan-Meier survival curve showed that 50% of the employees were expected to RTW within the first 8 months of absence. Four of the most frequently implemented work accommodations were actions directly involving the supervisor (i.e. providing assistance, feedback, recognition, and emotional support to the employee). Conclusions This study shed light on the less explored point of view of the supervisor involved in the RTW process of employees post-depression. It highlighted the most frequent and effective supervisor contributions to the process. These results can be used to develop concrete action plans for training supervisors to contribute to the sustainable RTW of employees on sick leave due to depression.

[Sick leave during pregnancy: an analysis of French hospitals from 2005 until 2008 demonstrates the major importance for jobs with physical demands].

PubMed

Estryn-Behar, Madeleine; Amar, Emile; Choudat, Dominique

2013-06-01

sick-leave in the course of pregnancy play a role under estimated according to several studies.They bring to light the existence of risk factors concerning the physical load for contractions, sick-leave, hospitalizations and prematurity.The data obtained on the totality of the wage earners of the AP-HP allow to avoid all the possible bias and to determine the potential impact of a policy of reduction of the physical load The data of four years could be analyzed.The used database is PILOT RH, intranet application restoring information extracted from GIPSIE who was until 2008 the institutional software of management of the careers of all the workers of the AP-HP. In 2008,3 937 women having had a maternity leave (ML) accumulated 132 360 days of ordinary sick-leave (OL) (that is 33,6 days on average) without inclusion of the 15 days accepted for "pathological pregnancy" (PP) and "post pregnancy leave". Ordinary sick-leave of all the 53 132 women amounts to 11.5 days by agent. But, the set apart of the women having had a ML reduces the number of days of sick-leave to 9,7 days This difference weighs for 15.6 % of the total of the absenteeism OL. The results are similar on the four years. The analysis by occupational catégory, for 2008, shows that the average number of days of sick-leave, after exclusion of women having had a ML, decreases with the physical load of the posts estimated by the study PRESST-NEXT :ancillary staff 19.9 days, nursing aids 13.7 days, registered nurses 8.2 days, specialized nurses 7.7 days, medico - technical workers 5.7 days and head nurses 5.1 days. For the women having had a ML, the average number of days of ordinary sick-leave, is the most raised for nursing aids (41.9 days) followed by the ancillary staff (36 days) and the registered nurses (36 days) and slightly less for the specialized nurses (28.3 days). On the other hand, in the professions having least physical load the women have less than 25 days of ordinary sick-leave the year of their pregnancy :medico-technical workers 21.3 days, head nurses 23.1 days and administration staff 23.7 days.The results are similar on the four years. For the nurses, it is 25.5% of total ordinary sick-leave that are attributable to the women having had a pregnancy, and 34.4 % if we add OL and 15 days of official "pathological pregnancy". An intervention to reduce the physical load in test hospitals could be led.The reduction of sick-leave in the course of pregnancy can be a fast indicator of evaluation of the efficiency of the investments. The improvements will benefit to all the agents, in the medium term, with a reduction of the risks of musculoskeletal disorders. Such an action also allows to maintain the employability of the older employees and to integrate) persons into situation of handicap in a work which has for them a strong sense and which they do not want to give up.

Working parents: what factors are involved in their ability to take time off from work when their children are sick?

PubMed

Heymann, S J; Toomey, S; Furstenberg, F

1999-08-01

A series of studies has demonstrated that sick children fare better when their parents are present. To examine working conditions that determine whether parents can spend time with and become involved in the care of their children when they are sick. Survey with a multivariate analysis of factors influencing parental care of sick children. Mixed-income urban working parents aged 26 to 29 years participating in the Baltimore Parenthood Study. Only 42% of working parents in our sample cared for their young children when they became sick. A multivariate logistic regression analysis was conducted to predict which parents stayed at home when their children were sick. Those parents who had either paid sick or vacation leave were 5.2 times as likely to care for their children themselves when they were sick. Of parents with less than a high school education, 17% received paid leave, compared with 57% of parents with a general equivalency diploma, 76% of parents with a high school diploma, and 92% of parents with more than a high school education (P<.001). The finding that many parents were unable to care for their sick children themselves is important for pediatric care. While low-income children are more likely to face marked health problems and to be in need of parental care, they are more likely to live in households in which parents lack paid leave and cannot afford to take unpaid leave.

Measures of work-family conflict predict sickness absence from work.

PubMed

Clays, Els; Kittel, France; Godin, Isabelle; Bacquer, Dirk De; Backer, Guy De

2009-08-01

To examine the relation between work-family conflict and sickness absence. The BELSTRESS III study comprised 2983 middle-aged workers. Strain-based work-home interference (WHI) and home-work interference (HWI) were assessed by means of self-administered questionnaires. Prospective data of registered sickness absence during 12-months follow-up were collected. Multiple logistic regression analysis was conducted. HWI was positively and significantly related to high sickness absence duration (at least 10 sick leave days) and high sickness absence frequency (at least 3 sick leave episodes) in men and women, also after adjustments were made for sociodemographic variables, health indicators, and environmental psychosocial factors. In multivariate analysis, no association between WHI and sickness absence was found. HWI was positively and significantly related to high sickness absence duration and frequency during 12-months follow-up in male and female workers.

A two-year follow-up on a program theory of return to work intervention.

PubMed

Jensen, Anne Grete Claudi

2013-01-01

Validation of a salutogenic theory for return to work (RTW) and an associated program process theory. A longitudinal non-randomized one-year trial study design was used with a two-year follow-up and with comparison to a reference group. Changes in attitudes and active behaviour in the intervention group and at the workplace were supported by cognitive and behavioural approaches. The intervention group included 118 unskilled Danish public employees and privately employed house-cleaners on sick leave due to musculoskeletal and/or common mental illnesses. Significant improvements of work ability index and perceived health (SF36 subgroups) were reported. A significantly higher RTW and a shorter sick leave than in the reference group also emerged. Positive predictors of RTW were keeping the pre-sick-leave job and improving work ability index and physical impairment/role physical. Decline in self-efficacy was a negative predictor. Support for the theory and associated program process theory was found. The intervention seemed to influence RTW and the employees' attitudes, behaviour and health by affecting comprehensibility, meaningfulness and manageability. Sustainable RTW emerged from a synergism of support from the work place and improved personal resources, especially such as concern mental health. The approach is consistent with integrating health promotion in RTW.

Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of depression and anxiety (the Danish IBBIS trial): study protocol for a randomized controlled trial.

PubMed

Poulsen, Rie; Hoff, Andreas; Fisker, Jonas; Hjorthøj, Carsten; Eplov, Lene Falgaard

2017-12-02

Depression and anxiety are among the largest contributors to the global burden of disease and have negative effects on both the individual and society. Depression and anxiety are very likely to influence the individual's work ability, and up to 40% of the people on sick leave in Denmark have depression and/or anxiety. There is no clear evidence that treatment alone will provide sufficient support for vocational recovery in this group. Integrated vocational and health care services have shown good effects on return to work in other, similar welfare contexts. The purpose of the IBBIS (Integrated Mental Health Care and Vocational Rehabilitation to Individuals on Sick Leave Due to Anxiety and Depression) interventions is to improve and hasten the process of return to employment for people in Denmark on sick leave because of depression and anxiety. This three-arm, parallel-group, randomized superiority trial has been set up to investigate the effectiveness of the IBBIS mental health care intervention and the integrated IBBIS mental health care and IBBIS vocational rehabilitation intervention for people on sick leave because of depression and/or anxiety in Denmark. The trial has an investigator-initiated multicenter design. A total of 603 patients will be recruited from Danish job centers in 4 municipalities and randomly assigned to one of 3 groups: (1) IBBIS mental health care integrated with IBBIS vocational rehabilitation, (2) IBBIS mental health care and standard vocational rehabilitation, and (3) standard mental health care and standard vocational rehabilitation. The primary outcome is register-based return to work at 12 months. The secondary outcome measures are self-assessed level of depression (Beck Depression Inventory II), anxiety (Beck Anxiety Inventory), stress symptoms (Four-Dimensional Symptom Questionnaire), work and social functioning (Work and Social Adjustment Scale), and register-based recurrent sickness absence. This study will provide new knowledge on vocational recovery, integrated vocational and health care interventions, and prevention of recurrent sickness absence among people with depression and anxiety. If the effect on return to work is different in the intervention groups, this study can contribute to current knowledge on shared care models for health care and vocational rehabilitation services. ClinicalTrials.gov, NCT02872051 . Retrospectively registered on 15 August 2016.

Early identification of work-related stress predicted sickness absence in employed women with musculoskeletal or mental disorders: a prospective, longitudinal study in a primary health care setting.

PubMed

Holmgren, Kristina; Fjällström-Lundgren, Malin; Hensing, Gunnel

2013-03-01

The objectives were to identify work-related stress, and to analyse whether or not work-related stress served to predict sick-leave in a population of employed women who saw a doctor due to musculoskeletal or mental disorder at primary health care centres. This prospective study was based on data collected with the Work Stress Questionnaire (WSQ) at baseline 2008 and at follow-up 2009 in the primary health care centres in western Sweden. A total of 198 women participated. High perceived stress owing to indistinct organization and conflicts at baseline increased the risk for sick-leave 8 days or longer at follow-up. The adjusted relative risk (RR) was 2.50 (1.14-5.49). The combination of high stress perception owing to indistinct organization and high stress perception owing to individual demands and commitment increased the risk for sickness absence of 8 days or longer with an adjusted RR of 4.34 (1.72-10.99). Work-related stress predicted sick-leave during the follow-up at 12 months. The WSQ seemed to be useful in identifying women at risk of future sick-leave. Thus, it can be recommended to introduce questions and questionnaires on work-related stress in primary health care settings to early identify women with the need for preventive measures in order to decrease risk for sick-leave due to work-related stress.

Prospective Cohort Study of Work Functioning Impairment and Subsequent Absenteeism Among Japanese Workers.

PubMed

Fujino, Yoshihisa; Shazuki, Shuichiro; Izumi, Hiroyuki; Uehara, Masamichi; Muramatsu, Keiji; Kubo, Tatsuhiko; Oyama, Ichiro; Matsuda, Shinya

2016-07-01

This study examined the association of work functioning impairment as measured by work functioning impairment scale (WFun) and subsequent sick leave. A prospective cohort study was conducted at a manufacturer in Japan, and 1263 employees participated. Information on sick leave was gathered during an 18-month follow-up period. The hazard ratios (HRs) of long-term sick leave were substantially increased for those with a WFun score greater than 25 (HR = 3.99, P = 0.003). The incidence rate ratios (IRRs) of days of short-term absence gradually increased as scores of WFun increased (IRR = 1.18, P < 0.001 in the subjects with WFun of over 25 comparing with those with WFun of 14 or less). Assessing work functioning impairment is a useful way of classifying risk for future sick leave among employees.

Integrated health programme: a workplace randomized controlled trial.

PubMed

Tveito, Torill H; Eriksen, Hege R

2009-01-01

This paper is the report of a pilot study to assess if an Integrated Health Programme would reduce sick leave and subjective health complaints, and increase coping in a population of nursing personnel. BACKGROUND. The work group in Norway with most sick leave is healthcare workers. More than 50% of the sick leave is because of subjective health complaints. Work place physical exercise interventions have a documented positive effect on sick leave. After baseline screening, employees who had agreed to participate (n=40) were randomized to an intervention or control group. The intervention group participated in an Integrated Health Programme twice weekly during working hours. The programme consisted of physical exercise, stress management training, health information and an examination of the participants' workplace. The control group was offered the same intervention after the project was finished. This study was carried out from 2001 to 2002. There were no statistically significant effects on sick leave or health-related quality of life. The intervention group reported fewer neck complaints compared to the control group, but otherwise there were no effects on subjective health complaints. However, the subjective effects were large and highly statistically significant, the intervention group reporting improvement in health, physical fitness, muscle pain, stress management, maintenance of health and work situation. The Integrated Health Programme was not effective in reducing sick leave and subjective health complaints, but may be of use to employers wanting to increase employee job satisfaction and well-being.

Workplace as an origin of health inequalities.

PubMed

Vahtera, J; Virtanen, P; Kivimäki, M; Pentti, J

1999-07-01

To investigate the effect of the workplace on the socioeconomic gradient of sickness absence. Comparison of the relation between socioeconomic status and employee sickness absence in three different towns. The towns of Raisio, Valkeakoski, and Nokia in Finland. They are equal in size and regional social deprivation indices, located in the neighbourhood of a larger city, and produce the same services to the inhabitants. All permanent local government employees from Raisio (n = 887), Valkeakoski (n = 972), and Nokia (n = 934) on the employer's registers during 1991 to 1993. Rates of short (1-3 days) and long (> 3 days) spells of sickness absence, irrespective of cause, and separately for infection, musculoskeletal disorder, and trauma. In blue collar male and female workers, compared with the same sex higher grade white collar workers, the age adjusted numbers of long sick leaves were 4.9 (95% CI 4.2, 5.8) and 2.8 (2.6, 3.1) times higher, respectively. The risk varied significantly between the towns, in men in relation to long sick leaves irrespective of cause and resulting from musculoskeletal disorders, and in women in relation to long leaves resulting from infection. The numbers of long sick leaves were 3.9 (95% CI 2.8, 5.4) times higher in blue collar male workers than in higher grade white collar male workers in Raisio, 4.9 (95% CI 3.8, 6.3) times higher in Valkeakoski, and 5.8 (95% CI 4.5, 7.5) times higher in Nokia. Sickness absence of blue collar employees differed most between the towns. The rates of long sick leaves in blue collar men were 1.46 times greater (95% CI 1.25, 1.72) in Valkeakoski and 1.85 times greater (95% CI 1.58, 2.16) in Nokia than in Raisio. In men, no significant differences were found between the towns as regards the numbers of long sick leaves of higher grade white collar male workers. The socioeconomic gradients differed more between the towns in men who had worked for four years or more in the same employment than in men who had worked for shorter periods. No consistent health gradients of socioeconomic status were evident for short sick leaves among either sex. In men and to a lesser extent in women, the workplace is significantly associated with health inequalities as reflected by medically certified sickness absence and the corresponding socioeconomic gradients of health.

Mental disorder sick leave in Sweden: A population study.

PubMed

Lidwall, Ulrik; Bill, Sofia; Palmer, Edward; Olsson Bohlin, Christina

2018-01-01

The inability to perform productive work due to mental disorders is a growing concern in advanced societies. To investigate medically certified mental disorder and all-cause sick leave in a working population using demographic, socioeconomic and occupational predictors. The study population was the entire Swedish work force aged 16-64 years in December 31st 2011. The outcome was sick leave exceeding 14 days in 2012 with adjustment for 13 confounders. The risk of sick leave with a mental disorder is higher among women compared to men, among persons aged 30-39 and among parents in families with underage children. Employees in welfare service occupations within health care, education and social services have an elevated risk of mental disorder sick leave and constitute a large proportion of the workforce. The results support the need for improving early detection and prevention of mental disorders in the workforce. Improvements in psychosocial work environments are essential, where the higher risk in female dominated welfare occupations particularly, have repercussions on the quality of the welfare services provided for vulnerable groups in society. Better work-life balance in families with younger children could also mitigate the effects of a high total workload in that particular phase of life.

Workplace phobia--a first explorative study on its relation to established anxiety disorders, sick leave, and work-directed treatment.

PubMed

Muschalla, Beate; Linden, Michael

2009-10-01

Workplace phobia is defined as a phobic anxiety reaction with symptoms of panic occurring when thinking of or approaching the workplace. People suffering from workplace phobia regularly avoid confrontation with the workplace and are often on sick leave. The specific characteristics of workplace phobia are investigated empirically in comparison to established anxiety disorders. Two hundred thirty patients from an inpatient psychosomatic rehabilitation hospital were interviewed concerning workplace phobia and established anxiety disorders. Additionally, the patients filled in self-rating questionnaires on general and workplace phobic symptom load. Subjectively perceived degree of work load, sick leave, and therapy participation were assessed. Participants with workplace phobia reached significantly higher scores in workplace phobia self-rating than did participants with established anxiety disorders. A similar significant difference was not found concerning the general psychosomatic symptom load. Workplace phobics were more often on sick leave than patients with established anxiety disorders. Workplace phobia can occur as an alonestanding anxiety disorder. It has an own clinical value due to its specific consequences for work participation. Workplace phobia requires special therapeutic attention and treatment instead of purely 'sick leave' certification.

Associations between sickness absence and harassment, threats, violence, or discrimination: a cross-sectional study of the Swedish Police.

PubMed

Svedberg, Pia; Alexanderson, Kristina

2012-01-01

To study if sick leave among employees in the Swedish Police was associated with experiences of discrimination, harassment, or (threats of) violence. All employees in the Swedish Police in 2005. Analyses of data from a questionnaire to all employees; 74% (n=16,725) responded. Odds ratios (OR) with 95% confidence intervals (CI) between sick leave and the studied factors were assessed. The rate of sickness absence was higher for women (12%) than for men (8%) (p< 0.001). More women than men had experienced discrimination, while more men reported harassment from the public and experiences of threats or violence. ORs were significant between sick-leave and discrimination, sexual harassment, and violence, and higher for the men. Associations between harassment from the public, threats of violence or violence, and sickness absence were statistically significant for men only. The study identifies the importance of investigating discrimination, harassment, and violence in relation to health outcomes for both male and female Police employees.

Protocol for the atWork trial: a randomised controlled trial of a workplace intervention targeting subjective health complaints.

PubMed

Johnsen, Tone Langjordet; Indahl, Aage; Baste, Valborg; Eriksen, Hege Randi; Tveito, Torill Helene

2016-08-19

Subjective health complaints, such as musculoskeletal and mental health complaints, have a high prevalence in the general population, and account for a large proportion of sick leave in Norway. It may be difficult to prevent the occurrence of subjective health complaints, but it may be possible to influence employees' perception and management of these complaints, which in turn may have impact on sick leave and return to work after sick leave. Long term sick leave has many negative health and social consequences, and it is important to gain knowledge about effective interventions to prevent and reduce long term sick leave. This study is a cluster randomised controlled trial to evaluate the effect of the modified atWork intervention, targeting non-specific musculoskeletal complaints and mental health complaints. This intervention will be compared to the original atWork intervention targeting only non-specific musculoskeletal complaints. Kindergartens in Norway are invited to participate in the study and will be randomly assigned to one of the two interventions. Estimated sample size is 100 kindergartens, with a total of approximately 1100 employees. Primary outcome is sick leave at unit level, measured using register data from the Norwegian Labour and Welfare Administration. One kindergarten equals one unit, regardless of number of employees. Secondary outcomes will be measured at the individual level and include coping, health, job satisfaction, social support, and workplace inclusion, collected through questionnaires distributed at baseline and at 12 months follow up. All employees in the included kindergartens are eligible for participating in the survey. The effect evaluation of the modified atWork intervention is a large and comprehensive project, providing evidence-based information on prevention of long-term sick leave, which may be of considerable benefit both from a societal, organisational, and individual perspective. Clinicaltrials.gov: NCT02396797 . Registered March 23th, 2015.

Labour market participation and sick leave among patients diagnosed with myasthenia gravis in Denmark 1997-2011: a Danish nationwide cohort study.

PubMed

Frost, Asger; Svendsen, Marie Louise; Rahbek, Jes; Stapelfeldt, Christina Malmose; Nielsen, Claus Vinther; Lund, Thomas

2016-11-17

To examine labour market participation and long-term sick leave following a diagnosis with myasthenia gravis (MG) compared with the general Danish population and for specific subgroups of MG patients. A nationwide matched cohort study from 1997 to 2011 using data from population-based medical and social registries. The study includes 330 MG patients aged 18 to 65 years old identified from hospital diagnoses and dispensed prescriptions, and twenty references from the Danish population matching each MG patient on age, gender, and profession. Main outcome measures are labour market participation (yes/no) and long-term sick leave ≥9 weeks (yes/no) with follow-up at 1- and 2 years after the time of MG diagnosis or match. Based on complete person-level information on all public transfer payments in Denmark, persons having no labour market participation are defined as individuals receiving social benefits for severely reduced workability, flexijob, and disability pension. MG is consistently associated with higher odds of having no labour market participation and long-term sick leave compared with the general Danish population (no labour market participation & ≥9 weeks sick leave at 2-year follow-up, adjusted OR (95% CI): 5.76 (4.13 to 8.04) & 8.60 (6.60 to 11.23)). Among MG patients, females and patients treated with both acetylcholinesterase inhibitors and immunosuppression have higher odds of lost labour market participation and long-term sick leave. This study suggests that MG patients have almost 6 times higher odds of no labour market participation and almost 9 times higher odds of long-term sick leave 2 years after diagnosis compared with the general Danish population. In particular female MG patients and patients treated with both acetylcholinesterase and immunosuppression have high odds of a negative labour market outcome. Future research should focus on predictors in workplace and labour market policy of labour market participation among MG patients.

Paid health and family leave: the Canadian experience in the global context.

PubMed

Heymann, S Jody; Gerecke, Megan; Chaussard, Martine

2010-01-01

Two thirds of Canadian adults participate in the workforce. Their health and that of their families can be markedly affected by the availability of paid sick leave, paid leave to care for family members' health and paid parental leave. We gathered data from all Canadian provinces and territories on these essential leave policies and compared Canadian policies with data collected on 186 United Nations (UN) countries. While Canada pays sickness benefits for 15 weeks for serious illnesses, globally at least 90 countries provide benefits for at least 26 weeks or until recovery. Moreover, within Canada only Saskatchewan and Quebec guarantee job protection if sick leave lasts over 12 days. The federal government guarantees Canadian workers six weeks of paid leave to provide care or support to gravely ill family members. Only 39 countries guarantee such leave with pay. Most, but not all, provinces guarantee workers' job protection during compassionate care leave. Eligibility for job protection during parental leave varies across the country from having no restrictions to requiring at least one year of service. Compared with Canada, many countries offer a longer duration of paid sick leave for employees and replace a higher percentage of wages lost. Internationally, Canada performs well in having policies that guarantee paid leave to care for dependants with serious illnesses, but it lags behind in the provision of paid leave to address the health needs of children or family members' with non-life-threatening conditions. Finally, while paid parental leave is of adequate duration, the wage replacement rate lowers its accessibility to families with limited means.

Sickness absence and disability pension due to otoaudiological diagnoses: risk of premature death--a nationwide prospective cohort study.

PubMed

Friberg, Emilie; Rosenhall, Ulf; Alexanderson, Kristina

2014-02-08

It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. A cohort, based on Swedish registry data, including all 5,248,672 individuals living in Sweden in 2005, aged 20-64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses.

Employment status and sick-leave following obesity surgery: a five-year prospective cohort study.

PubMed

Andersen, John Roger; Hernæs, Ulrikke J V; Hufthammer, Karl Ove; Våge, Villy

2015-01-01

Background. Severe obesity is a risk factor for lower participation in paid work, but whether employment increases and sick leave decreases after obesity surgery is not well documented. Methods. We assessed 224 Norwegian patients with severe obesity (mean age: 40; mean BMI: 49; 61% female) regarding employment status (working versus not working) and the number of days of sick leave during the preceding 12 months, before and five years after obesity surgery (75% follow-up rate). Logistic regression analysis was used to study preoperative predictors of employment status after surgery. Results. There were no change in the employment rate over time (54% versus 58%), but the number of days of sick leave per year was significantly reduced, from a mean of 63 to a mean of 26, and from a median of 36 to a median of 4. Most of this change was attributable to patients with zero days of sick leave, which increased from 25% to 41%. Being female, older, having low education level, receiving disability pension and not being employed before obesity surgery were important risk factors for not being employed after obesity surgery. The type of obesity surgery, BMI and marital status were not useful predictors. Conclusions. Our findings suggest that undergoing obesity surgery is not associated with a higher rate of employment, although it may reduce the number of days of sick leave. Additional interventions are likely needed to influence the employment status of these patients. The significant preoperative predictors of not being employed in this study provide suggestions for further research.

Predictors of regained occupational functioning after electroconvulsive therapy (ECT) in patients with major depressive disorder--a population based cohort study.

PubMed

Nordenskjöld, Axel; von Knorring, Lars; Brus, Ole; Engström, Ingemar

2013-10-01

The aim of the present study is to investigate the rate of regained occupational functioning among patients treated with electroconvulsive therapy (ECT) for major depression and to define predictors of time to regained occupational functioning. A nested cohort study was performed of patients treated by ECT for unipolar major depressive disorder registered in the Quality register for ECT and in the Swedish Social Insurance Agency registry. Predictive values of single clinical variables and their relative importance were tested with Cox regression analysis. 394 patients were identified. Of those, 266 were on non-permanent sick leave and 128 on disability pension during ECT. Within 1 year post-ECT, 71% of the patients with non-permanent sick leave regained occupational functioning. Factors independently associated with a statistically significant increased time to regained occupational functioning were longer duration of sick leave pre-ECT, milder depression pre-ECT, less complete improvement with ECT, benzodiazepine treatment after ECT and co-morbid substance dependence. A large proportion of the patients do not return to work within several months post-ECT. Paradoxically, patients with more severe depression pre-ECT had a reduced time to regained occupational functioning, indicating a larger effect in this patients group of the treatment. Moreover, the period with sick leave compensation might be reduced if ECT is initiated within the first 3 months of sick leave. Most patients on non-permanent sick leave regain occupational functioning after ECT. However, it usually takes a few months even in symptomatically improved patients.

Adult social position and sick leave: the mediating effect of physical workload.

PubMed

Corbett, Karina; Gran, Jon Michaeal; Kristensen, Petter; Mehlum, Ingrid Sivesind

2015-11-01

This study aimed to quantify how much of the adult social gradient in sick leave can be attributed to the mediating role of physical workload while accounting for the role of childhood and adolescent social position and neuroticism. Our sample consisted of 2099 women and 1229 men from a Norwegian birth cohort study (born 1967-1976) who participated in the Nord-Trøndelag Health Study (2006-2008) (HUNT3). Data on sick leave (defined as >16 calendar days; 2006-2009) and social position during childhood, adolescence, and adulthood were obtained from national registers. Study outcome was time-to-first sick leave spell. Physical workload and neuroticism were self-reported in HUNT3. Mediating effects through physical workload were estimated using a method based on the additive hazards survival model. A hypothetical change from highest to lowest group in adult social position was, for women, associated with 51.6 [95% confidence interval (95% CI) 24.7-78.5] additional spells per 100,000 person-days at risk, in a model adjusted for childhood and adolescent social position and neuroticism. The corresponding rate increase for men was 41.1 (95% CI 21.4-60.8). Of these additional spells, the proportion mediated through physical workload was 24% (95% CI 10-49) and 30% (95% CI 10-63) for women and men, respectively. The effect of adult social position on sick leave was partly mediated through physical workload, even while accounting for earlier life course factors. Our findings provide support that interventions aimed at reducing physical workload among those with lower adult social position could reduce sick leave risk.

Sick leave and its determinants in professional soldiers of the Slovenian Armed Forces.

PubMed

Selič, Polona; Petek, Davorina; Serec, Maša; Rus Makovec, Maja

2010-12-01

To assess whether demographic characteristics, self-rated health status, coping behaviors, satisfaction with important interpersonal relationships, financial situation, and current overall quality of life are determinants of sick leave duration in professional soldiers of the Slovenian Armed Forces. In 2008, 448 military personnel on active duty in the Slovenian Armed Forces were invited to participate in the study and 390 returned the completed questionnaires (response rate 87%). The questionnaires used were the self-rated health scale, sick leave scale, life satisfaction scale, Folkman-Lazarus' Ways of Coping Questionnaire, and a demographic data questionnaire. To partition the variance across a wide variety of indicators of participants' experiences, ordinal modeling procedures were used. A multivariate ordinal regression model, explaining 24% of sick leave variance, showed that the following variables significantly predicted longer sick leave duration: female sex (estimate, 1.185; 95% confidence interval [CI], 0.579-1.791), poorer self-rated health (estimate, 3.243; 95% CI, 1.755-4.731), lower satisfaction with relationships with coworkers (estimate, 1.333; 95% CI, 0.399-2.267), and lower education (estimate, 1.577; 95% CI, 0.717-2.436). The impact of age and coping mechanisms was not significant. Longer sick leave duration was found in women and respondents less satisfied with their relationships with coworkers, and these are the groups to which special attention should be awarded when planning supervision, work procedures, and gender equality policy of the Armed Forces. A good way of increasing the quality of interpersonal relationships at work would be to teach such skills in teaching programs for commanding officers.

Health-related effects of early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial.

PubMed

Shiri, Rahman; Kausto, Johanna; Martimo, Kari-Pekka; Kaila-Kangas, Leena; Takala, Esa-Pekka; Viikari-Juntura, Eira

2013-01-01

Previously we reported that early part-time sick leave enhances return to work (RTW) among employees with musculoskeletal disorders (MSD). This paper assesses the health-related effects of this intervention. Patients aged 18-60 years who were unable to perform their regular work due to MSD were randomized to part- or full-time sick leave groups. In the former, workload was reduced by halving working time. Using validated questionnaires, we assessed pain intensity and interference with work and sleep, region-specific disability due to MSD, self-rated general health, health-related quality of life (measured via EuroQol), productivity loss, depression, and sleep disturbance at baseline, 1, 3, 8, 12, and 52 weeks. We analyzed the repeated measures data (171-356 observations) with the generalized estimating equation approach. The intervention (part-time sick leave) and control (full-time sick leave) groups did not differ with regard to pain intensity, pain interference with work and sleep, region-specific disability, productivity loss, depression, or sleep disturbance. The intervention group reported better self-rated general health (adjusted P=0.07) and health-related quality of life (adjusted P=0.02) than the control group. In subgroup analyses, the intervention was more effective among the patients whose current problem began occurring <6 weeks before baseline and those with ≤30% productivity loss at baseline. Our findings showed that part-time sick leave did not exacerbate pain-related symptoms and functional disability, but improved self-rated general health and health-related quality of life in the early stage of work disability due to MSD.

Effect of Reassuring Information About Musculoskeletal and Mental Health Complaints at the Workplace: A Cluster Randomized Trial of the atWork Intervention.

PubMed

Johnsen, Tone Langjordet; Eriksen, Hege Randi; Baste, Valborg; Indahl, Aage; Odeen, Magnus; Tveito, Torill Helene

2018-05-21

Purpose The purpose of this study was to investigate the possible difference between the Modified atWork intervention (MAW) and the Original atWork intervention (OAW) on sick leave and other health related outcomes. atWork is a group intervention using the workplace as an arena for distribution of evidence-based knowledge about musculoskeletal and mental health complaints. Methods A cluster randomized controlled trial with 93 kindergartens, comprising a total of 1011 employees, was conducted. Kindergartens were stratified by county and size and randomly allocated to MAW (45 clusters, 324 respondents) or OAW (48 clusters, 313 respondents). The randomization and intervention allocation processes were concealed. There was no blinding to group allocation. Primary outcome was register data on sick leave at cluster level. Secondary outcomes were health complaints, job satisfaction, social support, coping, and beliefs about musculoskeletal and mental health complaints, measured at the individual level. Results The MAW group reduced sick leave by 5.7% during the intervention year, while the OAW group had a 7.5% increase. Overall, the changes were not statistically significant, and no difference was detected between groups, based on 45 and 47 kindergartens. Compared to the OAW group, the MAW group had a smaller reduction for two of the statements concerning faulty beliefs about back pain, but believed less in the hereditary nature of depression. Conclusions The MAW did not have a different effect on sick leave at cluster level compared to the OAW. Trial registration https://Clinicaltrials.gov/ : NCT02396797. Registered March 23th, 2015.

Effectiveness of new legislation on partial sickness benefit on work participation: a quasi-experiment in Finland

PubMed Central

Kausto, Johanna; Viikari-Juntura, Eira; Virta, Lauri J; Gould, Raija; Koskinen, Aki; Solovieva, Svetlana

2014-01-01

Objectives To examine the effect of the new legislation on partial sickness benefit on subsequent work participation of Finns with long-term sickness absence. Additionally, we investigated whether the effect differed by sex, age or diagnostic category. Design A register-based quasi-experimental study compared the intervention (partial sick leave) group with the comparison (full sick leave) group regarding their pre-post differences in the outcome. The preintervention and postintervention period each consisted of 365 days. Setting Nationwide, individual-level data on the beneficiaries of partial or full sickness benefit in 2008 were obtained from national sickness insurance, pension and earnings registers. Participants 1738 persons in the intervention and 56 754 persons in the comparison group. Outcome Work participation, measured as the proportion (%) of time within 365 days when participants were gainfully employed and did not receive either partial or full ill-health-related or unemployment benefits. Results Although work participation declined in both groups, the decline was 5% (absolute difference-in-differences) smaller in the intervention than in the comparison group, with a minor sex difference. The beneficial effect of partial sick leave was seen especially among those aged 45–54 (5%) and 55–65 (6%) and in mental disorders (13%). When the groups were rendered more exchangeable (propensity score matching on age, sex, diagnostic category, income, occupation, insurance district, work participation, sickness absence, rehabilitation periods and unemployment, prior to intervention and their interaction terms), the effects on work participation were doubled and seen in all age groups and in other diagnostic categories than traumas. Conclusions The results suggest that the new legislation has potential to increase work participation of the population with long-term sickness absence in Finland. If applied in a larger scale, partial sick leave may turn out to be a useful tool in reducing withdrawal of workers from the labour market due to health reasons. PMID:25539780

Employer, insurance, and health system response to long-term sick leave in the public sector: policy implications.

PubMed

Heijbel, Bodil; Josephson, Malin; Jensen, Irene; Vingård, Eva

2005-06-01

This study has been conducted to describe the situation of long-term sick-listed persons employed in the public sector regarding the medical reasons of their sick leave, the duration of their problems, the duration of the actual sick leave, rehabilitation support, rehabilitation measures, and the persons expectations of the future. Response rate of a postal questionnaire, where 484 women and 51 men on long-term sick leave answered, was 69%. The study-group consisted of 90% women with a median age of 50 years. The most common reasons for sick listing were long-lasting musculoskeletal problems, especially neck/shoulder pain, low back pain and osteoarthritis or other joint problems and mental problems, especially depression and burn-out syndromes. Forty-seven procent of the men and 57% of the women had been on the sick list for more than a year. Only half of them had been subjected to the legally required rehabilitation investigation of the employer This half got access to rehabilitation programs and/or vocational rehabilitation to a greater extent than those who not had been subjected to rehabilitation investigation. Less than half had been in contact with the workplace-connected rehabilitation actors, the Occupational Health Service or the Trade Union. In spite of this the sick-listed persons had a positive view of their future return to work. For long-term sick-listed persons in the public sector, there is a great potential for improvements of the rehabilitation at the workplace arena, in the involvement and cooperation between the already existing rehabilitation actors, in order to promote return to work.

Hearing difficulties, ear-related diagnoses and sickness absence or disability pension--a systematic literature review.

PubMed

Friberg, Emilie; Gustafsson, Klas; Alexanderson, Kristina

2012-09-12

Hearing difficulties is a large public health problem, prognosticated to be the ninth leading burden of disease in 2030, and may also involve large consequences for work capacity. However, research regarding sickness absence and disability pension in relation to hearing difficulties is scarce. The aim was to gain knowledge about hearing difficulties or other ear-related diagnoses and sickness absence and disability pension through conducting a systematic literature review of published studies. Studies presenting empirical data on hearing difficulties or ear-related diagnoses and sick leave or disability pension, published in scientific peer-reviewed journals, were included. Studies were sought for in three ways: in literature databases (Pub-Med, Embase, PsycInfo, SSCI, and Cochrane) through March 2011, through scrutinising lists of references, and through contacts. Identified publications were assessed for relevance and data was extracted from the studies deemed relevant. A total of 18 studies were assessed as relevant and included in this review, regardless of scientific quality. Fourteen studies presented empirical data on hearing difficulties/ear diagnoses and sick leave and six on these conditions and disability pension. Only two studies presented rate ratios or odds ratios regarding associations between hearing difficulties and sick leave, and only two on hearing difficulties and risk of disability pension. Both measures of hearing difficulties and of sick leave varied considerable between the studies. Remarkably few studies on hearing difficulties in relation to sickness absence or disability pension were identified. The results presented in them cannot provide evidence for direction or magnitude of potential associations.

Hearing difficulties, ear-related diagnoses and sickness absence or disability pension - a systematic literature review

PubMed Central

2012-01-01

Background Hearing difficulties is a large public health problem, prognosticated to be the ninth leading burden of disease in 2030, and may also involve large consequences for work capacity. However, research regarding sickness absence and disability pension in relation to hearing difficulties is scarce. The aim was to gain knowledge about hearing difficulties or other ear-related diagnoses and sickness absence and disability pension through conducting a systematic literature review of published studies. Methods Studies presenting empirical data on hearing difficulties or ear-related diagnoses and sick leave or disability pension, published in scientific peer-reviewed journals, were included. Studies were sought for in three ways: in literature databases (Pub-Med, Embase, PsycInfo, SSCI, and Cochrane) through March 2011, through scrutinising lists of references, and through contacts. Identified publications were assessed for relevance and data was extracted from the studies deemed relevant. Results A total of 18 studies were assessed as relevant and included in this review, regardless of scientific quality. Fourteen studies presented empirical data on hearing difficulties/ear diagnoses and sick leave and six on these conditions and disability pension. Only two studies presented rate ratios or odds ratios regarding associations between hearing difficulties and sick leave, and only two on hearing difficulties and risk of disability pension. Both measures of hearing difficulties and of sick leave varied considerable between the studies. Conclusions Remarkably few studies on hearing difficulties in relation to sickness absence or disability pension were identified. The results presented in them cannot provide evidence for direction or magnitude of potential associations. PMID:22966953

Reading fiction during sick leave, a multidimensional occupation.

PubMed

Mårtensson, Lena; Andersson, Christina

2015-01-01

In bibliotherapy, the therapeutic gains of reading fiction are ascribed to the literature. Viewing reading fiction as an occupation may give other explanations of its therapeutic function. The aim of this qualitative study was to explore the experiences of reading fiction among women during a period of sick leave. A qualitative approach was applied. Eight women who had been reading fiction during sick leave were interviewed. An overarching theme: Supporting one's active self, comprised five categories of experiences: a prospect of ordinary life, a place of refuge, a life together with others, a source of power, and as supporting an active life. Based on the categories, reading fiction is seen to comprise intentional, functional, mental, relational, and personal dimensions. A tentative model of supporting one's active self is proposed, which may be helpful in clarifying the mechanisms of the process of change. The health-related dimensions of reading fiction suggest that reading fiction should be regarded as a significant occupation comparable with other, more highlighted ones. Understood in this way, it is argued that the results add to the knowledge base in occupational therapy focusing on how meaningful occupations connect to occupational life trajectories.

Sickness absence and disability pension due to otoaudiological diagnoses: risk of premature death – a nationwide prospective cohort study

PubMed Central

2014-01-01

Background It is estimated that hearing difficulties will be one of the top ten leading burdens of disease by 2030. Knowledge of mortality among individuals on sick leave or disability pension due to hearing diagnoses is virtually non-existent. We aimed prospectively to examine the associations of diagnosis-specific sick leave and disability pension due to different otoaudiological diagnoses with risks of all-cause and cause-specific mortality. Methods A cohort, based on Swedish registry data, including all 5 248 672 individuals living in Sweden in 2005, aged 20–64, and not on old-age pension, was followed through 2010. Otoaudiological diagnoses were placed in the following categories: otological, hearing, vertigo, and tinnitus. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models; individuals on sick leave or disability pension due to different otoaudiological diagnoses during 2005 were compared with those not on sick leave or disability pension. Results In multivariable models, individuals with sickness absence due to otoaudiological diagnoses showed a lower risk of mortality, while individuals on disability pension due to otoaudiological diagnoses showed a 14% (95% CI 1-29%) increased risk of mortality, compared with individuals not on sick leave or disability pension. The risk increase among individuals on disability pension was largely attributable to otological (HR 1.56; 95% CI = 1.04-2.33) and hearing diagnoses (HR 1.20; 95% CI = 1.00-1.43). Conclusion This large nationwide population-based cohort study suggests an increased risk of mortality among individuals on disability pension due to otoaudiological diagnoses. PMID:24507477

Macro-organizational factors, the incidence of work disability, and work ability among the total workforce of home care workers in Sweden.

PubMed

Dellve, Lotta; Karlberg, Catarina; Allebeck, Peter; Herloff, Birgitta; Hagberg, Mats

2006-01-01

To investigate the importance of macro-organizational factors, i.e. organizational sociodemographic and socioeconomic preconditions, of the municipal incidence of long-term sick leave, disability pension, and prevalence of workers with long-term work ability among home care workers. In an ecological study design, data from national databases were combined by record linkage. Descriptive and analytical statistics were used to estimate and interpret macro-organizational factors (economic resources, region, unemployment, employment, occupational rehabilitation, return to work, age structures of inhabitants and home care workers). The incidence of long-term sick leave among female home care workers was twice as high as that of male home care workers, and incidence of disability pension was about four times as high for the women. A great variation in municipal incidence of long-term sick leave, disability pension, and long-term work ability (101-264, 0.6-19.6, and 913-1,279 per 1,000 full-time equivalent workers and year) was also found. The strongest single factor for long-term work ability was a high proportion of part-time or hourly paid employees, which explained 35% of the municipal variation. Macro-organizational factors explained long-term work ability (47-62% explained variance) better than long-term sick leave (33% explained variance). There was a low rehabilitation activity; only 2% received occupational rehabilitation and 5% of those on sick leave longer than 2 weeks returned to work within 30 days. The differences in the municipal proportion of work ability incidence indicate a preventive potential, especially related to employment and return to work after sick leave.

Being on sick leave due to heart failure: self-rated health, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work.

PubMed

Nordgren, Lena; Söderlund, Anne

2015-01-01

Younger people with heart failure often experience poor self-rated health. Furthermore, poor self-rated health is associated with long-term sick leave and disability pension. Socio-demographic factors affect the ability to return to work. However, little is known about people on sick leave due to heart failure. The aim of this study was to investigate associations between self-rated health, mood, socio-demographic factors, sick leave compensation, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work, for people on sick leave due to heart failure. This population-based investigation had a cross-sectional design. Data were collected in Sweden in 2012 from two official registries and from a postal questionnaire. In total, 590 subjects, aged 23-67, responded (response rate 45.8%). Descriptive statistics, correlation analyses (Spearman bivariate analysis) and logistic regression analyses were used to investigate associations. Poor self-rated health was strongly associated with full sick leave compensation (OR = 4.1, p < .001). Compared self-rated health was moderately associated with low income (OR =  .6, p =  .003). Good self-rated health was strongly associated with positive encounters with healthcare professionals (OR = 3.0, p =  .022) and to the impact of positive encounters with healthcare professionals on self-estimated ability to return to work (OR = 3.3, p < .001). People with heart failure are sicklisted for long periods of time and to a great extent receive disability pension. Not being able to work imposes reduced quality of life. Positive encounters with healthcare professionals and social insurance officers can be supportive when people with heart failure struggle to remain in working life.

Relationship of airflow limitation severity with work productivity reduction and sick leave in a Japanese working population.

PubMed

Onoue, Ayumi; Omori, Hisamitsu; Katoh, Takahiko; Kubota, Kenichi; Nonami, Yoshio; Ogata, Yasuhiro; Inoue, Hiromasa

2016-01-01

The aim of this study was to reveal the association between airflow limitation (AL) severity and reduction with work productivity as well as use of sick leave among Japanese workers. This cross-sectional study included 1,378 workers who underwent a lung function test during a health checkup at the Japanese Red Cross Kumamoto Health Care Center. AL was defined as forced expiratory volume in 1 second/forced vital capacity of <0.7. Workers completed a questionnaire on productivity loss at work and sick leave. The quality and quantity of productivity loss at work were measured on a ten-point scale indicating how much work was actually performed on the previous workday. Participants were asked how many days in the past 12 months they were unable to work because of health problems. Logistic regression analysis was used to assess the associations between AL severity and the quality and quantity of productivity loss at work as well as use of sick leave. Compared with workers without AL, workers with moderate-to-severe AL showed a significant productivity loss (quality: odds ratio [OR] =2.04, 95% confidence interval [CI]: 1.12-3.71, P=0.02 and quantity: OR =2.19, 95% CI: 1.20-4.00, P=0.011) and use of sick leave (OR =2.69, 95% CI: 1.33-5.44, P=0.006) after adjusting for sex, age, body mass index, smoking status, hypertension, hyperglycemia, dyslipidemia, sleep duration, work hours per day, and workplace smoking environment. AL severity was significantly associated with work productivity loss and use of sick leave. Our findings suggested that early intervention in the subjects with AL at the workforce might be beneficial for promoting work ability.

Economic costs due to workers' sick leave at wastewater treatment plants in Bulgaria.

PubMed

Toseva, Elka Ilieva; Stoyanova, Rumyana; Turnovska, Tanya

2018-03-09

The compensatory mechanisms of social security include expenses for sick leave. The aim of the study is to determine the economic cost due to sick leave among workers in wastewater treatment plants (WWTPs), comparing with the same economic indicators of the National Social Security Institute (NSSI) in Bulgaria. The sick leave of 111 workers at 3 WWTPs was studied in the period 2012-2014 on the grounds of registered absences from work due to temporary incapacity for work. The economic indicators of the NSSI, the gross salary at WWTPs, payable social security contributions and compensatory payments for sick leave have been used for economic cost calculation for temporary incapacity of the workers. The frequency of cases and the frequency of lost days due to temporary incapacity were increased in the observed period at WWTPs and in Bulgaria, and it is significantly higher for the employed at WWTPs. The percentage share of workers equivalent to 1.66% at WWTPs have not worked for an entire year as a result of temporary incapacity in 2012, 2.76% - in 2013, and 4.61% - in 2014. The economic burden due to sick leave at WWTPs was raised from EUR 4913.02 in 2012 to EUR 16 895.80 for 2014 for employers and the NSSI. The frequency of cases and the frequency of lost days due to temporary incapacity were increased in the observed period at WWTPs and in Bulgaria, and it is significantly higher for the employed at WWTPs. The economic burden was equally distributed between employers and the NSSI. Med Pr 2018;69(2):129-141. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Multidisciplinary intensive functional restoration versus outpatient active physiotherapy in chronic low back pain: a randomized controlled trial.

PubMed

Roche-Leboucher, Ghislaine; Petit-Lemanac'h, Audrey; Bontoux, Luc; Dubus-Bausière, Valérie; Parot-Shinkel, Elsa; Fanello, Serge; Penneau-Fontbonne, Dominique; Fouquet, Natacha; Legrand, Erick; Roquelaure, Yves; Richard, Isabelle

2011-12-15

Randomized parallel group comparative trial with a 1-year follow-up period. To compare in a population of patients with chronic low back pain, the effectiveness of a functional restoration program (FRP), including intensive physical training and a multidisciplinary approach, with an outpatient active physiotherapy program at 1-year follow-up. Controlled studies conducted in the United States and in Northern Europe showed a benefit of FRPs, especially on return to work. Randomized studies have compared these programs with standard care. A previously reported study presented the effectiveness at 6 months of both functional restoration and active physiotherapy, with a significantly greater reduction of sick-leave days for functional restoration. A total of 132 patients with low back pain were randomized to either FRP (68 patients) or active individual therapy (64 patients). One patient did not complete the FRP; 19 patients were lost to follow-up (4 in the FRP group and 15 in the active individual treatment group). The number of sick-leave days in 2 years before the program was similar in both groups (180 ± 135.1 days in active individual treatment vs. 185 ± 149.8 days in FRP, P = 0.847). In both groups, at 1-year follow-up, intensity of pain, flexibility, trunk muscle endurance, Dallas daily activities and work and leisure scores, and number of sick-leave days were significantly improved compared with baseline. The number of sick-leave days was significantly lower in the FRP group. Both programs are efficient in reducing disability and sick-leave days. The FRP is significantly more effective in reducing sick-leave days. Further analysis is required to determine if this overweighs the difference in costs of both programs.

Outpatient rehabilitation of workers with musculoskeletal disorders using structured workplace description.

PubMed

Weiler, Stephan W; Foeh, Kay Peter; van Mark, Anke; Touissant, Rene; Sonntag, Nina; Gaessler, Annette; Schulze, Johannes; Kessel, Richard

2009-03-01

In most industrialized countries musculoskeletal disorders contribute considerably (25%) to illness induced work absence. A special interest to reduce worker absences exists in highly specialized industries such as jet manufacturing, where specific knowledge is hard to replace. We investigated the reduction and sustainability in sick leave days by a workplace oriented outpatient rehabilitation program based on structured information exchange between occupational physicians and therapists. Sick leave days reduction and return-to-work-ratios were analysed for 79 male blue collar workers with musculoskeletal disease, who voluntarily participated in an outpatient rehabilitation treatment between 2002 and 2005. During rehabilitation therapy standardized workplace descriptions were given to the therapists and individual return-to-work (rtw) schemes were implemented. Therapy lasted from 3 to 4 weeks followed by workplace reintegration. Off-work-time was calculated from 0 to 6 years before and 0 to 3 years after rehabilitation from insurance and industrial medical reports. A total of 97% of the patients returned to their original job at the workplace, usually directly after the rehabilitation. Average sick leave days per year were reduced from 48.8 +/- 32.8 days before to 34.2 +/- 37.3 days after the rehabilitation. The therapy interrupted an increase in sick leave days over the years stabilizing absence at a low level for at least 2 years. Duration of illness related work absence was the only significant predictor for sick leave reduction (P < 0.05). Other common risk factors for musculoskeletal diseases like smoking or body mass index did not significantly influence the therapeutic effect. Our results support evidence that information exchange for workplace description and rehabilitation therapist may help to reduce sick leave days and achieve very high rtw-ratio. However it is important to observe the effects of this shared information for longer intervals.

Importance of social capital at the workplace for return to work among women with a history of long-term sick leave: a cohort study.

PubMed

Rydström, Ingela; Dalheim Englund, Lotta; Dellve, Lotta; Ahlstrom, Linda

2017-01-01

The workplace is an essential source of social capital for many people; it provides mutual support and gives meaning to life. However, few prospective studies have thoroughly investigated the importance of aspects of social capital in the workplace. The aim of this study was to investigate the associations between aspects of social capital (social support, sense of community, and quality of leadership) at the workplace, and work ability, working degree, and vitality among women with a history of long-term sick leave from human service organizations. A longitudinal cohort study was performed among women with a history of long-term sick leave. The study started in 2005, and the women were followed up at 6 months, 1 year, and 6 years using self-reported questionnaires (baseline n  = 283). Linear mixed models were used for longitudinal analysis of the repeated measurements of prospective degree of work ability, working degree, and vitality. Analyses were performed with different models; the explanatory variables for each model were social support, sense of community, and quality of leadership and time. Social capital in terms of quality of leadership (being good at solving conflicts and giving high priority to job satisfaction), sense of community (co-operation between colleagues) and social support (help and support from immediate superiors and colleagues) increased the women's work ability score (WAS) as well as working degree over time. Additionally, social capital in terms of quality of leadership increased the women's vitality score over time. A sustainable return-to-work process among individuals with a history of long-term sick leave, going in and out of work participation, could be supported with social support, good quality of leadership, and a sense of community at the workplace. The responsibility for the rehabilitation process can not be reduced to an individual problem, but ought to include all stakeholders involved in the process, such as managers, colleagues, health care services, and the social security agency.

Sick-listed workers' expectations about and experiences with independent medical evaluation: a qualitative interview study from Norway.

PubMed

Aamland, Aase; Maeland, Silje

2018-06-01

To reduce the country's sick leave rate, Norwegian politicians have suggested independent medical evaluations (IMEs) for sick-listed workers. IME was tested in a large, randomized controlled trial in one Norwegian county (Evaluation of IME in Norway, or 'the NIME trial'). The current study´s aim was to explore sick-listed workers' expectations about and experiences with participating in an IME. Nine individual semi-structured telephone interviews were conducted. Our convenience sample included six women and three men, aged 35-59 years, who had diverse medical reasons for being on sick leave. Systematic text condensation was used for analysis. The participants questioned both the IME purpose and timing, but felt a moral obligation to participate. Inadequate information provided by their general practitioner (GP) to the IME doctor was considered burdensome by several participants. However, most participants appreciated the IME as a positive discussion, even if they did not feel it had any impact on their follow-up or return-to-work process. According to the sick-listed workers the IMEs were administered too late and disturbed already initiated treatment processes and return to work efforts. Still, the consultation with the IME doctor was rated as a positive encounter, contrary to their expectations. Our results diverge from findings in other countries where experiences with IME consultations have been reported as predominantly negative. These findings, along with additional, upcoming evaluations, will serve as a basis for the Norwegian government's decision about whether to implement IMEs on a regular basis. Key points   Independent medical evaluations for sick-listed workers has been tested out in a large Norwegian RCT and will be evaluated through qualitative interviews with participating stakeholders and by assessing the effects on RTW and costs/benefits. In this study, we explored sick-listed workers' expectations about and experiences with participating in an IME.   • Participants questioned both the IME purpose and timing, but felt a moral obligation to participate.   • Inadequate information provided by their general practitioner (GP) to the IME doctor was considered burdensome by several participants   • Sick-listed workers appreciated the IME as a positive discussion, even if they did not feel it had any impact on their follow-up or return-to-work process.

Is Your Sick Leave Bank in Good Health?

ERIC Educational Resources Information Center

Hoover, James P.

2012-01-01

Sick leave banks are a common staple of teacher contracts. Although these banks may benefit employees, they expose school districts to a variety of complications and unintended consequences, including administrative complexity, potential cash flow implications, cost disparities, increased absenteeism, instructional instability, privacy issues, and…

29 CFR Appendix to Part 1604 - Questions and Answers on the Pregnancy Discrimination Act, Public Law 95-555, 92 Stat. 2076 (1978)

Code of Federal Regulations, 2010 CFR

2010-07-01

.... If other employees who take disability leave are entitled to get their jobs back when they are able... benefits, such as disability benefits, sick leave and health insurance, the same principle applies. A woman unable to work for pregnancy-related reasons is entitled to disability benefits or sick leave on the same...

Maternal Sick Leave Due to Psychiatric Disorders Following the Birth of a Child With Special Health Care Needs

PubMed Central

Nes, Ragnhild Bang; Kornstad, Tom; Kristensen, Petter; Irgens, Lorentz M.; Landolt, Markus A.; Eskedal, Leif T.; Vollrath, Margarete E.

2015-01-01

Objective Child-related stress following the birth of a child with special health care needs (SHCN) can take a toll on parental health. This study examined how the risk of sick leave due to psychiatric disorders (PD) among mothers of children with SHCN compares with that of mothers of children without SHCN during early motherhood. Methods Responses from 58,532 mothers participating in the Norwegian Mother and Child Cohort Study were linked to national registries and monitored for physician-certified sick leave from the month of their child’s first birthday until the month of their child’s fourth birthday. Results As compared with mothers of children without SHCN, mothers of children with mild and moderate/severe care needs were at substantial risk of a long-term sick leave due to PD in general and due to depression more specifically. Conclusions Extensive childhood care needs are strongly associated with impaired mental health in maternal caregivers during early motherhood. PMID:25911588

Access to and use of paid sick leave among low-income families with children.

PubMed

Clemans-Cope, Lisa; Perry, Cynthia D; Kenney, Genevieve M; Pelletier, Jennifer E; Pantell, Matthew S

2008-08-01

The ability of employed parents to meet the health needs of their children may depend on their access to sick leave, especially for low-income workers, who may be afforded less flexibility in their work schedules to accommodate these needs yet also more likely to have children in poor health. Our goal was to provide rates of access to paid sick leave and paid vacation leave among low-income families with children and to assess whether access to these benefits is associated with parents' leave taking to care for themselves or others. We used a sample of low-income families (<200% of the federal poverty level) with children aged 0 to 17 years in the 2003 and 2004 Medical Expenditure Panel Survey to examine bivariate relationships between access to and use of paid leave and characteristics of children, families, and parents' employer. Access to paid leave was lower among children in low-income families than among those in families with higher income. Within low-income families, children without >or=1 full-time worker in the household were especially likely to lack access to this benefit, as were children whose parents work for small employers. Among children whose parents had access to paid sick leave, parents were more likely to take time away from work to care for themselves or others. This relationship is even more pronounced among families with the highest need, such as children in fair or poor health and children with all parents in full-time employment. Legislation mandating paid sick leave could dramatically increase access to this benefit among low-income families. It would likely diminish gaps in parents' leave taking to care for others between families with and without the benefit. However, until the health-related consequences are better understood, the full impact of such legislation remains unknown.

Effect of change in the psychosocial work environment on sickness absence: a seven year follow up of initially healthy employees

PubMed Central

Vahtera, J.; Kivimaki, M.; Pentti, J.; Theorell, T.

2000-01-01

STUDY OBJECTIVE—To investigate the impact of changes in psychosocial work environment on subsequent sickness absence.
DESIGN—Analysis of questionnaire and sickness absence data collected in three time periods: 1990-1991, before the recession; 1993, worst slump during the recession; and 1993-1997, a period after changes.
SETTING—Raisio, a town in south western Finland, during and after a period of economic decline.
PARTICIPANTS—530 municipal employees (138 men, 392 women) working during 1990-1997 who had no medically certified sick leaves in 1991. Mean length of follow up was 6.7 years.
MAIN RESULTS—After adjustment for the pre-recession levels, the changes in the job characteristics of the workers during the recession predicted their subsequent sick leaves. Lowered job control caused a 1.30 (95% CI = 1.19, 1.41) times higher risk of sick leave than an increase in job control. The corresponding figures in relation to decreased social support and increased job demands were 1.30 (95% CI = 1.20, 1.41) and 1.10 (95% CI = 1.03, 1.17), respectively. In some cases there was an interaction with socioeconomic status, changes in the job characteristics being stronger predictors of sick leaves for employees with a high income than for the others. The highest risks of sick leave (ranging from 1.40 to 1.90) were associated with combined effects related to poor levels of and negative changes in job control, job demands and social support.
CONCLUSION—Negative changes in psychosocial work environment have adverse effects on the health of employees. Those working in an unfavourable psychosocial environment before changes are at greatest risk.


Keywords: job characteristics; social support; ill health PMID:10846190

[Sick teachers? --Analysis of disability data from Mecklenburg-Vorpommern].

PubMed

Meierjürgen, R; Paulus, P

2002-11-01

Based on a review of the latest research results on teachers' health, the review shows the extent as well as the structure of sick-leave of people working in schools in the Bundesland Mecklenburg-Vorpommern. Data concerning diseases of more than 7,000 employees who are insured by the Barmer Ersatzkasse were analysed. The results show that teachers are more often sick than all the persons insured by the Barmer Ersatzkasse. Differences between sexes show disadvantages for women. The sick-leave rates increase with age. Dominant diseases reflect very well the job routine of people working in schools: The most frequent diseases concern the respiratory organs, the skeleton, muscles and the connective tissue and mental illness issues; mental illnesses cause the longest periods of disablement. The conclusion refers to the restrictions of sick-leave statistics. It is argued that it is necessary to combine different data sources (e. g. work-place health reports) in order to get a more differentiated picture of factors of demand and strain on teachers' health.

[Work accommodation at the time of Return-to-Work for workers on sick leave: a qualitative systematic review with recommendations for Return-to-work Guidance 2017].

PubMed

Nogawa, Kazuhiro; Kojimahara, Noriko

2018-05-31

We conducted a systematic review to determine whether work accommodation at the time of return-to-work (RTW) following a period of sick leave would improve work-related outcomes. Using a Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, we developed recommendations applicable to the field of occupational health in Japan. We approached our review question for "Evidence-based Return-to-work Guidance in Occupational Health 2017 (RTW 2017) " using a PICO framework (P: workers on sick leave; I: work accommodation; C: usual care; O: improvement of work-related outcomes, such as shortened sick leave period or lower rate of sick leave recurrence). To identify relevant intervention studies about work accommodation at the time of RTW, for example, modified work or partial RTW, we searched Cochrane Library, PubMed, and ICHUSHI Web using keywords/phrases such as workplace accommodation, partial RTW, rehabilitation, and modified work. Although we found no systematic reviews, we did identify 632 randomized controlled trials and cohort studies. Two researchers screened them independently using selection and exclusion criteria defined by the RTW guidance committee in the scope. For intervention studies, we extracted PICO and evaluated risk of bias using RevMan 5.3. For cohort studies, we applied the Newcastle-Ottawa scale for evaluation of risk of bias. We then evaluated the body of evidence based on risk of bias, indirectness, inconsistency, imprecision, and publication bias using GRADEPro GDT. Finally, we adopted Evidence to Decision from GRADE and developed recommendations based on anonymous panels' votes. We identified three relevant studies, which were one randomized controlled trial and two cohort studies, on Partial RTW or modified work for musculoskeletal disorders. Although we could not conduct a meta-analysis, our qualitative systematic review of these studies led us to conclude that partial RTW could shorten the period of sick leave and modified work could lower the recurrence rates of sick leave. Therefore, "Work accommodation at the time of RTW could be provided for workers on sick leave for musculoskeletal disorders" was weakly recommended on the basis of low evidence. Our recommendation, though plausible, is weak, as it is based on evidence from a small number of studies of foreign occupational health systems. Development of robust recommendations will require accumulation of additional information on diverse factors, such as cost-effectiveness, and on other diseases, for example, mental health disorders or malignant diseases, in Japan.

[Pregnancy-related and work-related sick leave of pregnant women].

PubMed

Tophøj, A; Mortensen, J T

1999-09-06

Pregnant women are allowed sick leave (SL) due to obstetrical or occupational risk factors. The aim was to describe reasons for SL during pregnancy. Pregnant women in a Danish county applying for SL were consecutively included in the study during 12 months in 1991-92. Data were obtained by questionnaires mailed to the women and their medical doctors. Of 1483 pregnant women on SL, 994 participated. Approximately 96% were on SL due to obstetrical risk factors. Occupational factors contributed to SL in at least 50% of the cases, mainly when working in a standing or walking position or when lifting. The women were rarely replaced in other jobs before leaving work. On average the women were absent for 83 days before official pregnancy leave started. Although SL during pregnancy is overwhelmingly due to obstetrical risk factors, occupational factors often contribute. Occupational Health and Safety Organizations are rarely involved at the workplace before issuing a sick leave certificate.

[Psychosocial workload, sick leave, and health-related well being: an empirical study from the perspective of gender research].

PubMed

Siegrist, K; Rödel, A; Hessel, A; Brähler, E

2006-01-01

The aim of this study was to test hypotheses on the consequences of gender role expectations with regard to the extent of work stress, selected health-related measures and their associations. Data on psychosocial workload (questionnaire of effort-reward imbalance), sick leave (self-reports of the duration of medically certified sick leave during the past two years) and health-related well being were collected in a representative sample of German full-time employees (n = 666). Hypotheses were tested using analyses of variance (ANOVA) and covariance (ANCOVA) and moderated linear regression analyses. Women reported lower health-related well-being as compared to men while effort-reward imbalance and sick leave did not differ between the sexes. Parents reported slightly longer durations of sick leave during the past two years than childless participants (not significant). The results of stratified linear regression analyses show stronger associations between effort-reward imbalance and both health-related measures for women with children than for men with children, while single men and women do not differ in this regard. Evidence of this kind can be useful for the purposeful planning and implementation of health promotion measures at work. Women with children would be a group deserving special attention. The findings also point to continuing differences in gender role expectations in the family context.

Nature-Based Stress Management Course for Individuals at Risk of Adverse Health Effects from Work-Related Stress—Effects on Stress Related Symptoms, Workability and Sick Leave

PubMed Central

Sahlin, Eva; Ahlborg, Gunnar; Vega Matuszczyk, Josefa; Grahn, Patrik

2014-01-01

Sick leave due to stress-related disorders is increasing in Sweden after a period of decrease. To avoid that individuals living under heavy stress develop more severe stress-related disorders, different stress management interventions are offered. Self-assessed health, burnout-scores and well-being are commonly used as outcome measures. Few studies have used sick-leave to compare effects of stress interventions. A new approach is to use nature and garden in a multimodal stress management context. This study aimed to explore effects on burnout, work ability, stress-related health symptoms, and sick leave for 33 women participating in a 12-weeks nature based stress management course and to investigate how the nature/garden activities were experienced. A mixed method approach was used. Measures were taken at course start and three follow-ups. Results showed decreased burnout-scores and long-term sick leaves, and increased work ability; furthermore less stress-related symptoms were reported. Tools and strategies to better handle stress were achieved and were widely at use at all follow-ups. The garden and nature content played an important role for stress relief and for tools and strategies to develop. The results from this study points to beneficial effects of using garden activities and natural environments in a stress management intervention. PMID:25003175

Minor long-term effects 3-4 years after the ReDO™ intervention for women with stress-related disorders: A focus on sick leave rate, everyday occupations and well-being.

PubMed

Eklund, Mona

2017-01-01

The Redesigning Daily Occupations (ReDO™) work rehabilitation method has been found effective, compared with care as usual (CAU), for women with stress-related disorders. To conduct a long-term follow-up of former ReDO™ and CAU participants with respect to sick leave, well-being and everyday occupations 3-4 years after completed work rehabilitation. Forty-two women in each group participated. An index day was decided to estimate sick-leave rate, retrieved from register data. Fifty-five women also participated in a telephone interview addressing well-being, everyday occupations and life events. Both groups had reduced their sick-leave rate further, but no difference between the groups was established. The ReDO™ women perceived a better balance in the work domain of everyday occupations, whereas the CAU group reported more over-occupation. No differences were found on well-being. The groups had experienced similar important life events, affecting the women's work and private lives. Previous stress and anxiety predicted sick leave at the long-term follow-up. Although the ReDO™ intervention had speeded up return to work in the immediate follow-up perspective, the CAU had caught up in the longer term. Still, the ReDO™ women exhibited better balance in the work domain.

[Productivity costs of rheumatoid arthritis in Germany. Cost composition and prediction of main cost components].

PubMed

Merkesdal, S; Huelsemann, J L; Mittendorf, T; Zeh, S; Zeidler, H; Ruof, J

2006-10-01

Identification of predictors for the productivity cost components: (1) sick leave, and (2) work disability in gainfully employed and (3) impaired household productivity in unemployed patients with rheumatoid arthritis (RA) from the societal perspective. Investigation of productivity costs was linked to a multicenter, randomized, controlled trial evaluating the effectiveness of clinical quality management in 338 patients with RA. The productivity losses were assessed according to the German Guidelines on Health Economic Evaluation. By means of multivariate logistic regression analyses, predictors of sick leave, work disability (employed patients, n=96), and for days confined to bed in unemployed patient (n=242) were determined. Mean annual costs of 970 EUR arose per person taking into consideration all patients (453 EUR sick leave, 63 EUR work disability, 454 EUR impaired productivity of unemployed patients). Disease activity, disease severity, and impaired physical function were global predictors for all of the cost components investigated. Sick leave costs were predicted by prior sick leave periods and the vocational status blue collar worker, work disability costs by sociodemographic variables (marital status, schooling), and the productivity costs of unemployed patients by impaired mental health and impaired physical functions. Interventions such as reduction in disease progression and control of disease activity, early vocational rehabilitation measures and vocational retraining in patients at risk of quitting working life, and self-management programs to learn coping strategies might decrease future RA-related productivity costs.

Prognostic Factors of Returning to Work after Sick Leave due to Work-Related Common Mental Disorders: A One- and Three-Year Follow-Up Study.

PubMed

Netterstrøm, Bo; Eller, Nanna Hurwitz; Borritz, Marianne

2015-01-01

The aim of this paper was to assess the prognostic factors of return to work (RTW) after one and three years among people on sick leave due to occupational stress. Methods. The study population comprised 223 completers on sick leave, who participated in a stress treatment program. Self-reported psychosocial work environment, life events during the past year, severity of the condition, occupational position, employment sector, marital status, and medication were assessed at baseline. RTW was assessed with data from a national compensation database (DREAM). Results. Self-reported high demands, low decision authority, low reward, low support from leaders and colleagues, bullying, high global symptom index, length of sick leave at baseline, and stressful negative life events during the year before baseline were associated with no RTW after one year. Low work ability and full-time sick leave at inclusion were predictors after three years too. Being single was associated with no RTW after three years. The type of treatment, occupational position, gender, age, and degree of depression were not associated with RTW after one or three years. Conclusion. The impact of the psychosocial work environment as predictor for RTW disappeared over time and only the severity of the condition was a predictor for RTW in the long run.

Work situation and sickness absence in the initial period after breast cancer surgery.

PubMed

Petersson, Lena-Marie; Wennman-Larsen, Agneta; Nilsson, Marie; Olsson, Mariann; Alexanderson, Kristina

2011-02-01

Breast cancer is the most common cancer diagnosis in women, many of whom are of working age, and the five-year survival rate in Sweden is approaching 90%. Accordingly, aspects of working life and sickness absence are of increasing importance for breast cancer survivors and may have a long-term impact on health and quality of life of these women. The aim was to elucidate the work situation and sickness absence during the initial period after breast cancer surgery and to explore factors associated with sickness absence. This is a cross-sectional questionnaire study 4-6 weeks after breast cancer surgery of women aged 20-63 years, and living in Stockholm. A consecutive sample of 933 women were invited and 756 (81%) accepted to participate. Logistic regression analyses were computed to estimate crude and adjusted odds ratios for associations between sick leave and other variables. Most women (86%) were employed (including self-employed) at diagnosis, and 91% of those worked ≥75% of full-time. At time of survey, 56% were on sick leave, the majority for full-time. Low self-rated health, poorer health than before diagnosis, having a strenuous work posture, and younger age were associated with sick leave during the initial period after breast cancer surgery in both univariate and multivariate analyses. The results of this study is not fully consistent compared to previous studies in this field, often performed in later phases after breast cancer surgery or after other cancer diagnoses. Therefore our results indicate that knowledge is needed during all phases of the breast cancer trajectory to determine factors of importance regarding sick leave and their impact throughout the disease trajectory.

12 CFR 360.3 - Priorities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... vacation and sick leave pay and contributions to employee benefit plans, earned prior to the appointment of... interests of the receivership to engage or retain for a reasonable period of time; (4) If authorized by the receiver, claims for wages and salaries, including vacation and sick leave pay and contributions to...

Ontario Universities Benefits Survey, 1990-91: Part I, Benefits Excluding Pensions.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

The report details, in tabular form, non-pension benefits offered by each of 17 Ontario universities. These include: supplementary health insurance; long term disability; sick leave entitlement; sick leave-benefits continuance; long term disability-benefits continuance; life insurance; survivor benefit; dental plan; post-retirement benefits;…

Sex differences in the return-to-work process of cancer survivors 2 years after diagnosis: results from a large French population-based sample.

PubMed

Marino, Patricia; Teyssier, Luis Sagaon; Malavolti, Laetitia; Le Corroller-Soriano, Anne-Gaelle

2013-04-01

To investigate the effects of clinical, sociodemographic, and occupational factors on time to return to work (RTW) during the 2 years after cancer diagnosis and to analyze whether sex differences exist. This study was based on a French national cross-sectional survey involving 4,270 cancer survivors. Time to RTW was estimated through the duration of sick leave of 801 cancer survivors younger than 58 years who were employed during the 2-year survey. Multivariate analysis of the RTW after sick leave was performed using a Weibull accelerated failure time model. We found some sex differences in the RTW process. Older men returned to work more slowly than older women (P = .013), whereas married men returned to work much faster than married women (P = .019). Duration dependence was also sex-specific. In men, the time spent on sick leave was independent of the probability of returning to work, whereas in women, this duration dependence was positive (P < .001). For both men and women, clinical factors including chemotherapy, adverse effects, and cancer severity were found to delay RTW (P = .035, P = .001, and P < .001, respectively). Survivors investing most strongly in their personal lives also delayed their RTW (P = .006), as did those with a permanent work contract (P = .042). The factor found to accelerate RTW was a higher educational level (P = .014). The RTW process 2 years after cancer diagnosis differed between men and women. A better knowledge of this process should help the national implementation of more cost-effective strategies for managing the RTW of cancer survivors.

Leave taking and overtime behavior as related to demographic, health, and job variables

NASA Technical Reports Server (NTRS)

Arnoldi, L. B.; Townsend, J. C.

1969-01-01

An intra-installation model is formulated that correlates demographic, health and job related variables to the various types and amounts of leave and overtime taking behavior of employees. Statistical comparison of composite health ratings assigned to subjects based upon clinical criteria and bio-statistical data show that those employees who take the most annual leave as well as sick leave are the ones that have the poorest health ratings; employees who put in the most overtime have also the poorest health records. Stress effects of peak activity periods increase use of sick leave immediately after peak activity but not the use of annual leave.

Labour market trajectories following sickness absence due to self-reported all cause morbidity--a longitudinal study.

PubMed

Pedersen, Pernille; Lund, Thomas; Lindholdt, Louise; Nohr, Ellen A; Jensen, Chris; Søgaard, Hans Jørgen; Labriola, Merete

2016-04-16

To investigate differences in return to work (RTW) and employment trajectories in individuals on sick leave for either mental health reasons or other health related reasons. This study was based on 2036 new sickness absence cases who completed a questionnaire on social characteristics, expectations for RTW and reasons for sickness absence. They were divided into two exposure groups according to their self-reported sickness absence reason: mental health reasons or other health reasons. The outcome was employment status during the following 51 weeks and was measured both as time-to-event analysis and with sequence analysis. Individuals with mental health reasons for sickness absence had a higher risk of not having returned to work (RR 0.87 (0.80;0.93)). Adjusting for gender, age, education and employment did not change the estimate, however, after adding RTW expectations to the model, the excess risk was no longer present (RR 1.01 (0.95;1.08)). In relation to the sequence analysis, individuals with mental health related absence had significantly higher odds of being in the sickness absence cluster and significantly lower odds for being in the fast RTW cluster, but when adjusting for RTW expectations, the odds were somewhat attenuated and no longer significant. Employees on sick leave due to self-reported mental health problems spent more weeks in sickness absence and temporary benefits and had a higher risk of not having returned to work within a year compared to employees on sick leave due to other health reasons. The difference could be explained by their lower RTW expectations at baseline. This emphasises the need to develop suitable and specific interventions to facilitate RTW for this group of sickness absentees.

Being on sick leave due to heart failure: Encounters with social insurance officers and associations with sociodemographic factors and self-estimated ability to return to work.

PubMed

Nordgren, Lena; Söderlund, Anne

2016-04-01

Little is known about sick leave and the ability to return to work (RTW) for people with heart failure (HF). Previous research findings raise questions about the significance of encounters with social insurance officers (SIOs) and sociodemographics in people sick-listed due to HF. To investigate how people on sick leave due to HF experience encounters with SIOs and associations between sociodemographic factors, experiences of positive/negative encounters with SIOs, and self-estimated ability to RTW. This was a population-based study with a cross-sectional design. The sample consisted of 590 sick-listed people with HF in Sweden. A register-based investigation supplemented with a postal survey questionnaire was conducted. Bivariate correlations and logistic regression analysis was used to test associations between sociodemographic factors, positive and negative encounters, and self-estimated ability to RTW. People with low income were more likely to receive sickness compensation. A majority of the responders experienced encounters with SIOs as positive. Being married was significantly associated with positive encounters. Having a low income was related to negative encounters. More than a third of the responders agreed that positive encounters with SIOs facilitated self-estimated ability to RTW. High income was strongly associated with the impact of positive encounters on self-estimated ability to RTW. Encounters between SIOs and people on sick leave due to HF need to be characterized by a person-centred approach including confidence and trust. People with low income need special attention. © The European Society of Cardiology 2015.

Effectiveness of new legislation on partial sickness benefit on work participation: a quasi-experiment in Finland.

PubMed

Kausto, Johanna; Viikari-Juntura, Eira; Virta, Lauri J; Gould, Raija; Koskinen, Aki; Solovieva, Svetlana

2014-12-24

To examine the effect of the new legislation on partial sickness benefit on subsequent work participation of Finns with long-term sickness absence. Additionally, we investigated whether the effect differed by sex, age or diagnostic category. A register-based quasi-experimental study compared the intervention (partial sick leave) group with the comparison (full sick leave) group regarding their pre-post differences in the outcome. The preintervention and postintervention period each consisted of 365 days. Nationwide, individual-level data on the beneficiaries of partial or full sickness benefit in 2008 were obtained from national sickness insurance, pension and earnings registers. 1738 persons in the intervention and 56,754 persons in the comparison group. Work participation, measured as the proportion (%) of time within 365 days when participants were gainfully employed and did not receive either partial or full ill-health-related or unemployment benefits. Although work participation declined in both groups, the decline was 5% (absolute difference-in-differences) smaller in the intervention than in the comparison group, with a minor sex difference. The beneficial effect of partial sick leave was seen especially among those aged 45-54 (5%) and 55-65 (6%) and in mental disorders (13%). When the groups were rendered more exchangeable (propensity score matching on age, sex, diagnostic category, income, occupation, insurance district, work participation, sickness absence, rehabilitation periods and unemployment, prior to intervention and their interaction terms), the effects on work participation were doubled and seen in all age groups and in other diagnostic categories than traumas. The results suggest that the new legislation has potential to increase work participation of the population with long-term sickness absence in Finland. If applied in a larger scale, partial sick leave may turn out to be a useful tool in reducing withdrawal of workers from the labour market due to health reasons. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Sickness absence patterns and trends in the health care sector: 5-year monitoring of female municipal employees in the health and care sectors in Norway and Denmark

PubMed Central

2014-01-01

Background Sickness absence is a growing public health problem in Norway and Denmark, with the highest absence rates being registered in Norway. We compared time trends in sickness absence patterns of municipal employees in the health and care sectors in Norway and Denmark. Methods Data from 2004 to 2008 were extracted from the personnel registers of the municipalities of Kristiansand, Norway, and Aarhus, Denmark, for 3,181 and 8,545 female employees, respectively. Age-specific comparative statistics on sickness absence rates (number of calendar days of sickness absence/possible working days) and number of sick leave episodes were calculated for each year of the study period. Results There was an overall increasing trend in sickness absence rates in Denmark (P = 0.002), where rates were highest in the 20–29- (P = 0.01) and 50–59-year-old age groups (P = 0.03). Sickness absence rates in Norway were stable, except for an increase in the 20–29-year-old age group (P = 0.004). In both Norway and Denmark, the mean number of sick leave episodes increased (P <0.0001 and P <0.0001, respectively) in all age groups except for the 30–39- and 60–67-year-old age groups. The proportion of employees without sickness absence was higher in Norway than in Denmark. Both short-term and long-term absence increased in Denmark (P = 0.003 and P <0.0001, respectively), while in Norway, only short-term absence increased (P = 0.09). Conclusions We found an overall increase in sickness absence rates in Denmark, while the largest overall increase in sick leave episodes was found in Norway. In both countries, the largest increases were observed among young employees. The results indicate that the two countries are converging in regard to sickness absence measured as rates and episodes. PMID:25005027

Teachers' Professional Goal Orientations: Importance for Further Training and Sick Leave

ERIC Educational Resources Information Center

Nitsche, Sebastian; Dickhauser, Oliver; Fasching, Michaela S.; Dresel, Markus

2013-01-01

The present study examined the relevance of teachers' individual goal orientations for the attendance of further training and sick leave in the teaching profession. Regression analysis indicated a positive effect of learning goal orientation (i.e., the desire to improve one's teaching skills and knowledge) along with a negative effect of work…

Maternal Sick Leave Due to Psychiatric Disorders Following the Birth of a Child With Special Health Care Needs.

PubMed

Hauge, Lars Johan; Nes, Ragnhild Bang; Kornstad, Tom; Kristensen, Petter; Irgens, Lorentz M; Landolt, Markus A; Eskedal, Leif T; Vollrath, Margarete E

2015-09-01

Child-related stress following the birth of a child with special health care needs (SHCN) can take a toll on parental health. This study examined how the risk of sick leave due to psychiatric disorders (PD) among mothers of children with SHCN compares with that of mothers of children without SHCN during early motherhood. Responses from 58,532 mothers participating in the Norwegian Mother and Child Cohort Study were linked to national registries and monitored for physician-certified sick leave from the month of their child's first birthday until the month of their child's fourth birthday. As compared with mothers of children without SHCN, mothers of children with mild and moderate/severe care needs were at substantial risk of a long-term sick leave due to PD in general and due to depression more specifically. Extensive childhood care needs are strongly associated with impaired mental health in maternal caregivers during early motherhood. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology.

Stress amongst nurses working in a healthcare telephone-advice service: relationship with job satisfaction, intention to leave, sickness absence, and performance.

PubMed

Farquharson, Barbara; Allan, Julia; Johnston, Derek; Johnston, Marie; Choudhary, Carolyn; Jones, Martyn

2012-07-01

This paper is a report of a study, which assessed levels of stress amongst nurses working in a healthcare telephone-advice service. We explored whether stress related to performance, sickness absence, and intention to leave. Nurses report high levels of stress, as do call-centre workers. The emergence of telephone health advice services means many nurses now work in call-centres, doing work that differs markedly from traditional nursing roles. Stress associated with these roles could have implications for nurses, patients, and service provision. This paper reports cross-sectional survey results. The design of the overall study included longitudinal elements. A comprehensive study of stress was conducted amongst nurses working for a telephone-advice service in Scotland (2008-2010). All nurse-advisors were approached by letter and invited to participate. A total of 152 participants (33%) completed a questionnaire including General Health Questionnaire-12, Work Family Conflict Questionnaire, Job Satisfaction Scale and a measure of intention to leave the telephone-advice service and rated the perceived stress of 2 working shifts. Nurses' employers provided data on sickness absence and performance. Overall levels of psychological distress were similar to those found amongst Scottish women generally. In multiple regression, work-family conflict was identified as a significant predictor of job satisfaction and intention to leave, and significantly related to sickness absence. There were significant correlations between General Health Questionnaire scores and perceived stress of shifts and some performance measures. Work-family conflict is a significant predictor of job satisfaction, intention to leave, and sickness absence amongst telephone helpline nurses. Minimizing the impact of nurses' work on their home lives might reduce turnover and sickness absence. © 2012 Blackwell Publishing Ltd.

Cost effectiveness of a multi-stage return to work program for workers on sick leave due to low back pain, design of a population based controlled trial [ISRCTN60233560].

PubMed

Steenstra, Ivan A; Anema, Johannes R; Bongers, Paulien M; de Vet, Henrica C W; van Mechelen, Willem

2003-11-21

To describe the design of a population based randomized controlled trial (RCT), including a cost-effectiveness analysis, comparing participative ergonomics interventions between 2-8 weeks of sick leave and Graded Activity after 8 weeks of sick leave with usual care, in occupational back pain management. An RCT and cost-effectiveness evaluation in employees sick-listed for a period of 2 to 6 weeks due to low back pain. Interventions used are 1. Communication between general practitioner and occupational physician plus Participative Ergonomics protocol performed by an ergonomist. 2. Graded Activity based on cognitive behavioural principles by a physiotherapist. 3. Usual care, provided by an occupational physician according to the Dutch guidelines for the occupational health management of workers with low back pain. The primary outcome measure is return to work. Secondary outcome measures are pain intensity, functional status and general improvement. Intermediate variables are kinesiophobia and pain coping. The cost-effectiveness analysis includes the direct and indirect costs due to low back pain. The outcome measures are assessed before randomization (after 2-6 weeks on sick leave) and 12 weeks, 26 weeks and 52 weeks after first day of sick leave. The combination of these interventions has been subject of earlier research in Canada. The results of the current RCT will: 1. crossvalidate the Canadian findings in an different sociocultural environment; 2. add to the cost-effectiveness on treatment options for workers in the sub acute phase of low back pain. Results might lead to alterations of existing (inter)national guidelines.

Maternity Leave and Mothers' Long-Term Sickness Absence: Evidence From West Germany.

PubMed

Guertzgen, Nicole; Hank, Karsten

2018-04-01

Exploiting unique German administrative data, we estimate the association between an expansion in maternity leave duration from two to six months in 1979 and mothers' postbirth long-term sickness absence over a period of three decades after childbirth. Adopting a difference-in-difference approach, we first assess the reform's labor market effects and, subsequently, prebirth and postbirth maternal long-term sickness absence, accounting for the potential role of the reform in mothers' selection into employment. Consistent with previous research, our estimates show that the leave extension caused mothers to significantly delay their return to work within the first year after childbirth. We then provide difference-in-difference estimates for the number and length of spells of long-term sickness absence among returned mothers. Our findings suggest that among those returned, mothers subject to the leave extension exhibit a higher incidence of long-term sickness absence compared with mothers who gave birth before the reform. This also holds true after we control for observable differences in prebirth illness histories. At the same time, we find no pronounced effects on mothers' medium-run labor market attachment following the short-run delay in return to work, which might rationalize a negative causal health effect. Breaking down the results by mothers' prebirth health status suggests that the higher incidence of long-term sickness absence among mothers subject to the reform may be explained by the fact that the reform facilitated the reentry of a negative health selection into the labor market.

Healthy workplace indicators: costing reasons for sickness absence within the UK National Health Service.

PubMed

Verow, P; Hargreaves, C

2000-05-01

Sandwell Healthcare NHS Trust has been developing a tool for monitoring the reasons and costs of long-term sick leave (> 7 days). The data obtained from this process has been used to modify the type of occupational health and safety services provided for the Trust. Adoption of more standardized tools of this nature throughout the National Health Service (NHS) would help trusts to compare, and where appropriate enhance, the services provided by occupational health. Musculo-skeletal and mental health problems, account for the greatest costs arising from long-term sickness absence. It may therefore be prudent for NHS employers and their occupational health services to target their efforts on these particular problems.

Occupational exposures and sick leave during pregnancy: results from a Danish cohort study.

PubMed

Hansen, Mette Lausten; Thulstrup, Ane Marie; Juhl, Mette; Kristensen, Jette Kolding; Ramlau-Hansen, Cecilia Høst

2015-07-01

This study aimed to investigate associations between work postures, lifting at work, shift work, work hours, and job strain and the risk of sick leave during pregnancy from 10-29 completed pregnancy weeks in a large cohort of Danish pregnant women. Data from 51 874 pregnancies in the Danish National Birth Cohort collected between 1996-2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on telephone interviews. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated by Cox regression analysis, using time of first episode of sick leave as the primary outcome. We found statistically significant associations between all the predictors and risk of sick leave; for non-sitting work postures (HRrange 1.55-2.79), cumulative lifting HRtrend 1.29, 95% CI 1.26-1.31, shift work (HRevening 1.90, 95% CI 1.73-2.09, HRnight 1.52, 95% CI 1.15-2.01), monthly night shifts HRtrend 1.12, 95% CI 1.11-1.14, increasing weekly work hours HRtrend 0.93, 95% CI 0.91-0.95 and high job strain HR 1.52, 95% CI 1.42-1.63. Some exposures influenced HR in either a positive or negative time-dependent way. Our results support previous findings and suggest that initiatives to prevent sick leave during pregnancy could be based on work conditions. Preventive measures may have important implications for pregnant women and workplaces.

The role of stress in absenteeism: cortisol responsiveness among patients on long-term sick leave.

PubMed

Jacobsen, Henrik B; Bjørngaard, Johan Håkon; Hara, Karen W; Borchgrevink, Petter C; Woodhouse, Astrid; Landrø, Nils Inge; Harris, Anette; Stiles, Tore C

2014-01-01

This study aimed to (1) See whether increased or decreased variation relate to subjective reports of common somatic and psychological symptoms for a population on long-term sick leave; and (2) See if this pattern in variation is correlated with autonomic activation and psychological appraisal. Our participants (n = 87) were referred to a 3.5-week return-to-work rehabilitation program, and had been on paid sick leave >8 weeks due to musculoskeletal pain, fatigue and/or common mental disorders. An extensive survey was completed, addressing socio-demographics, somatic and psychological complaints. In addition, a physician and a psychologist examined the participants, determining baseline heart rate, medication use and SCID-I diagnoses. During the 3.5-week program, the participants completed the Trier Social Stress Test for Groups. Participants wore heart rate monitors and filled out Visual Analogue Scales during the TSST-G. Our participants presented a low cortisol variation, with mixed model analyses showing a maximal increase in free saliva cortisol of 26% (95% CI, 0.21-0.32). Simultaneously, the increase in heart rate and Visual Analogue Scales was substantial, indicating autonomic and psychological activation consistent with intense stress from the Trier Social Stress Test for Groups. The current findings are the first description of a blunted cortisol response in a heterogeneous group of patients on long-term sick leave. The results suggest lack of cortisol reactivity as a possible biological link involved in the pathway between stress, sustained activation and long-term sick leave.

Working ability in relation to disease severity, everyday occupations and well-being in women with limited systemic sclerosis.

PubMed

Sandqvist, G; Scheja, A; Eklund, M

2008-11-01

To investigate how women with SSc and varying degrees of working ability differed regarding disease severity, everyday occupations and well-being. Working ability was operationalized according to the degree of sick leave. Forty-four women of working age with lcSSc were assessed regarding sociodemographic characteristics, disease severity including organ manifestation, perceived physical symptoms, hand function, and satisfaction with everyday occupations, self-rated health and well-being. The subjects formed three groups with regard to reduction in working capacity. Twenty-one women (48%) had no sick leave, 15 women (34%) were on partial sick leave and eight women (18%) were temporarily on full-time sick leave or had a full disability pension. There were no statistically significant differences concerning sociodemographics between the groups. Women without sick leave had less physically demanding jobs (P = 0.026), and the hypothesis that working ability reflects lower disease severity was confirmed regarding dexterity grip force and perceived fatigue and breathlessness (P < 0.05). Greater working ability was associated with better capacity to perform activities of daily life (P < 0.01), greater satisfaction with occupations (P < 0.01), better well-being (P < 0.001) and better health (P < 0.001). Fifty per cent of the women were restricted in their working ability; the lower the working ability, the lower their perceived well-being. This emphasizes the need for further research into the factors that promote working ability and the development of suitable methods to improve working ability.

Multidisciplinary outpatient care program for patients with chronic low back pain: design of a randomized controlled trial and cost-effectiveness study [ISRCTN28478651].

PubMed

Lambeek, Ludeke C; Anema, Johannes R; van Royen, Barend J; Buijs, Peter C; Wuisman, Paul I; van Tulder, Maurits W; van Mechelen, Willem

2007-09-20

Chronic low back pain (LBP) is a major public and occupational health problem, which is associated with very high costs. Although medical costs for chronic LBP are high, most costs are related to productivity losses due to sick leave. In general, the prognosis for return to work (RTW) is good but a minority of patients will be absent long-term from work. Research shows that work related problems are associated with an increase in seeking medical care and sick leave. Usual medical care of patients is however, not specifically aimed at RTW. The objective is to present the design of a randomized controlled trial, i.e. the BRIDGE-study, evaluating the effectiveness in improving RTW and cost-effectiveness of a multidisciplinary outpatient care program situated in both primary and outpatient care setting compared with usual clinical medical care for patients with chronic LBP. The design is a randomized controlled trial with an economic evaluation alongside. The study population consists of patients with chronic LBP who are completely or partially sick listed and visit an outpatient clinic of one of the participating hospitals in Amsterdam (the Netherlands). Two interventions will be compared. 1. a multidisciplinary outpatient care program consisting of a workplace intervention based on participatory ergonomics, and a graded activity program using cognitive behavioural principles. 2. usual care provided by the medical specialist, the occupational physician, the patient's general practitioner and allied health professionals. The primary outcome measure is sick leave duration until full RTW. Sick leave duration is measured monthly by self-report during one year. Data on sick leave during one-year follow-up are also requested form the employers. Secondary outcome measures are pain intensity, functional status, pain coping, patient satisfaction and quality of life. Outcome measures are assessed before randomization and 3, 6, and 12 months later. All statistical analysis will be performed according to the intension-to-treat principle. Usual care of primary and outpatient health services isn't directly aimed at RTW, therefore it is desirable to look for care which is aimed at RTW. Research shows that several occupational interventions in primary care are aimed at RTW. They have shown a significant reduction of sick leave for employee with LBP. If a comparable reduction of sick leave duration of patients with chronic LBP of who attend an outpatient clinic can be achieved, such reductions will be obviously substantial for the Netherlands and will have a considerable impact.

Cost-effectiveness of 40-hour versus 100-hour vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain: study protocol for a randomized controlled trial.

PubMed

Beemster, Timo T; van Velzen, Judith M; van Bennekom, Coen A M; Frings-Dresen, Monique H W; Reneman, Michiel F

2015-07-28

Although vocational rehabilitation is a widely advocated intervention for workers on sick leave due to subacute or chronic nonspecific musculoskeletal pain, the optimal dosage of effective and cost-effective vocational rehabilitation remains unknown. The objective of this paper is to describe the design of a non-inferiority trial evaluating the effectiveness and cost-effectiveness of 40-h multidisciplinary vocational rehabilitation compared with 100-h multidisciplinary vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain. A non-inferiority study design will be applied. The study population consists of workers who are on part-time or full-time sick leave due to subacute or chronic nonspecific musculoskeletal pain. Two multidisciplinary vocational rehabilitation programs following the bio-psychosocial approach will be evaluated in this study: 40-h vocational rehabilitation and 100-h vocational rehabilitation, both delivered over a maximum of 15 weeks. The 100-h vocational rehabilitation comprises five modules: work participation coordination, graded activity, cognitive behavioral therapy, group education, and relaxation. The 40-h vocational rehabilitation comprises work participation coordination and a well-reasoned choice from the other four modules. Four rehabilitation centers will participate in this study, each delivering both interventions. Patients will be randomized into one of the interventions, stratified for the duration of sick leave (<6 weeks or ≥ 6 weeks) and type of sick leave (part-time or full-time). The primary outcome is work participation, measured by self-reported sick leave days, and will be assessed at baseline, mid-term, discharge, and at 2, 4, 6, 8, 10, and 12 months follow-up. Secondary outcomes are work ability, disability, quality of life, and physical functioning and will be assessed at baseline, discharge, and at 6 and 12 months follow-up. Cost outcomes are absenteeism, presenteeism, healthcare usage, and travelling costs. Cost-effectiveness will be evaluated from the societal and employer perspectives. The results obtained from this study will be useful for vocational rehabilitation practice and will provide stakeholders with relevant insights into two versions of vocational rehabilitation. Dutch Trial Register identifier: NTR4362 (registered 17 March 2014).

GP consultations for common mental disorders and subsequent sickness certification: register-based study of the employed population in Norway

PubMed Central

Gjesdal, Sturla; Holmaas, Tor Helge; Monstad, Karin; Hetlevik, Øystein

2016-01-01

Background. Challenges related to work are in focus when employed people with common mental disorders (CMDs) consult their GPs. Many become sickness certified and remain on sick leave over time. Objectives. To investigate the frequency of new CMD episodes among employed patients in Norwegian general practice and subsequent sickness certification. Methods. Using a national claims register, employed persons with a new episode of CMD were included. Sickness certification, sick leave over 16 days and length of absences were identified. Patient- and GP-related predictors for the different outcomes were assessed by means of logistic regression. Results. During 1 year 2.6% of employed men and 4.2% of employed women consulted their GP with a new episode of CMD. Forty-five percent were sickness certified, and 24 percent were absent over 16 days. Thirty-eight percent had depression and 19% acute stress reaction, which carried the highest risk for initial sickness certification, 75%, though not for prolonged absence. Men and older patients had lower risk for sickness certification, but higher risk for long-term absence. Conclusion. Better knowledge of factors at the workplace detrimental to mental health, and better treatment for depression and stress reactions might contribute to timely return of sickness absentees. PMID:27535329

Job satisfaction and short-term sickness absence among Dutch workers.

PubMed

Notenbomer, Annette; Roelen, Corné A M; Groothoff, Johan W

2006-06-01

Sickness absence is a considerable economic and social problem. Short-term sickness absence is known to be associated with behavioural attitudes. The correlation between sickness absence and job satisfaction has been studied infrequently and with contradictory results. This study investigated the correlation between short-term sickness absence and both global and specific job satisfaction. We defined short-term sickness absence as spells of up to 42 days. A random sample of 898 Dutch workers from a variety of economic sectors and companies received a self-report questionnaire on their first day of sick leave. The questionnaire measured global and specific job satisfaction. In our regression analysis, we controlled for the confounding factors of age, gender, educational level, perceived workload, job autonomy and decision latitude. The duration of an absence spell was defined as the amount of calendar days between sick leave and return to work. Global job satisfaction did not correlate significantly with the duration of short-term sickness absence. While increasing physical job demands predicted longer absence, increasing job autonomy and educational level predicted shorter absence. Satisfaction with colleagues predicted longer duration absence. Global job satisfaction did not correlate with the duration of short-term absence spells, but specific satisfaction with colleagues was associated with longer sickness spells.

High prevalence of sickness absence and disability pension among multiple sclerosis patients: a nationwide population-based study.

PubMed

Tinghög, Petter; Hillert, Jan; Kjeldgård, Linnea; Wiberg, Michael; Glaser, Anna; Alexanderson, Kristina

2013-12-01

Although multiple sclerosis (MS) often implies substantial disability, there is little knowledge about sick leave and disability pension among MS patients. The purpose of this study was to estimate the prevalence rates of sick leave and disability pension among MS patients and to explore how socio-demographics are associated with such rates. The register data of all people who lived in Sweden in 2005 and were 16-64 years old was used to identify 9721 MS patients and matched controls. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated and effect modifications were evaluated with Wald X(2) tests. In 2005, 61.7% of the MS patients were on partial or full disability pension compared to 14.2% among the controls. Of the others, 36.8% had ≥ 1 sick-leave spell for >14 days during that year. Socio-demographics were similarly associated with sick leave and disability pension among MS patients and controls, with the noteworthy exceptions that female gender and immigration status were less potent risk factors in the MS population (p<0.05). In spite of widespread access to modern health care including disease-modifying drugs, the majority of MS patients of working ages were on a disability pension. Strategies enabling MS patients to retain their footing in the labour market are needed.

[Follow-up of persons on long-term sick-leave. A cohort study in the city of Moss].

PubMed

Bjørndal, A

1994-10-10

Follow-up of people on long-term sickness leave has been a priority for central and local authorities for a number of years. In this study we have followed a cohort of such people from the city of Moss. We wanted to find out how many returned to work, and who these were. The cohort consisted of 1,975 persons. Median age was 45 years (25-75 percentile: 35-54 years). 55% were women. Median follow-up time was two years and four months. Incidence of long-term sickness leave (more than eight weeks off sick) was 4.2 per month per 1,000 persons between 16 and 66 years of age. Less than half (47%) of those who had been off sick for more than eight weeks were working at follow-up. Few people were recruited to active rehabilitation programmes; for instance new education and on-the-job training. Age, especially from 45 years and upwards, many earlier sickness leaves and diagnosis (persons with psychiatric and other diagnoses did worst) influenced the result towards inactivity. When tested by multivariate analysis these variables explained little of the total variation in re-entry to the job market. A separate study of a random sample who were offered more time and indepth counselling showed no effect on job status at follow-up. Most probably, the success or lack of success are dominated by two factors which we could not measure directly; the seriousness of the medical condition and the climate on the labour market.

Work attendance among healthcare workers: prevalence, incentives, and long-term consequences for health and performance.

PubMed

Dellve, Lotta; Hadzibajramovic, Emina; Ahlborg, Gunnar

2011-09-01

This paper is a report of a cohort study of healthcare workers' work attendance, and its long-term consequences' on health, burnout, work ability and performance. Concepts and measures of work attendance have varied in the scientific literature. Attending work in spite of being sick can have serious consequences on health. There is little knowledge on which individual and work-related conditions that increase work attendance and the long-term impact on health and performance. Prospective analyses of three measures of work attendance i.e. sickness attendance, uninterrupted long-term attendance and balanced attendance (≤7 days of sick leave per year and no sickness attendance) were done using questionnaire data from a 2-year cohort study (2004-2006) of randomly selected healthcare workers (n = 2624). Incentives (e.g. effort-reward balance, social support, meaningfulness) and requirements (e.g. time-pressure, dutifulness, high responsibility) to attend work as well as general health, burnout, sick leave, work ability and performance were assessed. There was a positive relation between balanced work attendance and incentives, whereas high sickness attendance was associated with requirements. Follow up after 2 years showed that balanced attendance was associated with sustained health and performance while sickness attendance was associated with poor health, burnout, sick-leave and decreased performance. It is important to distinguish between measures of work attendance as they differ in relation to incentives, and health- and performance-related consequences. Sickness attendance seems to be an important risk indicator. A balanced work attendance should be promoted for sustained health and performance in healthcare organisations. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Health-related quality of life and postoperative recovery in fast-track hysterectomy.

PubMed

Wodlin, Ninnie Borendal; Nilsson, Lena; Kjølhede, Preben

2011-04-01

To determine whether health-related quality of life (HRQoL) and postoperative recovery of women who undergo abdominal hysterectomy in a fast-track program under general anesthesia (GA) differ from women who receive spinal anesthesia with intrathecal morphine (SA). Secondary analysis from an open randomized controlled multicenter study. Five hospitals in south-east Sweden. One hundred and eighty women admitted for abdominal hysterectomy for benign disease were randomized; 162 completed the study, 80 with GA and 82 with SA. The HRQoL was measured preoperatively using the EuroQoL EQ-5D and the Short-Form-36 health survey (SF-36) questionnaires. The EQ-5D was used daily for 1 week; thereafter, once weekly for 4 weeks and again 6 months after operation. The SF-36 was completed at 5 weeks and 6 months. Dates of commencing and ending sick leave were registered. Changes in HRQoL; duration of sick leave. The HRQoL improved significantly faster in women after SA than after GA. Sick leave was significantly shorter after SA than after GA (median 22.5 vs. 28 days). Recovery of HRQoL and duration of sick leave were negatively influenced by postoperative complications. In particular, the mental component of HRQoL was negatively affected by minor complications, even 6 months after the operation. Spinal anesthesia with intrathecal morphine provided substantial advantages in fast-track abdominal hysterectomy for benign gynecological disorders by providing faster recovery and shorter sick leave compared with general anesthesia. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

Return to work following surgery for lumbar radiculopathy: a systematic review.

PubMed

Huysmans, Eva; Goudman, Lisa; Van Belleghem, Griet; De Jaeger, Mats; Moens, Maarten; Nijs, Jo; Ickmans, Kelly; Buyl, Ronald; Vanroelen, Christophe; Putman, Koen

2018-05-22

Informing patients about postoperative return to work (RTW) expectations is of utmost importance because of the influence of realistic expectations on RTW outcomes. We aimed to give an overview of the duration of sick leave and RTW rates after surgery for lumbar radiculopathy and to list predictors of and factors related to RTW. A systematic review was carried out. A systematic literature search was conducted in PubMed, Web of Science, EMBASE, and SCOPUS. Full-text articles on RTW following surgery for lumbar radiculopathy were included through double-blind screening. Risk of bias was assessed using a modified version of the Downs and Black checklist. Sixty-three full-text articles (total sample size: 7,100 patients) were included. Risk of bias was scored low to high. Mean duration of sick leave ranged from 0.8 to 20 weeks. Within 0.1-240 months post surgery, 3%-100% of patients resumed work. Most important predictors for work resumption were preoperative work status, presence of comorbidities, age, sex and duration of preoperative symptoms. Duration of sick leave can be predicted by the preoperative level of pain or disability and presence of symptoms of depression, occupational mental stress, and lateral disc prolapse. Furthermore, less invasive surgical techniques were found to result in better RTW outcomes compared with more invasive techniques. Diverse results were found for RTW rates and duration of sick leave. Preoperative work status, presence of comorbidities, and several demographic factors were retrieved as predictors of RTW and duration of sick leave. Copyright © 2018 Elsevier Inc. All rights reserved.

Work-related gender differences in physician-certified sick leave: a prospective study of the general working population in Norway.

PubMed

Sterud, Tom

2014-07-01

This study aimed to examine gender differences in physician-certified sick leave and the extent to which these differences can be explained by work-related psychosocial and mechanical risk factors. Randomly drawn from the general population in Norway, the cohort comprised working men and women aged 18-69 years (N=12 255, response rate at baseline = 60.9%). Eligible respondents were interviewed in 2009 and registered with an active employee relationship of ≥ 100 actual working days in 2009 and 2010 (N=3688 men and 3070 women). The study measured 11 work-related psychosocial factors and 11 mechanical exposures, and outcomes of interest were physician-certified general sick leave (GSL) >0 days and long-term sick leave (LTSL) ≥ 40 working days during 2010. Women reported a significantly higher level of exposure to 9 of the 11 psychosocial factors evaluated. For mechanical factors, the reporting was mixed. After controlling for age, educational level, sick leave during 2009, housework, working hours and family status, a 1.7-fold risk for GSL and LTSL were found among women. In comparison with the initial model, adjusting for psychosocial factors reduced the excess risk by 21% and 27% for GSL and LTSL, respectively. The total effect of mechanical factors was negligible. Differences between occupations held by women and men explained an additional one-tenth of the excess risk for LTSL among women. Work-related psychosocial factors contributed significantly to a higher level of GSL and LTSL among women. The most important factors were demands for hiding emotions, emotional demands, and effort-payment imbalance.

Biopsychosocial function analyses changes the assessment of the ability to work in patients on long-term sick-leave due to chronic musculoskeletal pain: the role of undiagnosed mental health comorbidity.

PubMed

Olaya-Contreras, Patricia; Styf, Jorma

2013-05-01

To study the prevalence of somatic and mental health comorbidity and the use of opioid medication among patients on long-term sick-leave due to chronic musculoskeletal pain (CMP); to compare an orthopaedic-based assessment of ability to work with a team assessment; to investigate the relationship between intensity of pain and psychosocial characteristics in this group. A cross-sectional study was carried out with 174 consecutive patients on sick-leave for a mean of 21 months. All were referred from the Social Insurance Office for orthopaedic evaluation and assessment of the ability to work. Of them, only 83/174 patients were referred by the Office for psychiatric evaluation. Neck pain was the main cause of disability. Patients with neck pain often suffered pain in more than two sites, and greater intensity of pain. Thirty-four percent of all participants had been prescribed opioid medication before consultation. Degrees of disability, unemployment, low degree of education and to be an immigrant were related to intensity of pain. Unrecognized psychiatric disorders changed the main cause of inability to work in 69% of patients who underwent both orthopaedic and psychiatric evaluation. An evaluation based on biopsychosocial function is valuable in reaching an accurate assessment of the patient's diagnosis, and ability to work in CMP. Ability to work and degree of sick-leave in patients on long-term sick-leave is determined to a large extent by undiagnosed mental health comorbidities, and not solely somatic complaints.

Influence of psoriasis on work.

PubMed

Mattila, Kalle; Leino, Mauri; Mustonen, Anssi; Koulu, Leena; Tuominen, Risto

2013-04-01

Previous research indicates that psoriasis has an impact on early retirement, sick leave days and reduced work performance. To evaluate the disadvantages at work caused by psoriasis. The sample was based on patients visiting the dermatology outpatient clinic in Turku University Hospital. 262 returned a mailed questionnaire. The subjects were asked how many hours they were on a sick leave (absenteeism) and working while sick (presenteeism) due to psoriasis and other health reasons. Of the retired, 17.0% felt they were retired due to psoriasis. Those in the active work force reported on average 4.5 hours absenteeism and 8.3 hours of presenteeism due to psoriasis during the last 4 weeks. Psoriasis caused 27.0% of the total absenteeism and 39.0% of presenteeism. More than a quarter (28.9%) had been forced to modify their work due to psoriasis, most frequently to make the work less irritating for the skin. Psoriasis has a negative effect on patients' work in many ways, causing early retirement from work, sick leave days, change of occupation and work modifications.

Employee well-being and sick leave, occupational accident, and disability pension: a cohort study of civil servants.

PubMed

Kuoppala, Jaana; Lamminpää, Anne; Väänänen-Tomppo, Irma; Hinkka, Katariina

2011-06-01

To study the association between employee well-being and sick leave, occupational accident, and disability pension. A random population of 967 civil servants participated in a survey on psychosocial factors and health at work in 2000 in Finland. The median follow-up time was 7.3 years. The risks of sick leave and disability pension were decreased by job satisfaction (RR = 0.78, 95% CI = 0.58 to 1.05; RR = 0.47, CI = 0.20 to 1.06; respectively), good work ability (RR = 0.35, CI = 0.22 to 0.56; RR = 0.11, CI = 0.04 to 0.33), good health (RR = 0.42, CI = 0.27 to 0.64; RR = 0.32, CI = 0.11 to 0.98), and strong sense of coherence (RR = 0.53, CI = 0.36 to 0.79; RR = 0.17, CI = 0.07 to 0.37). Employee well-being was also associated with occupational accident but somewhat less consistently. Employee well-being is associated with sick leave, occupational accident, and disability pension. It is important to find means to support employee well-being both in general and at work.

Effect on work ability after team evaluation of functioning regarding pain, self-rated disability, and work ability assessment.

PubMed

Norrefalk, Jan-Rickard; Littwold-Pöljö, Agneta; Ryhle, Leif; Jansen, Gunilla Brodda

2010-08-26

To evaluate the effect of a 1-2 week multiprofessional team assessment, without a real rehabilitation effort, 60 patients suffering from long-standing pain and on long-lasting time on sick leave were studied. A questionnaire concerning their daily activities, quality of life, pain intensity, sick-leave level, and their work state was filled out by all patients before starting the assessment and at a 1-year follow-up. The results from the assessment period and the multiprofessional team decision of the patient's working ability were compared with the actual working rate after 1 year. The follow-up showed a significant reduction of sick leave and a higher level of activity (P < 0.001). One year after the initial evaluation, 40% showed a reduction in sickness benefit level and 12% resumed full-time work. However, the team evaluation of the patient's work ability did not correlate to predict the actual outcome. The patient's pain intensity, life satisfaction, gender, age, ethnic background, and time absent from work before the start of the evaluation showed no correlation to reduction on time on sickness benefit level. These parameters could not be used as predictors in this study.

Supervisors' Strategies to Facilitate Work Functioning among Employees with Musculoskeletal Complaints: A Focus Group Study.

PubMed

Ask, Tove; Magnussen, Liv Heide

2015-01-01

To explore what strategies the supervisors found beneficial to prevent or reduce sickness absence among employees with musculoskeletal complaints. Five focus groups were conducted and 26 supervisors from health and social sector participated. Commonly used strategies to prevent sickness absence and interdisciplinary cooperation in this work were discussed in the focus groups. Systematic text condensation was used to analyse the data. The supervisors described five strategies for sick leave management: (1) promoting well-being and a healthy working environment, (2) providing early support and adjustments, (3) making employees more responsible, (4) using confrontational strategies in relation to employees on long-term sick leave, and (5) cooperation with general practitioners (GPs). Strategies of promoting a healthy working environment and facilitating early return to work were utilised in the follow-up of employees with musculoskeletal complaints. Supportive strategies were found most useful especially in the early phases, while finding a balance between being supportive, on one side, and confronting the employee, on the other, was endeavoured in cases of recurrent or long-term sick leave. Further, the supervisors requested a closer cooperation with the GPs, which they believed would facilitate return to work.

Supervisors' Strategies to Facilitate Work Functioning among Employees with Musculoskeletal Complaints: A Focus Group Study

PubMed Central

Magnussen, Liv Heide

2015-01-01

Aim. To explore what strategies the supervisors found beneficial to prevent or reduce sickness absence among employees with musculoskeletal complaints. Methods. Five focus groups were conducted and 26 supervisors from health and social sector participated. Commonly used strategies to prevent sickness absence and interdisciplinary cooperation in this work were discussed in the focus groups. Systematic text condensation was used to analyse the data. Results. The supervisors described five strategies for sick leave management: (1) promoting well-being and a healthy working environment, (2) providing early support and adjustments, (3) making employees more responsible, (4) using confrontational strategies in relation to employees on long-term sick leave, and (5) cooperation with general practitioners (GPs). Conclusions. Strategies of promoting a healthy working environment and facilitating early return to work were utilised in the follow-up of employees with musculoskeletal complaints. Supportive strategies were found most useful especially in the early phases, while finding a balance between being supportive, on one side, and confronting the employee, on the other, was endeavoured in cases of recurrent or long-term sick leave. Further, the supervisors requested a closer cooperation with the GPs, which they believed would facilitate return to work. PMID:26380370

Risk factors for disability pension over 11 years in a cohort of young persons initially sick-listed with low back, neck, or shoulder diagnoses.

PubMed

Borg, Karin; Hensing, Gunnel; Alexanderson, Kristina

2004-01-01

A study was undertaken to ascertain whether the differences in risk in relation to gender and citizenship observed in a previous study of the same cohort would remain if more recent data on sickness absence were used. This was an 11-year prospective population-based cohort study. The dataset includes all individuals in a Swedish city who, in 1985, were aged 25-34 and had a sick-leave spell > or = 28 days with neck, shoulder, or back diagnoses (n=213). The data covered the following: for 1985-96, disability pension, emigration, and death; for 1982-96, sickness absence; for 1985, sex and citizenship. The data were subjected to Cox regression analyses with a time-dependent covariate. Disability pension was granted to 22% (n=46) of the cohort. The relative risk for disability pension increased by 9.3 with each sick-leave spell > or = 90 days during the two previous years. The risk was higher for women than men, and also higher for foreign citizens than Swedes. Many studies have revealed a gender difference in the risk of being on disability pension, and it was found that this difference was still apparent when sick leave during the follow-up period is taken into account. Thus, the reason for the gender differences ought to be found among other factors than prior levels of sickness absence. Copyright 2004 Taylor & Francis

Prediction of sickness absenteeism, disability pension and sickness presenteeism among employees with back pain.

PubMed

Bergström, Gunnar; Hagberg, Jan; Busch, Hillevi; Jensen, Irene; Björklund, Christina

2014-06-01

The primary aim of this study was to evaluate the predictive ability of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) concerning long-term sick leave, sickness presenteeism and disability pension during a follow-up period of 2 years. The study group consisted of 195 employees visiting the occupational health service (OHS) due to back pain. Using receiver operating characteristic (ROC) curves, the area under the curve (AUC) varied from 0.67 to 0.93, which was from less accurate for sickness presenteeism to highly accurate for the prediction of disability pension. For registered sick leave during 6 months following the baseline the AUC from the ROC analyses was moderately accurate (0.81) and a cut off score of 90 rendered a high sensitivity of 0.89 but a low specificity of 0.46 whereas a cut off score of 105 improves the specificity substantially but at the cost of some sensitivity. The predictive ability appears to decrease with time. Several workplace factors beyond those included in the ÖMPSQ were considered but only social support at the workplace was significantly related to future long-term sick leave besides the total score of the ÖMPSQ. The results of this study extend and confirm the findings of earlier research on the ÖMPSQ. Assessment of psychosocial risk factors among employees seeking help for back pain at the OHS could be helpful in the prevention of work disabling problems.

[Social security and labor absenteeism in a regional health service].

PubMed

Soto Caro, Ariel; Herrera Cofré, Roberto; Fuentes Solís, Rodrigo

2015-08-01

Absenteism can generate important economic costs. To analyze the determinants of the time off work for sick leaves granted to workers of a regional health service. Information about 2033 individuals, working at a health service, that were granted at least one sick leave during 2012, was analyzed. Personal identification was censored. Special emphasis was given to the type of health insurance system of the workers (public or private). Workers ascribed to the Chilean public health insurance system (FONASA) had 11 days more off work than their counterparts ascribed to private health insurance systems. A higher amount of time off work was observed among older subjects and women. Age, gender and the type of health insurance system influence the number of day off work due to sick leaves.

Effects of internet-based cognitive behavioural therapy and physical exercise on sick leave and employment in primary care patients with depression: two subgroup analyses.

PubMed

Kaldo, Viktor; Lundin, Andreas; Hallgren, Mats; Kraepelien, Martin; Strid, Catharina; Ekblom, Örjan; Lavebratt, Catharina; Lindefors, Nils; Öjehagen, Agneta; Forsell, Yvonne

2018-01-01

Depression can negatively impact work capacity, but treatment effects on sick leave and employment are unclear. This study evaluates if internet-based cognitive behavioural therapy (ICBT) or physical exercise (PE), with already reported positive effects on clinical outcome and short-term work ability, has better effects on employment, sick leave and long-term work ability compared with treatment as usual (TAU) for depressed primary care patients (German clinical trials: DRKS00008745). After randomisation and exclusion of patients not relevant for work-related analysis, patients were divided into two subgroups: initially unemployed (total n=118) evaluated on employment, and employed (total n=703) evaluated on long-term sick leave. Secondary outcomes were self-rated work ability and average number of sick days per month evaluated for both subgroups. Assessments (self-reports) were made at baseline and follow-up at 3 and 12 months. For the initially unemployed subgroup, 52.6% were employed after 1 year (response rate 82%). Both PE (risk ratio (RR)=0.44; 95% CI 0.23 to 0.87) and ICBT (RR=0.37; 95% CI 0.16 to 0.84) showed lower rates compared with TAU after 3 months, but no difference was found after 1 year (PE: RR=0.97; 95% CI 0.69 to 1.57; ICBT: RR=1.23; 95% CI 0.72 to 2.13). For those with initial employment, long-term sick leave (response rate 75%) decreased from 7.8% to 6.5%, but neither PE (RR=1.4; 95% CI 0.52 to 3.74) nor ICBT (RR=0.99; 95% CI 0.39 to 2.46) decreased more than TAU, although a temporary positive effect for PE was found. All groups increased self-rated work ability with no differences found. No long-term effects were found for the initially unemployed on employment status or for the initially employed on sick leave. New types of interventions need to be explored. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

29 CFR 825.207 - Substitution of paid leave.

Code of Federal Regulations, 2012 CFR

2012-07-01

... AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825... against the employee's FMLA leave entitlement. For example, paid sick leave used for a medical condition... between workers' compensation absences and FMLA leave. (f) Section 7(o) of the Fair Labor Standards Act...

29 CFR 825.207 - Substitution of paid leave.

Code of Federal Regulations, 2011 CFR

2011-07-01

... AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825... against the employee's FMLA leave entitlement. For example, paid sick leave used for a medical condition... between workers' compensation absences and FMLA leave. (f) Section 7(o) of the Fair Labor Standards Act...

[Effect of the sociodemographic, occupational, organisational and environmental variables on the duration of temporary sick leave in Spain].

PubMed

Villaplana García, María; Sáez Navarro, Concepción; Meseguer de Pedro, Mariano; García-Izquierdo, Mariano

2015-02-01

This study examines the relationship, and relevance of the effect between the duration of the cases of temporary sick leave, as an indicator of absenteeism, and several characteristics (sociodemographic, labor, organizational and the environment) of workers covered by the Social Security System in Spain. A retrospective analysis was conducted on 598,988 processes, between 15 and 365days. The relationships between length of absence, and several characteristics such as demographic, sociodemographic, occupational, organizational and environment characteristics were determined (using P values). The mean duration for each of the features is described, and the size effect is calculated to estimate the importance of the relationships found. There were significant relationships between the duration of temporary sick leave and several demographic characteristics (gender, age, nationality and length of service), occupational (wages, type of contract), organizational (economic sector, activity and size company), the environmental (region, state) characteristics. The age also showed a significant size effect (rxy=.134), especially after age 44. Only age had a significance effect on the duration of work absence, although there was also a relationship with the rest of the demographic, occupational and work environment characteristics. There was also evidence of a cross-effects between the variables, which could cause errors in interpreting the results. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income in native Swedes and immigrants.

PubMed

Helgesson, Magnus; Johansson, Bo; Nordqvist, Tobias; Lundberg, Ingvar; Vingård, Eva

2015-08-01

Sickness absence with cash benefits from the sickness insurance gives an opportunity to be relieved from work without losing financial security. There are, however, downsides to taking sickness absence. Periods of sickness absence, even short ones, can increase the risk for future spells of sickness absence and unemployment. The sickness period may in itself have a detrimental effect on health. The aim of the study was to investigate if there is an association between exposure to sickness absence at a young age and later sickness absence, disability pension, death, unemployment and income from work. Our cohort consisted of all immigrants aged 21-25 years in Sweden in 1993 (N = 38 207) and a control group of native Swedes in the same age group (N = 225 977). We measured exposure to sickness absence in 1993 with a follow-up period of 15 years. We conducted separate analyses for men and women, and for immigrants and native Swedes. Exposure to ≥60 days of sickness absence in 1993 increased the risk of sickness absence [hazard ratio (HR) 1.6-11.4], unemployment (HR 1.1-1.2), disability pension (HR 1.2-5.3) and death (HR 1.2-3.5). The income from work, during the follow-up period, among individuals with spells of sick leave for ≥60 days in 1993 was around two-thirds of that of the working population who did not take sick leave. Individuals on sickness absence had an increased risk for work absence, death and lower future income. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

Occupational rehabilitation programs for musculoskeletal pain and common mental health disorders: study protocol of a randomized controlled trial

PubMed Central

2014-01-01

Background Long-term sick leave has considerably negative impact on the individual and society. Hence, the need to identify effective occupational rehabilitation programs is pressing. In Norway, group based occupational rehabilitation programs merging patients with different diagnoses have existed for many years, but no rigorous evaluation has been performed. The described randomized controlled trial aims primarily to compare two structured multicomponent inpatient rehabilitation programs, differing in length and content, with a comparative cognitive intervention. Secondarily the two inpatient programs will be compared with each other, and with a usual care reference group. Methods/design The study is designed as a randomized controlled trial with parallel groups. The Social Security Office performs monthly extractions of sick listed individuals aged 18–60 years, on sick leave 2–12 months, with sick leave status 50% - 100% due to musculoskeletal, mental or unspecific disorders. Sick-listed persons are randomized twice: 1) to receive one of two invitations to participate in the study or not receive an invitation, where the latter “untouched” control group will be monitored for future sick leave in the National Social Security Register, and 2) after inclusion, to a Long or Short inpatient multicomponent rehabilitation program (depending on which invitation was sent) or an outpatient cognitive behavioral therapy group comparative program. The Long program consists of 3 ½ weeks with full rehabilitation days. The Short program consists of 4 + 4 full days, separated by two weeks, in which a workplace visit will be performed if desirable. Three areas of rehabilitation are targeted: mental training, physical training and work-related problem solving. The primary outcome is number of sick leave days. Secondary outcomes include time until full sustainable return to work, health related quality of life, health related behavior, functional status, somatic and mental health, and perceptions of work. In addition, health economic evaluation will be performed, and the implementation of the interventions, expectations and experiences of users and service providers will be investigated with different qualitative methods. Trial registration ClinicalTrials.gov: NCT01926574. PMID:24735616

Reincentivizing--a new theory of work and work absence.

PubMed

Thulesius, Hans O; Grahn, Birgitta E

2007-07-03

Work capacity correlates weakly to disease concepts, which in turn are insufficient to explain sick leave behavior. With data mainly from Sweden, a welfare state with high sickness absence rates, our aim was to develop an explanatory theory of how to understand and deal with work absence and sick leave. We used classic grounded theory for analyzing data from >130 interviews with people working or on sick leave, physicians, social security officers, and literature. Several hundreds of typed and handwritten memos were the basis for writing up the theory. In this paper we present a theory of work incentives and how to deal with work absence. We suggest that work disability can be seen as hurt work drivers or people caught in mode traps. Work drivers are specified as work capacities + work incentives, monetary and non-monetary. Also, people can get trapped in certain modes of behavior through changed capacities or incentives, or by inertia. Different modes have different drivers and these can trap the individual from reincentivizing, ie from going back to work or go on working. Hurt drivers and mode traps are recognized by driver assessments done on several different levels. Mode driver calculations are done by the worker. Then follows employer, physician, and social insurance officer assessments. Also, driver assessments are done on the macro level by legislators and other stakeholders. Reincentivizing is done by different repair strategies for hurt work drivers such as body repair, self repair, work-place repair, rehumanizing, controlling sick leave insurance, and strengthening monetary work incentives. Combinations of these driver repair strategies also do release people from mode traps. Reincentivizing is about recognizing hurt work drivers and mode traps followed by repairing and releasing the same drivers and traps. Reincentivizing aims at explaining what is going on when work absence is dealt with and the theory may add to social psychological research on work and work absence, and possibly inform sick leave policies.

Reincentivizing – a new theory of work and work absence

PubMed Central

Thulesius, Hans O; Grahn, Birgitta E

2007-01-01

Background Work capacity correlates weakly to disease concepts, which in turn are insufficient to explain sick leave behavior. With data mainly from Sweden, a welfare state with high sickness absence rates, our aim was to develop an explanatory theory of how to understand and deal with work absence and sick leave. Methods We used classic grounded theory for analyzing data from >130 interviews with people working or on sick leave, physicians, social security officers, and literature. Several hundreds of typed and handwritten memos were the basis for writing up the theory. Results In this paper we present a theory of work incentives and how to deal with work absence. We suggest that work disability can be seen as hurt work drivers or people caught in mode traps. Work drivers are specified as work capacities + work incentives, monetary and non-monetary. Also, people can get trapped in certain modes of behavior through changed capacities or incentives, or by inertia. Different modes have different drivers and these can trap the individual from reincentivizing, ie from going back to work or go on working. Hurt drivers and mode traps are recognized by driver assessments done on several different levels. Mode driver calculations are done by the worker. Then follows employer, physician, and social insurance officer assessments. Also, driver assessments are done on the macro level by legislators and other stakeholders. Reincentivizing is done by different repair strategies for hurt work drivers such as body repair, self repair, work-place repair, rehumanizing, controlling sick leave insurance, and strengthening monetary work incentives. Combinations of these driver repair strategies also do release people from mode traps. Conclusion Reincentivizing is about recognizing hurt work drivers and mode traps followed by repairing and releasing the same drivers and traps. Reincentivizing aims at explaining what is going on when work absence is dealt with and the theory may add to social psychological research on work and work absence, and possibly inform sick leave policies. PMID:17608942

The effect of community-acquired bacteraemia on return to workforce, risk of sick leave, permanent disability pension and death: a Danish population-based cohort study.

PubMed

Dalager-Pedersen, Michael; Koch, Kristoffer; Thomsen, Reimar Wernich; Schønheyder, Henrik Carl; Nielsen, Henrik

2014-01-29

Little is known about the prognosis of community-acquired bacteraemia (CAB) in workforce adults. We assessed return to workforce, risk for sick leave, disability pension and mortality within 1 year after CAB in workforce adults compared with blood culture-negative controls and population controls. Population-based cohort study. North Denmark, 1996-2011. We used population-based healthcare registries to identify all patients aged 20-58 years who had first-time blood cultures obtained within 48 h of medical hospital admission, and who were part of the workforce (450 bacteraemia exposed patients and 6936 culture-negative control patients). For each bacteraemia patient, we included up to 10 matched population controls. Return to workforce, risk of sick leave, permanent disability pension and mortality within 1 year after bacteraemia. Regression analyses were used to compute adjusted relative risks (RRs) with 95% CIs. One year after admission, 78% of patients with CAB, 85.7% of culture-negative controls and 96.8% of population controls were alive and in the workforce, and free from sick leave or disability pension. Compared with culture-negative controls, bacteraemia was associated with an increased risk for long-term sick leave (4-week duration, 40.2% vs 23.9%, adjusted RR, 1.51; CI 1.34 to 1.70) and an increased risk for mortality (30-day mortality, 4% vs 1.4%, adjusted RR, 2.34, CI 1.22 to 4.50; 1-year mortality, 8% vs 3.9%, adjusted RR, 1.73; CI 1.18 to 2.55). Bacteraemia patients had a risk for disability pension similar to culture-negative controls (2.7% vs 2.6%, adjusted RR, 0.99, CI 0.48 to 2.02) but greater than population controls (adjusted RR, 5.20; 95% CI 2.16 to 12.50). CAB is associated with long duration of sick leave and considerable mortality in working-age adults when compared with blood culture-negative controls, and an increased 1-year risk for disability pension when compared with population controls.

Effort-reward imbalance, overcommitment and their associations with all-cause and mental disorder long-term sick leave - A case-control study of the Swedish working population.

PubMed

Lidwall, Ulrik

2016-11-18

To investigate if effort-reward imbalance (ERI) and overcommitment (OC) are associated with all-cause and mental disorder long-term sick leave (LS), and to identify differences in associations between genders, private versus public sector employees and socioeconomic status groups. The study uses a cross-sectional case-control design with a sample of 3477 persons on long-term sick leave of more than 59 days and a control group of 2078 in employment. Data on sick leave originate from social insurance registers, while data on health, working and living conditions were gathered through a survey. The binary logistic regression was used to test the multivariate associations. Effort-reward imbalance was associated with all-cause LS among the women (odds ratio (OR) = 1.58, 95% CI: 1.2-2.08), but not among the men. Associations for mental disorder LS were evident for both ERI and OC among both genders (ERI/OC: women OR = 2.76/2.82; men OR = 2.18/2.92). For the men these associations were driven by high effort, while for the women it was low job esteem in public sector and low job security in private sector. Among the highly educated women, ERI was strongly related to mental disorder LS (OR = 6.94, 95% CI: 3.2-15.04), while the highly educated men seemed to be strongly affected by OC for the same outcome (OR = 5.79, 95% CI: 1.48-22.57). The study confirmed the independent roles of ERI and OC for LS, with stronger associations among the women and for mental disorders. The ERI model is a promising tool that can contribute to understanding the prevailing gender gap in sick leave and increasing sick leave due to mental disorders. Int J Occup Med Environ Health 2016;29(6):973-989. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Return to work after work-related stress: a randomized controlled trial of a work-focused cognitive behavioral intervention.

PubMed

Dalgaard, Vita Ligaya; Aschbacher, Kirstin; Andersen, Johan Hviid; Glasscock, David John; Willert, Morten Vejs; Carstensen, Ole; Biering, Karin

2017-09-01

Objectives This study aimed to evaluate the effect of a stress management intervention (SMI) on lasting return to work (RTW) among patients with work-related stress complaints. Methods Sickness benefit departments from three local municipalities referred patients on sick leave with work-related adjustment disorders or mild depression to the Department of Occupational Medicine, Regional Hospital West Jutland. A 2× randomization procedure allocated patients into one of three groups: intervention (N=58), control A (which received a clinical assessment; N=56), or control B (no assessment; N=49). Treatment comprised individual work-focused cognitive behavioral therapy (CBT) with an optional workplace intervention. The outcome was time until lasting RTW (16 and 44 weeks follow-up) using register data. Results Median number of weeks until lasting RTW was 15, 19, and 32 for the intervention group, control A, and control B respectively. However, for group B, clinical assessment was not part of the inclusion process, which may have introduced selection bias. In the fully-adjusted Cox regression model, the intervention group exhibited significantly faster lasting RTW at 44 weeks; hazard ratio (HR) 1.57 [95% confidence interval (95% CI) 1.01-2.44] relative to control group A, with a non-significant trend evident at 16 weeks; HR 1.70 (95% CI 0.94-3.10), when controlling for age, gender, occupation, sick leave during previous year, full or partial sick leave, and diagnosis. Unadjusted analyses remained directionally consistent but were reduced to marginal significance. Conclusions There was a tendency towards faster lasting RTW in the intervention group compared to control A, which received clinical assessment, in all analyses. The intervention group returned to work about 4 weeks earlier than control A, which could translate into substantial financial gains.

Reliance on social security benefits by Swedish patients with ill-health attributed to dental fillings: a register-based cohort study.

PubMed

Naimi-Akbar, Aron; Svedberg, Pia; Alexanderson, Kristina; Ekstrand, Jan; Sandborgh-Englund, Gunilla

2012-08-30

Some people attribute their ill health to dental filling materials, experiencing a variety of symptoms. Yet, it is not known if they continue to financially support themselves by work or become reliant on different types of social security benefits. The aim of this study was to analyse reliance on different forms of social security benefits by patients who attribute their poor health to dental filling materials. A longitudinal cohort study with a 13-year follow up. The subjects included were 505 patients attributing their ill health to dental restorative materials, who applied for subsidised filling replacement. They were compared to a cohort of matched controls representing the general population (three controls per patient). Annual individual data on disability pension, sick leave, unemployment benefits, and socio-demographic factors was obtained from Statistics Sweden. Generalized estimating equations were used to test for differences between cohorts in number of days on different types of social security benefits. The cohort of dental filling patients had a significantly higher number of days on sick leave and disability pension than the general population. The test of an overall interaction effect between time and cohort showed a significant difference between the two cohorts regarding both sick leave and disability pension. In the replacement cohort, the highest number of sick-leave days was recorded in the year they applied for subsidised replacement of fillings. While sick leave decreased following the year of application, the number of days on disability pension increased and peaked at the end of follow-up. Ill health related to dental materials is likely to be associated with dependence on social security benefits. Dental filling replacement does not seem to improve workforce participation.

The effectiveness of a construction worksite prevention program on work ability, health, and sick leave: results from a cluster randomized controlled trial.

PubMed

Oude Hengel, Karen M; Blatter, Brigitte M; van der Molen, Henk F; Bongers, Paulien M; van der Beek, Allard J

2013-09-01

This study aimed to investigate the effectiveness of a prevention program on work ability, health, and sick leave targeted at construction worksites. A total of 15 departments (N = 297 workers) from 6 construction companies participated in this cluster randomized controlled trial and were randomly allocated to the intervention (8 departments; N = 171 workers) or control (7 departments; N = 122 workers) group. The intervention consisted of two individual training sessions with a physical therapist aimed at lowering the physical workload, a rest-break tool to improve the balance between work and recovery, and two empowerment training sessions to increase the worker's influence at the worksite. Data on work ability, physical and mental health status, and musculoskeletal symptoms were collected at baseline, and at 3, 6, and 12 months follow-up. Sick leave data were obtained from the companies. Overall, no differences in work ability [β 0.02, 95% confidence interval (95% CI) -0.34-0.37] or physical and mental health status (β -0.04, 95% CI -1.43-1.35, and β 0.80 95% CI -0.51-2.11, respectively) were found between the intervention and control group. The intervention showed an overall decline in musculoskeletal symptoms (ranging from OR 0.68, 95% CI 0.34-1.33, to OR 0.86, 95% CI 0.47-1.57) and long-term sick leave (OR 0.44, 95% CI 0.13-1.26) among construction workers. Both reductions were not statistically significant. The prevention program seemed to result in a beneficial but not statistically significant decline in the prevalence of musculoskeletal symptoms and long-term sick leave among construction workers, but showed no effects with regard to work ability, physical health, and mental health.

The impact of inflammatory bowel disease on labor force participation: results of a population sampled case-control study.

PubMed

Boonen, Annelies; Dagnelie, Pieter C; Feleus, Anita; Hesselink, Martine A; Muris, Jean W; Stockbrügger, Reinhold W; Russel, Maurice G

2002-11-01

Inflammatory bowel diseases are chronic conditions that might cause a severe impact on social life. The aim of the study was to assess employment, chronic work disability, and sick leave in patients with inflammatory bowel disease. A postal questionnaire was sent to 984 patients with inflammatory bowel disease and 1504 controls. Age- and gender-adjusted employment and chronic work disability ratios and rates were calculated using indirect standardization. In subjects in paid employment, proportions of those having an episode of sick leave and lost workdays were analyzed. Logistic regression was used to assess the contribution of age, gender, education, and course of disease. The results of 680 (69%) patients and 715 (48%) controls could be analyzed. For the entire group of patients, employment was 6.5% lower, compared with controls (95% CI: 4.0-9.0). Chronic work disability was 17.1% higher than expected (95% CI: 15.1-19.1). In those in paid employment, 62% of patients compared with 53% of controls had experienced one or more episodes of sick leave during the past year (p = 0.002). This resulted in 19.2 versus 11.8 days of sick leave per subject per year for patients and controls respectively (p = 0.002). Relative to controls, the risk of chronic work disability was more increased in younger (p = 0.02) and higher educated (p = 0.02) patients. Course of disease contributed to chronic work disability and sick leave. IBD has a significant impact on labor force participation that is higher in CD compared with UC and highest in younger and more highly educated patients.

Employment status, difficulties at work and quality of life in inflammatory bowel disease patients.

PubMed

De Boer, Angela G E M; Bennebroek Evertsz', Floor; Stokkers, Pieter C; Bockting, Claudia L; Sanderman, Robert; Hommes, Daniel W; Sprangers, Mirjam A G; Frings-Dresen, Monique H W

2016-10-01

To assess employment status, difficulties at work and sick leave in inflammatory bowel disease (IBD) patients and their relation with sociodemographic and clinical factors, quality of life (QoL), and anxiety and depression. IBD patients attending an IBD outpatients' clinic received self-report questionnaires on employment status, IBD-related difficulties at work and sick leave (Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness), sociodemographic factors, QoL (Inflammatory Bowel Disease Questionnaire and 12-item Short-form Health Survey) and anxiety and depression (Hospital Anxiety and Depression Scale). Disease activity was assessed by their gastroenterologist. Associations between paid employment and sick leave with sociodemographic and clinical factors, QoL and anxiety and depression were assessed by regression analyses. In total, 202 IBD patients of working age, with a mean age of 41 years, participated; 63% had Crohn's disease and 37% had ulcerative colitis, and 57% were women and 19% had active disease. In all, 123 (61%) patients were in paid employment, of whom 31 (25%) were on sick leave, whereas 46 (23%) received a disability pension. Concentration problems (72%), low working pace (78%) and delayed work production (50%) were the most prevalent IBD-related work difficulties. IBD patients without paid employment were older and more often women, with active disease, lower QoL and higher anxiety and depression rates. Sick leave was associated with lower QoL and higher anxiety and depression rates. More than half of IBD patients were in paid employment, whereas almost a quarter was receiving a disability pension. A large majority experienced work difficulties. Having no paid employment was associated with poorer QoL and more anxiety and depression symptomatology.

Physiotherapy triage assessment of patients referred for orthopaedic consultation - Long-term follow-up of health-related quality of life, pain-related disability and sick leave.

PubMed

Samsson, Karin S; Larsson, Maria E H

2015-02-01

The literature indicates that physiotherapy triage assessment can be efficient for patients referred for orthopaedic consultation, however long-term follow up of patient reported outcome measures are not available. To report a long-term evaluation of patient-reported health-related quality of life, pain-related disability, and sick leave after a physiotherapy triage assessment of patients referred for orthopaedic consultation compared with standard practice. Patients referred for orthopaedic consultation (n = 208) were randomised to physiotherapy triage assessment or standard practice. The randomised cohort was analysed on an intention-to-treat (ITT) basis. The patient reported outcome measures EuroQol VAS (self-reported health-state), EuroQol 5D-3L (EQ-5D) and Pain Disability Index (PDI) were assessed at baseline and after 3, 6 and 12 months. EQ VAS was analysed using a repeated measure ANOVA. PDI and EQ-5D were analysed using a marginal logistic regression model. Sick leave was analysed for the 12 months following consultation using a Mann-Whitney U-test. The patients rated a significantly better health-state at 3 after physiotherapy triage assessment [mean difference -5.7 (95% CI -11.1; -0.2); p = 0.04]. There were no other statistically significant differences in perceived health-related quality of life or pain related disability between the groups at any of the follow-ups, or sick leave. This study reports that the long-term follow up of the patient related outcome measures health-related quality of life, pain-related disability and sick leave after physiotherapy triage assessment did not differ from standard practice, indicating the possible benefits of implementation of this model of care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Re-initiating professional working activity after myocardial infarction in primary percutaneous coronary intervention networks era.

PubMed

Babić, Zdravko; Pavlov, Marin; Oštrić, Mirjana; Milošević, Milan; Misigoj Duraković, Marjeta; Pintarić, Hrvoje

2015-01-01

To investigate the aspects of return to work, socio-economic and quality of life aspects in 145 employed patients under 60 years of age treated with primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. During hospital treatment demographic and clinical data was collected. Data about major adverse cardiovascular events, rehabilitation, sick leave, discharge from job and retirement, salary, major life events and estimation of quality of life after myocardial infarction were obtained after follow-up (mean: 836±242 days). Average sick leave was 126±125 days. Following myocardial infarction, 3.4% of patients were discharged from their jobs while 31.7% retired. Lower salary was reported in 17.9% patients, major life events in 9.7%, while 40.7% estimated quality of life as worse following the event. Longer hospitalization was reported in patients transferred from surrounding counties, those with inferior myocardial wall and right coronary artery affected. Age, hyperlipoproteinemia and lower education degree were connected to permanent working cessation. Significant salary decrease was observed in male patients. Employer type was related to sick leave duration. Impaired quality of life was observed in patients who underwent in-hospital rehabilitation and those from surrounding counties. Longer sick leave was observed in patients with lower income before and after myocardial infarction. These patients reported lower quality of life after myocardial infarction. Inadequate health policy and delayed cardiac rehabilitation after myocardial infarction may lead to prolonged hospitalization and sick leave as well as lower quality of life after the event, regardless of optimal treatment in acute phase of disease. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Annual incidence of non-specific low back pain as an occupational disease attributed to whole-body vibration according to the National Dutch Register 2005-2012.

PubMed

Kuijer, P Paul F M; van der Molen, Henk F; Schop, Astrid; Moeijes, Fred; Frings-Dresen, Monique H W; Hulshof, Carel T J

2015-01-01

Non-specific low back pain (nLBP) is the second most important reason for sick leave in the Netherlands, and more than 50% of the workers on sick leave attribute these complaints to their work. To stimulate recognition and prevention, an occupational disease (OD) registration-guideline was implemented for the assessment of the work-relatedness of nLBP in the Netherlands in 2005. The aim of this study is to present the annual incidence of nLBP as an OD and specifically for whole-body vibration (WBV) including patient characteristics such as age, sick leave and actions initiated by the occupational physician (OP). The data were retrieved from the National Dutch Register for 2005-2012. Each year about 118 OPs reported 509 cases (SD 139) of nLBP as an OD in a Dutch working population of 7.5 million workers (8% of all annual reported ODs). Less than 1% of these cases were attributed to WBV: 94% were men, 45% were between 51 and 60 years and 35% were on sick leave for more than 2 weeks. Most initiated actions were ergonomic interventions (35%). The number of notified cases of nLPB as an occupational disease attributed to whole-body vibration is low with less than 1% of all cases in the Netherlands. An explanation is that other work-related risk factors for nLBP such as lifting are more frequently occurring, more visible and have a higher attributable risk than WBV. However, continuing attention for WBV remains warranted given a higher percentage of cases with sick leave of more than 2 weeks.

[Evaluation of the management of nonwork-related sick leave lasting more than 15 days in Catalonia (Spain)].

PubMed

Benavides, Fernando G; Torá, Isabel; Miguel Martínez, José; Jardí, Josefina; Manzanera, Rafael; Alberti, Constança; Delclós, Jordi

2010-01-01

To compare the length of nonwork-related sick leave among cases managed by an insurance company versus those managed by the National Institute of Social Security (NISS). We performed a retrospective cohort study of 289,686 cases of sick leave lasting for more than 15 days that began in 2005 after certification by a primary care physician in Catalonia, were reported to the Catalonian Institute of Medical Evaluations, and were followed to term. Of the total, 156,676 cases were managed by the NISS. To account for repeat episodes (approximately 25% of the total), the Wang-Chang estimator was used to calculate the median duration and percentiles; comparisons were made using log-logistic regression with shared gamma frailty models, with calculation of time ratios (TR) and their corresponding 95% confidence intervals (95% CI). The median duration of sick leave was 43 days for cases managed by the NISS and 39 days for those managed by the insurance company. This difference was statistically significant both for men employed under contract (TR=0.87; 95% CI: 0.85-0.88) and for those who were self-employed (TR=0.78; 95% CI: 0.75-0.80) as well as for women under contract (TR=0.85; 95% CI: 0.84-0.87) and self-employed women (TR=0.84; 95% CI: 0.81-0.88). These differences persisted after adjustment was performed for age and health region. For sick leave lasting more than 15 days, these results confirm that cases managed by an insurance company ended earlier than for those managed by the NISS, both for contract and self-employed workers. Further research is needed to explore the reasons for these differences. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

A Study of Factors Affecting the Attraction and Retention of High Caliber Personnel to Department of Defense Contracting.

DTIC Science & Technology

1987-09-01

from studies of met expectations: (1) The decision to participate or withdraw from an organization may be looked upon as a process of balancing ...was included in this study tu provide some balance and because a large number of Air Force contract specialists are employed at Aeronautical Systems...thirteen days of sick leave per year. Vacation or leave is accrued constantly with an updated balance provided at the end of each pay period

29 CFR 825.207 - Substitution of paid leave.

Code of Federal Regulations, 2013 CFR

2013-07-01

... AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825... against the employee's FMLA leave entitlement. For example, paid sick leave used for a medical condition...' compensation absences and FMLA leave. (f) Section 7(o) of the Fair Labor Standards Act (FLSA) permits public...

29 CFR 825.207 - Substitution of paid leave.

Code of Federal Regulations, 2014 CFR

2014-07-01

... AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825... against the employee's FMLA leave entitlement. For example, paid sick leave used for a medical condition...' compensation absences and FMLA leave. (f) Section 7(o) of the Fair Labor Standards Act (FLSA) permits public...

Betwixt and between: workplace perspectives on work reintegration in the eldercare sector in Denmark.

PubMed

Ladekjær Larsen, Eva; Labriola, Merete; Vinther Nielsen, Claus; Schultz Petersen, Kirsten

2015-01-01

Contemporary return-to-work (RTW) policies in Denmark and other welfare nations recommend employees on long-term sick leave, due to physical or mental health problems, to RTW gradually. Factors that influence the process of work reintegration (WR) is well documented, however, co-workers experiences of this process are a rather new research topic. Moreover, in the context of the present research, no studies have so far explored the workplace as an arena for social interaction. The aim of this study was to explore co-workers' experiences of the reintegration process and how these experiences are related to social positions at the workplace. Ethnographic fieldwork was conducted at two nursing homes that were in a process WR after long-term sick leave. The data consist of field notes, policy documents, individual interviews, and focus group interviews. Data were organized by use of NVivo. A theoretical framework was adopted which enabled us to approach and interpret the reintegration process as one that changed the social position of the returning employee. The dataset demonstrates how the returnee is in a state of being betwixt and between the social positions of a co-worker and a non-co-worker. This is illustrated in three cases which show that this state prevents the returnee from taking on the role as a co-worker, excludes the returnee from the workplace, and creates uncertainty for all workplace actors. The study highlighted that WR creates a social position for the returnee that complicates the working routine and causes uncertainty in social interactions. Implications for Rehabilitation Work reintegration (WR) after long-term sick leave is commonly characterized by reduced working hours and modified working tasks. The WR process influences the whole work place including co-workers' everyday working life and complicates work situations where work tasks and roles are negotiated between the returning worker and co-workers. Future WR policies and guidelines could benefit from integrating co-workers' perspective to ensure that the returning worker is not socially excluded as well as ensuring that co-workers are not overburdened in the process.

Effects of Multiple Cleaning and Disinfection Interventions on Infectious Diseases in Children: A Group Randomized Trial in China.

PubMed

Ban, Hai Qun; Li, Tao; Shen, Jin; Li, Jin; Peng, Pin Zhang; Ye, Heng Ping; Zhang, Liu Bo

2015-11-01

To assess the effectiveness of multiple cleaning and disinfection interventions in the homes and kindergartens, in reducing gastrointestinal and respiratory illnesses of children. From October 2010 to September 2011, we performed a prospective, controlled study in China. 408 children under 5 years old were recruited and group randomized into intervention and control groups. Families and kindergartens in the intervention group were provided with antibacterial products for hand hygiene and surface cleaning or disinfection for one year. Each child's illness symptoms and sick leave were recorded every day. A total of 393 children completed the study, with similar baseline demographics in each of the 2 groups. Except for abdominal pain, the odds of symptoms (fever, cough and expectoration, runny nose and nasal congestion, diarrhea), illness (acute respiratory illness and gastrointestinal illness), and sick leave per person each month were significantly reduced by interventions. The rates of fever, diarrhea, acute respiratory illness, gastrointestinal illness and sick leave per person per year were significantly decreased as well. Not only the acute respiratory and gastrointestinal illness but the sick leave rate in children were significantly reduced by multiple interventions. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Early coordinated multidisciplinary intervention to prevent sickness absence and labour market exclusion in patients with low back pain: study protocol of a randomized controlled trial.

PubMed

Fisker, Annette; Langberg, Henning; Petersen, Tom; Mortensen, Ole Steen

2013-03-13

Musculoskeletal disorders account for one third of the long-term absenteeism in Denmark and the number of individuals sick listed for more than four weeks is increasing. Compared to other diagnoses, patients with musculoskeletal diseases, including low back pain, are less likely to return to work after a period of sick leave. It seems that a multidisciplinary intervention, including cooperation between the health sector, the social sector and in the work place, has a positive effect on days off work due to musculoskeletal disorders and particularly low back pain. It is a challenge to coordinate this type of intervention, and the implementation of a return-to-work (RTW)-coordinator is suggested as an effective strategy in this process. The purpose of this paper is to describe the study protocol and present a new type of intervention, where the physiotherapist both has the role as RTW-coordinator and treating the patient. A randomized controlled trial (RCT) is currently on-going. The RCT includes 770 patients with low back pain of minimum four weeks who are referred to an outpatient back centre. The study population consists of patients, who are sick-listed or at risk of sick-leave due to LBP. The control group is treated with usual care in a team of a physiotherapist, a chiropractor, a rheumatologist and a social worker employed at the centre. The Intervention group is treated with usual care and in addition intervention of a psychologist, an occupational physician, an ergonomist, a case manager from the municipal sickness benefit office, who has the authority in the actual case concerning sickness benefit payment and contact to the patients employer/work place. The treating physiotherapist is the RTW-coordinator. Outcome will be reported at the end of treatment as well as 6 and 12 months follow up. The primary outcome is number of days off work. Secondary outcomes are disability, pain, and quality of life. The study will follow the recommendations in CONSORT-statement in designing and reporting RCTs. This large RCT is testing the effectiveness of a preventive intervention targeting patients on short term sick leave or at risk being sick listed because of low back pain. We have developed a novel multidisciplinary team structure using the treating physiotherapist as the return to work coordinator, and having the case manager from the municipal sickness benefit office participating in team meetings. The study has the potential to contribute to the knowledge about how to target the challenges in the treatment of LBP. The aim is to prevent sickness absence and labour market exclusion--both on the individual level and economic costs at community level. Short term results will be available in 2014.This study is approved by the Danish Regional Ethics Committee (J.nr: H-C-2008-112) and is registered at ClinicalTrials.gov: NCT01690234.

43 CFR 17.210 - Employment practices.

Code of Federal Regulations, 2014 CFR

2014-10-01

... classifications, organizational structures, position descriptions, lines of progressions, and seniority lists; (5) Leaves of absence, sick leave, or any other leave; (6) Fringe benefits available by virtue of employment... apprenticeship, professional meetings, conferences, and other related activities, and selection for leaves of...

5 CFR 900.706 - Employment practices.

Code of Federal Regulations, 2012 CFR

2012-01-01

... changes in compensation; (iv) Job assignments, job classifications, organizational structures, position descriptions, lines of progression, and seniority lists; (v) Leaves of absence, sick leave, or any other leave..., conferences, and other related activities, and selection for leaves of absence to pursue training; (viii...

43 CFR 17.210 - Employment practices.

Code of Federal Regulations, 2011 CFR

2011-10-01

... classifications, organizational structures, position descriptions, lines of progressions, and seniority lists; (5) Leaves of absence, sick leave, or any other leave; (6) Fringe benefits available by virtue of employment... apprenticeship, professional meetings, conferences, and other related activities, and selection for leaves of...

5 CFR 900.706 - Employment practices.

Code of Federal Regulations, 2014 CFR

2014-01-01

... changes in compensation; (iv) Job assignments, job classifications, organizational structures, position descriptions, lines of progression, and seniority lists; (v) Leaves of absence, sick leave, or any other leave..., conferences, and other related activities, and selection for leaves of absence to pursue training; (viii...

5 CFR 900.706 - Employment practices.

Code of Federal Regulations, 2013 CFR

2013-01-01

... changes in compensation; (iv) Job assignments, job classifications, organizational structures, position descriptions, lines of progression, and seniority lists; (v) Leaves of absence, sick leave, or any other leave..., conferences, and other related activities, and selection for leaves of absence to pursue training; (viii...

Effects of a weight-gain restriction programme for obese pregnant women on sickness absence and pregnancy benefits.

PubMed

Sydsjö, Gunilla; Monfils, Wiktor Gustafsson; de Keyser, Nicholas; Claesson, Ing-Marie; Sydsjö, Adam; Josefsson, Ann

2013-06-01

To evaluate the effect of a weight-gain restriction programme for obese pregnant women on sickness absence days and pregnancy benefit days during pregnancy and postpartum. A prospective, controlled intervention study. The Swedish Social Security Agency's records were utilized to compile sickness absence and pregnancy benefit information. Antenatal care clinics in the south-east of Sweden. One hundred fifty-five obese pregnant women who participated in a weight restriction program with weekly structured motivational and behavioural talks combined with aqua-aerobics during pregnancy. A total of 193 obese pregnant women with no intervention served as controls. Sickness absence benefits and pregnancy benefits expressed as a percentage. On average women in the intervention group had 76.68 total full days of sickness absence benefit compared with 53.09 days in the control group. Total full days of pregnancy benefits were 39.66% days and 41.41% for the intervention and control groups respectively. For the women who were on sick leave there were no differences between the groups in the amount of days taken. Given the complexity of factors that have an influence on sickness absence leave, it is possible that programmes that do not address the influence of social aspects and attitudes towards sickness absence have limited effect.

Severe to profound hearing impairment: quality of life, psychosocial consequences and audiological rehabilitation.

PubMed

Carlsson, Per-Inge; Hjaldahl, Jennie; Magnuson, Anders; Ternevall, Elisabeth; Edén, Margareta; Skagerstrand, Åsa; Jönsson, Radi

2015-01-01

To study the quality of life (QoL) and psychosocial consequences in terms of sick leave and audiological rehabilitation given to patients with severe to profound hearing impairment. A retrospective study of data on 2319 patients with severe to profound hearing impairment in The Swedish Quality Register of Otorhinolaryngology, followed by a posted questionnaire including The Hospital Anxiety and Depression Scale (HADS). The results indicate greater levels of anxiety and depression among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo had strong negative effects on QoL. The proportion of sick leave differed between the studied dimensions in the study. The proportion of patients who received extended audiological rehabilitation was 38% in the present study. Treatment focused on anxiety, depression, tinnitus and vertigo must be given early in the rehabilitation process in patients with severe or profound hearing impairment. Because sick leave differs greatly within this group of patients, collaboration with the regional Social Insurance Agency is crucial part of the rehabilitation. The study also shows that presently, only a small proportion of patients in Sweden with severe to profound hearing impairment receive extended audiological rehabilitation. Implications for Rehabilitation Greater levels of anxiety and depression have been found among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo have strong negative effects on QoL in this group of patients. Only a small proportion of patients with severe to profound hearing impairment receive extended audiological rehabilitation today, including medical, technical and psychosocial efforts. Extended audiological rehabilitation focused on anxiety, depression, tinnitus and vertigo must be given, together with technical rehabilitation, early in the rehabilitation process in patients with severe or profound hearing impairment.

Leaves of Absence. School Law Summary.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. Research Div.

This report contains State-by-State statutory summaries on three types of leaves of absence relating to teachers -- sick leave, maternity leave, and sabbatical leave. Only State laws that have specific reference to one of these three types of leaves of absence are included. Not included are those statutes granting boards of education the general…

Family Benefits--What Are Students' Attitudes and Expectations by Gender?

ERIC Educational Resources Information Center

Waner, Karen K.; Winter, Janet K.; Mansfield, Joan C.

2007-01-01

Benefits and leave policies are important aspects of employment when employees attempt to balance career and family. These policies include salary, promotion, vacation, tuition reimbursement, sick leave, medical insurance, life insurance, maternity or paternity leave, elder-care leave, discriminatory leave, and company support and counseling. The…

41 CFR 60-741.20 - Covered employment activities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... classifications, organizational structures, position descriptions, lines of progression, and seniority lists; (e) Leaves of absence, sick leave, or any other leave; (f) Fringe benefits available by virtue of employment... apprenticeships, professional meetings, conferences and other related activities, and selection for leaves of...

41 CFR 60-300.20 - Covered employment activities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... classifications, organizational structures, position descriptions, lines of progression, and seniority lists; (e) Leaves of absence, sick leave, or any other leave; (f) Fringe benefits available by virtue of employment..., apprenticeships, professional meetings, conferences and other related activities, and selection for leaves of...

Integrated Employee Occupational Health and Organizational-Level Registered Nurse Outcomes.

PubMed

Mohr, David C; Schult, Tamara; Eaton, Jennifer Lipkowitz; Awosika, Ebi; McPhaul, Kathleen M

2016-05-01

The study examined organizational culture, structural supports, and employee health program integration influence on registered nurse (RN) outcomes. An organizational health survey, employee health clinical operations survey, employee attitudes survey, and administration data were collected. Multivariate regression models examined outcomes of sick leave, leave without pay, voluntary turnover, intention to leave, and organizational culture using 122 medical centers. Lower staffing ratios were associated with greater sick leave, higher turnover, and intention to leave. Safety climate was favorably associated with each of the five outcomes. Both onsite employee occupational health services and a robust health promotion program were associated with more positive organizational culture perceptions. Findings highlight the positive influence of integrating employee health and health promotion services on organizational health outcomes. Attention to promoting employee health may benefit organizations in multiple, synergistic ways.

Workplace mental health training for managers and its effect on sick leave in employees: a cluster randomised controlled trial.

PubMed

Milligan-Saville, Josie S; Tan, Leona; Gayed, Aimée; Barnes, Caryl; Madan, Ira; Dobson, Mark; Bryant, Richard A; Christensen, Helen; Mykletun, Arnstein; Harvey, Samuel B

2017-11-01

Mental illness is one of the most rapidly increasing causes of long-term sickness absence, despite improved rates of detection and development of more effective interventions. However, mental health training for managers might help improve occupational outcomes for people with mental health problems. We aimed to investigate the effect of mental health training on managers' knowledge, attitudes, confidence, and behaviour towards employees with mental health problems, and its effect on employee sickness absence. We did a cluster randomised controlled trial of manager mental health training within a large Australian fire and rescue service, with a 6-month follow-up. Managers (clusters) at the level of duty commander or equivalent were randomly assigned (1:1) using an online random sequence generator to either a 4-h face-to-face RESPECT mental health training programme or a deferred training control group. Researchers, managers, and employees were not masked to the outcome of randomisation. Firefighters and station officers supervised by each manager were included in the study via their anonymised sickness absence records. The primary outcome measure was change in sickness absence among those supervised by each of the managers. We analysed rates of work-related sick leave and standard sick leave seperately, with rate being defined as sickness absence hours divided by the sum of hours of sickness absence and hours of attendance. This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613001156774). 128 managers were recruited between Feb 18, 2014, and May 17, 2014. 46 (71%) of 65 managers allocated to the intervention group received the intervention, and 42 (67%) of 63 managers allocated to the control group were entered in the deferred training group. Managers and their employees were followed up and reassessed at 6 months after randomisation. 25 managers (1233 employees) in the intervention group and 19 managers (733 employees) in the control group provided data for the primary analysis. During the 6-month follow-up, the mean rate of work-related sick leave decreased by 0·28 percentage points (pp) from a pre-training mean of 1·56% (SE 0·23) in the intervention group and increased by 0·28 pp from 0·95% (0·20) in the control group (p=0·049), corresponding to a reduction of 6·45 h per employee per 6 months. The mean percentage of standard sick leave increased by 0·48 pp from 4·97% (0·22) in the intervention group and by 0·31 pp from 5·27% (0·21) in the control group (p=0·169). A 4-h manager mental health training programme could lead to a significant reduction in work-related sickness absence, with an associated return on investment of £9.98 for each pound spent on such training. Further research is needed to confirm these findings and test their applicability in other work settings. NSW Health and Employers Mutual Ltd. Copyright © 2017 Elsevier Ltd. All rights reserved.

Working hours as a risk factor in the development of musculoskeletal complaints.

PubMed

Waersted, M; Westgaard, R H

1991-03-01

The length of daily working hours as a risk factor for the development of musculoskeletal complaints was studied by comparing the sick leave statistics of 408 sewing machine operators on full-time schedules (8 h working day) with 210 operators on part-time schedules (5 h working day). Working part-time was shown to postpone the occurrence of sick leave due to musculoskeletal disorders by approximately half a year. There was no lasting effect on the reduction in working hours on sick leave due to shoulder-neck complaints, but a reduction in low back complaints was indicated. It is suggested that any reorganization of work activities to counteract musculoskeletal injuries from repetitive work should aim to break up the muscular activity patterns over time periods considerably shorter than the 5 h working day of the part-time workers in the present study.

Does part-time sick leave help individuals with mental disorders recover lost work capacity?

PubMed

Andrén, Daniela

2014-06-01

This paper aims to answer the question whether combining sick leave with some hours of work can help employees diagnosed with a mental disorder (MD) increase their probability of returning to work. Given the available data, this paper analyzes the impact of part-time sick leave (PTSL) on the probability of fully recovering lost work capacity for employees diagnosed with an MD. The effects of PTSL on the probability of fully recovering lost work capacity are estimated by a discrete choice one-factor model using data on a nationally representative sample extracted from the register of the National Agency of Social Insurance in Sweden and supplemented with information from questionnaires. All individuals in the sample were 20-64 years old and started a sickness spell of at least 15 days between 1 and 16 February 2001. We selected all employed individuals diagnosed with an MD, with a final sample of 629 individuals. The results show that PTSL is associated with a low likelihood of full recovery, yet the timing of the assignment is important. PTSL's effect is relatively low (0.015) when it is assigned in the beginning of the spell but relatively high (0.387), and statistically significant, when assigned after 60 days of full-time sick leave (FTSL). This suggests efficiency improvements from assigning employees with an MD diagnosis, when possible, to PTSL. The employment gains will be enhanced if employees with an MD diagnosis are encouraged to return to work part-time after 60 days or more of FTSL.

48 CFR 52.222-36 - Affirmative Action for Workers With Disabilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Job assignments, job classifications, organizational structures, position descriptions, lines of progression, and seniority lists; (v) Leaves of absence, sick leave, or any other leave; (vi) Fringe benefits... related activities, and selection for leaves of absence to pursue training; (viii) Activities sponsored by...

48 CFR 52.222-36 - Affirmative Action for Workers With Disabilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Job assignments, job classifications, organizational structures, position descriptions, lines of progression, and seniority lists; (v) Leaves of absence, sick leave, or any other leave; (vi) Fringe benefits... related activities, and selection for leaves of absence to pursue training; (viii) Activities sponsored by...

28 CFR 41.52 - General prohibitions against employment discrimination.

Code of Federal Regulations, 2013 CFR

2013-07-01

... changes in compensation; (4) Job assignments, job classifications, organizational structures, position descriptions, lines of progression, and seniority lists; (5) Leaves of absence, sick leave, or any other leave..., conferences, and other related activities, and selection for leaves of absence to pursue training; (8...

Impact of Loss of Work Productivity in Patients with Overactive Bladder Treated with Antimuscarinics in Spain: Study in Routine Clinical Practice Conditions.

PubMed

Sicras-Mainar, Antoni; Navarro-Artieda, Ruth; Ruiz-Torrejón, Amador; Sáez-Zafra, Marc; Coll-de Tuero, Gabriel

2015-12-01

Overactive bladder (OAB) is a syndrome characterized by presenting symptoms of urgency, with or without urge incontinence, and normally accompanied by day and night frequency. The aim of this study was to evaluate the impact of lost work productivity [number of days of sick leave] in patients treated with fesoterodine versus tolterodine and solifenacin to treat OAB in Spain. A retrospective, observational study was carried out using the records (digital databases) of actively working patients (2008-2013). The study population comprised of patients from two autonomous communities; 31 primary care centres agreed to participate. Patients who began first treatment with antimuscarinics (fesoterodine, solifenacin or tolterodine) and who met certain inclusion/exclusion criteria were included in the study. Follow-up lasted for 1 year. The main outcome measures were comorbidity, medication possession ratio (MPR), treatment persistence, and number of days of sick leave and associated costs. Indirect costs were considered to be those related to lost work productivity (number of days of sick leave, exclusively), (1) due to OAB and (2) overall total. The cost was expressed as the average cost per patient (cost/unit). Multivariate analyses (Cox, ANCOVA) were used to correct the models. A total of 3094 patients were recruited into the study; 43.0 % were treated with solifenacin, 29.2 % with tolterodine, and 27.8 % with fesoterodine. The average age of patients was 54 years (standard deviation 9.2), and 62.2 % were women. The comparison of fesoterodine versus solifenacin and tolterodine showed a higher MPR (90.0 vs. 87.0 and 86.1 %, respectively), higher treatment persistence (40.2 vs. 34.7 and 33.6 %), lower use of sick leave (22.8 vs. 52.9 and 36.7 %), total number of days of sick leave (5.1 vs. 9.7 and 9.3 days) and costs corrected for covariates (€371 vs. €703 and €683); p < 0.05. Despite the possible limitations of this study, active patients who began treatment with fesoterodine to treat OAB (compared with solifenacin or tolterodine) had fewer days of sick leave, resulting in lower costs due to lost productivity.

Secondary prevention of work-related disability in nonspecific low back pain: does problem-solving therapy help? A randomized clinical trial.

PubMed

van den Hout, Johanna H C; Vlaeyen, Johan W S; Heuts, Peter H T G; Zijlema, Johan H L; Wijnen, Joseph A G

2003-01-01

Given the individual and economic burden of chronic work disability in low back pain patients, there is a need for effective preventive interventions. The aim of the present study was to investigate whether problem-solving therapy had a supplemental value when added to behavioral graded activity, regarding days of sick leave and work status. Randomized controlled trial. Employees who were recently on sick leave as a result of nonspecific low back pain were referred to the rehabilitation center by general practitioner, occupational physician, or rehabilitation physician. Forty-five employees had been randomly assigned to the experimental treatment condition that included behavioral graded activity and problem-solving therapy (GAPS), and 39 employees had been randomly assigned to behavioral graded activity and group education (GAGE). Days of sick leave and work status. Data were retrieved from occupational health services. Data analyses showed that employees in the GAPS group had significantly fewer days of sick leave in the second half-year after the intervention. Moreover, work status was more favorable for employees in this condition, in that more employees had a 100% return-to-work and fewer patients ended up receiving disability pensions one year after the intervention. Sensitivity analyses confirmed these results. The addition of problem-solving therapy to behavioral graded activity had supplemental value in employees with nonspecific low back pain.

[Return to Work Strategies of Employees who Experienced Depression: Employers and HR's Perspectives].

PubMed

Corbière, Marc; Lecomte, Tania; Lachance, Jean-Philippe; Coutu, Marie-France; Negrini, Alessia; Laberon, Sonia

Major depression is one of the leading causes of work disability across the world. In Canada, the lifetime prevalence of depression varies from 10 to 12%. Depression impacts not only the employee who is often stigmatized and can lose his professional identity, but also has consequences on colleagues and supervisors in organizations. In the literature, four models are described from which employers and managers use in their organizations to make decisions regarding the work disability of employees on sick leave: biomedical, financial management, personnel management, and organizational development. These models can also be supported by economic, legal and ethical interests. Even though these models are essential to better understand the decision of employers and HR regarding work disability, information remains scarce regarding the concrete strategies used by these stakeholders to facilitate the return to work for employees on sick leave due to depression.Objectives the aim of this paper is to document, considering employers' and human resources' perspectives, the best strategies to put in place to facilitate the return to work of employees on sick leave due to depression.Method This study was part of a larger study carried out in Canada to assess factors influencing the return to work after a depression-related sick leave, taking into account the viewpoint of four types of stakeholders: employers/human resources, supervisors, unions and people diagnosed with depression. 219 employers (68.5%) and human resources directors (31.5%) from 82.6% organizations having more than 100 employees accepted to answer a telephone semi-structured interview. The question of interest in this study is: In your opinion, what are the best strategies to help an employee who has had a depression to return to work? Coding was influenced by empirical findings and theories related to psychosocial risk factors that the authors use in their respective disciplines as well as return to work principles/steps mentioned in the literature. The main objective was to keep all the strategies mentioned by participants, and analyzing them with major principles of return to work.Results 24 return to work strategies spread on six principles emerged: 1) Contact with the employee during his sick leave (10 strategies); 2) Evaluate and plan the return to work without precipitating it (6); 3) Training for managers and colleagues regarding mental health in the workplace (4); 4) Concertation between key return to work stakeholders (4); 5) Progressive return to work with work accommodations (4); 6) Health and work follow-up regarding the employee (6).Conclusion These six principles including 34 strategies are usually related to the timeframe process of the return to work, though they can be implemented sometimes in parallel. This possible overlap reinforces the idea to consider the return to work as sustainable in order to prevent potential relapses and improve the performance at work. Next steps will be to systematically implement these principles and strategies in organizations in order to evaluate their impact on return to work of employees on sick leave due to depression.

Effects of a weight-gain restriction programme for obese pregnant women on sickness absence and pregnancy benefits

PubMed Central

2013-01-01

Abstract Objective To evaluate the effect of a weight-gain restriction programme for obese pregnant women on sickness absence days and pregnancy benefit days during pregnancy and postpartum. Design A prospective, controlled intervention study. The Swedish Social Security Agency's records were utilized to compile sickness absence and pregnancy benefit information. Setting Antenatal care clinics in the south-east of Sweden. Subjects One hundred fifty-five obese pregnant women who participated in a weight restriction program with weekly structured motivational and behavioural talks combined with aqua-aerobics during pregnancy. A total of 193 obese pregnant women with no intervention served as controls. Main outcome measures Sickness absence benefits and pregnancy benefits expressed as a percentage. Results On average women in the intervention group had 76.68 total full days of sickness absence benefit compared with 53.09days in the control group. Total full days of pregnancy benefits were 39.66% days and 41.41% for the intervention and control groups respectively. For the women who were on sick leave there were no differences between the groups in the amount of days taken. Conclusions Given the complexity of factors that have an influence on sickness absence leave, it is possible that programmes that do not address the influence of social aspects and attitudes towards sickness absence have limited effect. PMID:23301596

The effects of a graded activity intervention for low back pain in occupational health on sick leave, functional status and pain: 12-month results of a randomized controlled trial.

PubMed

Hlobil, Hynek; Staal, J Bart; Twisk, Jos; Köke, Albere; Ariëns, Geertje; Smid, Tjabe; van Mechelen, Willem

2005-12-01

Behaviorally oriented graded activity interventions have been suggested for sick-listed workers with low back pain on return to work, but have not been extensively evaluated. One hundred and thirty-four workers were randomly assigned to either a graded activity intervention (n = 67) or usual care (n = 67) and followed-up for 12 months. The graded activity group returned back to work faster with a median of 54 days compared to 67 days in the usual care group. The graded activity intervention was more effective after approximately 50 days post-randomization (HRR = 1.9, CI = 1.2-3.1, p = 0.01). Differences between the groups in number of recurrent episodes, total number of days of sick leave due to low back pain, and total number of days of sick leave due to all diagnoses, were in favor of the graded activity group, although not statistically significant. No effects of the graded activity intervention were found for functional status or pain. Graded activity intervention is a valuable strategy to enhance short-term return to work outcomes.

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.

PubMed

Soler, Jean Karl

2003-03-27

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. 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. 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. 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.

Age differences in the associations between sick leave and aspects of health, psychosocial workload and family life: a cross-sectional study

PubMed Central

Bos, Judith T; van der Velden, Koos; van der Gulden, Joost W J

2012-01-01

Objectives To investigate differences in associations between sick leave and aspects of health, psychosocial workload, family life and work–family interference between four age groups (<36, 36–45, 46–55 and 55+ years). Design A cross-sectional study; a questionnaire was sent to the home addresses of all employees of a university. Setting A Dutch university. Participants 1843 employees returned the questionnaire (net response: 49.1%). The age distribution was as follows: <36: 32%; 36–45: 26%; 46–55: 27% and 55+: 12%. Primary outcomes Frequent sick leave (FSL, ≥3 times in the past 12 months) and prolonged sick leave (PSL, >2 weeks in total in the past 12 months). Differences between the age groups in independent variables and outcomes were investigated. Logistic regression analysis was used to calculate associations between various variables and the sick leave outcomes. Interaction terms were included to detect differences between the age groups. Results Age differences were found for many work- and family-related characteristics but not in the mean scores for health-related aspects. Presence of chronic disease was reported more frequently with increasing age. The 55+ age group had almost two times less chance of FSL, but 1.6 times more chance of PSL than the <36 age group. Age moderates the associations between career opportunities, partner's contribution in domestic tasks and sex, and FSL. Job security and pay, support from supervisor, challenging work and being breadwinner have different associations with PSL. However, life events in private lives and perceived health complaints are important in all age groups. FSL and PSL have some determinants in common, but there are differences between the outcomes as well. Conclusions Age should be treated as a variable of interest instead of a control variable. Employers and occupational physicians need to be aware that each phase in life has specific difficulties that can lead to FSL and PSL. PMID:22855622

The impact of internet-based cognitive behavior therapy on work ability in patients with depression - a randomized controlled study.

PubMed

Hange, Dominique; Ariai, Nashmil; Kivi, Marie; Eriksson, Maria Cm; Nejati, Shabnam; Petersson, Eva-Lisa

2017-01-01

The aim of this randomized controlled trial (RCT) was to investigate the effects of internet-based cognitive behavior therapy (ICBT) treatment for depression compared to treatment-as-usual (TAU) on improving work ability and quality of life in patients with mild-to-moderate depression. We also examined whether patients treated with ICBT returned to work more rapidly, that is, had fewer days of sick leave, than patients treated with TAU. This study is based on material from the PRIM-NET RCT that took place between 2010 and 2013. Primary care centers in Region Vastra Gotaland, Sweden, population about 1.6 million. A total of 77 patients with depression randomized to either ICBT (46 patients) or TAU (31 patients). Mean age of participants was 35.8 years, and 67.5% were women. Work ability was measured with the Work Ability Index, depressive symptoms with Montgomery Asberg Depression Rating Scale - self-rating version (MADRS-S), quality of life with EuroQoL-5D (EQ-5D), and number of sick leave days. Both groups showed an association between improved work ability and reduction of depressive symptoms and between improved work ability and better quality of life. ICBT could not be shown to improve work ability more than TAU among patients with mild-to-moderate depression. There were no differences between the groups concerning number of patients with sick leave or number of sick leave days. Our study indicates that a high level of work ability has an association with high health-related quality of life in patients with mild-to-moderate depression, whether they are treated with ICBT or TAU. ICBT has previously been found to be cost-effective and can be seen as a good alternative to TAU. In addition to the ICBT, an intervention oriented toward the work place might improve work ability and reduce the number of sick leave days among patients with depression.

What works best for whom? An exploratory, subgroup analysis in a randomized, controlled trial on the effectiveness of a workplace intervention in low back pain patients on return to work.

PubMed

Steenstra, Ivan A; Knol, Dirk L; Bongers, Paulien M; Anema, Johannes R; van Mechelen, Willem; de Vet, Henrica C W

2009-05-20

Exploratory subgroup analysis in a randomized controlled trial (RCT). To detect possible moderators in the effectiveness of a workplace intervention in a population of workers with sick leave due to sub acute nonspecific low back pain. In a recently published RCT, a workplace intervention was effective on return to work, compared to usual care. Examining the heterogeneity of effect sizes within the population in this RCT (n = 196) can lead to information on the effectiveness of the intervention in subgroups of patients. A subgroup analysis was performed by adding interaction terms to the statistical model. Before analysis the following possible moderators for treatment were identified: age, gender, pain, functional status, heavy work, and sick leave in the previous 12 months. Cox regression analyses were performed and survival curves were plotted. The interaction (P = 0.02) between age (dichotomized at the median value) and the workplace intervention indicates a modifying effect. The workplace intervention is more effective for workers > or =44 years (HR, 95% CI = 2.5, [1.6, 4.1] vs. 1.2 [0.8, 1.8] for workers <44 years old). The interaction between sick leave in the previous 12 months and the workplace intervention is significant (P = 0.02). The intervention is more effective for workers with previous sick leave (HR, 95% CI = 2.8 [1.7, 4.9] vs. 1.3 [0.8, 2.0]). A modifying effect of gender, heavy work, and pain score and functional status on the effectiveness of this intervention was not found. The findings from these exploratory analyses should be tested in future RCTs. This workplace intervention seems very suitable for return to work of older workers and workers with previous sick leave. Gender, perceived heavy work, and baseline scores in pain and functional status should not be a basis for assignment to this intervention.

Sickness benefit cuts mainly affect blue-collar workers.

PubMed

Aaviksoo, E; Kiivet, R-A

2014-08-01

To analyse the impact of sick-pay cuts on the use of sickness absence by employees of different socioeconomic groups. In 2009 cuts in sick pay were implemented in reaction to an economic crisis in Estonia. Nationwide health survey data from the years 2004, 2006, 2008, and 2010 were used to evaluate sickness absence among blue-collar and white-collar workers. The dataset comprised 7,449 employees of 20-64 years of age. Difference in prevalence of absentees before and after the reform was assessed using the chi-squared test. Odds ratios (OR) for sickness absence were calculated in a multivariate logistic regression model. After the reform, the proportion of blue-collar workers who had been on sick leave decreased from 51% to 40% (p<0.001) and among white-collar employees from 45% to 41% (p=0.026). This reduction had a similar pattern in all the subgroups of blue-collar employees as stratified according to gender, age, self-rated health, and presence of chronic disease, especially among those with low incomes; in white-collar employees it reached statistical significance only in those with good self-rated health (p=0.033). In a multivariate model the odds of having lower sickness absence were highly significant only in blue-collar employees (OR 0.63; 95% confidence interval 0.51-0.77, p<0.001). The cuts in sickness benefits had a major impact on the use of sickness absence by blue-collar employees with low salaries. This indicates that lower income was a major factor hindering the use of sick leave as these employees are most vulnerable to the loss of income. © 2014 the Nordic Societies of Public Health.

Return to Work in Employees on Sick Leave due to Neck or Shoulder Pain: A Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention with One-Year Register-Based Follow-Up.

PubMed

Moll, Line Thorndal; Jensen, Ole Kudsk; Schiøttz-Christensen, Berit; Stapelfeldt, Christina Malmose; Christiansen, David Høyrup; Nielsen, Claus Vinther; Labriola, Merete

2018-06-01

Purpose The aim of this study was to evaluate the effect of a multidisciplinary intervention (MDI) compared to a brief intervention (BI) with respect to return to work (RTW), pain and disability in workers on sick leave because of neck or shoulder pain. Methods 168 study participants with sickness absence for 4-16 weeks due to neck or shoulder pain were enrolled in a hospital-based clinical study and randomized to either MDI or BI. The primary outcome was RTW obtained by a national registry on public transfer payments. Secondary outcomes were self-reported pain and disability levels. One-year follow-up RTW rates were estimated by Cox proportional hazard regression adjusted for gender, age, sick leave prior to inclusion, part-time sick leave and clinical diagnosis. Secondary outcomes were analysed using logistic and linear regression analysis for pain and disability, respectively. Results In the MDI group, 50 participants (59%) experienced four or more continuous weeks of RTW while 48 (58%) returned to work in the BI group during the 1 year of follow-up. Results showed a statistically non significant tendency towards a lower rate of RTW in the MDI group than in the BI group (adjusted HR = 0.84, 95% CI 0.54, 1.31). There were no statistically significant differences in secondary outcomes between the MDI and BI groups. Conclusion The brief and the multidisciplinary interventions performed equally with respect to both primary and secondary outcomes. The added focus on RTW in the multidisciplinary group did not improve RTW rates in this group.

Sick-leave measures, socio-demographic factors and health care as risk indicators for suicidal behavior in patients with depressive disorders--a nationwide prospective cohort study in Sweden.

PubMed

Wang, Mo; Alexanderson, Kristina; Runeson, Bo; Mittendorfer-Rutz, Ellenor

2015-03-01

Studies based on large data sets investigating a wide range of risk indicators on suicidal behavior in patients with depressive disorders are sparse. This study aimed to examine the association of sick-leave measured in different ways on one hand and socio-demographics, medication, and health care on the other hand with suicide attempt and suicide among patients with depressive disorders. This is a population-based prospective cohort study using nationwide register data. All individuals who lived in Sweden 31.12.2004, then aged 16-64 years, and had psychiatric in- or out-patient care due to depressive disorders in 2005 were included (N = 21,096). Univariate and multivariate hazard ratios (HR) and 95% Confidence Intervals (CI) with regard to suicide attempt and suicide during 2006-2010 were estimated by Cox regression. Those with new sick-leave spells, full-time spells, spells due to mental diagnoses and exceeding one year and those having ≥ 1 sick-leave spells had a higher risk of suicide attempt. Female sex, young age, lower education, living alone, prescription of antidepressants and anxiolytics, inpatient health care, and suicide attempts resulted in higher HRs of suicide attempt in the multivariate analyses (range of HRs 1.17-3.28). Male sex, combined antidepressant and anxiolytic prescription, mental inpatient health care, and suicide attempts predicted subsequent suicide (range of HRs 1.84-3.33). Focus on specialized health care limited generalization. Sickness absence, social-demographics, and medical determinants were associated with suicidal behavior. These risk indicators should be considered when monitoring individuals with depressive disorders and assessing suicide risk. Copyright © 2014 Elsevier B.V. All rights reserved.

Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial.

PubMed

Uegaki, Kimi; Stomp-van den Berg, Suzanne G M; de Bruijne, Martine C; van Poppel, Mireille N M; Heymans, Martijn W; van Mechelen, Willem; van Tulder, Maurits W

2011-01-27

Working women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum interventions to prevent work disability. The purpose of the study was to evaluate whether supervisor telephone contact (STC) during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality-adjusted life years (QALYs) compared to common practice (CP). We conducted an economic evaluation alongside a randomized controlled trial. QALYs were measured by the EuroQol 5-D, and sick leave and presenteeism by the Health and work Performance Questionnaire. Resource use was collected by questionnaires. Data were analysed according to intention-to-treat. Missing data were imputed via multiple imputation. Uncertainty was estimated by 95% confidence intervals, cost-utility planes and curves, and sensitivity analyses. 541 working women from 15 companies participated. Response rates were above 85% at each measurement moment. At the end of the follow-up, no statistically significant between-group differences in QALYs, mean hours of sick leave or presenteeism or costs were observed. STC was found to be less effective and more costly. For willingness-to-pay levels from €0 through €50,000, the probability that STC was cost-effective compared to CP was 0.2. Overall resource use was low. Mean total costs were €3678 (95% CI: 3386; 3951). Productivity loss costs represented 37% of the total costs and of these costs, 48% was attributable to sick leave and 52% to work presenteeism. The cost analysis from a company's perspective indicated that there was a net cost associated with the STC intervention. STC was not cost-effective compared to common practice for a healthy population of working mothers; therefore, implementation is not indicated. The cost-utility of STC for working mothers with more severe post-partum health problems, however, needs to be investigated. Work presenteeism accounted for half of the total productivity loss and warrants attention in future studies. ISRCTN: ISRCTN73119486.

Cost-utility analysis of a one-time supervisor telephone contact at 6-weeks post-partum to prevent extended sick leave following maternity leave in The Netherlands: results of an economic evaluation alongside a randomized controlled trial

PubMed Central

2011-01-01

Background Working women of childbearing age are a vital part of the population. Following childbirth, this group of women can experience a myriad of physical and mental health problems that can interfere with their ability to work. Currently, there is little known about cost-effective post-partum interventions to prevent work disability. The purpose of the study was to evaluate whether supervisor telephone contact (STC) during maternity leave is cost-effective from a societal perspective in reducing sick leave and improving quality-adjusted life years (QALYs) compared to common practice (CP). Methods We conducted an economic evaluation alongside a randomized controlled trial. QALYs were measured by the EuroQol 5-D, and sick leave and presenteeism by the Health and work Performance Questionnaire. Resource use was collected by questionnaires. Data were analysed according to intention-to-treat. Missing data were imputed via multiple imputation. Uncertainty was estimated by 95% confidence intervals, cost-utility planes and curves, and sensitivity analyses. Results 541 working women from 15 companies participated. Response rates were above 85% at each measurement moment. At the end of the follow-up, no statistically significant between-group differences in QALYs, mean hours of sick leave or presenteeism or costs were observed. STC was found to be less effective and more costly. For willingness-to-pay levels from €0 through €50,000, the probability that STC was cost-effective compared to CP was 0.2. Overall resource use was low. Mean total costs were €3678 (95% CI: 3386; 3951). Productivity loss costs represented 37% of the total costs and of these costs, 48% was attributable to sick leave and 52% to work presenteeism. The cost analysis from a company's perspective indicated that there was a net cost associated with the STC intervention. Conclusions STC was not cost-effective compared to common practice for a healthy population of working mothers; therefore, implementation is not indicated. The cost-utility of STC for working mothers with more severe post-partum health problems, however, needs to be investigated. Work presenteeism accounted for half of the total productivity loss and warrants attention in future studies. Trial registration number ISRCTN: ISRCTN73119486 PMID:21272325

[Work-related disability among postal employees: incidence, duration, and social security costs in 2008].

PubMed

Mascarenhas, Flávia Alves Neves; Barbosa-Branco, Anadergh

2014-06-01

This study analyzed the characteristics of Brazilian postal workers that received sick leave benefits in 2008. The databases were from the Unified Benefits System (SUB) and the National Registry of Social Information (CNIS). The incidence rate was 556.5 benefits per 10,000 employees, and the leading causes of work-related sick leave were injuries, musculoskeletal disorders, and mental disorders. Areas most frequently reported in injuries were knees and legs, wrists and hands, ankles and feet, and shoulders and arms, with higher incidence rates in men. Women were more affected by musculoskeletal disorders and mental disorders. Average sick leave lasted longer in men, and the incidence of benefits increased with age. The States with the highest incidence rates were Mato Grosso do Sul, Goiás, and Santa Catarina, and security benefits averaged BRL 1,847.00. Postal work may involve additional risk of injuries to the limbs, due to the long distances carrying heavy weight, assault, and dog bites.

Predictive factors for disability pension--an 11-year follow up of young persons on sick leave due to neck, shoulder, or back diagnoses.

PubMed

Borg, K; Hensing, G; Alexanderson, K

2001-06-01

Although back diagnoses are recurrent and the main diagnoses behind sickness absence and disability pension surprisingly few longitudinal studies have been performed. This study identifies predictive factors for disability pension among young persons initially sick-listed with back diagnoses. An 11-year prospective cohort study was conducted, including all individuals in a Swedish city who, in 1985, were aged 25-34 and sick-listed > or =28 days owing to neck, shoulder, or back diagnoses (n = 213). The following data was obtained: disability pension, emigration, and death for 1985-96, sickness absence for 1982-84, and demographics in 1985 regarding sex, income, occupation, marital status, diagnosis, socioeconomic group, and citizenship. Cox regression and life tables were used in the analyses. In 1996, i.e. within 11 years, 22% of the individuals (27% of the women and 14% of the men) had been granted disability pension. The relative risk for disability pension was higher for women (2.4; p = 0.010), persons with foreign citizenship (3.6; p=0.009), and those who had had >14 sick-leave days per spell during the three years before inclusion, compared to those with <7 days/spell (3.1; p=0.003). This cohort of young persons proved to be a high-risk group for disability pension. Some of the factors known to predict long-time sickness absence also predict disability pension in a cohort of already sick-listed persons.

Quality in sickness certificates in a Swedish social security system perspective.

PubMed

Sturesson, Marine; Bylund, Sonya Hörnqvist; Edlund, Curt; Falkdal, Annie Hansen; Bernspång, Birgitta

2015-12-01

In Sweden, the information in the sickness certificate is crucially important for the sick-listed person as well as for the Swedish Social Insurance Agency and the sick-listed person's employer. The certificate is used as the basis for deciding whether a person is entitled to sickness benefits. Further, it communicates information significant for the return-to-work process. The aim of the study was to evaluate the quality of sickness certificates issued in primary health care and examine if the patients' or physicians' gender influences the information in the sickness certificate. An insurance specialist at the Swedish Social Insurance Agency assessed the quality of the stated information in a sample of 323 certificates issued by 146 different general practitioners at 29 different primary health care centres in northern Sweden. Thirty-four percent of the certificates did not contain sufficient information requested. The areas of the certificates in need of supplementary information were mainly the descriptions of impairment of body function and activity limitation. More certificates issued for women than certificates issued for men lacked the required information. Full-time sick leave was more often prescribed for male patients than for female. Significant differences between certificates issued for women and certificates issued for men appeared in the group of musculoskeletal diseases. No differences in quality aspects connected to physicians' gender were found. Our study indicates a need for increased knowledge about the descriptions of functioning for sick-listed persons; more cooperation between health professionals in primary health care and a better gender awareness in health care encounters. © 2015 the Nordic Societies of Public Health.

Lifestyle factors, direct and indirect costs for a Brazilian airline company.

PubMed

Rabacow, Fabiana Maluf; Luiz, Olinda do Carmo; Malik, Ana Maria; Burdorf, Alex

2014-12-01

OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.

Counselling low-back-pain patients in secondary healthcare: a randomised trial addressing experienced workplace barriers and physical activity.

PubMed

Jensen, Lone Donbæk; Maribo, Thomas; Schiøttz-Christensen, Berit; Madsen, Finn Hjorth; Gonge, Bigitte; Christensen, Michael; Frost, Poul

2012-01-01

To assess if counselling by an occupational physician (OP) addressing experienced workplace barriers and physical activity integrated as a part of low-back pain (LBP) outpatient treatment influences pain, function and sick leave. Randomised controlled trial in the secondary healthcare sector with 3 months' follow-up. The participants were LBP patients who, independently of sick-leave status, expressed concerns about the ability to maintain their current job. Patients referred for surgery were excluded. The intervention consisted of two counselling sessions conducted by an OP addressing both workplace barriers and leisure-time physical activity. A workplace visit was performed if required. Pain, function and duration of sick leave due to LBP were primary outcomes. A reduction in bodily pain and improvement in physical function both measured by the 36-item short-form health survey questionnaire in favour of the intervention group was found. The change in pain score was found to be clinically relevant. The risk of sick leave for at least 8 weeks due to LBP was significantly reduced in the intervention group. Two secondary outcomes, Fear Avoidance Beliefs about physical activity and maximum oxygen uptake, supported compliance and adherence to the part of the intervention focusing on enhanced physical activity. Two short counselling sessions by an OP combining advice on meeting workplace barriers and enhancing physical activity had a substantial effect on important prognostic factors for LBP patients with moderate to severe symptoms diagnosed in outpatient rheumatological clinics. Current Controlled Trials ISRCTN13071157.

Return to work from long-term sick leave: a six-year prospective study of the importance of adjustment latitudes at work and home.

PubMed

Dellve, Lotta; Fallman, Sara L; Ahlstrom, Linda

2016-01-01

The aim was to investigate the long-term importance of adjustment latitude for increased work ability and return to work among female human service workers on long-term sick leave. A cohort of female human service workers on long-term sick leave (>60 days) was given a questionnaire four times (0, 6, 12, 60 months). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability and return to work. Having a higher level of adjustment latitude was associated with both increased work ability and return to work. Adjustments related to work pace were strongly associated with increased work ability, as were adjustments to the work place. Having individual opportunities for taking short breaks and a general acceptance of taking short breaks were associated with increased work ability. At home, a higher level of responsibility for household work was related to increased work ability and return to work. Individuals with possibilities for adjustment latitude, especially pace and place at work, and an acceptance of taking breaks had greater increased work ability over time and a greater work ability compared with individuals who did not have such opportunities. This study highlights the importance of opportunities for adjustment latitude at work to increase work ability and return to work among female human service workers who have been on long-term sick leave. The results support push and pull theories for individual decision-making on return to work.

Lifestyle factors, direct and indirect costs for a Brazilian airline company

PubMed Central

Rabacow, Fabiana Maluf; Luiz, Olinda do Carmo; Malik, Ana Maria; Burdorf, Alex

2014-01-01

OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population. PMID:26039398

Swedish Council on Technology Assessment in Health Care (SBU). Chapter 5. Risk factors for sick leave - general studies.

PubMed

Allebeck, Peter; Mastekaasa, Arne

2004-01-01

Extensive information is available from official statistics and descriptive studies on the association between different socio-demographic background factors and sickness absence. This information addresses age, gender, place of residence, and socio-economic status. However, few studies have thoroughly analysed these background factors, and rigorous scientific evidence on the causal relationship between these factors and sick leave is lacking. Regarding the family, we found no scientific evidence that marital status or children living at home were associated with sickness absence. However, we found limited scientific evidence for an effect of divorce. Regarding work-related factors, we found limited scientific evidence for an effect of physically stressful work, and moderate scientific evidence for low psychological control over the work situation. We found limited scientific evidence for a correlation in time between unemployment and sickness absence, but insufficient scientific evidence for the causes of the association. There was moderate scientific evidence that the amount of sickness absence is influenced by the design of the social insurance system, but insufficient evidence on the magnitude of change required to influence the level of sickness absence. Essentially the same results apply to disability pension, although the number of studies is small. However, we found moderate scientific evidence for the effects of socio-economic status, which could be explained partly by childhood experiences.

Bridging the gap: support groups do not enhance long-term outcome in chronic back pain.

PubMed

Linton, S J; Hellsing, A L; Larsson, I

1997-09-01

Because back pain patients often relapse within months of treatment, the effects of two types of support groups as a complement to usual medical treatment was investigated on long-term outcome. Regular treatment was compared with an "educational" support group and a professional support group before and 1 year after intervention in a randomized controlled trial. A total of 76 women and 27 men, average age of 50 years and with an accumulated sick leave for musculoskeletal pain of 2-24 weeks during the past year, were randomly assigned to the three groups. Sick leave records were obtained from the National Insurance Authority. A battery of standardized instruments was employed, which featured the Sickness Impact Profile, the Coping Strategies Questionnaire, the Multidimensional Pain Inventory, the Pain and Impairment Relationship Scale, the Pain and Discomfort Scale, the Pain Beliefs and Perceptions Inventory, and the Outcome Evaluation Questionnaire. The Educational Support Group demonstrated greater attendance than did the Professional Support Group. However, long-term outcome was not significantly different between any of the groups for sick leave, coping, function, or experienced pain. Both support groups, relative to the Regular Treatment Group, made greater improvements on the Sickness Impact Profile. This study provides little evidence that support groups, as a complement to regular treatment, enhance long-term outcome for subacute musculoskeletal pain problems. Specific treatment techniques, matched to the patient's needs, stringently taught, and delivered in a more compact form, may be necessary for enhancing outcome.

Pioneers and laggards - is the effect of gender equality on health dependent on context?

PubMed

Backhans, Mona Christina; Burström, Bo; Lindholm, Lars; Månsdotter, Anna

2009-04-01

This study combines data at individual and area level to examine interactions between equality within couples and gender equality in the municipality in which individuals live. The research question is whether the context impacts on the association between gender equality and health. The material consists of data on 37,423 men and 37,616 women in 279 Swedish municipalities, who had their first child in 1978. The couples were classified according to indicators of their level of gender equality in 1980 in the public sphere (occupation and income) and private sphere (child care leave and parental leave) compared to that of their municipality. The health outcome is compensated days from sickness insurance during 1986-1999 with a cut-off at the 85% percentile. Data were analysed using logistic regression with the overall odds as reference. The results concerning gender equality in the private sphere show that among fathers, those who are equal in an equal municipality have lower levels of sick leave than the average while laggards (less equal than their municipality) and modest laggards have higher levels. In the public sphere, pioneers (more equal t han their municipality) fare better than the average while laggards fare worse. For mothers, those who are traditional in their roles in the public sphere are protected from high levels of sick leave, while the reverse is true for those who are equal. Traditional mothers in a traditional municipality have the lowest level of sick leave and pioneers the highest. These results show that there are distinct benefits as well as disadvantages to being a gender pioneer and/or a laggard in comparison to your municipality. The associations are markedly different for men and women.

Desire, longing and vanity: emotions behind successful return to work for women on long-term sick leave.

PubMed

Ahrberg, Y; Landstad, B J; Bergroth, A; Ekholm, J

2010-01-01

The purpose of this study is to identify situations and phenomena that have simplified returning to work for women on long-term sick leave. Seven women who were exposed to a relatively large number of risk factors that normally are associated with difficulties in returning to work. In-depth interviews with qualitative content analysis. The analysis indicated four main categories of factors: The Individual, Interactions, Surrounding Resources, and Situations. In each of the main categories structural factors exist and it appears that these have been of significant importance to the women in their return to work. These are presented as Key Factors and they are: clarification of--and the need for--support in the personal process of change; desire, longing, and vanity; respectful interactions between the individual and people in her surroundings; the structure and content of the rehabilitation clinic; the importance of the perceived reality; and the individual's sense of control during the work related rehabilitation process. The results mostly revealed phenomena that have been indicated and described in earlier research studies. However, emotions such as desire, longing and vanity as motivation and driving forces behind a return to work have not been earlier described.

School Board Policies on Leaves and Absences. Educational Policies Development Kit.

ERIC Educational Resources Information Center

National School Boards Association, Waterford, CT. Educational Policies Service.

This report provides board policy samples and other policy resources on leaves and absences. The intent in providing policy samples is to encourage thinking in policy terms and to provide working papers that can be edited, modified, or adapted to meet local requirements. Topics covered in the samples include (1) sick leave, (2) maternity leave,…

The effectiveness of the "Brainwork Intervention" in reducing sick leave for unemployed workers with psychological problems: design of a controlled clinical trial.

PubMed

Audhoe, Selwin S; Nieuwenhuijsen, Karen; Hoving, Jan L; Sluiter, Judith K; Frings-Dresen, Monique H W

2015-04-14

Among the working population, unemployed, temporary agency and expired fixed-term contract workers having psychological problems are a particularly vulnerable group, at risk for sickness absence and prolonged work disability. Studies investigating the effectiveness of return-to-work (RTW) interventions on these workers, who are without an employment contract, are scarce. Therefore, a RTW intervention called 'Brainwork' was developed. The objective of this paper is to describe the 'Brainwork Intervention' and the trial design evaluating its effectiveness in reducing the duration of sick leave compared to usual care. The 'Brainwork Intervention' is designed to assist unemployed, temporary agency and expired fixed-term contract workers who are sick-listed due to psychological problems, with their return to work. The 'Brainwork Intervention' uses an activating approach: in the early stage of sick leave, workers are encouraged to exercise and undertake activities aimed at regaining control and functional recovery while job coaches actively support their search for (temporary) jobs. The content of the intervention is tailored to the severity of the psychological problems and functional impairments, as well as the specific psychosocial problems encountered by the sick-listed worker. The intervention study is designed as a quasi-randomized controlled clinical trial with a one-year follow-up and is being conducted in the Netherlands. The control group receives care as usual with minimal involvement of occupational health professionals. Outcomes are measured at baseline, and 4, 8 and 12 months after initiation of the program. The primary outcome measure is the duration of sick leave. Secondary outcome measures are: the proportion of subjects who returned to work at 8 and 12 months; the number of days of paid employment during the follow-up period; the degree of worker participation; the level of psychological complaints; and the self-efficacy for return to work. The cost-benefit analysis will be evaluated from an insurer's perspective. The methodological considerations of the study design are discussed. In this trial we evaluate the effectiveness of an intervention in real occupational health practice, rather than under highly controlled circumstances. The results will be published in 2015. NTR4190. Date of registration: September 27(th) 2013.

[Modulating variables of work disability in depressive disorders].

PubMed

Catalina Romero, C; Cabrera Sierra, M; Sainz Gutiérrez, J C; Barrenechea Albarrán, J L; Madrid Conesa, A; Calvo Bonacho, E

2011-01-01

To describe the duration of sickness absence in unipolar depression and to determine the relationship of demographic, job-related and clinical variables with length of temporary work disability in depressive disorders. Prospective observational study. A total of 1,292 subjects with depressive disorder diagnosis (ICD-9-CM) were selected claiming sick leave in an Occupational Diseases and Accident sat Work Insurance Scheme (sampling on successive occasions). Descriptive analyses of sickness absence duration, and bivariate (median test) and multivariate analysis (logistic regression) were performed to find relationships between demographic, job-related and clinical variables. Mean duration of sickness absence episodes due to a depressive disorder was 120 days. After multivariate analyses, female sex (p < 0.01), higher age (p < 0.01), lower educational level (p < 0.01), method of payment according to whether self-employed or unemployed workers (p < 0.01) and being referred to both psychiatrist and psychologist (p < 0.01) remained significantly associated with sick leave length. These findings confirm a strong association of depression with long periods of work disability and high absenteeism, and also suggest the need for improvements in functional ability assessment and promotion, treatment and referral of depressed patients. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

Psychiatrists′ work with sickness certification: frequency, experiences and severity of the certification tasks in a national survey in Sweden

PubMed Central

2012-01-01

Background Many psychiatrists are involved in sickness certification of their patients; however, there is very limited knowledge about this aspect of their work. The objective of this study was to explore frequencies of problematic issues in the sickness certification tasks and experiences of severity regarding these problematic issues among psychiatrists. Methods A cross-sectional nationwide questionnaire study to all physicians in Sweden. The 579 specialists in psychiatry who answered the questionnaire, were under 65 years of age, worked mainly in psychiatric care, and had consultations involving sickness certification at least once a week were included. Results The frequency of problematic sickness certification consultations a few times per year or more often was considered by 87.3% of the psychiatrists; 11.7% handle such cases at least once a week. A majority (60.9%) reported ‘not having enough time with the patient’ at least once a week. The psychiatrists had access to several categories of professionals in their daily work. More than one third certified unnecessarily long sick-leave periods at least once a month due to waiting times for Social Insurance Office investigations or for treatments or investigations within health care. Conclusion The majority found it problematic to assess the level and duration of work incapacity, but also other types of problems like unnecessarily long sick-leave periods due to different types of waiting times. The findings have implications for different kinds of organisational and managerial support and training in sickness certification issues, like guidance to assess the level and duration of work incapacity. PMID:23075202

The effects of an unsupervised water exercise program on low back pain and sick leave among healthy pregnant women - A randomised controlled trial.

PubMed

Backhausen, Mette G; Tabor, Ann; Albert, Hanne; Rosthøj, Susanne; Damm, Peter; Hegaard, Hanne K

2017-01-01

Low back pain is highly prevalent among pregnant women, but evidence of an effective treatment are still lacking. Supervised exercise-either land or water based-has shown benefits for low back pain, but no trial has investigated the evidence of an unsupervised water exercise program on low back pain. We aimed to assess the effect of an unsupervised water exercise program on low back pain intensity and days spent on sick leave among healthy pregnant women. In this randomised, controlled, parallel-group trial, 516 healthy pregnant women were randomly assigned to either unsupervised water exercise twice a week for a period of 12 weeks or standard prenatal care. Healthy pregnant women aged 18 years or older, with a single fetus and between 16-17 gestational weeks were eligible. The primary outcome was low back pain intensity measured by the Low Back Pain Rating scale at 32 weeks. The secondary outcomes were self-reported days spent on sick leave, disability due to low back pain (Roland Morris Disability Questionnaire) and self-rated general health (EQ-5D and EQ-VAS). Low back pain intensity was significantly lower in the water exercise group, with a score of 2.01 (95% CI 1.75-2.26) vs. 2.38 in the control group (95% CI 2.12-2.64) (mean difference = 0.38, 95% CI 0.02-0.74 p = 0.04). No difference was found in the number of days spent on sick leave (median 4 vs. 4, p = 0.83), disability due to low back pain nor self-rated general health. There was a trend towards more women in the water exercise group reporting no low back pain at 32 weeks (21% vs. 14%, p = 0.07). Unsupervised water exercise results in a statistically significant lower intensity of low back pain in healthy pregnant women, but the result was most likely not clinically significant. It did not affect the number of days on sick leave, disability due to low back pain nor self-rated health. ClinicalTrials.gov NCT02354430.

The impact of internet-based cognitive behavior therapy on work ability in patients with depression – a randomized controlled study

PubMed Central

Hange, Dominique; Ariai, Nashmil; Kivi, Marie; Eriksson, Maria CM; Nejati, Shabnam; Petersson, Eva-Lisa

2017-01-01

Objectives The aim of this randomized controlled trial (RCT) was to investigate the effects of internet-based cognitive behavior therapy (ICBT) treatment for depression compared to treatment-as-usual (TAU) on improving work ability and quality of life in patients with mild-to-moderate depression. We also examined whether patients treated with ICBT returned to work more rapidly, that is, had fewer days of sick leave, than patients treated with TAU. Design This study is based on material from the PRIM-NET RCT that took place between 2010 and 2013. Setting Primary care centers in Region Vastra Gotaland, Sweden, population about 1.6 million. Patients A total of 77 patients with depression randomized to either ICBT (46 patients) or TAU (31 patients). Mean age of participants was 35.8 years, and 67.5% were women. Main outcome measures Work ability was measured with the Work Ability Index, depressive symptoms with Montgomery Asberg Depression Rating Scale – self-rating version (MADRS-S), quality of life with EuroQoL-5D (EQ-5D), and number of sick leave days. Results Both groups showed an association between improved work ability and reduction of depressive symptoms and between improved work ability and better quality of life. ICBT could not be shown to improve work ability more than TAU among patients with mild-to-moderate depression. There were no differences between the groups concerning number of patients with sick leave or number of sick leave days. Conclusion Our study indicates that a high level of work ability has an association with high health-related quality of life in patients with mild-to-moderate depression, whether they are treated with ICBT or TAU. ICBT has previously been found to be cost-effective and can be seen as a good alternative to TAU. In addition to the ICBT, an intervention oriented toward the work place might improve work ability and reduce the number of sick leave days among patients with depression. PMID:28579817

Indirect costs associated with metastatic breast cancer.

PubMed

Wan, Yin; Gao, Xin; Mehta, Sonam; Wang, Zhixiao; Faria, Claudio; Schwartzberg, Lee

2013-10-01

To compare the indirect costs of productivity loss between metastatic breast cancer (MBC) and early stage breast cancer (EBC) patients, as well as their respective family members. The MarketScan Health and Productivity Management database (2005-2009) was used. Adult BC patients eligible for employee benefits of sick leave and/or short-term disability were identified with ICD-9 codes. Difference in sick leave and short-term disability days was calculated between MBC patients and their propensity score matched EBC cohort and general population (controls) during a 12-month follow-up period. Generalized linear models were used to examine the impact of MBC on indirect costs to patients and their families. A total of 139 MBC, 432 EBC, and 820 controls were eligible for sick leave and 432 MBC, 1552 EBC, and 4682 controls were eligible for short-term disability (not mutually exclusive). After matching, no statistical difference was found in sick leave days and the associated costs between MBC and EBC cohorts. However, MBC patients had significantly higher short-term disability costs than EBC patients and controls (MBC: $6166 ± $9194 vs. EBC: $3690 ± $6673 vs. $558 ± $2487, both p < 0.001). MBC patients had more sick leave cost than controls ($2383 ± $5539 vs. $1282 ± $2083, p < 0.05). Controlling for covariates, MBC patients incurred 47% more short-term disability costs vs EBC patients (p = 0.009). Older patients (p = 0.002), non-HMO payers (p < 0.05), or patients not receiving chemotherapy during follow-up (p < 0.001) were associated with lower short-term disability costs. MBC patients' families incurred 39.7% (p = 0.06) higher indirect costs compared to EBC patients' families after controlling for key covariates. Productivity loss and associated costs in MBC patients are substantially higher than EBC patients or the general population. These findings underscore the economic burden of MBC from a US societal perspective. Various treatment regimens should be evaluated to identify opportunities to reduce the disease burden from the societal perspective.

The effects of an unsupervised water exercise program on low back pain and sick leave among healthy pregnant women – A randomised controlled trial

PubMed Central

Tabor, Ann; Albert, Hanne; Rosthøj, Susanne; Damm, Peter; Hegaard, Hanne K.

2017-01-01

Background Low back pain is highly prevalent among pregnant women, but evidence of an effective treatment are still lacking. Supervised exercise–either land or water based–has shown benefits for low back pain, but no trial has investigated the evidence of an unsupervised water exercise program on low back pain. We aimed to assess the effect of an unsupervised water exercise program on low back pain intensity and days spent on sick leave among healthy pregnant women. Methods In this randomised, controlled, parallel-group trial, 516 healthy pregnant women were randomly assigned to either unsupervised water exercise twice a week for a period of 12 weeks or standard prenatal care. Healthy pregnant women aged 18 years or older, with a single fetus and between 16–17 gestational weeks were eligible. The primary outcome was low back pain intensity measured by the Low Back Pain Rating scale at 32 weeks. The secondary outcomes were self-reported days spent on sick leave, disability due to low back pain (Roland Morris Disability Questionnaire) and self-rated general health (EQ-5D and EQ-VAS). Results Low back pain intensity was significantly lower in the water exercise group, with a score of 2.01 (95% CI 1.75–2.26) vs. 2.38 in the control group (95% CI 2.12–2.64) (mean difference = 0.38, 95% CI 0.02–0.74 p = 0.04). No difference was found in the number of days spent on sick leave (median 4 vs. 4, p = 0.83), disability due to low back pain nor self-rated general health. There was a trend towards more women in the water exercise group reporting no low back pain at 32 weeks (21% vs. 14%, p = 0.07). Conclusions Unsupervised water exercise results in a statistically significant lower intensity of low back pain in healthy pregnant women, but the result was most likely not clinically significant. It did not affect the number of days on sick leave, disability due to low back pain nor self-rated health. Trial registration ClinicalTrials.gov NCT02354430 PMID:28877165

Road casualties in work-related and private contexts: Occupational medical impact: Results from the ESPARR cohort.

PubMed

Fort, E; Pélissier, C; Fanjas, A; Charnay, P; Charbotel, B; Bergeret, A; Fontana, L; Hours, M

2018-05-22

Road accidents may impact victims' physical and/or mental health and socio-occupational life, notably including return to work. To assess whether the occupational medical consequences sustained by subjects injured in road accidents occurring in a work-related context differ from those associated with private accidents. 778 adults who were in work or occupational training at the time of their accident were included. Two groups were distinguished: 354 (45.5%) injured in road accidents occurring in a work-related context (commuting or on duty) and 424 (54.5%) injured in a private accident. The groups were compared on medical and occupational factors assessed on prospective follow-up at 6 months and 1 and 3 years. Multivariate analysis explored for factors associated at 6 months and 1 year with sick leave following the accident and duration of sick leave. There were no significant differences between groups for demographic data apart from a slightly higher injury severity in private accidents (32.5% of private accidents with MAIS3+(Maximum Abbreviated Injury Scale greater or equal to 3) vs. 23.7% for work-related accidents, p = 0.007). Victims of work-related accidents were more often on sick leave (OR = 1.8; 95% CI, 1.1-2.9). Although the length of sick leave is higher for work-related accidents that for private accidents, multivariate analysis showed that the injury severity and the post-traumatic stress disorder (PTSD) are significant factors to explain the time to return to work. There were no significant differences according to occupational impact during follow-up, notably including sick-leave duration, number of victims returning to work within 3 years and number of victims out of work due to incapacity. In the ESPARR (follow-up study of a road-accident population in the Rhône administrative county: Etude de Suivi d'une Population d'Accidentés de la Route dans le Rhône) cohort, the fact that a road accident occurred in a work-related context did not affect the occupational consequences.

Relationships of organizational social capital with the presence of "gossip and slander," "quarrels and conflicts," sick leave, and poor work ability in nursing homes.

PubMed

Kiss, Philippe; De Meester, Marc; Kristensen, Tage S; Braeckman, Lutgart

2014-11-01

This study aimed to explore the associations of organizational social capital (OSC) with the presence of "gossip and slander," the presence of "conflicts and quarrels," sick leave prevalence, and prevalence of poor work ability in frontline working personnel of nursing homes. A total of 239 subjects (81 % participation), working in 11 different nursing homes, took part in a cross-sectional questionnaire study. Following end points were considered, they are as follows: prevalence of "gossip and slander," "conflicts and quarrels," sick leave, and poor work ability. Associations with OSC were explored at individual level (binomial log-linear regression analysis) and on group level (Kendall's tau correlation coefficients). Significant associations were found between OSC and "gossip and slander," sick leave, and poor work ability, both in the individual- and group-level analyses. The associations showed a higher significance level in the group-level analyses, with the strongest association found between mean OSC of the workplace and the prevalence of poor work ability at the workplace (τ = -0.722; p = 0.002). This study demonstrated significant associations of OSC with three end points that are relevant within the framework of well-being at work in nursing homes. The results are suggestive that OSC should be treated as a characteristic of the entire workplace, rather than as an individually experienced characteristic. The strikingly strong association between OSC and prevalence of poor work ability is suggestive for an important role of OSC within the context of maintaining work ability.

Influence of occupational factors on regional differences in sick leave: A prospective population study.

PubMed

Sterud, Tom; Johannessen, Håkon A

2018-05-01

Number of sick leave days vary by county, but little is known about the extent to which this gradient may be explained by differences pertaining to occupational composition and occupational exposure. A randomly drawn cohort from the general population in Norway, aged 18-69 years, was interviewed by telephone in the second half of 2009 ( n=12,255; response at baseline=60.9%) and followed up in national registries to the end of 2010. Eligible respondents were registered with an active employee relationship in 2009 and 2010 ( n=8275). Information on counties ( n=19) was based on the administrative register. The outcome of interest was the number of physician-certified sick-leave days divided by scheduled man-days during 2010 (i.e. sick-leave percentage (SLP)). The average SLP during 2010 was 5.2%. The between-county variation in SLP ranged from 4.0% to 7.2%. Compared to the age- and gender-adjusted model, adjustment for occupation, economic sector and self-reported occupational exposure reduced the median difference in SLP between the county with the lowest SLP (reference county) and the SLP in the other counties by 1.08 percentage points (i.e. a 58% reduction). The impact of occupational composition and occupational exposure on the total between-county variance in SLP was a 16% reduction. Occupational composition and self-reported occupational exposure help to explain a significant part of the difference in SLP between counties, and appear to be more important explanatory factors than demographic variables, self-reported health and smoking.

Tuberculosis Costs in Spain and Related Factors.

PubMed

Gullón, José Antonio; García-García, José María; Villanueva, Manuel Ángel; Álvarez-Navascues, Fernando; Rodrigo, Teresa; Casals, Martí; Anibarro, Luis; García-Clemente, Marta María; Jiménez, María Ángeles; Bustamante, Ana; Penas, Antón; Caminero, José Antonio; Caylà, Joan

2016-12-01

To analyze the direct and indirect costs of diagnosis and management of tuberculosis (TB) and associated factors. Prospective study of patients diagnosed with TB between September 2014 and September 2015. We calculated direct (hospital stays, visits, diagnostic tests, and treatment) and indirect (sick leave and loss of productivity, contact tracing, and rehabilitation) costs. The following cost-related variables were compared: age, gender, country of origin, hospital stays, diagnostic testing, sensitivity testing, treatment, resistance, directed observed therapy (DOT), and days of sick leave. Proportions were compared using the chi-squared test and significant variables were included in a logistic regression analysis to calculate odds ratio (OR) and corresponding 95% confidence intervals. 319 patients were included with a mean age of 56.72±20.79 years. The average cost was €10,262.62±14,961.66, which increased significantly when associated with hospital admission, polymerase chain reaction, sputum smears and cultures, sensitvity testing, chest computed tomography, pleural biopsy, drug treatment longer than nine months, DOT and sick leave. In the multivariate analysis, hospitalization (OR=96.8; CI 29-472), sensitivity testing (OR=4.34; CI 1.71-12.1), chest CT (OR= 2.25; CI 1.08-4.77), DOT (OR=20.76; CI 4.11-148) and sick leave (OR=26,9; CI 8,51-122) showed an independent association with cost. Tuberculosis gives rise to significant health spending. In order to reduce these costs, more control of transmission, and fewer hospital admissions would be required. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

[Development and Implementation of a Comprehensive Health Management System (Fit for Work and Life) for Employees of a University Hospital - A Practice Report].

PubMed

Gutenbrunner, C; Egen, C; Kahl, K G; Briest, J; Tegtbur, U; Miede, J; Born, M

2017-07-01

Background: Due to the increase of sick leave, prolonging working life and the prediction of shortage of skilled workers in the future, health management systems are continuously gaining importance. Employees in a University Hospital are exposed to particular stress factors, which are also reflected in a higher than average amount of sick leave. Against this background, the project "Fit for Work and Life" (FWL) was developed and implemented by the Hannover Medical School (MHH). Aims: FWL aims to maintain, improve or recover the work ability of employees by offering both preventive and rehabilitative treatments. A second goal is to significantly reduce the days of sick leave. Methods: The project was jointly developed and implemented by five MHH departments and the DRV Braunschweig-Hannover (DRV BS-H) according to previously defined principles. It was scientifically evaluated by the following outcomes: average days of sick leave, work ability (WAI), quality of life (SF-36, WHOQOL), coping strategies (FERUS) and effort-reward imbalance (ERI). Results and Conclusions: So far, this project is unique in its concept. It has been successfully implemented in the organisational structures of the MHH. 376 employees have registered during the first project year. Up to now, 182 participants have completed their individual programmes. The results show that 60.4% of employees have moderate to poor WAI values. The average of the mental summary scale of the SF-36 was 44.9, indicating a high workload. © Georg Thieme Verlag KG Stuttgart · New York.

Employment consequences of depressive symptoms and work demands individually and combined.

PubMed

Thielen, Karsten; Nygaard, Else; Andersen, Ingelise; Diderichsen, Finn

2014-02-01

Denmark, like other Western countries, is recently burdened by increasingly high social spending on employment consequences caused by ill mental health. This might be the result of high work demands affecting persons with ill mental health. Therefore, this study assesses to what extent depressive symptoms and high work demands, individually and combined, have an effect on employment consequences. We conducted a population-based 7-year longitudinal follow-up study with baseline information from the year 2000 on socio-demographics, lifestyle, depressive symptoms and work demands. In total, 5785 employed persons, aged 40 and 50 years, were included. Information about employment status, sick leave and work disability was obtained from registers. Logistic regression models were used to measure separate and combined effects of depressive symptoms and work demands on job change, unemployment and sick leave during 2001-02 and work disability during 2003-07. After adjustment for covariates, high physical work demands and depressive symptoms had a graded effect on subsequent unemployment, sick leave and permanent work disability. Persons with both depressive symptoms and high physical demands had the highest risks, especially for sick leave, but the combined effect did not exceed the product of single effects. Persons who perceived high amount of work changed job significantly more frequently. Persons with depressive symptoms might have an increased risk of negative employment consequences irrespective of the kind and amount of work demands. This might be an effect on the level of work ability in general as well as partly the result of health selection and co-morbidity.

Limitations on work and attendance rates after employees with cancer returned to work at a single manufacturing company in Japan.

PubMed

Ohguri, Takayuki; Narai, Rie; Funahashi, Atsushi; Nishiura, Chihiro; Yamashita, Tsuyoshi; Yarita, Keiichiro; Korogi, Yukunori

2009-01-01

The purpose of this study was to evaluate the work limitations and attendance rates after employees diagnosed with cancer returned to work from sick leave, and to identify the related factors for the limitations and attendance rates at a single manufacturing company in Japan. This study retrospectively analyzed 129 men and 4 women, employed in a single manufacturing industry, who returned to work after sick leave due to newly diagnosis of cancer. Limitations on work after the return to work were enforced in the workplace based on an industrial physician's evaluation. All the employees who needed measures for work were examined by the industrial physicians every 1-6 months until the termination of such work limitations. Limitations on work after the return to work were enforced for 79 (59%) employees (36 employees with alteration of work, 31 with prohibition of shift work and 55 with prohibition of overtime work). A higher degree of work limitations was significantly correlated with work-related factors before sick leave (i.e. shift work, production line) as well as disease/treatment-related factors (i.e. chemotherapy, recurrence/metastasis), while the attendance rates after the return to work were not correlated with adverse work-related factors before sick leave. The enforcement of work limitations for employees with cancer was relatively common and was based on both disease/treatment- and work-related factors, and this phenomenon may play an important role in the return to work as well as the successful continuation of work after cancer survivors return to work.

Costs, benefits and effectiveness of worksite physical activity counseling from the employer's perspective.

PubMed

Proper, Karin I; de Bruyne, Martine C; Hildebrandt, Vincent H; van der Beek, Allard J; Meerding, Willem Jan; van Mechelen, Willem

2004-02-01

This study evaluated the impact of worksite physical activity counseling using cost-benefit and cost-effectiveness analyses. Civil servants (N = 299) were randomly assigned to an intervention (N = 131) or control (N = 168) group for 9 months. The intervention costs were compared with the monetary benefits gained from reduced sick leave. In addition, the intervention costs minus the monetary benefits from sick leave reduction were compared with the effects (percentage meeting the public health recommendation for moderate-intensity physical activity, energy expenditure, cardiorespiratory fitness, and upper extremity symptoms). The intervention costs were EUR 430 per participant, and the benefits were EUR 125 due to sick leave during the intervention period, for net total costs of EUR 305 for the intervention. During the same 9-month period the year after the intervention, the benefits from sick leave reduction were EUR 635. No statistically significant differences in costs and benefits were found between the groups. As to the cost-effectiveness, improvement in energy expenditure and cardiorespiratory fitness was observed at higher costs. The point estimates of the cost-effectiveness ratios were EUR 5.2 (without imputation of effect data) and EUR 2.7 (with imputation of effect data) per extra kilocalorie of energy expenditure per day and EUR 235 (without imputation of effect data) and EUR 45.9 (with imputation of effect data) per beat per minute of decrease in submaximal heart rate. This study does not provide a financial reason for implementing worksite counseling intervention on physical activity on the short-term. However, positive effects were shown for energy expenditure and cardiorespiratory fitness.

42 CFR 413.100 - Special treatment of certain accrued costs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific... nonforfeitable right to demand cash payment for unused sick leave at the end of each year, sick pay is includable... reporting periods that produce the highest average contribution(s), out of the five most recent Medicare...

Solution-focused intervention for sick listed employees with psychological problems or muscle skeletal pain: a randomised controlled trial [ISRCTN39140363

PubMed Central

Nystuen, Pal; Hagen, Kare B

2006-01-01

Background Long-term sick leave has been of concern to politicians and decision-makers in Norway for several years. In the current study we assess the efficacy of a solution-focused follow-up for sick-listed employees. Methods Employees on long-term sick leave due to psychological problems or muscle skeletal pain (n = 703) were invited to participate in the project. Following self-recruitment, 103 were randomly allocated to receive solution-focused follow-up (n = 53) or "treatment as usual" (n = 50). The intervention was integrated within the regular follow up of six social security offices and organised as eight weekly solution focused work sessions. Effectiveness was measured by rate of return to work and health related quality of life (SF-36). Results Intention to treat analysis showed no significant differences between the two groups for any of the outcome measures. Secondary analysis, comparing those who attended at least 50% of the sessions with the control group revealed a significant difference in favour of the active intervention group in the SF-36 subscale of mental health (Effect Size 0.56, p = 0.05). When comparing the subgroup of participants with psychological problems there was a significant difference in mental health in favour of the intervention group (Effect Size 0.71, p = 0.041). Conclusion A voluntary solution-focused intervention offered by social-security offices is no more effective than regular follow up for employees on long-term sick leave due to psychological problems or muscle skeletal pain. PMID:16542443

Determinants of sickness absence duration after an occupational back injury in the Belgian population.

PubMed

Mazina, D; Donneau, A-F; Mairiaux, Ph

2012-03-01

This study aimed at assessing factors associated to the duration of sickness absence after a back injury in the Belgian working population, with a special emphasis on cultural factors. The data were retrieved from the Belgian Fund for Work Accidents database over a 3-year period (2001-2003). The population source involved all Belgian workers under a job contract in the private sector registered as compensated cases for an accident that occurred at the workplace (n = 558,276). From that database, all back injury cases involving a complete data set and registered during the first 6 months of each year (n = 11,262) were selected and eight factors (gender, age, seniority in the current job, job category, accident regional location, enterprise size, sector of activity, and accident circumstances) were analyzed in relation to the outcome variable, sick leave duration recorded as ordered time intervals between 0 and 183-366 days. Sick leave duration was strongly associated in a multivariate model to age (≥40 years: OR = 2.18), blue-collar job (1.55), work in building industry (1.32), and enterprise size (>100: 0.85), and to a less extent to seniority (>10y: 0.88), and circumstance of accident (falls: 1.26). Injuries occurring in the French-speaking part of the country were associated to a longer sick leave (1.07; P = 0.034). This study shows that besides well-known risk factors, subtle cultural language-linked factors and/or regional differences in economic climate may significantly influence the length of disability period after a back injury. Copyright © 2012 Wiley Periodicals, Inc.

Presenteeism Attitudes and Behavior Among Missouri Kindergarten to Twelfth Grade (K-12) School Nurses.

PubMed

Rebmann, Terri; Turner, James Austin; Kunerth, Allison K

2016-12-01

Working while ill (presenteeism) with symptoms of influenza-like illness can contribute to outbreaks, but little is known about school nurse presenteeism. Missouri Association of School Nurses members (N = 396) were sent a survey in 2013/2014. A chi square test was conducted to compare having a school culture that encourages presenteeism versus actual sick leave policies. Multivariate logistic regression was conducted to delineate factors associated with presenteeism. In total, 133 school nurses participated (33.6% response rate). Almost half (42.1%, n = 56) reported presenteeism. Nurses were more likely to feel pressure to engage in presenteeism than reported punitive sick leave policies (14.3% vs. 3.8%, χ 2 = 18.3, p < .001). Presenteeism was associated with perceived pressure, odds ratio (OR) = 4.8, confidence interval (CI) = [1.5, 15.8], p < .01, and having a mild illness, OR = 3.6, CI = [1.4, 9.7], p = .01. Many school nurses engage in presenteeism, and this appears to be associated with organizational cultural norms rather than established sick leave policies. © The Author(s) 2016.

The indirect costs of cancer-related absenteeism in the workplace in Poland.

PubMed

Macioch, Tomasz; Hermanowski, Tomasz

2011-12-01

The aim of this study was to evaluate cancer-related absenteeism costs in Poland. Data on sickness absences and disability were retrieved from the Department of Statistics of the Social Insurance Institution. The cost of lost productivity owing to premature death was estimated from data retrieved from the Polish National Cancer Registry. Absenteeism costs were estimated on the basis of the measure of gross value added per employee. The costs of lost productivity owing to sick leave, disability, and premature death were estimated to be 1.572 billion EUR, 0.504 billion EUR, and 0.535 billion EUR, respectively, in 2009. The indirect costs of lost productivity owing to cancer-related sick leave, disability, and premature death have a substantial effect on the Polish economy. In 2009, they accounted for more than 0.8% of GDP.

Positive experiences of a vocational rehabilitation intervention for individuals on long-term sick leave, the Dirigo project: a qualitative study.

PubMed

Andersén, Åsa; Ståhl, Christian; Anderzén, Ingrid; Kristiansson, Per; Larsson, Kjerstin

2017-10-10

The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy) may have an impact on an individual's ability to work. The aim of this study was to investigate clients' experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training and real jobs.

Unemployment, labor force composition and sickness absence: a panel data study.

PubMed

Askildsen, Jan Erik; Bratberg, Espen; Nilsen, Oivind Anti

2005-11-01

Sickness absence tends to be negatively correlated with unemployment rates. In addition to pure health effects, this may be due to moral hazard behavior by workers who are fully insured against income loss during sickness and to physicians who meet demand for medical certificates. Alternatively, it may reflect changes in the composition of the labor force, with more sickness-prone workers entering the labor force in upturns. A panel of Norwegian register data is used to analyze long-term sickness absences. The unemployment rate is shown to be negatively associated with the probability of absence, and with the number of days of sick leave. Restricting the sample to workers who are present in the whole sample period, the negative relationship between absence and unemployment becomes clearer. This indicates that procyclical variations in sickness absence are caused by established workers and not by the composition of the labor force.

Sickness absence due to mental disorders and psychosocial stressors at work.

PubMed

Silva-Junior, João Silvestre; Fischer, Frida Marina

2015-01-01

Mental disorders are the third leading cause of social security benefit due to sickness in Brazil. Occupational exposure to psychosocial stressors can affect the workers' mental health. The social security medical experts are responsible for characterizing if those sicknesses are work-related. To evaluate the factors associated with sick leave due to mental disorders, in particular, the perception of workers on psychosocial factors at work. This is an analytical study carried out in São Paulo, Brazil, with 131 applicants for sickness benefit due to mental disorders. Questionnaires were applied to assess the sociodemographic data, habits/lifestyle information, and perceived psychosocial factors at work. The most common diagnosis was depressive disorders (40.4%). The medical experts considered 23.7% of all applications as work-related. Most of the participants were female (68.7%), up to 40 years of age (73.3%), married/common-law marriage (51.1%), with educational level greater than or equal to 11 years (80.2%), nonsmokers (80.9%), not alcohol consumers (84%), and practice of physical activities (77.9%). Regarding psychosocial factors, most of the participants informed a high job strain (56.5%), low social support (52.7%), effort-reward imbalance (55.7%), and high overcommitment (87.0%). There was no statistical association between the work-related mental disorders sickness benefits and independent variables. The concession of social security sickness benefits is not associated with sociodemographic data, habits/lifestyle, or psychosocial factors at work. Occupational exposure to unfavorable psychosocial factors was reported by most workers on sick leave due to mental disorders. However, several cases were not recognized by the social security medical experts as work-related, which may have influenced the results of the associations.

A survey of support systems for return to work in Japanese companies: a cross-sectional study.

PubMed

Doki, Shotaro; Sasahara, Shinichiro; Oi, Yuichi; Matsuzaki, Ichiyo

2016-12-07

The present study aimed to survey systems in Japanese companies for supporting workers returning to work from sickness absence due to mental illness. A questionnaire survey was mailed to 3,545 companies. Support systems for return to work, sick leave, and multiple sick-listed (MSL) workers were examined. A total of 161 companies responded to the survey (response rate: 4.5%). About 80% of the companies expressed difficulty in dealing with workers with mental health problems. About half of all companies reported having reset period and financial compensation systems, as well as gradual resumption and trial attendance systems. Most large companies tended to have reset period and trial attendance systems. No association was found between company size and MSL rates. The most frequent diagnosis among workers was depression, and the mean number of sick leave days was 275.3. Although there might have been a selection bias due to the low response rate, the results of this study are expected to be useful for companies when formulating employment systems.

A survey of support systems for return to work in Japanese companies: a cross-sectional study

PubMed Central

DOKI, Shotaro; SASAHARA, Shinichiro; OI, Yuichi; MATSUZAKI, Ichiyo

2016-01-01

The present study aimed to survey systems in Japanese companies for supporting workers returning to work from sickness absence due to mental illness. A questionnaire survey was mailed to 3,545 companies. Support systems for return to work, sick leave, and multiple sick-listed (MSL) workers were examined. A total of 161 companies responded to the survey (response rate: 4.5%). About 80% of the companies expressed difficulty in dealing with workers with mental health problems. About half of all companies reported having reset period and financial compensation systems, as well as gradual resumption and trial attendance systems. Most large companies tended to have reset period and trial attendance systems. No association was found between company size and MSL rates. The most frequent diagnosis among workers was depression, and the mean number of sick leave days was 275.3. Although there might have been a selection bias due to the low response rate, the results of this study are expected to be useful for companies when formulating employment systems. PMID:27181916

Salivary cotinine levels as a biomarker for green tobacco sickness in dry tobacco production among Thai traditional tobacco farmers.

PubMed

Saleeon, Thanusin; Siriwong, Wattasit; Maldonado-Pérez, Héctor Luis; Robson, Mark Gregory

2016-01-01

Dry Thai traditional tobacco (Nicotiana Tabacum L.) production involves a unique process: (a) picking tobacco leaves, (b) curing tobacco leaves, (c) removing stems of tobacco leaves, cutting leaves and putting on a bamboo rack, (d) drying in the sun, reversing a rack, spraying a tobacco extract to adjust the tobacco's color, storing dried tobacco and packaging. These processes may lead to adverse health effects caused by dermal absorption of nicotine such as Green Tobacco Sickness (GTS). The aim of this study was to determine the correlation between GTS resulting from dry Thai traditional tobacco production and salivary cotinine levels among Thai traditional tobacco farmers in Nan Province, Thailand. A prospective cohort study was conducted with 20 tobacco farmers and 20 non-tobacco farmers in Praputtabath Sub-District and Phatow Sub-District. The participants were randomly selected and interviewed using in person questionnaires with bi-weekly follow-up for 14 weeks. During each contact, the cotinine concentration was measured by NicAlert(TM) Saliva strip tests (NCTS). Descriptive statistics and Spearman's correlation (Spearman's rho) was used to examine the relationship between the variables at both 0.01 and 0.05 significant probability levels. This study indicated that GTS from dry tobacco production has the potential to be considered a common occupational disease. This study demonstrated the usefulness of salivary cotinine level measurements by NCTS. The levels were well correlated with farmers who were employed in the dry Thai tobacco production industry. Salivary cotinine levels were also significantly correlated with the prevalence of GTS in the group of tobacco farmers at any given time within a crop season. However, the production process of dry Thai traditional tobacco is different from that evaluated in our previous studies where GTS and salivary cotinine level were correlated in workers working in humid conditions. The long-term effects of such exposure should be investigated and health education programs with health risk exposure studies to increase awareness amongst farmers is recommended.

Does unbalanced gender composition in the workplace influence the association between psychosocial working conditions and sickness absence?

PubMed

Jonsson, Robin; Lidwall, Ulrik; Holmgren, Kristina

2013-01-01

Earlier research has shown that bad psychosocial working conditions contribute to sick-leave. Some theorists argue that skewed gender composition can be one of the factors contributing to bad psychosocial working conditions. We examine whether workplace gender composition has an effect on the association between job strain and sick-leave. Associations were assessed using a case-control study with Swedish data collected in 2008 (n=5595). Results indicated that there was an association between high strain jobs and sickness absence among both women (Adj. OR 2.04, CI95% 1.62-2.57) and men (2.24, 1.67-3.01). Furthermore, both women (2.87, 1.34-6.26) and men (2.53, 1.74-3.69) in male-dominated workplaces had the highest risk for sickness absence due to high strain jobs. Male-dominated workplaces were, in general adverse for both women and men. The results indicated that a minority position strengthens job strain for women while it weakens the association for men. Using modern gender theories, we could argue that some of these results might be explained by the general use of masculinity as the social norm in the labor market. However, findings from this study need to be validated by further research.

Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden.

PubMed

Virta, Lena; Joranger, Pål; Brox, Jens Ivar; Eriksson, Rikard

2012-02-10

Painful shoulders pose a substantial socioeconomic burden. A prospective cost-of-illness study was performed to assess the costs associated with healthcare use and loss of productivity in patients with shoulder pain in primary health care in Sweden. The study was performed in western Sweden, in a region with 24 000 inhabitants. Data were collected during six months from electronic patient records at three primary healthcare centres in two municipalities. All patients between 20 and 64 years of age who presented with shoulder pain to a general practitioner or a physiotherapist were included. Diagnostic codes were used for selection, and the cases were manually controlled. The cost for sick leave was calculated according to the human capital approach. Sensitivity analysis was used to explore uncertainty in various factors used in the model. 204 (103 women) patients, mean age 48 (SD 11) years, were registered. Half of the cases were closed within six weeks, whereas 32 patients (16%) remained in the system for more than six months. A fifth of the patients were responsible for 91% of the total costs, and for 44% of the healthcare costs. The mean healthcare cost per patient was €326 (SD 389) during six months. Physiotherapy treatments accounted for 60%. The costs for sick leave contributed to 84% of the total costs. The mean annual total cost was €4139 per patient. Estimated costs for secondary care increased the total costs by one third. The model applied in this study provides valuable information that can be used in cost evaluations. Costs for secondary care and particularly for sick leave have a major influence on total costs and interventions that can reduce long periods of sick leave are warranted.

Health-related quality of life in patients with Burnout on sick leave: descriptive and comparative results from a clinical study.

PubMed

Grensman, Astrid; Acharya, Bikash Dev; Wändell, Per; Nilsson, Gunnar; Werner, Sigbritt

2016-02-01

To explore the health-related quality of life (HRQoL), the cause of being ill, and the pharmacological treatment in patients on sick leave because of Burnout. The HRQoL among these patients was also compared with that of individuals who were working full time. HRQoL was measured using the SWED-QUAL questionnaire, comprising 67 items grouped into 13 subscales, scored from 0 (worst) to 100 (best) points, and covering aspects of physical and emotional well-being, cognitive function, sleep, general health, social, and sexual functioning. The Burnout group (n = 94), mean age 43 years, were on 50% sick leave or more. The comparison group consisted of healthy persons (n = 88) of similar age and educational level who were working full time. The Burnout group had markedly low scores in general. The cause of illness was mainly work-related. Psychotropic medication was prescribed for 55%. Significantly lower scores were found in the Burnout group than in the comparison group in all subscales, p < 0.001. The median differences in scores ranged from 10 to 56 points. Differences rated by effect size were large, 0.85-2.01. Patients on sick leave because of Burnout rated their HRQoL as very low in general, their cause of being ill was mainly work-related, and psychotropic medication was prescribed for a majority. Their scores were markedly lower in all subscales in comparison with healthy individuals working full time. The study adds to our understanding of the situation of patients with Burnout. The results can be useful in clinical work and future research.

Coping with Work-Related Stress through Guided Imagery and Music (GIM): Randomized Controlled Trial.

PubMed

Beck, Bolette Daniels; Hansen, Åse Marie; Gold, Christian

2015-01-01

Long-term stress-related sick leave constitutes a serious health threat and an economic burden on both the single worker and the society. Effective interventions for the rehabilitation and facilitation of return to work are needed. The aim of the study was to examine the effects of Guided Imagery and Music (GIM), a psychotherapy intervention including relaxation, music listening, and imagery, on biopsychosocial measures of work-related stress. Twenty Danish workers on sick leave were randomized to music therapy versus wait-list control. Data collection was carried out at an occupational health ward in the period 2008-2010. Changes in salivary cortisol, testosterone, and melatonin were explored, and self-reported data on psychological stress symptoms (perceived stress, mood disturbance, sleep quality, physical distress symptoms, work readiness, well-being, anxiety, depression, immediate stress) were collected. Data regarding sick leave situation and job return were collected from participants throughout the study. Significant beneficial effects of GIM compared to wait-list after nine weeks with large effect sizes were found in well-being, mood disturbance, and physical distress, and in cortisol concentrations with a medium effect size. A comparison between early and late intervention as related to the onset of sick leave showed faster job return and significantly improved perceived stress, well-being, mood disturbance, depression, anxiety, and physical distress symptoms in favor of early intervention. In the whole sample, 83% of the participants had returned to work at nine weeks' follow-up. The results indicate that GIM is a promising treatment for work-related chronic stress, and further studies are recommended. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Do work-related factors contribute to differences in doctor-certified sick leave? A prospective study comparing women in health and social occupations with women in the general working population.

PubMed

Aagestad, Cecilie; Tyssen, Reidar; Sterud, Tom

2016-03-08

Doctor -certified sick leave is prevalent in the health and social sector. We examined whether the higher risk of doctor-certified sick leave in women in health and social occupations compared to women in other occupations was explained by particular work-related psychosocial and mechanical risk factors. A randomly drawn cohort aged 18-69 years from the general population in Norway was surveyed in 2009 (n = 12,255, response at baseline = 60.9 %), and was followed up in the national registry of social transfer payments in 2010. Eligible respondents were women registered with an active employee relationship for ≥100 actual working days in 2009 and 2010 (n = 3032). Using this sample, we compared health and social workers (n = 661) with the general working population (n = 2371). The outcome of interest was long-term sick leave (LTSL) ≥21 working days during 2010. Eight psychosocial and eight mechanical factors were evaluated. After adjusting for age, previous LTSL, education and working hours/week, women in health and social occupations had a higher risk for LTSL compared with women in the general working population (OR = 1.42, 95 % CI = 1.13-1.79; p = 0.003). After adjusting for psychosocial and mechanical factors, 70 % of the excess risk for LTSL was explained compared with the initial model. The main contributory factors to the increased risk were threats of violence and violence, emotional demands and awkward lifting. Psychosocial and mechanical factors explained much of the excess risk for LTSL in women in health and social occupations compared with working women in general. Psychosocial risk factors were the most important contributors.

Work outcomes and their predictors in the Redesigning Daily Occupations (ReDO) rehabilitation programme for women with stress-related disorders.

PubMed

Eklund, Mona; Wästberg, Birgitta A; Erlandsson, Lena-Karin

2013-04-01

Previous research has shown that the Redesigning Daily Occupations programme reduced the degree of sick leave and increased return to work rates among women on sick leave for stress-related disorders when compared with "care as usual". To further investigate the Redesigning Daily Occupations intervention, this study explored changes in the work situation from baseline to a 12-month follow-up in the Redesigning Daily Occupations group compared with the "care as usual" group and analysed any predictors of change. A matched-control design was used and 84 women were recruited. Objective (return to work and sick leave) and subjective work outcomes (perceptions of the worker role and the work environment) were explored. Potential predictors were clinical and demographic variables and an anxiety-depression factor. In both groups, large positive effect sizes from baseline to follow-up were found regarding the objective outcomes, a moderate positive effect size was found for perceived work environment, whereas perceived worker role remained unaffected. Previous work rehabilitation predicted objective work outcomes in both groups. Higher education and older age were predictors of subjective outcomes in the Redesigning Daily Occupations group, whereas a more severe anxiety-depression rating was negative for work environment ratings in the "care as usual" group. Return to work seemed possible without a change in the women's perceptions of the worker role; rather they renegotiated their view of the work environment. The Redesigning Daily Occupations programme was found to be promising, with a positive effect on return to work and sick leave reduction. It seemed more suitable for the higher educated and older women. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

Systematic review: Factors associated with return to work in burnout.

PubMed

Kärkkäinen, R; Saaranen, T; Hiltunen, S; Ryynänen, O P; Räsänen, K

2017-08-01

Professional burnout predicts sick leave and even permanent withdrawal from the labour force. However, knowledge of the barriers to and facilitators of return to work (RTW) in such burnout is limited. To identify factors associated with RTW of burned-out individuals to inform occupational health care (OHC) RTW policy. A systematic search of peer-reviewed quantitative and mixed-method studies published from January 2005 to July 2016 in English and Finnish in ARTO, CINAHL (EBSCO), Medic, PsycINFO (ProQuest), PubMed, Scopus and Web of Science databases, followed by a manual search. We included studies that identify burnout with valid burnout measures and measure the degree of RTW or sick leave as outcomes. We excluded studies with heterogeneous samples without subgroup analyses of RTW in burnout cases. We included 10 studies (three experimental and seven observational) of the initial 1345 identified. The studies reported work-related factors; enhanced communication (positive association) and low control at work (negative association) and individual-related factors; male gender (positive association), covert coping (negative association), high over-commitment to work (positive association) and burnout-related factors; unimpaired sleep (positive association), duration of sick leave over 6 months (negative association) and part-time sick leave (positive association) associated with RTW in burnout. Associations between burnout rehabilitation and RTW, and the level of symptoms and cognitive impairment and RTW remained unclear. Few quantitative studies, of varied methodological quality, explore factors associated with RTW in burnout. Further research is needed to build an evidence base and develop guidelines for supportive OHC actions. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Caught in suffering bodies: a qualitative study of immigrant women on long-term sick leave in Norway.

PubMed

Nortvedt, Line; Hansen, Helle Ploug; Kumar, Bernadette N; Lohne, Vibeke

2015-11-01

This article explores the issues faced by immigrant women on long-term sick leave due to chronic pain, focusing on their personal perspectives on their daily lives, their bodies and their pain. An increasing number of immigrants in Norway present a challenge to the public health service, above all in relation to the health needs of immigrant women, many of whom risk having to take long-term sick leave due to chronic pain. This study has a qualitative design, with participant observation and in-depth interviews. Participant observations were carried out from a sample of fourteen immigrant women in an outpatient clinic at a rehabilitation hospital. In addition, qualitative interviews were conducted after the rehabilitation period. A hermeneutic approach was used to understand the meaning of the narrated text. The analysis revealed one main theme, 'Bodies marked by onerous experiences', as well as two subthemes: 'It is in my body' and 'Invisible pain'. The immigrant women struggled with invisible, chronic pain, which they blamed on physically tiring workdays and stressful life situations. Furthermore, they felt that their experiences of discriminative attitudes at the workplace worsened their suffering. The chronic pain made the immigrant women suffer, because they experienced it as a threatening, incomprehensible and unreal force, without meaning or the ability to be controlled. Their own psychological distress exacerbated their pain. Immigrant women on long-term sick leave are likely to need special approaches that are closely adapted to their different backgrounds and their unique personal experiences. We recommend culturally appropriate family counselling and collaboration with employers at the women's workplaces. © 2015 John Wiley & Sons Ltd.

29 CFR 825.801 - Special rules for airline flight crew employees, hours of service requirement.

Code of Federal Regulations, 2014 CFR

2014-07-01

... DIVISION, DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Special Rules Applicable... personal commute time or time spent on vacation, medical, or sick leave. (c) An airline flight crew... service requirement. (a) An airline flight crew employee's eligibility for FMLA leave is to be determined...

29 CFR 825.801 - Special rules for airline flight crew employees, hours of service requirement.

Code of Federal Regulations, 2013 CFR

2013-07-01

... DIVISION, DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Special Rules Applicable... personal commute time or time spent on vacation, medical, or sick leave. (c) An airline flight crew... service requirement. (a) An airline flight crew employee's eligibility for FMLA leave is to be determined...

31 CFR 29.105 - Computation of time.

Code of Federal Regulations, 2010 CFR

2010-07-01

...'s credit under a formal leave system; and (ii) The service of a participant under the Teachers Plan... work days, and no additional leave credit is earned for that period). (3) If an employee's tour of duty... and the last day of a 29-day month counts as 2 days. (c) For counting unused sick leave. (1) For...

Attending work while sick: implication of flexible sick leave policies.

PubMed

Rousculp, Matthew D; Johnston, Stephen S; Palmer, Liisa A; Chu, Bong-Chul; Mahadevia, Parthiv J; Nichol, Kristin L

2010-10-01

To examine the impact of various flexible sick leave policies (FSLPs) on workplace attendance of employees with self-reported "severe" influenza-like-illness (ILI) symptoms. This is a prospective study of employees from three US employers, which involved collection of information on employees' access to FSLPs and monthly experience with ILI and workplace attendance from November 2007 to April 2008. Multivariate analyses were used to estimate the impact of FSLPs on employees' workplace attendance while they were experiencing severe ILI symptoms. Among 793 employees with ILI, the average duration of severe ILI symptoms was 3.0 days. Most employees (71.9%) attended work with severe ILI symptoms, for an average of 1.3 days. Employees who could telework had a 29.7% lower rate of attending work with severe ILI symptoms (P = 0.026). Employers that implement teleworking policies may be able to reduce employee-to-employee transmission of respiratory illness, including seasonal and pandemic influenza.

[Estimating non work-related sickness leave absences related to a previous occupational injury in Catalonia (Spain)].

PubMed

Molinero-Ruiz, Emilia; Navarro, Albert; Moriña, David; Albertí-Casas, Constança; Jardí-Lliberia, Josefina; de Montserrat-Nonó, Jaume

2015-01-01

To estimate the frequency of non-work sickness absence (ITcc) related to previous occupational injuries with (ATB) or without (ATSB) sick leave. Prospective longitudinal study. Workers with ATB or ATSB notified to the Occupational Accident Registry of Catalonia were selected in the last term of 2009. They were followed-up for six months after returning to work (ATB) or after the accident (ATSB), by sex and occupation. Official labor and health authority registries were used as information sources. An "injury-associated ITcc" was defined when the sick leave occurred in the following six months and within the same diagnosis group. The absolute and relative frequency were calculated according to time elapsed and its duration (cumulated days, measures of central trend and dispersion), by diagnosis group or affected body area, as compared to all of Catalonia. 2,9%of ATB (n=627) had an injury-associated ITcc, with differences by diagnosis, sex and occupation; this was also the case for 2,1% of ATSB (n=496).With the same diagnosis, duration of ITcc was longer among those who had an associated injury, and with respect to all of Catalonia. Some of the under-reporting of occupational pathology corresponds to episodes initially recognized as being work-related. Duration of sickness absence depends not only on diagnosis and clinical course, but also on criteria established by the entities managing the case. This could imply that more complicated injuries are referred to the national health system, resulting in personal, legal, healthcare and economic cost consequences for all involved stakeholders. Copyright belongs to the Societat Catalana de Salut Laboral.

Searching for consensus among physicians involved in the management of sick-listed workers in the Belgian health care sector: a qualitative study among practitioners and stakeholders.

PubMed

Vanmeerbeek, Marc; Govers, Patrick; Schippers, Nathalie; Rieppi, Stéphane; Mortelmans, Katrien; Mairiaux, Philippe

2016-02-17

In Belgium, the management of sick leave involves general practitioners (GPs), occupational health physicians (OPs) and social insurance physicians (SIPs). A dysfunctional relationship among these physicians can impede a patient's ability to return to work. The objective of this study was to identify ways to improve these physicians' mutual collaboration. Two consensus techniques were successively performed among the three professional groups. Eight nominal groups (NGs) gathered 74 field practitioners, and a two-round Delphi process involved 32 stakeholders. From the results, it appears that two areas (reciprocal knowledge and evolution of the legal and regulatory framework) are objects of consensus among the three medical group that were surveyed. Information transfer, particularly electronic transfer, was stressed as an important way to improve. The consensual proposals regarding interdisciplinary collaboration indicate specific and practical changes to be implemented when professionals are managing workers who are on sick leave. The collaboration process appeared to be currently more problematic, but the participants correctly identified the need for common training. The three physician groups all agree regarding several inter-physician collaboration proposals. The study also revealed a latent conflict situation among the analysed professionals that can arise from a lack of mutual recognition. Practical changes or improvements must be included in an extended framework that involves the different determinants of interdisciplinary collaboration that are shown by theoretical models. Collaboration is a product of the actions and behaviours of various partners, which requires reciprocal knowledge and trust; collaboration also implies political and economic structures that are led by public health authorities.

Long-Term Sick Leavers with Difficulty in Resuming Work: Comparisons between Psychiatric-Somatic Comorbidity and Monodiagnosis

ERIC Educational Resources Information Center

Linder, Jurgen; Ekholm, Kristina Schuldt; Jansen, Gunilla Brodda; Lundh, Goran; Ekholm, Jan

2009-01-01

The number of patients with difficulty in resuming work after long-term sick leave has increased in several European countries including Sweden. The general aim of this study was a comprehensive description--based on multidisciplinary diagnostics and assessments--of patients with the common feature of marked difficulty in resuming working life…

Comparing multidisciplinary and brief intervention in employees with different job relations on sick leave due to low back pain: protocol of a randomised controlled trial.

PubMed

Pedersen, Pernille; Nielsen, Claus Vinther; Andersen, Morten Hovgaard; Langagergaard, Vivian; Boes, Anders; Jensen, Ole Kudsk; Jensen, Chris; Labriola, Merete

2017-12-16

Low back pain (LBP) is a common problem that affects the lives of many individuals and is a frequent cause of sickness absence. To help this group of individuals resume work, several interventions have been studied. However, not all individuals may profit from the same intervention and the effect of a given intervention on return to work (RTW) may depend on their work situation. The aim of this study is to evaluate whether employees on sick leave due to LBP and with poor job relations will benefit more from a multidisciplinary intervention, while patients with strong job relations will benefit more from a brief intervention. The study is designed as a randomised controlled trial with up to five years of follow-up comparing brief intervention with brief intervention plus multidisciplinary intervention. Employees, aged 18-60 years, are included in the study from March 2011 to August 2016 if they have been on sick leave for 4-12 weeks due to LBP with or without radiculopathy. They are divided into two groups, a group with poor job relations and a group with strong job relations based on their answers in the baseline questionnaire. Each group is randomised 1:1 to receive the brief intervention or brief intervention plus multidisciplinary intervention. The brief intervention comprises a clinical examination and advice offered by a rheumatologist and a physiotherapist, whereas the supplementary multidisciplinary intervention comprises the assignment of a case manager who draws up a rehabilitation plan in collaboration with the participant and the multidisciplinary team. The primary outcome is duration of sickness absence measured by register data. Secondary outcomes include sustainable RTW and questionnaire-based measures of functional capacity. Outcomes will be assessed at one, two and five years of follow-up. This trial will evaluate the effect of brief and multidisciplinary intervention on RTW and functional capacity among employees on sick leave due to LBP with poor or strong job relations. This will indicate whether work-related characteristics should be considered when providing treatment of LBP patients in the health care sector. Current Controlled Trials ISRCTN14136384 . Registered 4 August 2015.

"Young women": the meaning of a collaborative program supporting young women's rehabilitation and reintegration into the labor market.

PubMed

Stjernswärd, Sigrid; Bernce, Richard; Östman, Margareta

2013-01-01

Women are at a higher risk for long-term sick leaves and mental ill health. The aim of this study was to explore a supportive program's meaning for women with anxiety/stress/depression problems that are unemployed and/or on a sick leave, and for the personnel involved. Seven women and the personnel (n = 5) were interviewed individually pre- and post-intervention. Data was analyzed using content analysis. The program appeared to provide participants with tools to handle their physical and mental health, and occupational support, improving their social situation. Collaboration between organizations appears to be beneficial for all parties involved.

Subjective memory complaints among patients on sick leave are associated with symptoms of fatigue and anxiety

PubMed Central

Aasvik, Julie K.; Woodhouse, Astrid; Jacobsen, Henrik B.; Borchgrevink, Petter C.; Stiles, Tore C.; Landrø, Nils I.

2015-01-01

Objective: The aim of this study was to identify symptoms associated with subjective memory complaints (SMCs) among subjects who are currently on sick leave due to symptoms of chronic pain, fatigue, depression, anxiety, and insomnia. Methods: This was a cross-sectional study, subjects (n = 167) who were currently on sick leave were asked to complete an extensive survey consisting of the following: items addressing their sociodemographics, one item from the SF-8 health survey measuring pain, Chalder Fatigue Questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Index, and Everyday Memory Questionnaire – Revised. General linear modeling was used to analyze variables associated with SMCs. Results: Symptoms of fatigue (p-value < 0.001) and anxiety (p-value = 0.001) were uniquely and significantly associated with perceived memory failures. The associations with symptoms of pain, depression, and insomnia were not statistically significant. Conclusions: Subjective memory complaints should be recognized as part of the complex symptomatology among patients who report multiple symptoms, especially in cases of fatigue and anxiety. Self-report questionnaires measuring perceived memory failures may be a quick and easy way to incorporate and extend this knowledge into clinical practice. PMID:26441716

Subjective memory complaints among patients on sick leave are associated with symptoms of fatigue and anxiety.

PubMed

Aasvik, Julie K; Woodhouse, Astrid; Jacobsen, Henrik B; Borchgrevink, Petter C; Stiles, Tore C; Landrø, Nils I

2015-01-01

The aim of this study was to identify symptoms associated with subjective memory complaints (SMCs) among subjects who are currently on sick leave due to symptoms of chronic pain, fatigue, depression, anxiety, and insomnia. This was a cross-sectional study, subjects (n = 167) who were currently on sick leave were asked to complete an extensive survey consisting of the following: items addressing their sociodemographics, one item from the SF-8 health survey measuring pain, Chalder Fatigue Questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Index, and Everyday Memory Questionnaire - Revised. General linear modeling was used to analyze variables associated with SMCs. Symptoms of fatigue (p-value < 0.001) and anxiety (p-value = 0.001) were uniquely and significantly associated with perceived memory failures. The associations with symptoms of pain, depression, and insomnia were not statistically significant. Subjective memory complaints should be recognized as part of the complex symptomatology among patients who report multiple symptoms, especially in cases of fatigue and anxiety. Self-report questionnaires measuring perceived memory failures may be a quick and easy way to incorporate and extend this knowledge into clinical practice.

A Long-Term Follow-Up of the Efficacy of Nature-Based Therapy for Adults Suffering from Stress-Related Illnesses on Levels of Healthcare Consumption and Sick-Leave Absence: A Randomized Controlled Trial.

PubMed

Corazon, Sus Sola; Nyed, Patrik Karlsson; Sidenius, Ulrik; Poulsen, Dorthe Varning; Stigsdotter, Ulrika Karlsson

2018-01-15

Stress-related illnesses are a growing health problem in the Western world; which also has economic significance for society. As a consequence; there is a growing demand for effective treatments. The study investigates the long-term efficacy of the Nacadia ® nature-based therapy (NNBT) by comparing it to the efficacy of a validated cognitive behavioral therapy, called STreSS. The study is designed as a randomized controlled trial in which 84 participants are randomly allocated between the treatments. Long-term efficacy is investigated through data extracts from the national database of Statistics Denmark on the sick leave and the health-care consumption. The results show that both the NNBT and the STreSS lead to a significant decrease in number of contacts with a general practitioner in the period from twelve months prior to treatment to twelve months after treatment; and, a significant decrease in long-term sick leave from the month prior to treatment to twelve months after treatment. The positive long-term effects provide validation for the NNBT as an efficient treatment of stress-related illnesses.

A Long-Term Follow-Up of the Efficacy of Nature-Based Therapy for Adults Suffering from Stress-Related Illnesses on Levels of Healthcare Consumption and Sick-Leave Absence: A Randomized Controlled Trial

PubMed Central

Corazon, Sus Sola; Nyed, Patrik Karlsson; Sidenius, Ulrik

2018-01-01

Stress-related illnesses are a growing health problem in the Western world; which also has economic significance for society. As a consequence; there is a growing demand for effective treatments. The study investigates the long-term efficacy of the Nacadia® nature-based therapy (NNBT) by comparing it to the efficacy of a validated cognitive behavioral therapy, called STreSS. The study is designed as a randomized controlled trial in which 84 participants are randomly allocated between the treatments. Long-term efficacy is investigated through data extracts from the national database of Statistics Denmark on the sick leave and the health-care consumption. The results show that both the NNBT and the STreSS lead to a significant decrease in number of contacts with a general practitioner in the period from twelve months prior to treatment to twelve months after treatment; and, a significant decrease in long-term sick leave from the month prior to treatment to twelve months after treatment. The positive long-term effects provide validation for the NNBT as an efficient treatment of stress-related illnesses. PMID:29342952

Understanding long-term sick leave in female white-collar workers with burnout and stress-related diagnoses: a qualitative study.

PubMed

Sandmark, Hélène; Renstig, Monica

2010-04-26

Sick leave rates in Sweden have been significant since the end of the 1990s. In this paper we focus on individual female white-collar workers and explore various factors and setting-based sources of ill health in working life and in private life, in order to understand impaired work ability, leading ultimately to long-term sick leave. A qualitative methodology was chosen, and thematic, open-ended interviews were carried out with 16 women. The interviewees were strategically selected from a cohort of 300 women in full-time white-collar jobs in high-level positions, living in three urban areas in Sweden, and on long-term sick leave > or =90 days. A qualitative content analysis was carried out. The informants in the study were generally well educated, but a few had surprisingly little formal education considering their salary level and position on the labour market. The women were in professional positions more commonly held by men, either as specialists with some degree of managerial role or as executives with managerial responsibilities. Both external and internal stressors were identified. The analysis indicated that being in these gender-typed jobs could have induced sex discrimination and role conflicts. The women expressed strong agreement regarding success in working life, but emphasised the lack of competence matching in their present jobs. They also lacked the sense of having a rewarding job, saw leadership as weak, and disliked their present workplace and colleagues. Impaired health may have hindered them from changing jobs; conversely, their locked-in positions could have resulted in deterioration in their health status. The women displayed personal overcommitment, both at work and in private life, and had difficulties in setting limits. Factors in working life, as well as in private life, played an important role in the informants' deteriorated health and long-term sick leave. Job and workplace mismatching, problems in connection with company profitability, and poor leadership contributed to stress-related symptoms, resulting in reduced working capacity. On the basis of these findings, attention should be paid to identification of early indicators of exhaustion, and measures should be taken in work settings and in working life as a whole to promote retained work ability.

Nationwide cross-sectional study of the impact of chronic pain on an individual's employment: relationship with the family and the social support.

PubMed

de Sola, Helena; Salazar, Alejandro; Dueñas, María; Ojeda, Begoña; Failde, Inmaculada

2016-12-23

To determine the prevalence and the factors related to sick leave and job loss among individuals suffering from chronic pain (CP), and to analyse specifically the effect of family and social support on the individual's employment. Observational cross-sectional study. Data were collected using structured computer-assisted telephone interviews between February and June 2011. A nationwide study of 1543 Spanish adults of working age (<65), 213 of whom suffered from CP (pain suffered at least 4 or 5 days a week during the past 3 months, according to the criteria of the International Association for the Study of Pain (IASP)). Information was collected regarding the individual's sociodemographic status, pain characteristics, healthcare use and satisfaction, limitations in daily activities, mood status, perception of the impact of pain on their families, and their satisfaction with the family and social support. To identify factors associated with sick leave and job loss among those suffering CP, 2 logistic regression models were generated. The prevalence of sick leave due to CP in the general Spanish population was 4.21% (95% CI 3.2% to 5.2%). Sick leave were more likely for individuals who considered their family were affected by their pain (OR=2.18), needed help to dressing and grooming (OR=2.98), taking medication (OR=2.18), had a shorter pain duration (OR=0.99) and higher educational level. The prevalence of job loss due to CP was 1.8% (95% CI 1.1% to 2.5%). It was related to feelings of sadness (OR=4.25), being unsatisfied with the care provided by health professionals (OR=2.60) and consulting a doctor more often due to CP (OR=1.09). CP is negatively associated with an individual's employment. This detrimental effect could be ameliorated if the factors related to sick leave and job loss provoked by CP are identified, especially those related to the effect of CP on the family and social environment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Understanding long-term sick leave in female white-collar workers with burnout and stress-related diagnoses: a qualitative study

PubMed Central

2010-01-01

Background Sick leave rates in Sweden have been significant since the end of the 1990s. In this paper we focus on individual female white-collar workers and explore various factors and setting-based sources of ill health in working life and in private life, in order to understand impaired work ability, leading ultimately to long-term sick leave. Methods A qualitative methodology was chosen, and thematic, open-ended interviews were carried out with 16 women. The interviewees were strategically selected from a cohort of 300 women in full-time white-collar jobs in high-level positions, living in three urban areas in Sweden, and on long-term sick leave ≥90 days. A qualitative content analysis was carried out. Results The informants in the study were generally well educated, but a few had surprisingly little formal education considering their salary level and position on the labour market. The women were in professional positions more commonly held by men, either as specialists with some degree of managerial role or as executives with managerial responsibilities. Both external and internal stressors were identified. The analysis indicated that being in these gender-typed jobs could have induced sex discrimination and role conflicts. The women expressed strong agreement regarding success in working life, but emphasised the lack of competence matching in their present jobs. They also lacked the sense of having a rewarding job, saw leadership as weak, and disliked their present workplace and colleagues. Impaired health may have hindered them from changing jobs; conversely, their locked-in positions could have resulted in deterioration in their health status. The women displayed personal overcommitment, both at work and in private life, and had difficulties in setting limits. Conclusions Factors in working life, as well as in private life, played an important role in the informants' deteriorated health and long-term sick leave. Job and workplace mismatching, problems in connection with company profitability, and poor leadership contributed to stress-related symptoms, resulting in reduced working capacity. On the basis of these findings, attention should be paid to identification of early indicators of exhaustion, and measures should be taken in work settings and in working life as a whole to promote retained work ability. PMID:20420702

Self-assessed mental health problems and work capacity as determinants of return to work: a prospective general population-based study of individuals with all-cause sickness absence

PubMed Central

2013-01-01

Background Mental health problems are common in the work force and influence work capacity and sickness absence. The aim was to examine self-assessed mental health problems and work capacity as determinants of time until return to work (RTW). Methods Employed women and men (n=6140), aged 19–64 years, registered as sick with all-cause sickness absence between February 18 and April 15, 2008 received a self-administered questionnaire covering health and work situation (response rate 54%). Demographic data was collected from official registers. This follow-up study included 2502 individuals. Of these, 1082 were currently off sick when answering the questionnaire. Register data on total number of benefit compensated sick-leave days in the end of 2008 were used to determine the time until RTW. Self-reported persistent mental illness, the WHO (Ten) Mental Well-Being Index and self-assessed work capacity in relation to knowledge, mental, collaborative and physical demands at work were used as determinants. Multinomial and binary logistic regression analyses were used to estimate odds ratios with 95% confidence intervals (CI) for the likelihood of RTW. Results The likelihood of RTW (≥105 days) was higher among those with persistent mental illness OR= 2.97 (95% CI, 2.10-4.20) and those with low mental well-being OR= 2.89 (95% CI, 2.31-3.62) after adjusting for gender, age, SES, hours worked and sick leave 2007. An analysis of employees who were off sick when they answered the questionnaire, the likelihood of RTW (≥105 days) was higher among those who reported low capacity to work in relation to knowledge, mental, collaborative and physical demands at work. In a multivariable analysis, the likelihood of RTW (≥105 days) among those with low mental well-being remained significant OR=1.93 (95% CI 1.46-2.55) even after adjustment for all dimensions of capacity to work. Conclusion Self-assessed persistent mental illness, low mental well-being and low work capacity increased the likelihood of prolonged RTW. This study is unique because it is based on new sick-leave spells and is the first to show that low mental well-being was a strong determinant of RTW even after adjustment for work capacity. Our findings support the importance of identifying individuals with low mental well-being as a way to promote RTW. PMID:24124982

Social and diagnostic inequality in health.

PubMed

Bringedal, Berit; Tufte, Per Arne

2012-11-01

Empirical studies of social inequalities in health commonly take the diagnosing of disease for granted. Social inequalities in health are seen as the result of social processes, yet the diagnosis itself is rarely considered to contribute to such inequality. We argue that the influence of sociocultural and cognitive bias in the diagnosing process follows a social pattern, such that certain diagnoses are disproportionally over- or underrepresented in different socioeconomic groups due to interpretive bias of underlying symptoms. Norwegian data on sick leave for diffuse musculoskeletal and diffuse psychiatric disease in 2006 were analysed to study the distribution of the two diagnoses in different status groups. Socioeconomic status was measured by years of education. Diagnoses and occupational codes were based on national registers; diagnoses in accordance with the International Classification of Primary Care second edition. We compared occupations in technical sectors to occupations in the health sector and the relative number of cases of sick leave controlled for years of education, gender, occupational sector, and diagnosis. Data were analysed by cross-tabulation, ratio of diffuse psychiatric/musculoskeletal diseases, and logistic regression. The ratio of diffuse psychiatric/musculoskeletal diseases increases with education and decreases if the employee works in a technical job. The results challenge the traditional explanation that job features alone can explain the distribution of disease and suggest that a part of the persistent social inequality in health can be caused by the diagnosing process. In order to reach a better understanding of the processes behind the social inequalities in health, the diagnosing process itself should also be studied.

Will sick leave after a counselling intervention prevent later burnout? A 3-year follow-up study of Norwegian doctors.

PubMed

Isaksson Ro, Karin E; Tyssen, Reidar; Gude, Tore; Aasland, Olaf G

2012-05-01

Burnout and mental distress in working doctors increase the risk for both suboptimal treatment of patients and negative health consequences for the doctors. Doctors have low rates of sickness absence and are reluctant to seek help, especially for mental distress. We examined whether a spell of sickness absence after a counselling intervention could predict reduction in emotional exhaustion among doctors at work 3 years later. A 3-year follow up after a counselling intervention for burnout at the Resource Centre Villa Sana in Norway in 2003-05 was completed by 184/227 doctors. Self-report assessments were administered at baseline, 1-, and 3-years. The effect of number of weeks of sickness absence on reduction in emotional exhaustion among doctors working 3 years after the intervention was assessed by linear regression. Of the 184 doctors completing assessment, 149 were working at 3-year follow up. Emotional exhaustion (scale 1-5) was significantly reduced at follow up (from 3.00±0.96 to 2.37±0.79, p<0.001). The number of weeks of sickness absence after the intervention was a significant positive predictor of this reduction (β=0.31, p<0.001), also after including sex, age, neuroticism, reduction of work hours, and other forms for treatment in the model. The number of weeks of sickness absence after a counselling intervention for burnout had a positive predictive effect on reduction in emotional exhaustion among doctors at work 3 years later. Sick leave thus seems to "prevent" later burnout, which can be of importance both for their patients and for the doctors themselves.

An analysis of sickness absence in chronically ill patients receiving Complementary and Alternative Medicine: A longterm prospective intermittent study

PubMed Central

Moebus, Susanne; Lehmann, Nils; Bödeker, Wolfgang; Jöckel, Karl-Heinz

2006-01-01

Background The popularity of complementary and alternative medicine (CAM) has led to a growing amount of research in this area. All the same little is known about the effects of these special treatments in every-day practice of primary care, delivered by general practitioners within the health insurance system. From 1994 to 2000 more than 20 German Company health insurances initiated the first model project on CAM according to the German social law. Aim of this contribution is to investigate the effectiveness of multi-modal CAM on chronic diseases within primary health care. Methods A long-term prospective intermittent study was conducted including 44 CAM practitioners and 1221 self-selected chronically ill patients (64% women) of whom 441 were employed. Main outcome measure is sick-leave, controlled for secular trends and regression-to-the mean and self-perceived health status. Results Sick-leave per year of 441 patients at work increased from 22 (SD ± 45.2) to 31 (± 61.0) days within three years prior to intervention, and decreased to 24 (± 55.6) in the second year of treatment, sustaining at this level in the following two years. Detailed statistical analysis show that this development exceeds secular trends and the regression-toward-the-mean effect. Sick-leave reduction was corroborated by data on self-reported improvement of patients' health status. Conclusion Results of this longterm observational study show a reduction of sick leave in chronically ill patients after a complex multimodal CAM intervention. However, as this is an uncontrolled observational study efficacy of any specific CAM treatment can not be proven. The results might indicate an general effectiveness of CAM in primary care, worthwhile further investigations. Future studies should identify the most suitable patients for CAM practices, the most appropriate and safe treatments, provide information on the magnitude of the effects to facilitate subsequent definitive randomised controlled studies that will help to position complementary and alternative medicine in health care. PMID:16472403

Factors related to work ability and well-being among women on sick leave due to long-term pain in the neck/shoulders and/or back: a cross-sectional study.

PubMed

Rashid, Mamunur; Kristofferzon, Marja-Leena; Heiden, Marina; Nilsson, Annika

2018-05-30

Musculoskeletal pain is one of the leading causes of sick leave, especially among women, in Western countries. The aim of the present study was to identify factors associated with work ability and well-being, respectively, among women on sick leave due to long-term pain in the neck/shoulders and/or back. A cross-sectional study with a correlational design was conducted on women who were sick-listed due to long-term pain in the neck/shoulders and/or back. A total of 208 participants responded to a survey comprising eight instruments: Multidimensional Pain Inventory scale, General Self-Efficacy scale, Sense of Coherence scale, Coping Strategies Questionnaire, Demand-Control-Support Questionnaire, Hospital Anxiety and Depression Scale, Work Ability Index and Life Satisfaction questionnaire. Multiple linear regression analyses were performed to identify factors associated with work ability and well-being, respectively. Women who more strongly believed they would return to the same work had greater work ability (β = 0.39, p < 0.001), whereas women with higher pain intensity (β = - 0.30, p < 0.001) and higher job strain (β = - 0.12, p < 0.05) had lower work ability. Women with higher self-efficacy rated greater well-being (β = 0.14, p < 0.05). As the women's scores for depression increased, their well-being decreased by 48%, which was statistically significant (p < 0.001). The regression models for work ability and well-being were significant (p < 0.001), and their adjusted R- square values were 48% and 59%, respectively. The study suggests that the factors beliefs to be back at the same work, pain intensity and job strain are predictive of work ability. Moreover, the factors self-efficacy and depression seem to be predictive of well-being. The findings highlight factors that should be considered by health care professionals and policy-makers to guide attempts to reduce sick leave.

Work load, job control and risk of leaving work by sickness certification before delivery, Norway 1989.

PubMed

Strand, K; Wergeland, E; Bjerkedal, T

1997-09-01

Sickness absence in pregnancy has been shown to be associated with strenuous working conditions and parity. So far, few studies have made adjustments for possible interaction and confounding. Such adjustments are needed to more precisely identify targets for preventive measures. We have, therefore, in a representative population of pregnant employees in Norway 1989, computed adjusted odds ratios for leaving work by sickness absence more than three (LSC > 3) and eight (LSC > 8) weeks before delivery according to working conditions identified as risk factors in earlier studies; adjusted for job control, domestic conditions and sickness absence the year prior to pregnancy. The cumulative percentage of LSC > 8 and LSC > 3 was 26.4 and 51.1. Ergonomically strenuous postures and heavy lifting increased the risk of both outcomes. In addition, shift work and hectic work pace increased the risk of LSC > 3. Influence on breaks reduced risk. Only para experienced reduced risk of LSC when working part-time. Sicklisting the year prior to pregnancy had no confounding effect, which suggest that pregnancy represents a new incompatibility with work. Preventive measures should address work postures and heavy lifting, as well as conditions influencing the woman's control with her time.

Sickness absence due to back pain or depressive episode and the risk of all-cause and diagnosis-specific disability pension: A Swedish cohort study of 4,823,069 individuals.

PubMed

Dorner, T E; Alexanderson, K; Svedberg, P; Ropponen, A; Stein, K V; Mittendorfer-Rutz, E

2015-10-01

The aim of this study was to investigate the associations between sickness absence due to back pain or depressive episode with future all-cause and diagnosis-specific disability pension, while adjusting for comorbidity and socio-demographics, for all and stratifying for sex. In total, 4,823,069 individuals aged 16-64 years, living in Sweden at the end of 2004, not on old-age or disability pension in 2005 and without ongoing sickness absence at the turn of 2004/2005 formed the study population. Crude and adjusted hazard ratios (HRs) for all-cause and diagnosis-specific disability pension (2006-2010) in relation to diagnosis-specific sickness absence with sickness benefits paid by the Social Insurance Agency were estimated using Cox regression. The HR for all-cause disability pension was 7.52 (7.25-7.52) in individuals with an incident sick-leave spell due to back pain, compared to individuals without sickness absence in 2005 in the fully adjusted (socio-demographics and comorbidity) model. The fully adjusted (multivariate) HRs for diagnosis-specific disability pension were musculoskeletal diagnoses 23.87 (22.75-25.04), mental 2.49 (2.27-2.73) or all other diagnoses, 3.44 (3.17-3.75). In individuals with an incident sick-leave spell due to a depressive episode in 2005, the multivariate adjusted HR for all-cause disability pension was 12.87 (12.42-13.35), while the multivariate HRs for disability pension due to musculoskeletal diagnoses were 4.39 (3.89-4.96), for mental diagnoses 25.32 (24.29-26.38) and for all other somatic diagnoses 3.44 (3.09-3.82). Men who were sickness absent due to a depressive episode had a higher HR for disability pension compared to women. Results indicate that sickness absence due to a depressive episode or back pain is a strong risk factor for a future disability pension due to mental, musculoskeletal or other somatic diagnoses. © 2015 European Pain Federation - EFIC®

School Law.

ERIC Educational Resources Information Center

Splitt, David A.

1987-01-01

The United States Supreme Court upheld a California state law requiring employers to allow a pregnant woman up to four months of unpaid maternity leave if she claims pregnancy as a disability. A bill before Congress addresses parental leave and job protection for parents caring for a new baby or a sick child. (MLH)

Is mobility in the labor market a solution to sustainable return to work for some sick listed persons?

PubMed

Ekberg, Kerstin; Wåhlin, Charlotte; Persson, Jan; Bernfort, Lars; Öberg, Birgitta

2011-09-01

The study aims to identify characteristics associated with long-term expectations of professional stability or mobility among recently sick-listed workers, and to study whether expectations of professional mobility and turnover intentions were associated with duration of sick leave. A cross-sectional study was performed on baseline measures in a prospective cohort study of patients who were granted sick leave due to musculoskeletal (MSD) or mental (MD) disorders. A total of 1,375 individuals fulfilled the inclusion criteria. A baseline questionnaire was sent by mail within 3 weeks of their first day of certified medical sickness; 962 individuals responded (70%). The main diagnosis was MSD in 595 (62%) individuals and MD in 367 (38%). Expectations of ability to remain in the present profession in 2 years was associated with better health and health-related resources, younger age, higher education, and better effort-reward balance. Effort-reward imbalance, MD, high burnout scores, and better educational and occupational position were associated with turnover intentions. Low expectations of ability to remain in the present profession defined two vulnerable groups with regard to RTW, those with no turnover intentions were older, had lower personal resources, more often had MSD, and slower RTW rate. Those with turnover intentions had a clear effort-reward imbalance and high burnout scores. The results of this explorative study underline the importance of differentiating RTW-interventions based on knowledge about the sick-listed person's resources in relation to the labor market and the work place, and their expectations of future employment and employability.

Job adjustment as a means to reduce sickness absence during pregnancy.

PubMed

Strand, K; Wergeland, E; Bjerkedal, T

1997-10-01

This study examined the effect of job adjustment on sickness absence during pregnancy and also determined the conditions under which such adjustments are obtained. Data were derived from a nationally representative survey on work conditions during pregnancy in Norway in 1989. For employees (N = 2713) remaining in the same job throughout pregnancy, the percentage of women on sick leave immediately before delivery was determined according to the need for job adjustment and the obtainment of job adjustment. Those obtaining job adjustment were grouped according to workplace size, labor-market sector, co-worker gender, educational level, work schedules, weekly workhours, children under 16 years of age in the household, and age. All told, 1691 women (62.3%) needed job adjustment, among whom 936 (55.4%) obtained such adjustment. The proportions of those on sick leave before delivery were 45.2% for "no need", 67.9% for "need - adjustment obtained", and 79.2% for "need - adjustment not obtained". In the last category, the difference (versus "adjustment obtained") constituted 44.5% of the weeks lost because of sickness absence in the last half of pregnancy. The odds ratio (OR) for obtaining job adjustment was larger for workplaces with more than 50 employees (OR 1.4) and smaller for jobs with work schedules other than daytime or shift work (OR 0.5) and also for women living with children under 16 years of age (OR 0.8). Job adjustment is associated with reduced sickness absence during pregnancy. Further studies should explore workplace characteristics that make it difficult to obtain such adjustments, as required by law.

Does transfer of work from a public sector organisation to a commercial enterprise without staff reductions increase risk of long-term sickness absence among the staff? A cohort study of laboratory and radiology employees.

PubMed

Kokkinen, Lauri; Virtanen, Marianna; Pentti, Jaana; Vahtera, Jussi; Kivimäki, Mika

2013-08-01

Privatisations of public sector organisations are not uncommon, and some studies suggest that such organisational changes may adversely affect employee health. In this study, we examined whether transfer of work from public sector hospital units to commercial enterprises, without major staff reductions, was associated with an increased risk of long-term sickness absence among employees. A cohort study of 962 employees from four public hospital laboratory and radiology units in three hospitals which were privatised during the follow-up and 1832 employees from similar units without such organisational changes. Records of new long-term sick leaves (>90 days) were obtained from national health registers and were linked to the data. Mean follow-up was 9.2 years. Age- and sex-adjusted HR for long-term sickness absence after privatisation was 0.83 (95% CI 0.68 to 1.00) among employees whose work unit underwent a change from a public organisation to a commercial enterprise compared with employees in unchanged work units. Further adjustments for occupation, socioeconomic status, type of job contract, size of residence and sick leaves before privatisation had little impact on the observed association. A sensitivity analysis with harmonised occupations across the two groups replicated the finding (multivariable adjusted HR 0.92 (0.70-1.20)). In this study, transfer of work from public organisation to commercial enterprise did not increase the risk of long-term sickness absence among employees.

[Job satisfaction and organizational culture as predictors of absenteeism].

PubMed

Mendoza Llanos, Rodolfo

2015-08-01

Absenteeism caused by sick leaves generates an important economic burden. To determine if job satisfaction, psychological climate, hierarchic level and age are predictors of absenteeism caused by sick leaves. FOCUS-93 survey that measures organizational culture and the satisfaction scale of Warr, Cook and Wall were distributed to 1387 workers of a hospital and answered by 874. Absenteeism data was obtained from the justified absenteeism registry of the Chilean Health Services. Absenteeism is influenced by job satisfaction and organizational culture. Age has no influence. Hierarchic level has a negative influence on absenteeism among men and a negligible effect among women. Those workers that are not satisfied with their work have higher rates of absenteeism.

Entitlement to Sickness Benefits in Sweden: The Social Insurance Officers Experiences

PubMed Central

Söderberg, Elsy; Müssener, Ulrika

2008-01-01

Background: Social insurance offices (SIOs) handle a wide range of complex assessments of the entitlement to sickness benefits for an increasing number of clients on sick leave and consequently, the demands on the SIOs have increased considerably. Aim: To gain deeper knowledge of the problems experienced by the SIOs in their work associated with entitlement to sickness benefits. Method: A descriptive and explorative qualitative approach was used to analyse data from two focus-group interviews, including six participants in each group. Results: The participants discussed different dilemmas in regard to; physicians’ responsibility for issuing sickness certificates, interactions with the insured individuals, disclosure of decisions, communications with medical consultants, documentation of sickness benefit claims, threats in the workplace, as well as their own competence. The SIOs regarded incomplete information on sickness certificates as a main problem, because they frequently had to contact the client and the physicians who issued the certificates in order to obtain further details, leading to delays in the decision-making whether to grant sickness benefits. Conclusions: More knowledge regarding SIOs work is required to improve the methods used in the sickness insurance system and to ensure adequate training of new staff members. PMID:21572827

Paid Leave Benefits Among a National Sample of Working Mothers with Infants in the United States

PubMed Central

Shepherd-Banigan, Megan; Bell, Janice F.

2013-01-01

To describe a range of employment benefits, including maternity and other paid leave, afforded to working women with infants; and to examine the geographic, socio-demographic correlates of such benefits to inform the workplace policy agenda in the US. Using data from the Listening to Mothers II Survey, a national sample of English-speaking women who gave birth in 2005, we conducted multivariable linear and logistic regression analyses to examine the associations between socio-demographic factors and employment leave variables (paid maternity, sick and personal leave). Forty-one percent of women received paid maternity leave for an average of 3.3 weeks with 31 % wage replacement. On average women took 10 weeks of maternity leave and received 10.4 days of paid sick leave and 11.6 days of paid personal time per year. Women who were non-Hispanic Black, privately insured, working full-time, and from higher income families were more likely to receive paid maternity leave, for more time, and at higher levels of wage replacement, when controlling for the other socio-demographic characteristics. Race/ethnicity, family income and employment status were associated with the number of paid personal days. Currently, the majority of female employees with young children in the US do not receive financial compensation for maternity leave and women receive limited paid leave every year to manage health-related family issues. Further, women from disadvantaged backgrounds generally receive less generous benefits. Federal policy that supports paid leave may be one avenue to address such disparities and should be modified to reflect accepted international standards. PMID:23584928

Parental leave: comparing children's hospitals with Fortune 500 companies.

PubMed

Weiss, A H; Gordon, E J; O'Connor, M E

1998-07-01

To identify parental leave policies and availability of support systems for new parents employed by children's hospitals and compare these benefits with those offered by Fortune 500 companies. Telephone or facsimile survey of all (n=118) children's hospitals and pediatric medical centers in the National Association of Children's Hospitals and Related Institutions 1995 Directory of Members, and 118 geographically matched Fortune 500 companies. Policies for maternity and paternity leave, adoption benefits, and support services for new parents were compared. Ninety-four children's hospitals (80%) and 82 Fortune 500 companies (69%) responded to the survey. No difference in duration of maternity (P>.30) or paternity (P=.12) leave was found. Sixty-two companies (77%) classified maternity leave as short-term disability while 47 hospitals (50%) classified it as sick time (P<.005). Classifying maternity leave as short-term disability generally gives better benefits to employees with short duration of service, whereas classifying maternity leave as sick time usually favors employees with longer employment. Companies provided more financial support for adoption expenses (P<.05), but there was no difference in duration of paid or unpaid leave for adoption (P=.14). Hospitals provided more on-site day care (69% vs 42%; P<.001) and better support systems for breast-feeding mothers (49% vs 24%; P<.002). Children's hospitals do not offer better parental leave benefits than Fortune 500 companies; however, they offer better support systems for parents returning to work after the birth of a child.

Hearing loss and work participation: a cross-sectional study in Norway.

PubMed

Svinndal, Elisabeth Vigrestad; Solheim, Jorunn; Rise, Marit By; Jensen, Chris

2018-04-27

To study work participation of persons with hearing loss, and associations with hearing disabilities, self-reported workability, fatigue and work accommodation. Cross-sectional internet-based survey. A total of 10,679 persons with hearing loss within working-age were invited to answer the survey, where 3330 answered (35.6%). Degree of hearing loss was associated with low workability, fatigue and work place accommodation, while sick leave was associated with fatigue. Degree of hearing loss was positively associated with being unemployed (p < .001) and having part-time work (p < .01) (often combined with disability benefits) for women. Work place accommodation was more frequently provided among respondents working with sedentary postures, high seniority, long-term sick leave or low workability. Additional unfavourable sensory conditions were associated with decreased employment (p < .001) and workability, and an increase in sick leave (p < .01) and fatigue (p < .001). Hearing loss seemed to influence work participation factors negatively; particularly, for moderate hearing loss and for women, even though the degree of employment was high. A lack of work place accommodation when there was a need for such was found. This implies increased attentiveness towards individual needs concerning the experienced disability a hearing loss may produce. A more frequent use of hearing disability assessment is suggested.

Employment benefits and job retention: evidence among patients with colorectal cancer.

PubMed

Veenstra, Christine M; Abrahamse, Paul; Wagner, Todd H; Hawley, Sarah T; Banerjee, Mousumi; Morris, Arden M

2018-03-01

A "health shock," that is, a large, unanticipated adverse health event, can have long-term financial implications for patients and their families. Colorectal cancer is the third most commonly diagnosed cancer among men and women and is an example of a specific health shock. We examined whether specific benefits (employer-based health insurance, paid sick leave, extended sick leave, unpaid time off, disability benefits) are associated with job retention after diagnosis and treatment of colorectal cancer. In 2011-14, we surveyed patients with Stage III colorectal cancer from two representative SEER registries. The final sample was 1301 patients (68% survey response rate). For this study, we excluded 735 respondents who were not employed and 20 with unknown employment status. The final analytic sample included 546 respondents. Job retention in the year following diagnosis was assessed, and multivariable logistic regression was used to evaluate associations between job retention and access to specific employment benefits. Employer-based health insurance (OR = 2.97; 95% CI = 1.56-6.01; P = 0.003) and paid sick leave (OR = 2.93; 95% CI = 1.23-6.98; P = 0.015) were significantly associated with job retention, after adjusting for sociodemographic, clinical, geographic, and job characteristics. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Everyday hassles and uplifts among women on long-term sick-leave due to stress-related disorders.

PubMed

Johansson, Gun; Eklund, Mona; Erlandsson, Lena-Karin

2012-05-01

A balance between different experiences of occupations in everyday life is important for well-being. The study aim was to describe hassles and uplifts in everyday occupations among women on long-term sick-leave due to stress-related disorders. The sample consisted of 77 women and experiences were collected by the THU-5 instrument. The statements were analysed using quantitative content analysis. Data were categorized into three domains of hassles concerning oneself, doings, and social and physical context. The same domains occurred among the uplifts. Hassles were mostly generated by disturbing people around the women and by their limited body functions. The women were uplifted by supportive social relationships and by performing relaxing and calming occupations. The study illuminates the strong need for social support among women on sick-leave, as well as their low level of energy, which was an obvious obstacle for performing occupations. It is suggested that, in order to increase well-being in the target group, the occupational therapist should meet their need for occupations that match their current level of energy. The challenge for the client is to avoid remaining in a pattern of low-demand occupations without exceeding her/his capacity and returning to an unhealthy pattern of occupations.

Long-term effects of exercise programs among helicopter pilots with flying related LBP

PubMed Central

Andersen, Knut; Baardsen, Roald; Dalen, Ingvild; Larsen, Jan Petter

2017-01-01

BACKGROUND: Flying related transient Low Back Pain (LBP) among helicopter pilots is considered an occupational distress. OBJECTIVE: To examine if exercise programs can alleviate transient LBP. METHODS: Sixty-five helicopter pilots (92% males), all reporting flying related LBP, responded to an epidemiological survey and a long-term follow-up, 44.8 months later, comprising questions regarding transient LBP and number of sick leaves. Data from 37 pilots participating in two exercise programs, A; general for LBP, B; focused for lumbar trunk (LT), included information from clinical examinations and muscular endurance tests of the LT before and after intervention. Twenty-eight pilots did not participate in any intervention. RESULTS: At long-term follow-up 42% of the pilots still reported flying related transient LBP. Among participants in program B 26% had persistent pain, 70% in program A and 46% among pilots without intervention. Sick-leave reduction was only observed among participants in program B (30% to 4%). Upon re-occurrence of LBP symptoms, half of the pilots in program B again performed exercises to improve their pain. CONCLUSION: This study indicates that exercise programs focused towards lumbar trunk muscular endurance reduces flying related transient LBP and sick-leave among helicopter pilots. These findings may have implications for the pilots’ working conditions. PMID:29278872

Absenteeism among survivors of the atomic bombing of Hiroshima.

PubMed Central

Meigs, J W; Blot, W J; Inoue, S; Meigs, C R

1975-01-01

Atomic bomb survivors who worked at the Atomic Bomb Casualty Commission in Hiroshima during the years 1968-71 and held handbooks identifying them as survivors took significantly more days of both annual leave and sick leave than did matched and paired control subjects. These differences in leave-taking patterns are considered to be due to behavioural causes as they could not be attributed to radiation dose-response effects. PMID:1156567

The impact of welfare reform on parents' ability to care for their children's health.

PubMed Central

Heymann, S J; Earle, A

1999-01-01

OBJECTIVES: Most of the national policy debate regarding welfare assumed that if middle-income mothers could balance work while caring for their children's health and development, mothers leaving welfare for work should be able to do so as well. Yet, previous research has not examined the conditions faced by mothers leaving welfare for work. METHODS: Using data from the National Longitudinal Survey of Youth, this study examined the availability of benefits that working parents commonly use to meet the health and developmental needs of their children; paid sick leave, vacation leave, and flexible hours. RESULTS: In comparison with mothers who had never received welfare, mothers who had been on Aid to Families with Dependent Children were more likely to be caring for at least 1 child with a chronic condition (37% vs 21%, respectively). Yet, they were more likely to lack sick leave for the entire time they worked (36% vs 20%) and less likely to receive other paid leave or flexibility. CONCLUSIONS: If current welfare recipients face similar conditions when they return to work, many will face working conditions that make it difficult or impossible to succeed in the labor force at the same time as meeting their children's health and developmental needs. PMID:10191791

Costs of ulcerative colitis from a societal perspective in a regional health care area in Spain: A database study.

PubMed

Aldeguer, Xavier; Sicras-Mainar, Antoni

2016-01-01

To estimate the management of UC associated costs from the societal perspective in Spain. Observational, longitudinal study with retrospective data collection based on reviews of outpatient health records. Socio-demographic, clinical and sick leave information was gathered. Patients diagnosed of UC between 2002 and 2012, older than 18 years, followed-up by a minimum of 12 months post diagnosis, with at least two clinical and use of resources data recorded, were included. 285 UC patients [51.2% men; 44.5 (SD: 15.6) years old; 88.4% without family history of UC; 39.3% proctitis; 5.6 (2.5) years disease follow-up] participated. More than half (65.6%) were active workers, 75.9% were on sick leave for reasons different from UC [mean 0.66 (0.70) times per year] during (mean) 28.43 (34.45) days. Only 64 patients were on UC-related sick-leaves, lasting (mean) 26.17 (37.43) days. Absenteeism due to medical visits caused loss of 29.55 (21.38) working hours per year. Mean direct and indirect annual cost per UC patient were €1754.10 (95%CI: 1473.37-2034.83) and €399.32 (282.31-422.69), respectively. Absenteeism was estimated at €88.21(32.72-50.06) per patient per year, in which sick-leaves were the main component of indirect costs (88.2%). Age, UC family history, diarrhea at diagnosis, blood and blood-forming organs diseases and psychological disorders were the main predictors of indirect costs. UC is a costly disease for the society and the Spanish National Healthcare System. Indirect costs imply a major burden by affecting the most productive years of patients. Further research is needed considering all components of productivity loss, including presenteeism-associated costs. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

Effectiveness of job rotation for preventing work-related musculoskeletal diseases: a cluster randomised controlled trial.

PubMed

Comper, Maria Luiza Caires; Dennerlein, Jack Tigh; Evangelista, Gabriela Dos Santos; Rodrigues da Silva, Patricia; Padula, Rosimeire Simprini

2017-08-01

Job rotation is an organisational strategy widely used on assembly lines in manufacturing industries to mitigate workers' exposure so as to prevent musculoskeletal disorders. This study aimed to evaluate the effectiveness of job rotation for reducing working hours lost due to sick leave resulting from musculoskeletal diseases. The design consisted of a 1-year cluster randomised controlled trial with a blinded assessor. Production sectors of the textile industry were randomised to intervention and control groups. Both groups received ergonomic training. The intervention group performed a job rotation programme. The primary outcome measure was number of working hours lost due to sick leave as a result of musculoskeletal disease (ICD-10). The secondary outcome measures were musculoskeletal symptoms (Yes/No), risk factors for musculoskeletal diseases (0-10), psychosocial factors and fatigue (0-100), general health (0-100), and productivity (0-10). All secondary outcomes were measured at baseline and 12-month follow-up. At the 12-month follow-up, both groups showed an increase in the number of working hours lost due to sick leave for musculoskeletal disease. There was no significant difference between the job rotation intervention group (mean deviation -5.6 hours, 95% CI -25.0 to 13.8) at the 12-month follow-up and the control group. There were no significant differences between groups for the secondary outcomes (p>0.05). The job rotation programme was not effective in reducing the number of working hours lost due to sick leave, decreasing the prevalence of musculoskeletal symptoms, or improving perception of musculoskeletal pain and workplace risk factors, psychosocial risk factors and productivity. NCT01979731. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Who benefits from stepwise occupational reintegration provided under the statutory pension insurance scheme?].

PubMed

Bürger, W; Streibelt, M

2011-06-01

Stepwise occupational reintegration (SOR) - since law amendments in April 2004 also provided under the German pension insurance scheme (Deutsche Rentenversicherung, DRV) - is an instrument intended to support insurants on sick-leave in reintegrating into work step by step after long-term illness. In 2008, the effectiveness of SOR regarding return to work was affirmed for the first time in a comprehensive study. However, in view of the growing amount of SOR, the question of differential effects of SOR in special subgroups is raised. This paper presents a re-analysis of data collected in the 2008 study. A total of 696 patients after medical rehabilitation were included in the analyses, 348 with SOR provided by the DRV, and a control group of 348 patients without SOR matched on a multitude of different variables using the Propensity Scores. Successful outcome was measured using a combined criterion "Return to work in good health", that is, patients returning to gainful activity and with sick leave of under 6 weeks and no intention to retire within a one-year follow-period after medical rehabilitation. Differentiating criteria are age gender, rehab indication, periods of sick leave in the year before medical rehabilitation, kind of and access to medical rehabilitation. The data indicate especially good results of SOR for patients with mental disorders (OR=2.49), patients who were requested to participate in medical rehabilitation by a health insurance fund because of long-term sick leave (OR=2.71), and patients with longer periods of sick leave before medical rehabilitation (3 to <6 months: OR=2.41, 6 months and more: OR=2.23). In contrast, there are only minimal effects (statistically not significant) of SOR in patients with medical rehabilitation directly after a hospital stay ("Anschlussheilbehandlung"), patients with cardiac or oncological diseases, and in younger (age 19-34) and older patients (age 55-60). In-depth analyses show that SOR success is more marked in patients with poorer return to work prospects. The findings indicate differential effects of SOR after medical rehabilitation for subgroups, effects associated in particular with return to work problems, kind of disease, and age. There is evidence for greater benefits of SOR in groups of patients with a high risk of non-successful reintegration. Hence, SOR opens up new options after medical rehabilitation in patients with especially severe impairments. © Georg Thieme Verlag KG Stuttgart · New York.

Pain-related psychological cognitions and behaviours associated with sick leave due to neck pain: findings from the Nurses and Midwives e-Cohort Study

PubMed Central

2014-01-01

Background Sick leave due to neck pain (NP-SL) is costly and negatively impacts the productivity of the nursing and midwifery workforce. Identification of modifiable risk indicators is necessary to inform preventive efforts. This study aimed to investigate the role of pain-related psychological features (pain catastrophizing, fear of movement, and pain coping) in NP-SL alongside other potential risk indicators. Methods A cross-sectional analysis of a large cohort study of Australian and New Zealand nurses and midwives, established between 1st April 2006 to 30th March 2008, was undertaken. Recruitment procedures adopted within each Nursing Council jurisdiction were governed by the individual regulatory authorities and their willingness to engage with the study. Invitations directed potential participants to a purpose-built internet-based survey, where study information was provided and consent requested. Once consent was obtained, a range of standardized tools combined into one comprehensive electronic questionnaire was elicited. Exposure variables assessed included pain characteristics and a broad range of psychological, psychosocial, occupational, general health and demographic factors. Two-way interactions between age and gender and candidate exposures were also assessed. Binary logistic regression was performed using manual backward stepwise elimination of non-significant terms. Results The cohort included 4,903 currently working nurses or midwives aged 18–65 years. Of these, 2,481 (50.6%) reported neck pain in the preceding 12 months. Our sample comprised of 1,854 working nurses and midwives with neck pain in the preceding year who supplied sick leave data. Of these, 343 (18.5%) reported taking sick leave in the preceding year due to their neck pain. The final most parsimonious multivariable model demonstrated neck pain severity (adjusted odds ratio, [aOR] = 1.59), passive pain coping (aOR = 1.08) and fear of movement (aOR = 1.06) increased the likelihood of NP-SL in the previous year. Interactions between demographic and general health factors exhibited both protective and risk relationships with NP-SL, and there was no association between pain catastrophizing and NP-SL. Conclusions Findings demonstrate that sick leave due to neck pain was associated with pain severity, fear of movement and passive pain coping. In addition, there were complex interactions found between demographic and general health factors. These features represent potentially modifiable targets for preventive programs. PMID:24559152

A lonely life--A qualitative study of immigrant women on long-term sick leave in Norway.

PubMed

Nortvedt, Line; Lohne, Vibeke; Kumar, Bernadette Nirmal; Hansen, Helle Ploug

2016-02-01

This study focuses on the everyday life of immigrant women with chronic pain on long-term sick leave in Norway. Research has shown that rehabilitation of immigrant women with chronic pain might be challenging both due to their lack of linguistic competence, due to lack of sufficient confidence/trust in their employers and in health personnel and lack of knowledge/skills among health care personnel in meeting immigrants' special needs. The objective of the study was to explore how immigrant women on long-term sick leave in Norway due to chronic pain experience their illness and their relationships at work and in the family. This article has a qualitative design, using participant observation and in-depth interviews. Participant observations were carried out in an outpatient clinic and qualitative interviews were conducted after the rehabilitation period. A hermeneutic approach was used to understand the meaning of the narrated text. All the authors participated in the discussion of the findings, and consensus was obtained for each identified theme. The research was conducted at an outpatient clinic at a rehabilitation hospital in the southern part of Norway. The clinic offers wide-ranging, specialized, multidisciplinary patient evaluations that last between 24 and 48h, followed by advice and/or treatment either individually or in a group, i.e. in a rehabilitation course. Participants (immigrant women) who had been referred to the outpatient clinic and to a rehabilitation course were recruited. Fourteen African and Asian women were observed in two rehabilitation courses, and eleven of them agreed to be interviewed once or twice (3). The interpretation revealed the following two main themes: 'Shut inside the home' and 'Rejected at the workplace'. Based on the women's experiences, a new understanding emerged of how being excluded or not feeling sufficiently needed, wanted or valued by colleagues, employers or even by family members rendered their daily lives humiliating and lonely. The immigrant women on long-term sick leave live in triple jeopardy: being ill and being lonesome both at home and at the workplace. This can be described as a vicious circle where the humiliating domestic and workplace-rejection might reinforce both the women's experience of shame and avoidance of telling anybody about their illness/symptoms, which then results in more days on sick leave during which they are again isolated and lonesome. There is a need for more research on multidisciplinary rehabilitation approaches designed to cater for immigrants' special needs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prevalence and Causes of Medical Absenteeism Among Staff (Case Study at Mazandaran University of Medical Sciences: 2009-2010)

PubMed Central

Mohseni Saravi, Beyamin; Kabirzadeh, Azar; Rezazadeh, Esmaiel; Khariki, Mohammad Fallah; Asgari, Zolaykha; Bagherian Farahabadi, Ebrahim; Motamed, Nima; Siamian, Hasan

2013-01-01

Introduction: Work absenteeism is a significant issue and can be observed in terms of human resources management. Given the importance of staff practices, which are anticipated in every organization, the role of each employee in this system and the implications of their absence as well as the importance of recovery time rest in fast recovery of staff and anticipated costs for their lost work days, thus this study is aimed to determine the extent and causes of medical absenteeism (sickness absence) of head staff of Mazandaran University of Medical Sciences. Methods and Materials: This descriptive and cross-sectional study was conducted using medical absenteeism (sickness absence) persons happened in 2010. Research population was included all records of staff working in central departments of Mazandaran University of Medical Sciences. There was no sampling due to the importance of the issue. Studied variables were included age, gender, employment status, employees’ education, name of the disease, physician specialty in issuing the medical absence paper, leave issuing reference and department, position of the employee, number of absence days, number of absences, number of annual leave days. Also, data were gathered using a checklist, then were entered into the SPSS software and got analyzed using descriptive statistics. In order to respect the confidentiality, name of the doctors and employees weren’t mentioned publicly. Results: Based on the results, 1200 employees were leaved the organization due to the sickness issue, which 957 (79.7%) of them were studied. The mean age for those employees was 39±7. Also, total average sick leave days and total sick leave days were 2±1 and 2571, respectively. 40.8 % ( 390 employees) were male and the rest were female. Moreover, 18.3% of sick leaves were issued for singles and the remained were for married employees. Regarding the employees’ education, 2% under diploma, 11.3% diploma, 7.8% upper diploma, 47.6% B.Sc., 14.6% MS.c and 15.85 had doctorate degree. Considering their position, 65%, 30.3%, 2.5% and 1.8% were experts, others, heads, and mangers, respectively. Furthermore, their employment status indicated that 62.3%, 18.1%, 16.8% and 2.8% of employees were employed in form of formal, short-term contract, long-term contract and other forms, respectively. Among the aspiratory diseases, 115 persons had got cold and 97 were infected to flu. The prevalence of other diseases was as follows: neck and back pain among the skeletal diseases (118 persons), fever and headache among the signs (71 persons) and diarrhea and vomiting among the infectious diseases (88 persons). Conclusion: According to the study results, due to the nature of staff work, physical problems, which are caused by doing mental works as well as low mobility, are rising among the employees. Of course, practicing ergonomic considerations, devoting hours in form of exercise break for staff can be effective in this regard. In order to address other diseases, vaster researches are needed with a concentration on exact reasons of work absenteeism. PMID:24511264

Early-return-to-work in the context of an intensification of working life and changing employment relationships.

PubMed

Seing, Ida; MacEachen, Ellen; Ståhl, Christian; Ekberg, Kerstin

2015-03-01

Many Western welfare states have introduced early-return-to-work policies, in which getting sick-listed people back to work before they have fully recovered is presented as a rather unproblematic approach. This reflects a belief in the ability of employers and the labour market to solve sickness absence. Against this background, the aim of this study was to analyse return-to-work practice in local workplace contexts, in relation to Swedish early-return-to-work policy. Semi-structured interviews were conducted with 18 matched pairs of workers and managers. The material, comprising a total of 36 interviews, was analysed using qualitative content analysis. Three main themes were identified: (1) intensive workplaces and work conditions (2) employer support-a function of worker value and (3) work attachment and resistance to job transition. The results reflected the intensity of modern working life, which challenged return-to-work processes. Managers had different approaches to workers' return-to-work, depending on how they valued the worker. While managers used the discourse of 'new opportunities' and 'healthy change' to describe the transition process (e.g. relocation, unemployment and retirement), workers regularly experienced transitions as difficult and unjust. In the context of early-return-to-work policy and the intensity of modern working life, a great deal of responsibility was placed on workers to be adaptable to workplace demands in order to be able to return and stay at work. Overall, this study illustrates an emerging social climate where sick-listed workers are positioned as active agents who must take responsibility for sick leave and return-to-work process.

7 CFR 56.54 - Charges for continuous grading performed on a nonresident basis.

Code of Federal Regulations, 2011 CFR

2011-01-01

... grading service for other than the applicant. Base salary rates will be determined on a national average..., retirement benefits, group life insurance, severance pay, sick leave, annual leave, additional salary and... billing period in which the service was rendered and are payable upon receipt. (1) A charge for the salary...

Examination of the double burden hypothesis—a systematic review of work–family conflict and sickness absence

PubMed Central

Skipstein, Anni; Østby, Kristian A.; Mykletun, Arnstein

2017-01-01

Abstract Background: Women consistently have higher sickness absence than men. The double-burden hypothesis suggests this is due to higher work–family burden in women than men. The current study aimed to systematically review prospective studies of work–family conflict and subsequent sickness absence. Methods: A systematic search was conducted in the electronic databases Medline, PsycINFO, and Embase with subject heading terms and keywords with no language or time restrictions. Two reviewers independently screened abstracts and read full-texts with pre-defined inclusion and exclusion criteria. Results: Eight included studies (n = 40 856 respondents) measure perceived work–family conflict and subsequent sickness absence. We found moderate evidence for a positive relationship between work–family conflict and subsequent sickness absence, and that women experience higher levels of work–family conflict than men. Conclusion: Work–family conflict is associated with later sickness absence, and work–family conflict is more common for women than for men. This indicates that work–family conflict may contribute to the gender gap in sick leave. However, further studies are needed to confirm whether this relationship is causal. PMID:28486653

Shame-inducing encounters. Negative emotional aspects of sickness-absentees' interactions with rehabilitation professionals.

PubMed

Svensson, Tommy; Karlsson, Agneta; Alexanderson, Kristina; Nordqvist, Cecilia

2003-09-01

There is little knowledge on how sickness absentees experience encounters with rehabilitation professionals. This paper explores and describes negative emotions ("shame" in a broad sense) experienced by individuals on sick leave in their interactions with rehabilitation professionals. We performed a qualitative analysis of data from five focus-group interviews. The participants had experience of sickness absence with back diagnoses and discussed factors that facilitate or impede return to work. Reports of demeaning experiences in encounters with rehabilitation workers were frequent and could be divided into two major categories: 1) subjects perceived the behavior of rehabilitation professionals as distanced in a negative way, and felt that they were treated in an indifferent and nonchalant manner or fairly routinely; 2) subjects felt that they were disqualified, which included being discredited or belittled. This explorative study indicates the need for further, more directed investigations of emotional aspects of interactions between sickness absentees and rehabilitation professionals.

What positive encounters with healthcare and social insurance staff promotes ability to return to work of long-term sickness absentees?

PubMed

Olsson, Daniel; Alexanderson, Kristina; Bottai, Matteo

2016-02-01

Previous studies suggest that positive encounters with healthcare and social insurance staff may be important in promoting return to work among long-term sickness absentees. This study aimed to identify more specifically what positive encounters are important for promoting ability to return to work. A questionnaire about different types of encounters was sent to 10,042 people in Sweden on sick leave for 6-8 months (58% responded). For each positive encounter, we estimated the marginal probability difference (PD) of return to work, adjusting for age, sex, education, sick-leave diagnosis, and the sum score of all other encounters. Adjusting for the other encounters is important since of the observed variables these were the strongest confounders. The positive encounters with both healthcare and social insurance staff significantly associated with promoting ability to return to work after adjusting for the other positive encounters were "Believed in my work capacity" PD=16.9 (95% CI: 12.0, 21.9) and 12.0 (6.3, 17.7), respectively; "Supported my suggestions for solutions": 9.5 (3.1, 15.9) and 11.6 (5.7, 17.4); "Was supportive and encouraging": 10.1 (3.6, 16.7) and 7.3 (1.7, 12.8). Additionally, the encounter with healthcare staff most strongly associated with promoting return to work was "Let me take responsibility" 14.8 (7.2, 22.3); and with social security staff: "Showed that she/he liked me" 10.4 (5.4, 15.4). Healthcare and social security staff being supportive, encouraging, and believing in the sickness absentee's work capacity may be very important for increasing the probability for long-term sickness absentees' ability to return to work. © 2015 the Nordic Societies of Public Health.

Paid leave benefits among a national sample of working mothers with infants in the United States.

PubMed

Shepherd-Banigan, Megan; Bell, Janice F

2014-01-01

To describe a range of employment benefits, including maternity and other paid leave, afforded to working women with infants; and to examine the geographic, socio-demographic correlates of such benefits to inform the workplace policy agenda in the US. Using data from the Listening to Mothers II Survey, a national sample of English-speaking women who gave birth in 2005, we conducted multivariable linear and logistic regression analyses to examine the associations between socio-demographic factors and employment leave variables (paid maternity, sick and personal leave). Forty-one percent of women received paid maternity leave for an average of 3.3 weeks with 31 % wage replacement. On average women took 10 weeks of maternity leave and received 10.4 days of paid sick leave and 11.6 days of paid personal time per year. Women who were non-Hispanic Black, privately insured, working full-time, and from higher income families were more likely to receive paid maternity leave, for more time, and at higher levels of wage replacement, when controlling for the other socio-demographic characteristics. Race/ethnicity, family income and employment status were associated with the number of paid personal days. Currently, the majority of female employees with young children in the US do not receive financial compensation for maternity leave and women receive limited paid leave every year to manage health-related family issues. Further, women from disadvantaged backgrounds generally receive less generous benefits. Federal policy that supports paid leave may be one avenue to address such disparities and should be modified to reflect accepted international standards.

Systematic Review of Prognostic Factors for Return to Work in Workers with Sub Acute and Chronic Low Back Pain.

PubMed

Steenstra, Ivan A; Munhall, Claire; Irvin, Emma; Oranye, Nelson; Passmore, Steven; Van Eerd, Dwayne; Mahood, Quenby; Hogg-Johnson, Sheilah

2017-09-01

Purpose We systematically reviewed the evidence on factors that predict duration of sick leave in workers after 6 weeks low back pain (LBP) related sick leave. We hypothesized that different factors affect the duration of the leave depending on the time away from work. Methods The review occurred in seven phases: (1) developing the central question, (2) conducting the literature search, (3) identifying relevant publications, (4) quality appraisal, (5) data extraction, (6) evidence synthesis, and (7) knowledge translation. We searched for studies that reported episodes of LBP and sick leave that lasted more than 6 weeks. All included studies reported at least one prognostic factor where return to work was the outcome. Results We identified twenty-two relevant publications. The impact of pain, functional status and radiating pain seems to change with duration of work disability. Workers' recovery expectations remain important after 6 weeks. Modified duties are rarely studied in later phases of work disability. Depression/mental health did not appear to be an important factor in later phases. Workplace physical factors remain important. There is insufficient evidence that pain catastrophising and fear avoidance are predictive factors in later phases. There was moderate evidence for age in the later phases. Functional capacity and claim related factors were supported by some evidence. Discusion Physical demands in the workplace are preventing workers from getting back to work in a timely fashion across phases. The psychosocial work environment is understudied in later phases. Overall, we cannot conclude that prognostic factors change over time.

Leisure-time physical activity and absenteeism.

PubMed

Kerner, Ivana; Rakovac, Marija; Lazinica, Bruno

2017-09-26

Regular physical activity has a significant impact on health. There is scientific evidence for prescription of exercise in the treatment of at least 26 different chronic non-communicable diseases. Furthermore, it has an indirect role in the preservation of work capacity. The aim of this study was to review the published results of research on the relationship between leisure-time PA and absenteeism due to sickness. Medline database was searched using the keywords "leisuretime physical activity AND (sick leave OR sickness absence OR absenteeism)". Fifteen studies were included in the final analysis. A negative correlation between leisure-time PA and absenteeism due to sickness in working population was determined in 11 studies. The results support the inclusion of PA promotion in the programmes intended to reduce absenteeism prevalence, the latter being an important public health issue.

The effect of graded activity on patients with subacute low back pain: a randomized prospective clinical study with an operant-conditioning behavioral approach.

PubMed

Lindström, I; Ohlund, C; Eek, C; Wallin, L; Peterson, L E; Fordyce, W E; Nachemson, A L

1992-04-01

The aim of this study was to determine whether graded activity restored occupational function in industrial blue-collar workers who were sick-listed for 8 weeks because of subacute, nonspecific, mechanical low back pain (LBP). Patients with LBP, who had been examined by an orthopedic surgeon and a social worker, were randomly assigned to either an activity group (n = 51) or a control group (n = 52). Patients with defined orthopedic, medical, or psychiatric diagnoses were excluded before randomization. The graded activity program consisted of four parts: (1) measurements of functional capacity; (2) a work-place visit; (3) back school education; and (4) an individual, submaximal, gradually increased exercise program, with an operant-conditioning behavioral approach, based on the results of the tests and the demands of the patient's work. Records of the amount of sick leave taken over a 3-year period (ie, the 1-year periods before, during, and after intervention) were obtained from each patient's Social Insurance Office. The patients in the activity group returned to work significantly earlier than did the patients in the control group. The median number of physical therapist appointments before return to work was 5, and the average number of appointments was 10.7 (SD = 12.3). The average duration of sick leave attributable to LBP during the second follow-up year was 12.1 weeks (SD = 18.4) in the activity group and 19.6 weeks (SD = 20.7) in the control group. Four patients in the control group and 1 patient in the activity group received permanent disability pensions. The graded activity program made the patients occupationally functional again, as measured by return to work and significantly reduced long-term sick leave.

Injured workers' perception of loss and gain in the return to work process.

PubMed

Lai, Hon Sun; Szeto, Grace Py; Chan, Chetwyn Ch

2017-01-01

When a worker is injured at work, he has to face a tough decision-making process about when and how to return to work (RTW). This study tests how the prospect theory can be applied to influence the injured workers' perceptions about this important choice. One hundred forty-one injured workers were presented with wage- and pain-related information in four different message framing (negatively or positively) and precision (smaller or larger number) conditions. After exposure to the specific combination of this wage and pain information, the participants were asked to express intentions to RTW in terms of perceived chance, confidence, and anticipated sick leave duration. When asked to predict their RTW outcome, 101 participants (72.3%) responded favorably, whereas only 40 (27.7%) indicated an expectation for staying on sick leave. The present results did not show significant differences in the participants' responses to the positively and negatively framed information about wage and pain. However, it was noted that the control group that was presented with positive framing for both "wage" and "pain" information showed higher scores in expectation and confidence for RTW, whereas the Ambivalent Group that had both negative messages showed lower scores. Seventy-nine participants who had ≥60% perceived improvement in condition were selected for further analysis, and those who were presented with "wage loss" information rated significantly higher perceived chance of RTW than those in the "pain gain" group. More in-depth investigation is warranted on this topic, with a larger sample of injured workers to investigate the effects of message framing on the decision-making process about RTW.

International Perspectives on Work-Family Policies: Lessons from the World's Most Competitive Economies

ERIC Educational Resources Information Center

Earle, Alison; Mokomane, Zitha; Heymann, Jody

2011-01-01

The United States does not guarantee families a wide range of supportive workplace policies such as paid maternity and paternity leave or paid leave to care for sick children. Proposals to provide such benefits are invariably met with the complaint that the costs would reduce employment and undermine the international competitiveness of American…

Sabbatical, Personal, Maternity, and Sick Leave Policies. Collective Bargaining Perspectives, Volume 2, Number 10.

ERIC Educational Resources Information Center

Goeres, Ernest R.

While hiring and advancement considerations are of paramount importance to the faculty member as well as to the institution where collective bargaining agreements are negotiated each year, other employment conditions are accorded almost as much consideration. Allowances for leave follow closely on the heels of placement and promotion conditions in…

Return to work outcomes of the Redesigning Daily Occupations (ReDO) program for women with stress-related disorders--a comparative study.

PubMed

Eklund, Mona; Erlandsson, Lena-Karin

2011-11-01

Stress-related disorders are a frequent cause for sick leave, with consequences such as great distress and adverse economic effects for the affected person and substantial costs for society. Identifying effective interventions that facilitate return to work is thus important. The aim of this study was to evaluate the effectiveness of the 16-week Redesigning Daily Occupations program as a work rehabilitation method for Swedish women with stress-related disorders. The authors of this study hypothesized that, compared to women who got Care as Usual, 12 months after completed rehabilitation a larger proportion of the Redesigning Daily Occupations women would have returned to work, and they would have less sick leave, perceive less stress, and have greater self-esteem. Forty-two women entered the Redesigning Daily Occupations intervention and a matched comparison group received Care as Usual. The data, collected between 2007 and 2010, consisted of registry information and questionnaires targeting socio-demographics, perceived stress, and self-esteem. The findings partly verified the hypotheses. A larger proportion of the Redesigning Daily Occupations women returned to work and they decreased their sick leave and increased their self-esteem more than the Care as Usual group, but the groups did not differ in stress reduction. Thus, the Redesigning Daily Occupations seems to be a promising work rehabilitation method for women with stress-related disorders.

Do frequent exposures to threats and violence at work affect later workforce participation?

PubMed

Biering, Karin; Andersen, Lars Peter Sønderbo; Hogh, Annie; Andersen, Johan Hviid

2018-05-01

Threats and violence at work are common problems in the human service sector. It can result in physical and psychological health symptoms. The aim of this study was to examine the association between exposure to threats and violence and workforce participation in four human service sectors. 5170 employees answered questionnaires about threats and violence in 2010 and were followed in a register for public transfer incomes for 3.5 years to identify episodes of sick leave, general workforce participation, and permanent health-related benefits. We found associations between exposures to threats and violence at work and workforce participation, though only a few specific types of threats and violence were associated on their own. Self-rated severity of both threatening and violent episodes was associated with overall low workforce participation, new sick leave episodes, and permanent health-related benefits. However, the latter was not statistically significant. The same pattern seems to be present in the relation between the total amount of exposure to threats and violence (threats score and violence score), respectively, and overall low workforce participation and new sick leave episodes. The threats score was also related to permanent health-related benefits. Exposure to threats and violence is associated with temporary and permanent health-related benefits as well as with low workforce participation in general, although some of the associations were not statistically significant.

Nature-assisted rehabilitation for reactions to severe stress and/or depression in a rehabilitation garden: long-term follow-up including comparisons with a matched population-based reference cohort.

PubMed

Währborg, Peter; Petersson, Ingemar F; Grahn, Patrik

2014-03-01

To determine the effect of a nature-assisted rehabilitation programme in a group of patients with reactions to severe stress and/or mild to moderate depression. Changes in sick-leave status and healthcare consumption in these patients were compared with those in a matched population-based reference cohort (treatment as usual). Retrospective cohort study with a matched reference group from the general population. A total of 118 participants referred to a nature-assisted rehabilitation programme, and 678 controls recruited from the Skåne Health Care Register. For both groups, information on sick leave was extracted from the National Social Insurance Register and on healthcare consumption data from the Skåne Health Care Register. The interventional rehabilitation programme was designed as a multimodal programme involving professionals from horticulture and medicine. The programme was conducted in a rehabilitation garden, designed especially for this purpose. A significant reduction in healthcare consumption was noted among participants in the programme compared with the reference population. The main changes were a reduction in outpatient visits to primary healthcare and a reduction in inpatient psychiatric care. No significant difference in sick-leave status was found. A structured, nature-based rehabilitation programme for patients with reactions to severe stress and/or depression could be beneficial, as reflected in reduced healthcare consumption.

Workplace accidents, absenteeism and productivity in patients with sleep apnea.

PubMed

Jurado-Gámez, Bernabé; Guglielmi, Ottavia; Gude, Francisco; Buela-Casal, Gualberto

2015-05-01

Obstructive sleep apnea-hypopnea syndrome (OSAHS) has health-related outcomes, but the impact of OSAHS on occupational health has been scarcely studied. The aim of this study was to evaluate the effect of OSAHS on workplace accidents, absenteeism and productivity. One hundred eighty-two OSAHS patients and 71 healthy subjects completed the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index and the Spanish IMPALA (Impact of Disease on Work Productivity) index and answered various questions on workplace accidents and sick leave. Participants were classified to an OSAHS group or a non-OSAHS group according to polysomnography results. Patients with OSAHS had more sick leave lasting longer than 30days (16.6% vs. 7%, P=.049) and lower productivity (63.80% vs. 83.20%, P=.000) than subjects without OSAHS, although the rate of workplace accidents was similar in both groups (27.4% vs 25.4%; P>.050). None of the OSAHS-related variables was associated with workplace accidents. A diagnosis of OSAHS was related with absenteeism. Psychological distress and OSAHS were related with productivity. OSAHS causes limitations in the working lives of patients and leads to a higher incidence of sick leave and lower productivity. A diagnosis of OSAHS was the variable with most influence on the working lives of patients. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Obesity and sickness absence: results from the CHAP study.

PubMed

Harvey, S B; Glozier, N; Carlton, O; Mykletun, A; Henderson, M; Hotopf, M; Holland-Elliott, K

2010-08-01

Obesity is an increasing public health problem. A small number of studies have examined the relationship between obesity and sickness absence, with mixed results, particularly regarding short-term sickness absence. To determine if obesity is associated with short- and long-term sickness absence and to investigate the mechanisms that may underlie any association. Cross-sectional (n = 1489) and prospective (n = 625) analyses were conducted on staff from London Underground Ltd. All participants underwent regular clinical examinations that involved their height and weight being measured, obesity-related medical problems being diagnosed and psychiatric disorders being identified. The number of days taken for short- (<10 days in an episode) and long-term sickness absence were recorded by managers on an electronic database. There was a positive linear association between employees' body mass index (BMI) and the number of days' work missed due to sickness absence on both cross-sectional and prospective analyses (P < 0.001). Obesity was a risk factor for both short- and long-term sickness absence. Obese individuals typically took an extra 4 days sick leave every year. The majority of the increased risk for long-term sickness absence appeared to be mediated via co-morbid chronic medical conditions. The excess short-term sickness absence was not explained by obesity-related medical problems, psychiatric disorders or workplace factors. Obese employees take significantly more short- and long-term sickness absence than workers of a healthy weight. There is growing evidence to support employers becoming more involved in tackling obesity.

Low Cost Benefit Suggestions.

ERIC Educational Resources Information Center

Doyel, Hoyt W.; McMillan, John D.

1980-01-01

Outlines eight low-cost employee benefits and summarizes their relative advantages. The eight include a stock ownership program, a sick leave pool, flexible working hours, production incentives, and group purchase plans. (IRT)

Absenteeism and the impact of a 38-hour week, rostered day off option.

PubMed

Williams, G; Slater, K

2000-01-01

We undertook a comparative analysis of nurses working in two consecutive years: one in a 40-hour standard working week and the other in a 38-hour week with a rostered day off per month, in order to determine whether there was any effect on absenteeism. We found that total absenteeism between the two years fell significantly from 4.58% to 4.36% (chi 2 = 5.09, P = 0.024). Sick leave decreased but not to a significant degree. We conclude that the change to the 38-hour week and 19-day month (rostered day off) arrangements led to a significant reduction in overall absenteeism but not in sick leave. However, the cost in implementing a 19-day month is far in excess of any savings made through absenteeism reductions.

Cost of obesity in the workplace.

PubMed

Schmier, Jordana K; Jones, Mechelle L; Halpern, Michael T

2006-02-01

As the prevalence of obesity increases, its economic consequences must be understood. This review summarizes published literature on the costs and resource use associated with obesity in the workplace. A Medline literature search was conducted for English-language publications. References from identified articles were also reviewed for relevance. The identified studies evaluated several cost components, including absenteeism, sick leave, disability, injuries, and claims data. Overall, overweight or obese employees had higher sick leave or disability use. Workplace injuries were higher among overweight or obese employees. Health care costs, based on claims data analyses, were also consistently higher for employees with higher body mass indices. Obesity is an important driver of costs in the workplace. These findings quantify the costs and can help employers consider whether to introduce workplace interventions or provide coverage for weight loss programs.

Examination of the double burden hypothesis-a systematic review of work-family conflict and sickness absence.

PubMed

Nilsen, Wendy; Skipstein, Anni; Østby, Kristian A; Mykletun, Arnstein

2017-06-01

Women consistently have higher sickness absence than men. The double-burden hypothesis suggests this is due to higher work-family burden in women than men. The current study aimed to systematically review prospective studies of work-family conflict and subsequent sickness absence. A systematic search was conducted in the electronic databases Medline, PsycINFO, and Embase with subject heading terms and keywords with no language or time restrictions. Two reviewers independently screened abstracts and read full-texts with pre-defined inclusion and exclusion criteria. Eight included studies ( n = 40 856 respondents) measure perceived work-family conflict and subsequent sickness absence. We found moderate evidence for a positive relationship between work-family conflict and subsequent sickness absence, and that women experience higher levels of work-family conflict than men. Work-family conflict is associated with later sickness absence, and work-family conflict is more common for women than for men. This indicates that work-family conflict may contribute to the gender gap in sick leave. However, further studies are needed to confirm whether this relationship is causal. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association.

Can sickness absence be reduced by stress reduction programs: on the effectiveness of two approaches.

PubMed

van Rhenen, Willem; Blonk, Roland W B; Schaufeli, Wilmar B; van Dijk, Frank J H

2007-05-01

The aim of the study was to evaluate the effectiveness of two brief preventive stress reduction programs--a cognitive focused program and a combined intervention of physical exercise and relaxation--on sickness absence in stressed and non-stressed employees working in various jobs in a telecom company. The study was designed as an a priori randomized trial and the follow-up period for sickness absence was 1 year. Sickness absence data of 242 employees were analyzed with respect to spells of sickness (frequency, incidence rate), days (length, duration) and time between intervention and first subsequent absent spell. For stressed employees this study suggests that the illness burden represented by absenteeism is not affected by the interventions. There is no substantial difference in effectiveness between the cognitive and physical interventions. However, in comparison with the physical intervention the cognitive intervention decreases the period between the intervention and the first recurrence of a sick leave period with 144 days (marginal significant). The illness burden represented by absenteeism is effected in detail but not substantially by the interventions.

Sickness Presence among Disabled Workers at the University Medical Centre Ljubljana

PubMed Central

ŠKERJANC, Alenka; DODIČ FIKFAK, Metoda

2014-01-01

Objectives The aim of the article is to investigate the differences in sickness present and non-sickness present in the group of disabled health care professionals. Methods Data were gathered from all disabled health care professionals suffering from invalidity of category II or III who were identified in the research among all health care professionals at the University Medical Centre Ljubljana and who were employed there in the period between 1 January 2010 and 31 December 2010. Each employee obtained a questionnaire composed of three standardized international questionnaires. Results There were 248 disabled workers of the II. and III. category of invalidity among the participants. Disabled sickness present reported to have more chronic diseases than disabled non-sickness present (OR = 57.0; 95% CI = 24.4–133.2), lower salary when on sick leave (OR = 13.1; 95% CI = 5.7–30.2) and poor self-rated health (OR = 5.8; 95% CI = 2.7–12.3). Conclusions The prerequisite for sickness presence among disabled workers is their chronic bad health. It is also formally recognized with the degree of disability. Economic factors are among the most important to direct disabled workers towards sickness presence. The results indicate that workplaces are not adapted to disabled workers in regard to their limitations. PMID:27669513

Explaining occupational class differences in sickness absence: results from middle-aged municipal employees.

PubMed

Laaksonen, M; Piha, K; Rahkonen, O; Martikainen, P; Lahelma, E

2010-09-01

Low socioeconomic position is consistently associated with higher rates of sickness absence. We aimed to examine whether working conditions, health-related behaviours and family-related factors explain occupational class differences in medically certified sickness absence. The study included 5470 women and 1464 men employees of the City of Helsinki, surveyed in 2000-2002. These data were prospectively linked to sickness absence records until the end of 2005, providing a mean follow-up time of 3.9 years. Poisson regression was used to examine the occurrence of medically certified sickness absence episodes lasting 4 days or more. Medically certified sickness absence was roughly three times more common among manual workers than among managers and professionals in both women and men. Physical working conditions were the strongest explanatory factors for occupational class differences in sickness absence, followed by smoking and relative weight. Work arrangements and family-related factors had very small effects only. The effects of psychosocial working conditions were heterogeneous: job control narrowed occupational class differences in sickness absence while mental strain and job demands tended to widened them. Overall, the findings were quite similar in women and men. Physical working conditions provided strongest explanations for occupational class differences in sickness absence. Smoking and relative weight, which are well-known determinants of health, also explained part of the excess sickness absence in lower occupational classes. Applying tailored work arrangements to employees on sick leave, reducing physically heavy working conditions and promoting healthy behaviours provide potential routes to narrow occupational class differences in sickness absence.

Self-reported medical leave by Brazilian Labor-law magistrates.

PubMed

Assunção, Ada Ávila; de Medeiros, Adriane Mesquita; Pinheiro, Tarcísio Márcio Magalhães

2016-11-22

Sick leave can be envisaged as an important public health indicator. Health problems and trouble at work are predictors of absenteeism. Within the context of reforming the judicial system, the aim of this study was to examine whether individual characteristics and working conditions influenced reports of sick leave amongst a population of Brazilian magistrates. A web-based survey was conducted in 2011 in such a way as to reach the entire population of Brazilian Labor-law magistrates across the country. The variable of interest related to the question: "Have you taken any medical leave due to illness over the last 12 months?" Less than a quarter of the population participated in the survey, despite widespread publicity produced by the professional association. Among the work-related factors, experiences of violence in the courthouse were shown to be associated with the outcome. No significant association with the material or psychosocial working conditions or with the workload was found. Female, worse health assessment, not participating in social activities and having a mother with higher schooling level were significantly associated with absenteeism among the magistrates. It is desirable to formulate sectorial policies focusing on controlling and monitoring violent events in the courthouse.

Predictive values and other quality criteria of the German version of the Nurse-Work Instability Scale (Nurse-WIS) – follow-up survey findings of a prospective study of a cohort of geriatric care workers

PubMed Central

2014-01-01

Background Until now there has been a lack of effective screening instruments for health care workers at risk. To counteract the forecast shortage for health care workers, the offer of early interventions to maintain their work ability will become a central concern. The Nurse-Work Instability Scale (Nurse-WIS) seems to be suitable as a screening instrument and therefore a prospective study of a cohort of nursing staff from nursing homes was undertaken to validate the Nurse-Work Instability Scale (Nurse-WIS). Methods The follow-up data was used to test the sensitivity, specificity and the predictive values of the Nurse-WIS. The participants answered a questionnaire in the baseline investigation (T1) and in a follow-up 12 month after baseline. The hypothesis was that geriatric care workers with an increased risk according to the Nurse-WIS in T1 would be more likely to have taken long-term sick leave or drawn a pension for reduced work capacity in T2. Results 396 persons took part in T1 (21.3% response), 225 in T2 (42.3% loss-to-follow-up). In T1, 28.4% indicated an increased risk according to the Nurse-WIS. In T2, 10.2% had taken long-term sick leave or had drawn a pension for reduced work capacity. The sensitivity is 73.9% (95%-CI 55.7%–92.3%), the specificity is 76.7% (95%-CI 71.2%–82.8%). The ROC AUC indicated a moderate precision for the scale, at 0.74 (95%-CI 0.64–0.84). The PPV of the Nurse-WIS is 26.6%, and the NPV is 96.3%. For those with an increased risk according to the Nurse-WIS, the probability in T2 of long-term sick leave or a pension for reduced work capacity is around eight times higher (OR 8.3, 95%-CI 2.90–23.07). Persons who had indicated a long-term sick leave or made an application for a pension for reduced work capacity in T1 had a 17 times higher risk (OR 17.4, 95%-CI 3.34–90.55). Conclusion The German version of the Nurse-WIS appears to be a valid instrument with satisfactory predictive capabilities for recording an impending long-term sick leave. Whether the Nurse-WIS can be used as a screening tool which helps to design risk adjusted prevention programs for the afflicted nurse should be studied. PMID:25516765

Efficacy of 'Tailored Physical Activity' or 'Chronic Pain Self-Management Program' on return to work for sick-listed citizens: design of a randomised controlled trial.

PubMed

Andersen, Lotte Nygaard; Juul-Kristensen, Birgit; Roessler, Kirsten Kaya; Herborg, Lene Gram; Sørensen, Thomas Lund; Søgaard, Karen

2013-01-23

Pain affects quality of life and can result in absence from work. Treatment and/or prevention strategies for musculoskeletal pain-related long-term sick leave are currently undertaken in several health sectors. Moreover, there are few evidence-based guidelines for such treatment and prevention. The aim of this study is to evaluate the efficacy of 'Tailored Physical Activity' or 'Chronic Pain Self-Management Program' for sick-listed citizens with pain in the back and/or the upper body. This protocol describes the design of a parallel randomised controlled trial on the efficacy of 'Tailored Physical Activity' or a 'Chronic Pain Self-management Program' versus a reference group for sick-listed citizens with complaints of pain in the back or upper body. Participants will have been absent from work due to sick-listing for 3 to 9 weeks at the time of recruitment. All interventions will be performed at the 'Health Care Center' in the Sonderborg Municipality, and a minimum of 138 participants will be randomised into one of the three groups.All participants will receive 'Health Guidance', a (1.5-hour) individualised dialogue focusing on improving ways of living, based on assessments of risk behavior, motivation for change, level of self-care and personal resources. In addition, the experimental groups will receive either 'Tailored Physical Activity' (three 50-minute sessions/week over 10 weeks) or 'Chronic Pain Self-Management Program' (2.5-hours per week over 6 weeks). The reference group will receive only 'Health Guidance'.The primary outcome is the participants' sick-listed status at 3 and 12 months after baseline. The co-primary outcome is the time it takes to return to work. In addition, secondary outcomes include anthropometric measurements, functional capacity and self-reported number of sick days, musculoskeletal symptoms, general health, work ability, physical capacity, kinesiophobia, physical functional status, interpersonal problems and mental disorders. There are few evidence-based interventions for rehabilitation programmes assisting people with musculoskeletal pain-related work absence. This study will compare outcomes of interventions on return to work in order to increase the knowledge of evidence-based rehabilitation of sick-listed citizens to prevent long-term sick-leave and facilitate return to work. The trial is registered in the ClinicalTrials.gov, number NCT01356784.

20 CFR 617.11 - Qualifying requirements for TRA.

Code of Federal Regulations, 2010 CFR

2010-04-01

... employer-authorized leave from such adversely affected employment for purposes of vacation, sickness, injury, maternity, or inactive duty or active duty military service for training, or (ii) Does not work...

When Mothers and Fathers Work: How Employers Can Help.

ERIC Educational Resources Information Center

Magid, Renee Y.

1986-01-01

Discusses the plight of working parents. Offers suggestions for parent-tailored benefits such as flexible hours, benefits for permanent part-time employees, and family-oriented sick-leave policies. (JOW)

Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up-WorkUp, a randomised controlled trial in primary care.

PubMed

Sennehed, Charlotte P; Holmberg, Sara; Axén, Iben; Stigmar, Kjerstin; Forsbrand, Malin; Petersson, Ingemar F; Grahn, Birgitta

2018-03-15

Workplace involvement in rehabilitation for patients with musculoskeletal pain may improve work ability. Convergence Dialogue Meeting (CDM) is a model aimed at helping the patient, the care giver, and the employer to support work ability and return-to-work. Our aim was to study the effect on work ability when adding a workplace dialogue according to CDM in physiotherapy practice for patients with pain in ordinary primary care. We conducted a prospective pairwise cluster randomised controlled trial (ClinicalTrials.gov ID: NCT02609750) in primary care involving 20 primary care rehabilitation units with 1-year follow-up. Adult patients with acute/subacute neck and back pain, worked ≥4 weeks past year and not currently on sick leave or no more than 60 days of sick leave and considered at-risk of sick leave were included (n = 352). All patients received structured physiotherapy and the intervention was the addition of CDM, delivered by the treating physiotherapist. The main confirmatory outcome, work ability (defined as working at least 4 consecutive weeks at follow-up), was assessed by a weekly short text message question on number of sick leave days past week. Work ability was reached by significantly more patients in the intervention group (108/127, 85%) compared with the reference group (127/171, 74%) (P = 0.02). The intervention increased the odds of having work ability at 1-year follow-up, also after adjustment for baseline health-related quality of life (odds ratio 1.85, confidence interval 1.01-3.38). We conclude that an early workplace dialogue in addition to structured physiotherapy improved work ability significantly.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Psychoeducation against depression, anxiety, alexithymia and fibromyalgia: a pilot study in primary care for patients on sick leave.

PubMed

Melin, Eva O; Svensson, Ralph; Thulesius, Hans O

2018-06-01

Feasibility testing of a psychoeducational method -The Affect School and Script Analyses (ASSA) - in a Swedish primary care setting. Exploring associations between psychological, and medically unexplained physical symptoms (MUPS). Pilot study. Three Swedish primary care centers serving 20,000 people. 8 weekly 2-hour sessions with a 5-7 participant group led by two instructors - followed by 10 individual hour-long sessions. Thirty-six patients, 29 women (81%), on sick-leave due to depression, anxiety, or fibromyalgia. Feasibility in terms of participation rates and expected improvements of psychological symptoms and MUPS, assessed by self-report instruments pre-, one-week post-, and 18 months post-intervention. Regression coefficients between psychological symptoms and MUPS. The entire 26-hour psychoeducational intervention was completed by 30 patients (83%), and 33 patients (92%) completed the 16-hour Affect School. One-week post-intervention median test score changes were significantly favorable for 27 respondents, with p < .05 after correction for multiple testing for 9 of 11 measures (depression, anxiety, alexithymia, MUPS, general health, self-affirmation, self-love, self-blame, and self-hate); 18 months post intervention the results remained significantly favorable for 15 respondents for 7 of 11 measures (depression, alexithymia, MUPS, general health, self-affirmation, self-love, and self-hate). A psychoeducational method previously untested in primary care for mostly women patients on sick-leave due to depression, anxiety, or fibromyalgia had >80% participation rates, and clear improvements of self-assessed psychological symptoms and MUPS. The ASSA intervention thus showed adequate feasibility in a Swedish primary care setting. Key Points  A pilot study of a psychoeducational intervention - The Affect School and Script Analyses (ASSA) - was performed in primary care   • The intervention showed feasibility for patients on sick-leave due to depression, anxiety, or fibromyalgia   • 92% completed the 8 weeks/16 hours Affect School and 83% completed the entire 26-hour ASSA intervention   • 9 of 11 self-reported measures improved significantly one-week post intervention   • 7 of 11 self-reported measures improved significantly 18 months post-intervention.

Cognitive Interventions and Nutritional Supplements (The CINS Trial): A Randomized Controlled, Multicenter Trial Comparing a Brief Intervention With Additional Cognitive Behavioral Therapy, Seal Oil, and Soy Oil for Sick-Listed Low Back Pain Patients.

PubMed

Reme, Silje E; Tveito, Torill H; Harris, Anette; Lie, Stein Atle; Grasdal, Astrid; Indahl, Aage; Brox, Jens Ivar; Tangen, Tone; Hagen, Eli Molde; Gismervik, Sigmund; Ødegård, Arit; Frøyland, Livar; Fors, Egil A; Chalder, Trudie; Eriksen, Hege R

2016-10-15

A randomized controlled trial. The aim of this study was to evaluate whether a tailored and manualized cognitive behavior therapy (CBT) or nutritional supplements of seal oil and soy oil had any additional benefits over a brief cognitive intervention (BI) on return to work (RTW). Brief intervention programs are clinically beneficial and cost-effective for patients with low back pain (LBP). CBT is recommended for LBP, but evidence on RTW is lacking. Seal oil has previously been shown to have a possible effect on muscle pain, but no randomized controlled trials have so far been carried out in LBP patients. Four hundred thirteen adults aged 18 to 60 years were included. Participants were sick-listed 2 to 10 months due to LBP. Main outcome was objectively ascertained work participation at 12-month follow-up. Participants were randomly assigned to BI (n = 100), BI and CBT (n = 103), BI and seal oil (n = 105), or BI and soy oil (n = 105). BI is a two-session cognitive, clinical examination program followed by two booster sessions, while the CBT program is a tailored, individual, seven-session manual-based treatment. At 12-month follow-up, 60% of the participants in the BI group, 50% in the BI and CBT group, 51% in the BI and seal oil group, and 53% in the BI and soy oil group showed reduced sick leave from baseline, and had either partly or fully RTW. The differences between the groups were not statistically significant (χ = 2.54, P = 0.47). There were no significant differences between the treatment groups at any of the other follow-up assessments either, except for a significantly lower sick leave rate in the BI group than the other groups during the first 3 months of follow-up (χ = 9.50, P = 0.02). CBT and seal oil had no additional benefits over a brief cognitive intervention on sick leave. The brief cognitive intervention alone was superior in facilitating a fast RTW. 2.

29 CFR 4.53 - Collective bargaining agreement (successorship) determinations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... by job classification each provision relating to wages (such as the established straight time hourly... differentials) and to fringe benefits (such as holiday pay, vacation pay, sick leave pay, life, accidental death...

29 CFR 4.53 - Collective bargaining agreement (successorship) determinations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... by job classification each provision relating to wages (such as the established straight time hourly... differentials) and to fringe benefits (such as holiday pay, vacation pay, sick leave pay, life, accidental death...

5 CFR 630.401 - Granting sick leave.

Code of Federal Regulations, 2010 CFR

2010-01-01

... physical or mental illness, injury, pregnancy, or childbirth; (3)(i) Provides care for a family member who is incapacitated by a medical or mental condition or attends to a family member receiving medical...

29 CFR 4.53 - Collective bargaining agreement (successorship) determinations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... or salary rate, cost-of-living allowance, and any shift, hazardous, and other similar pay differentials) and to fringe benefits (such as holiday pay, vacation pay, sick leave pay, life, accidental death...

[Return to Work: A Workplace Focused Module to be Integrated in Cognitive Behavioral Therapy].

PubMed

Winter, Lotta; Kraft, Julia; Boss, Katharina; Kahl, Kai G

2015-08-01

Psychiatric disorders, in particular depression and anxiety disorders, are important causes of impaired job performance and increased sick leave. Longer periods of sickness leave lead regularly to difficulties concerning return to work. Furthermore, work is an important factor for psychological health. The central issue of the "return to work" (RTW) module by Lagerveldt and colleagues 5 is remission from psychiatric disorder, and structured support to return to work. The module is based on principles of cognitive-behavioral therapy (CBT), and can be integrated in standard CBT. Existing data from a randomized controlled trial suggest that treatment outcome concerning remission is similar between CBT supplemented with RTW (CBT-W) module and standard CBT. However, time to return to work is reduced in CBT-W. © Georg Thieme Verlag KG Stuttgart · New York.

Frequency and characteristics of occupational dental trauma.

PubMed

Trullás, J M; Ballester, M L; Bolíbar, I; Parellada, N; Berástegui, E

2013-03-01

Dental trauma at the workplace may have important clinical and occupational consequences, but little is known about its profile. To describe the frequency and characteristics of work-related dental injuries. For all patients with occupational dental trauma seen at the FREMAP Hospital of Barcelona (Spain) between January 2000 and December 2006, we recorded their characteristics, type of work and nature of the trauma, including cause of the accident, extent of trauma, reason for referral to a dentist, and days of sick leave. The frequency of dental trauma was 1.71 per 1000 occupational accidents attended and was related to the worker's occupation. In security services, it was 7.37 per 1000 and 2.01 in transport services. The frequency was similar in both genders. The most common causal mechanisms were direct impact (38%), traffic accidents (29%) and falls at the same level (16%). Causal mechanisms differed according to gender and type of job. Most injuries consisted of dental fracture (54%), and 67% of the patients required referral to a dental surgery. Injuries were limited to the mouth in 52% of cases, 8% of which required sick leave, with a mean duration of 23.0±21.8 days. The frequency of dental trauma in this working population was low and was related to the worker's occupation. Causal mechanisms differed according to gender and type of job. Most dental injuries were severe and required referral to a dental surgery. Frequency of sick leave was low.

Persistent musculoskeletal pain and productive employment; a systematic review of interventions.

PubMed

Oakman, Jodi; Keegel, Tessa; Kinsman, Natasha; Briggs, Andrew M

2016-03-01

A systematic analysis of the literature was undertaken to determine which characteristics of workplace interventions are most effective in assisting people with persistent musculoskeletal pain (PMP) to remain productively employed. Databases of Medline, PsychINFO, CINAHL and Embase were searched using MeSH and other relevant terms. Studies that reported on interventions at, or involving, the workplace were included. Interventions were considered as either focused on the individual or multilevel. Outcome measures assessed included: job loss, productivity, sick leave, pain and cost benefit. A quality assessment was undertaken using GRADE criteria with development of impact statements to synthesise the results. Eighteen relevant articles (14 studies) were identified for inclusion in the review. No high-level evidence for workplace interventions to assist people with PMP were identified. Low numbers of participants and limited studies resulted in downgrading of evidence. However, individually focused interventions will probably reduce job loss and sick leave, but are unlikely to reduce pain. Multilevel focused interventions will probably result in decreased sick leave and provide some cost benefit. The evidence on productivity was limited and of poor quality. Further research is required because sustainable employment for individuals with PMP is important and understanding what works is necessary to ensure effective workplace interventions are developed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Employment status five years after a randomised controlled trial comparing multidisciplinary and brief intervention in employees on sick leave due to low back pain.

PubMed

Pedersen, Pernille; Nielsen, Claus Vinther; Jensen, Ole Kudsk; Jensen, Chris; Labriola, Merete

2018-05-01

To evaluate differences in employment status, during a five-year follow-up period in patients on sick leave due to low back pain who had participated in a trial comparing a brief and a multidisciplinary intervention. From 2004 to 2008, 535 patients were referred to the Spine Centre at the Regional Hospital in Silkeborg if they had been on sick leave for 3-16 weeks due to low back pain. All patients underwent a clinical examination by a rehabilitation physician and a physiotherapist, and were randomised to either the brief intervention or the multidisciplinary intervention. The outcome was employment status from randomisation to five years of follow-up and was measured by the mean number of weeks in four different groups of employment status (sequence analysis) and a fraction of the number of weeks working (work participation score) that were accumulated over the years. A total of 231 patients were randomised to the brief intervention and 233 patients to the multidisciplinary intervention. No statistically significant differences in the mean weeks spent within the different employment statuses were found between the two intervention groups. After five years of follow-up, participants in the multidisciplinary intervention had a 19% higher risk of not having a work participation score above 75% compared to participants in the brief intervention. After five years of follow-up no differences in employment status were found between participants in the brief and the multidisciplinary intervention.

Injured workers’ perception of loss and gain in the return to work process

PubMed Central

Lai, Hon Sun; Szeto, Grace PY; Chan, Chetwyn CH

2017-01-01

When a worker is injured at work, he has to face a tough decision-making process about when and how to return to work (RTW). This study tests how the prospect theory can be applied to influence the injured workers’ perceptions about this important choice. One hundred forty-one injured workers were presented with wage- and pain-related information in four different message framing (negatively or positively) and precision (smaller or larger number) conditions. After exposure to the specific combination of this wage and pain information, the participants were asked to express intentions to RTW in terms of perceived chance, confidence, and anticipated sick leave duration. When asked to predict their RTW outcome, 101 participants (72.3%) responded favorably, whereas only 40 (27.7%) indicated an expectation for staying on sick leave. The present results did not show significant differences in the participants’ responses to the positively and negatively framed information about wage and pain. However, it was noted that the control group that was presented with positive framing for both “wage” and “pain” information showed higher scores in expectation and confidence for RTW, whereas the Ambivalent Group that had both negative messages showed lower scores. Seventy-nine participants who had ≥60% perceived improvement in condition were selected for further analysis, and those who were presented with “wage loss” information rated significantly higher perceived chance of RTW than those in the “pain gain” group. More in-depth investigation is warranted on this topic, with a larger sample of injured workers to investigate the effects of message framing on the decision-making process about RTW. PMID:28223852

Sick but yet at work. An empirical study of sickness presenteeism.

PubMed

Aronsson, G; Gustafsson, K; Dallner, M

2000-07-01

The study is an empirical investigation of sickness presenteeism in relation to occupation, irreplaceability, ill health, sickness absenteeism, personal income, and slimmed down organisation. Cross sectional design. Swedish workforce. The study group comprised a stratified subsample of 3801 employed persons working at the time of the survey, interviewed by telephone in conjunction with Statistics Sweden's labour market surveys of August and September 1997. The response rate was 87 per cent. A third of the persons in the total material reported that they had gone to work two or more times during the preceding year despite the feeling that, in the light of their perceived state of health, they should have taken sick leave. The highest presenteeism is largely to be found in the care and welfare and education sectors (nursing and midwifery professionals, registered nurses, nursing home aides, compulsory school teachers and preschool/primary educationalists. All these groups work in sectors that have faced personnel cutbacks during the 1990s). The risk ratio (odds ratio (OR)) for sickness presenteeism in the group that has to re-do work remaining after a period of absence through sickness is 2.29 (95% CI 1.79, 2.93). High proportions of persons with upper back/neck pain and fatigue/slightly depressed are among those with high presenteeism (p< 0.001). Occupational groups with high sickness presenteeism show high sickness absenteeism (rho = 0. 38; p<.01) and the hypothesis on level of pay and sickness presenteeism is also supported (rho = -0.22; p<0.01). Members of occupational groups whose everyday tasks are to provide care or welfare services, or teach or instruct, have a substantially increased risk of being at work when sick. The link between difficulties in replacement or finding a stand in and sickness presenteeism is confirmed by study results. The categories with high sickness presenteeism experience symptoms more often than those without presenteeism. The most common combination is low monthly income, high sickness absenteeism and high sickness presenteeism.

Effectiveness of guideline-based care by occupational physicians on the return-to-work of workers with common mental disorders: design of a cluster-randomised controlled trial.

PubMed

van Beurden, Karlijn M; Brouwers, Evelien P M; Joosen, Margot C W; Terluin, Berend; van der Klink, Jac J L; van Weeghel, Jaap

2013-03-06

Sickness absence due to common mental disorders (such as depression, anxiety disorder, adjustment disorder) is a problem in many Western countries. Long-term sickness absence leads to substantial societal and financial costs. In workers with common mental disorders, sickness absence costs are much higher than medical costs. In the Netherlands, a practice guideline was developed that promotes an activating approach of the occupational physician to establish faster return-to-work by enhancing the problem-solving capacity of workers, especially in relation to their work environment. Studies on this guideline indicate a promising association between guideline adherence and a shortened sick leave duration, but also minimal adherence to the guideline by occupational physicians. Therefore, this study evaluates the effect of guideline-based care on the full return-to-work of workers who are sick listed due to common mental disorders. This is a two-armed cluster-randomised controlled trial with randomisation at the occupational physician level. During one year, occupational physicians in the intervention group receive innovative training to improve their guideline-based care whereas occupational physicians in the control group provide care as usual. A total of 232 workers, sick listed due to common mental disorders and counselled by participating occupational physicians, will be included. Data are collected via the registration system of the occupational health service, and by questionnaires at baseline and at 3, 6 and 12 months. The primary outcome is time to full return-to-work. Secondary outcomes are partial return-to-work, total number of sick leave days, symptoms, and workability. Personal and work characteristics are the prognostic measures. Additional measures are coping, self-efficacy, remoralization, personal experiences, satisfaction with consultations with the occupational physician and with contact with the supervisor, experiences and behaviour of the supervisor, and the extent of guideline adherence. If the results show that guideline-based care in fact leads to faster and sustainable return-to-work, this study will contribute to lowering personal, societal and financial costs. ISRCTN86605310.

Effectiveness of guideline-based care by occupational physicians on the return-to-work of workers with common mental disorders: design of a cluster-randomised controlled trial

PubMed Central

2013-01-01

Background Sickness absence due to common mental disorders (such as depression, anxiety disorder, adjustment disorder) is a problem in many Western countries. Long-term sickness absence leads to substantial societal and financial costs. In workers with common mental disorders, sickness absence costs are much higher than medical costs. In the Netherlands, a practice guideline was developed that promotes an activating approach of the occupational physician to establish faster return-to-work by enhancing the problem-solving capacity of workers, especially in relation to their work environment. Studies on this guideline indicate a promising association between guideline adherence and a shortened sick leave duration, but also minimal adherence to the guideline by occupational physicians. Therefore, this study evaluates the effect of guideline-based care on the full return-to-work of workers who are sick listed due to common mental disorders. Methods/design This is a two-armed cluster-randomised controlled trial with randomisation at the occupational physician level. During one year, occupational physicians in the intervention group receive innovative training to improve their guideline-based care whereas occupational physicians in the control group provide care as usual. A total of 232 workers, sick listed due to common mental disorders and counselled by participating occupational physicians, will be included. Data are collected via the registration system of the occupational health service, and by questionnaires at baseline and at 3, 6 and 12 months. The primary outcome is time to full return-to-work. Secondary outcomes are partial return-to-work, total number of sick leave days, symptoms, and workability. Personal and work characteristics are the prognostic measures. Additional measures are coping, self-efficacy, remoralization, personal experiences, satisfaction with consultations with the occupational physician and with contact with the supervisor, experiences and behaviour of the supervisor, and the extent of guideline adherence. Discussion If the results show that guideline-based care in fact leads to faster and sustainable return-to-work, this study will contribute to lowering personal, societal and financial costs. Trial registration ISRCTN86605310 PMID:23496948

Factors Associated with Long-Term Sickness Absence Due to Mental Disorders: A Cohort Study of 7.112 Patients during the Spanish Economic Crisis.

PubMed

Real, Eva; Jover, Lluís; Verdaguer, Ricard; Griera, Antoni; Segalàs, Cinto; Alonso, Pino; Contreras, Fernando; Arteman, Antoni; Menchón, José M

2016-01-01

Mental health problems are very common and often lead to prolonged sickness absence, having serious economic repercussions for most European countries. Periods of economic crisis are important social phenomena that are assumed to increase sickness absence due to mental disorders, although research on this topic remains scarce. The aim of this study was to gather data on long-term sickness absence (and relapse) due to mental disorders in Spain during a period of considerable socio-economic crisis. Relationships were analyzed (using chi-squared tests and multivariate modelling via binary logistic regression) between clinical, social/employment-related and demographic factors associated and long-term sickness absence (>60 consecutive days) due to mental disorders in a cohort of 7112 Spanish patients during the period 2008-2012. Older age, severe mental disorders, being self-employed, having a non-permanent contract, and working in the real estate and construction sector were associated with an increased probability of long-term sickness absence (gender had a mediating role with respect to some of these variables). Relapses were associated with short-term sick leave (return to work due to 'improvement') and with working in the transport sector and public administration. Aside from medical factors, other social/employment-related and demographic factors have a significant influence on the duration of sickness absence due to mental disorders.

Sickness absence management: encouraging attendance or 'risk-taking' presenteeism in employees with chronic illness?

PubMed

Munir, Fehmidah; Yarker, Joanna; Haslam, Cheryl

2008-01-01

To investigate the organizational perspectives on the effectiveness of their attendance management policies for chronically ill employees. A mixed-method approach was employed involving questionnaire survey with employees and in-depth interviews with key stakeholders of the organizational policies. Participants reported that attendance management polices and the point at which systems were triggered, posed problems for employees managing chronic illness. These systems presented risk to health: employees were more likely to turn up for work despite feeling unwell (presenteeism) to avoid a disciplinary situation but absence-related support was only provided once illness progressed to long-term sick leave. Attendance management polices also raised ethical concerns for 'forced' illness disclosure and immense pressures on line managers to manage attendance. Participants felt their current attendance management polices were unfavourable toward those managing a chronic illness. The policies heavily focused on attendance despite illness and on providing return to work support following long-term sick leave. Drawing on the results, the authors conclude that attendance management should promote job retention rather than merely prevent absence per se. They outline areas of improvement in the attendance management of employees with chronic illness.

Employability and work ability: returning to the labour market after long-term absence.

PubMed

Nilsson, Staffan; Ekberg, Kerstin

2013-01-01

The aim of this study was to analyse how people who return to the labour market after long-term sickness absenteeism and subsequent job loss differ in employability, work ability, health, educational level, age, and gender, compared to those who do not. The cohort consisted of 191 individuals, 20 men and 171 women, whose employment was terminated because they had not been able to return to their regular work after taking a long-term sick leave and rehabilitation measures. This study is based on a postal questionnaire sent out to a cohort of previous employees in a Swedish municipality in 2008. At the time of the survey, 39% of the respondents had returned to the labour market and the remaining 61% had not. Return to the labour market after a long-term sick leave was positively associated with male gender, young age, and work ability, i.e. the ability to work with respect to health and work-related demands. Employability, educational level, and health were not significantly associated with a return to the labour market. In the discourse on employability, work ability is often neglected even though it is a central aspect of an individual's ability to obtain new employment.

CALIFORNIA STATE UNIVERSITY CATASTROPHIC (CAT) LEAVE DONATION PROGRAM: DEMOGRAPHICS, ECONOMIC SECURITY, AND SOCIAL EQUITY.

PubMed

Muller, Christina

2015-01-01

The California State University (CSU) Chancellor's Office reached an agreement with all CSU collective bargaining units and Employee Relations on a uniform Catastrophic (CAT) Leave Donation Program in 1992. The CAT Leave Donation Program allows employees to donate sick and/or vacation leave credits to employees who are incapacitated due to a catastrophic illness or injury and have exhausted all of their own leave credits. This also extends to employees with whom family illnesses are deemed catastrophic, thus requiring the employee to care for an immediate family member. Stakeholders include union represented employees who accrue leave credits as well as any employee who receives or donates hours of leave credits in the program. Other stakeholders include the family members and program administrators.

Prediction of helicopter simulator sickness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Horn, R.D.; Birdwell, J.D.; Allgood, G.O.

1990-01-01

Machine learning methods from artificial intelligence are used to identify information in sampled accelerometer signals and associative behavioral patterns which correlates pilot simulator sickness with helicopter simulator dynamics. These simulators are used to train pilots in fundamental procedures, tactics, and response to emergency conditions. Simulator sickness induced by these systems represents a risk factor to both the pilot and manufacturer. Simulator sickness symptoms are closely aligned with those of motion sickness. Previous studies have been performed by behavioral psychologists using information gathered with surveys and motor skills performance measures; however, the results are constrained by the limited information which ismore » accessible in this manner. In this work, accelerometers were installed in the simulator cab, enabling a complete record of flight dynamics and the pilot's control response as a function of time. Given the results of performance measures administered to detect simulator sickness symptoms, the problem was then to find functions of the recorded data which could be used to help predict the simulator sickness level and susceptibility. Methods based upon inductive inference were used, which yield decision trees whose leaves indicate the degree of simulator-induced sickness. The long-term goal is to develop a gauge'' which can provide an on-line prediction of simulator sickness level, given a pilot's associative behavioral patterns (learned expectations). This will allow informed decisions to be made on when to terminate a hop and provide an effective basis for determining training and flight restrictions placed upon the pilot after simulator use. 6 refs., 6 figs.« less

Means to an End: Collective Bargaining and Teacher Benefits

ERIC Educational Resources Information Center

Graham, Larry A.

1976-01-01

The intent of this investigation was to determine if and to what extent collective bargaining has influenced attainment of salary and economic benefits such as teacher salary, insurance premiums, and sick leave. (MM)

Frequency and nature of problems associated with sickness certification tasks: A cross-sectional questionnaire study of 5455 physicians

PubMed Central

Löfgren, Anna; Hagberg, Jan; Arrelöv, Britt; Ponzer, Sari; Alexanderson, Kristina

2007-01-01

Objective To study the frequency and nature of problems associated with physicians’ sickness certification practices. Design Cross-sectional questionnaire study. Setting Stockholm and Östergötland Counties in Sweden. Subjects Physicians aged ≤64 years, n =7665, response rate 71% (n =5455). Main outcome measures The frequency of consultations involving sickness certification, the frequency and nature of problems related to sickness certification. Results A total of 74% (n =4019) of the respondents had consultations including sickness certification at least a few times a year. About half of these physicians had sickness certification cases at least six times a week, and 1 out of 10 (9.4%) had this more than 20 times a week. The items that the highest percentage of physicians rated as very or fairly problematic included: handling conflicts with patients over certification, assessing work ability, estimating optimal length and degree of absence, and managing prolongation of sick leave initially certified by another physician. There were large differences in frequency and nature of problems between different types of clinics/practices. General practitioners had the highest frequency of problems concerning sickness certification while the lowest was found among specialists in internal medicine and surgery. Conclusion Sickness certification should be recognized as an important task also for physicians other than general practitioners. The physicians experienced problems with numerous tasks related to sickness certification and these varied considerably between types of clinics. The high rate of problems experienced may have consequences for the physicians’ work situation, for patients, and for society. PMID:17846937

[Morbidity of textile industry workers in Kaunas].

PubMed

Ustinaviciene, Rūta; Piesine, Loreta

2007-01-01

According to the Department of Statistics at the beginning of 2003, 551 textile industry and garment enterprises operated in Lithuania. The purpose of the study was to evaluate morbidity among workers in textile industry enterprises in Kaunas and analyze the data obtained in relation to sex, age, profession, and occupational health hazards. A sick-leave-based case-control study was conducted in the units of four textile enterprises where 1842 workers were employed. Data were categorized in relation to sex, profession, and kind of sickness. Age was grouped in the following way: under 29 years, 30-39 years, 40-49 years, and over 50 years. In the period of survey, 1482 cases of sick leave were reported in the enterprises where 1842 workers were employed. The main cause of absence because of sickness was respiratory diseases--37.3% (30.27 cases per 100 workers), nursing took the second place--17.0% (13.76 cases per 100 workers). Accidents and injuries made up 9.3% (7.5 cases per 100 workers), musculoskeletal and connective tissue disorders--7.9% (6.4 cases per 100 workers). Data were analyzed using statistical programs SPSS 97, Epi-Info 6.0. Main morbidities reported included respiratory diseases (37.3%), nursing (17.0%), accidents and injuries (9.3%), musculoskeletal and connective tissue disorders (7.9%). The incidence of morbidity among workers engaged in workplace where occupational risk factors exceeded hygienic standards was higher. The rate of morbidity also increased with age and sex; morbidity among women was 1.5 higher than among men.

The health system consequences of agency nursing and moonlighting in South Africa

PubMed Central

Rispel, Laetitia C.; Blaauw, Duane

2015-01-01

Background Worldwide, there is an increased reliance on casual staff in the health sector. Recent policy attention in South Africa has focused on the interrelated challenges of agency nursing and moonlighting in the health sector. Objective This paper examines the potential health system consequences of agency nursing and moonlighting among South African nurses. Methods During 2010, a cluster random sample of 80 hospitals was selected in four South African provinces. On the survey day, all nurses providing clinical care completed a self-administered questionnaire after giving informed consent. The questionnaire obtained information on socio-demographics, involvement in agency nursing and moonlighting, and self-reported indicators of potential health system consequences of agency nursing and moonlighting. A weighted analysis was done using STATA® 13. Results In the survey, 40.7% of nurses reported moonlighting or working for an agency in the preceding year. Of all participants, 51.5% reported feeling too tired to work, 11.5% paid less attention to nursing work on duty, and 10.9% took sick leave when not actually sick in the preceding year. Among the moonlighters, 11.9% had taken vacation leave to do agency work or moonlighting, and 9.8% reported conflicting schedules between their primary and secondary jobs. In the bivariate analysis, moonlighting nurses were significantly more likely than non-moonlighters to take sick leave when not sick (p=0.011) and to pay less attention to nursing work on duty (p=0.035). However, in a multiple logistic regression analysis, the differences between moonlighters and non-moonlighters did not remain statistically significant after adjusting for other socio-demographic variables. Conclusion Although moonlighting did not emerge as a statistically significant predictor, the reported health system consequences are serious. A combination of strong nursing leadership, effective management, and consultation with and buy-in from front-line nurses is needed to counteract the potential negative health system consequences of agency nursing and moonlighting. PMID:25971400

Workplace rehabilitation and supportive conditions at work: a prospective study.

PubMed

Ahlstrom, Linda; Hagberg, Mats; Dellve, Lotta

2013-06-01

To investigate the impact of rehabilitation measures on work ability and return to work (RTW), specifically the association between workplace rehabilitation/supportive conditions at work and work ability and RTW over time, among women on long-term sick leave. Questionnaire data were collected (baseline, 6 and 12 months) from a cohort of women (n = 324). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability index (WAI), work ability score and working degree. These analyses were performed with different models; the explanatory variables for each model were workplace rehabilitation, supportive conditions at work and time. The individuals provided with workplace rehabilitation and supportive conditions (e.g. influence at work, possibilities for development, degree of freedom at work, meaning of work, quality of leadership, social support, sense of community and work satisfaction) had significantly increased WAI and work ability score over time. These individuals scored higher work ability compared to those individuals having workplace rehabilitation without supportive conditions, or neither. Additionally, among the individuals provided with workplace rehabilitation and supportive conditions, working degree increased significantly more over time compared to those individuals with no workplace rehabilitation and no supportive conditions. The results highlight the importance of integrating workplace rehabilitation with supportive conditions at work in order to increase work ability and improve the RTW process for women on long-term sick leave.

Teachers' sick leave due to mental and behavioral disorders and return to work.

PubMed

Silva, Amanda Aparecida; Fischer, Frida Marina

2012-01-01

This manuscript presents a review of the literature about medical leaves due to mental and behavioral disorders and return to work of teachers. There are scarce published manuscripts. Most articles relate with prevalence of mental disorders and factors associated with the work organization, and did not mention intervention proposals and or changes in the work organization and teaching work. Proposed actions are discussed.

Time away from work predicts later cognitive function: differences by activity during leave.

PubMed

Leist, Anja K; Glymour, M Maria; Mackenbach, Johan P; van Lenthe, Frank J; Avendano, Mauricio

2013-08-01

We sought to examine how different activities performed during employment gaps are associated with later cognitive function and change. Five cognitive measures were used to indicate cognitive impairment of 18,259 respondents to the Survey of Health, Ageing, and Retirement in Europe (ages 50-73) in 2004/5 or 2006/7. Using complete employment histories, employment gaps of ≥6 months between ages 25 and 65 were identified. Controlling for early life socioeconomic status, school performance, and education, higher risk of cognitive impairment was associated with employment gaps described as unemployment (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.04-1.35) and sickness (OR, 1.78; 95% CI, 1.52-2.09). In contrast, lower risk of cognitive impairment was associated with employment gaps described as training (OR, 0.73; 95% CI, 0.52-1.01) or maternity leave (OR, 0.65; 95% CI, 0.57-0.79). In longitudinal mixed effects models, training and maternity leave were associated with lower 2-year aging-related cognitive decline. Periods away from work described as unemployment or sickness are associated with lower cognitive function, whereas maternity and training leaves are associated with better late-life cognitive function. Both causation and selection mechanisms may explain these findings. Copyright © 2013 Elsevier Inc. All rights reserved.

Feasibility trial of GP and case-managed support for workplace sickness absence.

PubMed

Rannard, Anne; Gabbay, Mark; Sen, Dil; Riley, Richard; Britt, David

2014-07-01

Aim Our aim was to compare the return-to-work rates between individuals supported by their GP plus workplace health advisers (intervention group) and those supported by their GP alone. Workplace sickness absence places a significant cost burden on individuals and the wider economy. Previous research shows better outcomes for individuals if they are supported while still in employment, or have been on sick leave for four weeks or less. Those helped back to work at an early stage are more likely to remain at work. A non-medicalised case-managed approach appears to have the best outcomes and can prevent or reduce the slide onto out-of-work benefits, but UK literature on its effectiveness is sparse. The design was a feasibility-controlled trial in which participants were sickness absentees, or presentees in employment with work-related health problems. Individuals completed health status measures (SF-36; EQ-5D) and a Job Content Questionnaire at baseline and again at four-month follow-up. Findings In the intervention group, 29/60 participants completed both phases of the trial. GP practices referred two control patients, and, despite various attempts by the research team, GPs failed to engage with the trial. This finding is of concern, although not unique in primary care research. In earlier studies, GPs reported a lack of knowledge and confidence in dealing with workplace health issues. Despite this, we report interesting findings from the case-managed group, the majority of whom returned to work within a month. Age and length of sickness absence at recruitment were better predictors of return-to-work rates than the number of case-managed contacts. The traditional randomised controlled trial approach was unsuitable for this study. GPs showed low interest in workplace sickness absence, despite their pivotal role in the process. This study informed a larger Department for Work and Pensions study of case-managed support.

Annual incremental health benefit costs and absenteeism among employees with and without rheumatoid arthritis.

PubMed

Kleinman, Nathan L; Cifaldi, Mary A; Smeeding, James E; Shaw, James W; Brook, Richard A

2013-03-01

To assess the impact of rheumatoid arthritis (RA) on absence time, absence payments, and other health benefit costs from the perspective of US employers. Retrospective regression-controlled analysis of a database containing US employees' administrative health care and payroll data for those who were enrolled for at least 1 year in an employer-sponsored health insurance plan. Employees with RA (N = 2705) had $4687 greater average annual medical and prescription drug costs (P < 0.0001) and $525 greater (P < 0.05) indirect costs (because of sick leave, short- and long-term disability, and workers' compensation absences) than controls (N = 338,035). Compared with controls, the employees with RA used an additional 3.58 annual absence days, including 1.2 more sick leave and 1.91 more short-term disability days (both P < 0.0001). Employees with RA have greater costs across all benefits than employees without RA.

Potential Economic Benefits of Paid Sick Leave in Reducing Absenteeism Related to the Spread of Influenza-Like Illness.

PubMed

Asfaw, Abay; Rosa, Roger; Pana-Cryan, Regina

2017-09-01

Most U.S. employers are not required to provide paid sick leave (PSL), and there is limited information on the economic return of providing PSL. We estimated potential benefits to employers of PSL in reducing absenteeism related to the spread of influenza-like illness (ILI). We used nationally representative data and a negative binomial random effects model to estimate the impact of PSL in reducing overall absence due to illness or injury. We used published data to compute the share of ILI from the total days of absence, ILI transmission rates at workplaces, wages, and other parameters. Providing PSL could have saved employers $0.63 to $1.88 billion in reduced ILI-related absenteeism costs per year during 2007 to 2014 in 2016 dollars. These findings might help employers consider PSL as an investment rather than as a cost without any return.

Double Bind: Primary Caregivers of Children with Special Health Care Needs and Their Access to Leave Benefits

PubMed Central

Chung, Paul J.; Garfield, Craig F.; Elliott, Marc N.; Vestal, Katherine D.; Klein, David J.; Schuster, Mark A.

2013-01-01

Objective Family leave benefits are a critical tool allowing parents to miss work to care for their ill children. We examined whether access to benefits varies by level of childcare responsibilities among employed parents of children with special health care needs (CSHCN). Methods We conducted telephone interviews with three successive cohorts of employed parents of CSHCN, randomly sampled from a California children’s hospital. At Wave 1 (November 2003 to January 2004) we conducted 372 parent interviews. At Wave 2 (November 2005 to January 2006) we conducted 396 parent interviews. At Wave 3 (November 2007 to December 2008) we conducted 393 parent interviews. We pooled these samples for bivariate and multivariate regression analyses, using wave indicators and sample weights. Results Parents with more childcare responsibilities (primary caregivers) reported less access to sick leave/vacation (65% vs. 82%, P<.001), access to paid leave outside of sick leave/vacation (41% vs. 51%, P<.05), and FMLA eligibility (2890025; vs. 44%, P<.001) than secondary caregivers. Part-time employment and female gender largely explained two of the three associations between more childcare responsibilities and less access to leave benefits. Even in the context of part-time employment, however, primary caregivers were just as likely as secondary caregivers both to miss work due to their child’s illness and to report being unable to miss work when they needed to. Conclusions Due in part to employment and gender differences, leave benefits among parents of CSHCN are skewed away from primary caregivers and toward secondary caregivers. Thus, primary caregivers may face particularly difficult choices between employment and childcare responsibilities. Reducing this disparity in access to benefits may improve health for CSHCN and their families. PMID:23477748

Protecting the health of employees caring for family members with special health care needs.

PubMed

Earle, Alison; Heymann, Jody

2011-07-01

Over half of American workers are holding a paid job while also providing unpaid assistance and support to a family member. Research shows that family members who provide care to children or adults with special health care needs are themselves at risk of physical and mental health problems. Yet, little research has explored how the work environment mediates the effects of caregiving on caregivers' mental and physical health. With a sample of 2455 currently employed U.S. adults from the Work, Family, Community Nexus (WFCN) survey, a random-digit dial, nationally representative survey of Americans aged 18-69, we examine whether paid leave and flexibility policies mediate the relationship between caregiving and health. In Ordinary Least Squares regression models, we find that paid leave to address family members' health was associated with better mental health status as measured by the 5-item Mental Health Inventory and paid sick leave with better physical health status as measured by self-rated overall health status. A supportive supervisor was also associated with improvements in mental and physical health. For both men and women, paid leave and a supervisor's support offset some or all of the negative effects of caregiving, but for women, the buffering effects of working conditions are slightly larger. Enhancing the unpaid leave guaranteed in the U.S. Family and Medical Leave Act so that it is paid and passing national paid sick days legislation will help ensure that employed caregivers can retain their jobs, receive needed income, and meet their own mental and physical health needs. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Development process of Evidence-based "Return-to-work Guidance in Occupational Health 2017"].

PubMed

Kojimahara, Noriko; Fukumoto, Masakatsu; Yoshikawa, Etsuko; Shinada, Kayoko; Tsuiki, Hirokazu

2018-06-05

Objective"Return-to-work Guidance in Occupational Health 2017 (RTW Guidance 2017) " is the first occupational health guide in Japan that evaluates the quality of evidence and offers recommendations based on results of the systematic review of randomized controlled trials. Details of the systematic review of each review question (RQs) will be described separately. This article presents an overview of the method and process of developing the "RTW Guidance 2017."Materials and MethodsThe guidance was developed following the previously-published "Method for developing evidence based occupational health guidance," which included the composition of a highly-transparent guidance developing group as well as the recruitment and selection of RQs. Using the Cochrane Library, PubMed, and Ichushi-Web, a literature search for the six RQs was conducted in January 2016 by partly modifying the search terms of the existing systematic review. Articles were selected according to the inclusion criteria, and the quality of evidence was evaluated using the GRADE approach. Meta-analysis was conducted for RQ2 and RQ4, and a qualitative systematic review was conducted for RQ5, RQ6, and cost-effectiveness. Recommendations were subsequently made after a thorough consideration for feasibility in Japan by examining the costs and available resources.ResultsBased on a comprehensive literature search, eleven RQ2, four RQ4, one RQ5, and three RQ6 were selected. Support program for returning to work, such as "Re-work" for those who are temporarily not working due to musculoskeletal disorders or mental health disorder, was recommended based on moderate evidence (RQ2). For RQ4, the collaboration between occupational health practice and clinical practice was weakly recommended based on low evidence. For RQ5 that evaluated the usefulness of social support, intervention by the manager/co-worker was proposed as a "best practice statement" without indicating it as a recommendation. Work accommodation was weakly recommended based on low evidence in RQ6.Discussion and ConclusionFrom the result of systematic reviews, it was recommended for workers on sick leave more than four weeks regardless of sick leave and sickness absence that interventions during leave would improve work-related outcomes, such as earlier reinstatement. Although there is limited evidence regarding occupational health in Japan, it is important for many occupational health professionals to learn the method of developing guidance and to identify issues for future studies with priority in Japan.

Cost-minimization analysis in a blind randomized trial on small-incision versus laparoscopic cholecystectomy from a societal perspective: sick leave outweighs efforts in hospital savings

PubMed Central

Keus, Frederik; de Jonge, Trudy; Gooszen, Hein G; Buskens, Erik; van Laarhoven, Cornelis JHM

2009-01-01

Background After its introduction, laparoscopic cholecystectomy rapidly expanded around the world and was accepted the procedure of choice by consensus. However, analysis of evidence shows no difference regarding primary outcome measures between laparoscopic and small-incision cholecystectomy. In absence of clear clinical benefit it may be interesting to focus on the resource use associated with the available techniques, a secondary outcome measure. This study focuses on a difference in costs between laparoscopic and small-incision cholecystectomy from a societal perspective with emphasis on internal validity and generalisability Methods A blinded randomized single-centre trial was conducted in a general teaching hospital in The Netherlands. Patients with reasonable to good health diagnosed with symptomatic cholecystolithiasis scheduled for cholecystectomy were included. Patients were randomized between laparoscopic and small-incision cholecystectomy. Total costs were analyzed from a societal perspective. Results Operative costs were higher in the laparoscopic group using reusable laparoscopic instruments (difference 203 euro; 95% confidence interval 147 to 259 euro). There were no significant differences in the other direct cost categories (outpatient clinic and admittance related costs), indirect costs, and total costs. More than 60% of costs in employed patients were caused by sick leave. Conclusion Based on differences in costs, small-incision cholecystectomy seems to be the preferred operative technique over the laparoscopic technique both from a hospital and societal cost perspective. Sick leave associated with convalescence after cholecystectomy in employed patients results in considerable costs to society. Trial registration ISRCTN Register, number ISRCTN67485658. PMID:19732431

Type 1 diabetes, quality of life, occupational status and education level - A comparative population-based study.

PubMed

Nielsen, Helena B; Ovesen, Louise L; Mortensen, Laust H; Lau, Cathrine J; Joensen, Lene E

2016-11-01

Type 1 diabetes requires extensive self-management to avoid complications and may have negative effects on the everyday life of people with the disease. The aim of this study was to compare adults with type 1 diabetes to the general population in terms of health-related quality of life, occupational status (level of employment, working hours and sick leave) and education level. 2415 adults (aged 18-98years) with type 1 diabetes were compared to 48,511 adults (aged 18-103years) from the general population. Data were obtained from two cross-sectional surveys conducted in 2010 and 2011 of adults living or treated in the Capital Region in Denmark. Differences between adults with type 1 diabetes and the general population were standardised for age and sex and analyzed using linear probability models and negative binomial regression. Differences were further analyzed in subgroups. Compared to the general population, adults with type 1 diabetes experienced lower health-related quality of life, were more frequently unemployed, had more sick leave per year and were slightly better educated. Differences in health-related quality of life and employment increased with age and were larger among women, as compared to men. No significant differences were found with regard to working hours. Our findings suggest that type 1 diabetes is associated with lower health-related quality of life, higher unemployment and additional sick leave. The negative association with type 1 diabetes is more pronounced in women and older adults. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Factors Associated with Long-Term Sickness Absence Due to Mental Disorders: A Cohort Study of 7.112 Patients during the Spanish Economic Crisis

PubMed Central

Real, Eva; Jover, Lluís; Verdaguer, Ricard; Griera, Antoni; Segalàs, Cinto; Alonso, Pino; Contreras, Fernando; Arteman, Antoni; Menchón, José M.

2016-01-01

Background Mental health problems are very common and often lead to prolonged sickness absence, having serious economic repercussions for most European countries. Periods of economic crisis are important social phenomena that are assumed to increase sickness absence due to mental disorders, although research on this topic remains scarce. The aim of this study was to gather data on long-term sickness absence (and relapse) due to mental disorders in Spain during a period of considerable socio-economic crisis. Methods Relationships were analyzed (using chi-squared tests and multivariate modelling via binary logistic regression) between clinical, social/employment-related and demographic factors associated and long-term sickness absence (>60 consecutive days) due to mental disorders in a cohort of 7112 Spanish patients during the period 2008–2012. Results Older age, severe mental disorders, being self-employed, having a non-permanent contract, and working in the real estate and construction sector were associated with an increased probability of long-term sickness absence (gender had a mediating role with respect to some of these variables). Relapses were associated with short-term sick leave (return to work due to ‘improvement’) and with working in the transport sector and public administration. Conclusions Aside from medical factors, other social/employment-related and demographic factors have a significant influence on the duration of sickness absence due to mental disorders. PMID:26730603

What makes men and women with musculoskeletal complaints decide they are too sick to work?

PubMed

Hooftman, Wendela E; Westerman, Marjan J; van der Beek, Allard J; Bongers, Paulien M; van Mechelen, Willem

2008-04-01

The objective of this study was to determine what makes men and women with musculoskeletal complaints decide to call in sick for work. Qualitative, face-to-face interviews were used with employees (16 men and 14 women) who had called in sick due to a musculoskeletal complaint and who expected to be absent from work for at least 2 weeks on sick leave. The participants fell into the following two main groups: those who were off sick because of a diagnosed medical condition, such as a fracture, and those who were off sick because of an unidentifiable complaint, such as low-back pain. Employees in the former group called in sick because they were in the hospital or because they reckoned that their condition was too serious to warrant a continuation of work. Employees in the latter group felt hesitant and insecure and found it hard to judge whether absenteeism was justified. They decided either to "play it safe" and stay off work to prevent the complaints from worsening or to seek advice from medical professionals. Their advice did not include explicit instructions to stay at home, but were usually interpreted as such. Finally, women, but not men, were likely to call in sick if they felt that their home situation was being negatively affected by attempts to keep working while suffering physical complaints. The decision to call in sick is not taken lightly. Employees with nonspecific disorders base their decision on several factors, including advice from medical professionals. A factor found only among women was work-home interference.

PTSD Trajectory, Comorbidity, and Utilization of Mental Health Services Among Reserves

DTIC Science & Technology

2010-07-01

Looking for work or unemployed 6 Retired 7 A homemaker 8 A student 9 On maternity or paternity leave 10 On illness or sick leave 11 On disability... benefits to participants. If this work is successful in identifying features of deployment that are associated with better long-term mental health...direct benefits to participants. If this work is successful in identifying features of deployment that are associated with better long-term mental

Return-to-Work Self-Efficacy and Actual Return to Work Among Long-Term Sick-Listed Employees.

PubMed

Volker, D; Zijlstra-Vlasveld, M C; Brouwers, E P M; van Lomwel, A G C; van der Feltz-Cornelis, C M

2015-06-01

Considering the costs incurred by sickness absence and the implications for the workers' quality of life, a fast return to work (RTW) is important. Self-efficacy (SE) seems to be an important predictor of RTW for employees with mental health problems. The predictive value of return-to-work self-efficacy (RTW-SE) has not been examined in employees on long-term sickness absence due to any cause. The aim of this study is to investigate whether RTW-SE is a predictor of time to RTW in long-term sick-listed employees with all-cause sickness absence. Furthermore, the relative contribution of RTW-SE in predicting RTW will be examined compared to health-related, job-related and personal factors. In a longitudinal study, sick-listed employees who were currently on sick leave for more than 4 weeks filled out a self-report questionnaire. Demographics, health-related, personal, and job-related factors, and RTW-SE were measured. Employees were followed for 2 years to determine the duration until full RTW. Cox proportional hazards regression analyses were used to identify factors associated with time to RTW. Data were collected from 493 sick-listed employees. RTW-SE was a significant predictor of RTW. In a multivariate model, low RTW-SE, the thought of not being able to work while having symptoms (illness behaviour) and having chronic medical conditions were predictors of a longer duration until RTW. When guiding long-term sick-listed employees, it is important to focus on factors such as SE and illness behaviour, instead of just focusing on the symptoms of the sick-listed employee.

Effect of traditional yoga, mindfulness-based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout.

PubMed

Grensman, Astrid; Acharya, Bikash Dev; Wändell, Per; Nilsson, Gunnar H; Falkenberg, Torkel; Sundin, Örjan; Werner, Sigbritt

2018-03-06

To explore if health related quality of life(HRQoL) increased after traditional yoga(TY), mindfulness based cognitive therapy(MBCT), or cognitive behavioral therapy(CBT), in patients on sick leave because of burnout. Randomized controlled trial, blinded, in ninety-four primary health care patients, block randomized to TY, MBCT or CBT (active control) between September 2007 and November 2009. Patients were living in the Stockholm metropolitan area, Sweden, were aged 18-65 years and were on 50%-100% sick leave. A group treatment for 20 weeks, three hours per week, with homework four hours per week. HRQoL was measured by the SWED-QUAL questionnaire, comprising 67 items grouped into 13 subscales, each with a separate index, and scores from 0 (worse) to 100 (best). SWED-QUAL covers aspects of physical and emotional well-being, cognitive function, sleep, general health and social and sexual functioning. Statistics: Wilcoxon's rank sum and Wilcoxon's sign rank tests, Bonett-Price for medians and confidence intervals, and Cohen's D. Twenty-six patients in the TY (21 women), and 27 patients in both the MBCT (24 women) and in the CBT (25 women), were analyzed. Ten subscales in TY and seven subscales in MBCT and CBT showed improvements, p < 0.05, in several of the main domains affected in burnout, e.g. emotional well-being, physical well-being, cognitive function and sleep. The median improvement ranged from 0 to 27 points in TY, from 4 to 25 points in CBT and from 0 to 25 points in MBCT. The effect size was mainly medium or large. Comparison of treatments showed no statistical differences, but better effect (small) of both TY and MBCT compared to CBT. When comparing the effect of TY and MBCT, both showed a better effect (small) in two subscales each. A 20 week group treatment with TY, CBT or MBCT had equal effects on HRQoL, and particularly on main domains affected in burnout. This indicates that TY, MBCT and CBT can be used as both treatment and prevention, to improve HRQoL in patients on sick leave because of burnout, reducing the risk of future morbidity. July 22, 2012, retrospectively registered. ClinicalTrails.gov NCT01168661 . Stockholm County Council, grant 2003-5.

Sick Leave within 5 Years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study

PubMed Central

Carstensen, Tina Birgitte Wisbech; Fink, Per; Oernboel, Eva; Kasch, Helge; Jensen, Troels Staehelin; Frostholm, Lisbeth

2015-01-01

Background 10–22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover. Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors. In particular, the impact of sickness and socioeconomic factors before the collision on recovery is sparsely explored. The aim of this study was to examine if welfare payments received within five years pre-collision predict neck pain and negative change in provisional situation one year post-collision. Methods and Findings 719 individuals with acute whiplash trauma consecutively recruited from emergency departments or primary care after car accidents in Denmark completed questionnaires on socio-demographic and health factors immediately after the collision. After 12 months, a visual analogue scale on neck pain intensity was completed. 3595 matched controls in the general population were sampled, and national public register data on social benefits and any other welfare payments were obtained for participants with acute whiplash trauma and controls from five years pre-collision to 15 months after. Participants with acute whiplash trauma who had received sickness benefit for more than 12 weeks pre-collision had increased odds for negative change in future provisional situation (Odds Ratio (OR) (95% Confidence Interval (CI) = 3.8 (2.1;7.1)) and future neck pain (OR (95%CI) = 3.3 (1.8;6.3)), controlling for other known risk factors. Participants with acute whiplash trauma had weaker attachment to labour market (more weeks of sick leave (χ2(2) = 36.7, p < 0.001) and unemployment (χ2(2) = 12.5, p = 0.002)) pre-collision compared with controls. Experiencing a whiplash trauma raised the odds for future negative change in provisional situation (OR (95%CI) = 3.1 (2.3;4.4)) compared with controls. Conclusions Sick leave before the collision strongly predicted prolonged recovery following whiplash trauma. Participants with acute whiplash trauma had weaker attachment to labour market pre-collision compared with the general population. Neck pain at inclusion predicted future neck pain. Acute whiplash trauma may trigger pre-existing vulnerabilities increasing risk of developing whiplash-associated disorders. PMID:26098860

Acceptance and Commitment Group Therapy (ACT-G) for health anxiety.

PubMed

Eilenberg, Trine

2016-10-01

Health anxiety is prevalent (5-9%) in all healthcare settings and in the general population, may have an early onset, and a poor prognosis is seen in severe cases if untreated. Research shows that health anxiety is rarely diagnosed though it causes great suffering for the individual and constitutes a substantial socio-economic burden. Studies have shown that individual cognitive behavioural therapy can relieve health anxiety, but these studies are affected by methodological problems, among others, struggling with patients declining participation, high dropout rates, and some patients not responding to the treatment. Moreover, the impact of health anxiety on sick leave is only scarcely examined. This thesis examines the effect of a new treatment approach, group-based Acceptance & Commitment Therapy (ACT-G) for patients with severe health anxiety in an uncontrolled pilot study and a randomised controlled study (RCT) on ACT-G compared with a 10-month waitlist control condition (paper I and II). Also, the thesis comprises a study on sick leave in patients with health anxiety compared with the general population during a 5-year period and the effect of ACT-G on sick leave. The findings from this study are described in paper III. Patients (age 20-60 years) consecutively referred from general practitioners from Jutland and Funen in the period of March 2010 - April 2012  (approx. 2.5 million citizens) to the Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, were included. The pilot study included 34 patients, the RCT on ACT-G included 126 patients. In the RCT, patients were block-randomised to either ACT-G and received treatment in 7 groups of each 9 patients in the period of December 2010 - October 2012, or to a 10-month waitlist control group. The primary outcome measure was the Whiteley-7 paper and pencil index for illness worrying. The last paper is based on data on sickness-related benefits from the DREAM social register of transfer benefits and also includes a matched general population register control cohort (n=12,600). In this thesis, we wish to answer the following questions: 1) Is ACT-G an acceptable, feasible and effective treatment approach for patients with severe health anxiety? 2) Can ACT-G improve severe illness worry compared with a waitlist control condition, and are the recently introduced diagnostic criteria for health anxiety acceptable for the patients? 3) Do patients with health anxiety show more sick leave than the general population during a 5-year period, and can ACT-G reduce sick leave measured by transfer benefits (weeks on sickness-related benefits) at 1-year follow-up? As ACT has not previously been examined as treatment approach for health anxiety, we initially conducted an uncontrolled pilot study to test the newly developed manualised program (ACT-G). The study included 34 patients with severe health anxiety and showed very low dropout and high treatment satisfaction. Significant improvements in self-reported illness worry were demonstrated post-treatment, and the results were sustained and further improved at 3- and 6-months follow-up compared to baseline. The subsequent RCT found high acceptance of the diagnosis of health anxiety. All patients (except 1) accepted the diagnosis as the right diagnosis to fit their ailment, and the majority of the patients found that the diagnosis helped them to better understand their symptoms. In an intention-to-treat analysis, ACT-G showed significant effect in the improvement of self-reported illness worry and other secondary measures compared with a waitlist control condition, both post-treatment and at 10-month follow-up (6 months post-treatment). The results were considered clinically significant as 2/3 of the patients in ACT-G at follow-up had demonstrated a pre-defined treatment response, and ¼ of the patients were considered to no longer have clinical case status. Furthermore, the number needed to treat was found to be 2.4. Patients with severe health anxiety showed significantly more weeks on sickness-related benefits than matched individuals from the general population during the 5 years prior to entering the RCT. This difference was stable until an estimated cut-point at 1 year before enrolment, where patients with health anxiety showed further increase in sickness-related-benefits. At one-year follow-up (8 months post-treatment), we did not find a significant difference between ACT-G and the waitlist group in weeks on sickness-related benefits. Post-hoc analysis, however, revealed a significant decrease in weeks on sickness-related benefits for ACT-G during the 2 years after randomisation. In conclusion, the thesis suggests that ACT-G is both an acceptable and effective treatment approach for patients with severe health anxiety. Hopefully, these findings can contribute to the future research and identification of which treatment approaches are the most effective and for which patients and contribute to tailored, early interventions. This may possibly prevent development of otherwise chronic symptoms, increase the quality of life for the patients, and potentially reduce socio-economic costs.

Coping and sickness absence

PubMed Central

Schaufeli, Wilmar B.; van Dijk, Frank J. H.; Blonk, Roland W. B.

2007-01-01

Objectives The aim of this study is to examine the role of coping styles in sickness absence. In line with findings that contrast the reactive–passive focused strategies, problem-solving strategies are generally associated with positive results in terms of well-being and overall health outcomes; our hypothesis is that such strategies are positively related to a low frequency of sickness absence and with short lengths (total number of days absent) and durations (mean duration per spell). Methods Using a prospective design, employees’ (N = 3,628) responses on a self-report coping inventory are used to predict future registered sickness absence (i.e. frequency, length, duration, and median time before the onset of a new sick leave period). Results and conclusions In accordance with our hypothesis, and after adjustment for potential confounders, employees with an active problem-solving coping strategy are less likely to drop out because of sickness absence in terms of frequency, length (longer than 14 days), and duration (more than 7 days) of sickness absence. This positive effect is observed in the case of seeking social support only for the duration of sickness absence and in the case of palliative reaction only for the length and frequency of absence. In contrast, an avoidant coping style, representing a reactive–passive strategy, increases the likelihood of frequent absences significantly, as well as the length and duration of sickness absence. Expression of emotions, representing another reactive–passive strategy, has no effect on future sickness absenteeism. The median time before the onset of a new episode of absenteeism is significantly extended for active problem-solving and reduced for avoidance and for a palliative response. The results of the present study support the notion that problem-solving coping and reactive–passive strategies are inextricably connected to frequency, duration, length and onset of sickness absence. Especially, active problem-solving decreases the chance of future sickness absence. PMID:17701200

Coping and sickness absence.

PubMed

van Rhenen, Willem; Schaufeli, Wilmar B; van Dijk, Frank J H; Blonk, Roland W B

2008-02-01

The aim of this study is to examine the role of coping styles in sickness absence. In line with findings that contrast the reactive-passive focused strategies, problem-solving strategies are generally associated with positive results in terms of well-being and overall health outcomes; our hypothesis is that such strategies are positively related to a low frequency of sickness absence and with short lengths (total number of days absent) and durations (mean duration per spell). Using a prospective design, employees' (N = 3,628) responses on a self-report coping inventory are used to predict future registered sickness absence (i.e. frequency, length, duration, and median time before the onset of a new sick leave period). In accordance with our hypothesis, and after adjustment for potential confounders, employees with an active problem-solving coping strategy are less likely to drop out because of sickness absence in terms of frequency, length (longer than 14 days), and duration (more than 7 days) of sickness absence. This positive effect is observed in the case of seeking social support only for the duration of sickness absence and in the case of palliative reaction only for the length and frequency of absence. In contrast, an avoidant coping style, representing a reactive-passive strategy, increases the likelihood of frequent absences significantly, as well as the length and duration of sickness absence. Expression of emotions, representing another reactive-passive strategy, has no effect on future sickness absenteeism. The median time before the onset of a new episode of absenteeism is significantly extended for active problem-solving and reduced for avoidance and for a palliative response. The results of the present study support the notion that problem-solving coping and reactive-passive strategies are inextricably connected to frequency, duration, length and onset of sickness absence. Especially, active problem-solving decreases the chance of future sickness absence.

Organizational climate, perceived work-related symptoms and sickness absence: a population-based survey.

PubMed

Piirainen, Helena; Räsänen, Kimmo; Kivimäki, Mika

2003-02-01

Very few reports have been published on organizational climate, health, and sickness absence in a representative sample of the entire workforce. The aim of this study was to determine how the perceived organizational climate of a workplace is related with work-related symptoms and sickness absence and how these factors vary according to sociodemographic and work-related characteristics. Data were collected in computer-assisted telephone interviews of a random sample of 4209 currently employed Finns drawn from the population register. A tense and prejudiced climate was associated with a higher risk of work-related symptoms than a relaxed and supportive climate (odds ratio [OR] 3.0 (95% CI = 2.4-3.7). The corresponding ORs were 4.3 (95% CI = 3.3-5.6) for psychological symptoms, 1.6 (95% CI = 1.2-2.0) for musculoskeletal symptoms, and 1.6 (95% CI = 1.3-2.1) for more than the average number of sick-leave days. Part of the impact of organizational climate on sickness absence is not caused by an increase in work-related symptoms. Thus, organizational climate seems not only to correspond with organizational practices and leadership but also occupational health. Organizational climate could be used as a research tool in attempts to reduce work-related ill health and sickness absenteeism.

Is family-friendly policy (FFP) working in the private sector of South Korea?

PubMed

Kang, Young-Hee

2013-01-01

Using the Korean Labor and Income Panel Study (KLIPS), I investigated the impact of family-friendly policies (FFPs) on job satisfaction and organizational commitment in the private sector of South Korea. Paid leave, childcare leave, and support for housing are positively related to both job satisfaction and organizational commitment. Sick leave is positively related to organizational commitment. However, subsidized family event cost is a marginally significant predictor of job satisfaction and organizational commitment. In addition, the relationships between subsidized childcare cost and employee attitudes were not supported. Implications and suggestions for future research are discussed.

Sickness absence in a Singapore refinery, 1981-1992.

PubMed

Lai, C S

1994-09-01

Sickness absence among the unionised staff of the largest petroleum refinery in Singapore was followed up from 1981 to 1992. The changes seen throughout these 12 years were related to national, organisational and personal factors. Initially because of increasing competitiveness in the industry, and later because of a national recession, manpower in the refinery was progressively reduced from 1981 to 1986. This however was not the main cause of the reduction in sickness absence rates from 8.4 working days in 1981 to 5.8 days in 1983. Organisational changes to medical leave entitlements and improved means of supervision of absence were responsible for the early fall in absence rates. Personal factors, such as the increasing age of the population, did not affect the amount of short-term absences, while shift work was associated with higher absences. From 1986 absence rates rose again, eventually to almost 1981 levels by 1992, a reflection of the tendency for sickness absence to increase with time, unless active measures are undertaken for its control.

Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies

PubMed Central

Ito, Elizabeth; Scaratti, Chiara; Vlachou, Anastasia; Stavroussi, Panayiota; Brecelj, Valentina; Kovačič, Dare S.

2018-01-01

Due to low employment rates associated to chronic conditions in Europe, it is essential to foster effective integration and re-integration into work strategies. The objective of this systematic review is to summarize the evidence on the effectiveness of strategies for integration and re-integration to work for persons with chronic diseases or with musculoskeletal disorders, implemented in Europe in the past five years. A systematic search was conducted in MedLine, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 32 relevant publications were identified. Of these, 21 were considered eligible after a methodological assessment and included. Positive changes in employment status, return to work and sick leave outcomes were achieved with graded sickness-absence certificates, part-time sick leave, early ergonomic interventions for back pain, disability evaluation followed by information and advice, and with multidisciplinary, coordinated and tailored return to work interventions. Additionally, a positive association between the co-existence of active labour market policies to promote employment and passive support measures (e.g., pensions or benefits) and the probability of finding a job was observed. Research on the evaluation of the effectiveness of strategies targeting integration and re-integration into work for persons with chronic health conditions needs, however, to be improved and strengthened. PMID:29562715

29 CFR 825.800 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... employees by an employer, including group life insurance, health insurance, disability insurance, sick leave... of their practice as defined under State law; (iii) Christian Science Practitioners listed with the... receiving treatment from a Christian Science practitioner, an employee may not object to any requirement...

Annuity-estimating program

NASA Technical Reports Server (NTRS)

Jillie, D. W.

1979-01-01

Program computes benefits and other relevant factors for Federal Civil Service employees. Computed information includes retirement annuity, survivor annuity for each retirement annuity, highest average annual consecutive 3-year salary, length of service including credit for unused sick leave, amount of deposit and redeposit plus interest.

Leadership in workplace health promotion projects: 1- and 2-year effects on long-term work attendance.

PubMed

Dellve, Lotta; Skagert, Katrin; Vilhelmsson, Rebecka

2007-10-01

Despite the acknowledged role of leadership in the psychosocial work environment, few studies focus on how leadership qualities and strategies may act as key processes of importance to positive effects of workplace health promotion (WHP). The aim of this study was to increase knowledge about how leadership qualities and strategies in WHP projects influence employees' long-term work attendance. The 1- and 2-year effect of leadership on the prevalence of long-term work attendance among municipal human service workers (n = 3 275) was analysed using 3-year register-based data on sick leave, questionnaires and a qualitative categorization of each unit. Increased leadership qualities, especially where leaders used rewards, recognition and respect, were associated with higher prevalence of work attendance at follow-up [PR 1.42 (1.20-1.69)]. Leaders' strategies and views on work-related health had a significant impact on increased work attendance in projects that had goals clearly focusing on changeable factors [1.36 (1.11-1.67)], in multi-focused projects [1.60 (1.24-2.04)] and in projects aimed to increase employees' awareness of their health. Workplace health promotion strategies with a single focus on strengthening individual, professional or organizational resources were negatively associated with work attendance. A higher proportion of employee work attendance was also seen in units whose leaders viewed the organization or the society (rather than individual workers) as responsible for the high rate of sick leave. Leadership, WHP strategies and leaders' attitudes towards employee work-related health have importance for implementation processes, as well as affecting employee work attendance. In this study, multi-focused WHP interventions had the largest effect on work attendance.

Modelling the effects of exposure to whole-body vibration on low-back pain and its long-term consequences for sickness absence and associated work disability

NASA Astrophysics Data System (ADS)

Burdorf, A.; Hulshof, C. T. J.

2006-12-01

BackgroundExposure to whole-body vibration (WBV) is a well-known risk factor for the occurrence of low-back pain (LBP). Little is known about the long-term course of back pain in workers exposed to WBV and the consequences for (temporary) disability, due to lack of cohort studies with sufficiently long follow-up periods. MethodsA systematic review of the literature was performed to assess associations between exposure to WBV and LBP, sickness absence due to low-back disorders and permanent disability. A meta-analysis was used to estimate the prevalences of LBP and sickness absence due to low-back disorders in occupational populations, depending on relevant exposure characteristics. These prevalences were converted into probabilities for transitions between no complaints, LBP, sickness due to LBP, and disability. A Markov model was applied to evaluate a hypothetical cohort of workers without LBP at the start of the cohort and a follow-up of 40 years (40 cycles of 1 year) to reflect a long-life career with continuous exposure to WBV. ResultsIn this hypothetical cohort it was estimated that among workers with the highest exposure to WBV on average about 47 weeks of their working life were lost due to sick leave because of LBP, which is approximately 2.5% of their working life. When all workers on prolonged sick leave for 52 weeks would remain disabled for the rest of their working life, a maximum of 23.4% of their working life could be lost due to high WBV exposure. Among workers without or low exposure to WBV the corresponding losses were 0.8% and 7.8%, respectively. ConclusionThe approach to assess years of work lost due to an occupational exposure may provide a more adequate description for stakeholders than the traditional measures of relative risk or attributable risk fraction. The concept of work years lost may also facilitate a better appreciation of the potential benefits of preventive measures.

"I Can't Go to School and Leave Her in so Much Pain": Educational Shortfalls among Adolescent "Young Carers" in the South African AIDS Epidemic

ERIC Educational Resources Information Center

Cluver, L.; Operario, D.; Lane, T.; Kganakga, M.

2012-01-01

"I go to the hospital with my mother when she is sick. I can't go to school and leave her in so much pain. I won't concentrate." Millions of adolescents live with AIDS-affected parents or primary caregivers. Little is known about educational impacts of living in an AIDS-affected home, or of acting as a "young carer" in the…

ANALYSIS OF ABSENTEEISM IN INDUSTRY

PubMed Central

Luongo, E. P.

1959-01-01

There are many nonmedical factors that contribute to employee absenteeism in industry. An employee's total life situation or total environment may be a causative factor in excessive “sick absenteeism.” In many instances the cure for “abnormal” sickness absenteeism is within the province of supervisory personnel, who should look upon abuse of sick leave benefits among employees as morale problems and as evidence of possible maladjustment to the demands of the job or the industry. There are, however, many problems in mental and physical health affecting absence rates in which preventive psychiatry and medicine can make greater contributions. Even truancy and malingering may sometimes be conditions requiring professional medical care. The role of a private physician in determining and certifying the true state of a patient's health is a most important one economically to industry and the community. The total problem of absenteeism for sickness, as it exists in industry today, points up the need for the most effective cooperation and communication possible between industrial and private physicians. Since no more than 25 per cent of the total work force is employed in industries having in-plant medical programs, the burden of responsibility for the control of absenteeism for sickness rests mainly with private practitioners. PMID:14418976

Access to leave benefits for primary caregivers of children with special health care needs: a double bind.

PubMed

Chung, Paul J; Garfield, Craig F; Elliott, Marc N; Vestal, Katherine D; Klein, David J; Schuster, Mark A

2013-01-01

Family leave benefits are a key tool that allow parents to miss work to care for their ill children. We examined whether access to benefits varies by level of childcare responsibilities among employed parents of children with special health care needs (CSHCN). We conducted telephone interviews with 3 successive cohorts of employed parents of CSHCN, randomly sampled from a California children's hospital. At Wave 1 (November 2003 to January 2004), we conducted 372 parent interviews. At Wave 2 (November 2005 to January 2006), we conducted 396 parent interviews. At Wave 3 (November 2007 to January 2008), we conducted 393 parent interviews. We pooled these samples for bivariate and multivariate regression analyses by using wave indicators and sample weights. Parents with more childcare responsibilities (primary caregivers) reported less access to sick leave/vacation (65% vs 82%, P < .001), access to paid leave outside of sick leave/vacation (41% vs 51%, P < .05), and eligibility for Family and Medical Leave Act benefits (28% vs 44%, P < .001) than secondary caregivers. Part-time employment and female gender largely explained 2 of the 3 associations between more childcare responsibilities and less access to leave benefits. Even in the context of part-time employment, however, primary caregivers were just as likely as secondary caregivers both to miss work due to their child's illness and to report being unable to miss work when they needed to. Due in part to employment and gender differences, leave benefits among parents of CSHCN are skewed away from primary caregivers and toward secondary caregivers. Thus, primary caregivers may face particularly difficult choices between employment and childcare responsibilities. Reducing this disparity in access to benefits may improve the circumstances of CSHCN and their families. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Joint association of sleep problems and psychosocial working conditions with registered long-term sickness absence. A Danish cohort study.

PubMed

Madsen, Ida Eh; Larsen, Ann D; Thorsen, Sannie V; Pejtersen, Jan H; Rugulies, Reiner; Sivertsen, Børge

2016-07-01

Sleep problems and adverse psychosocial working conditions are associated with increased risk of long-term sickness absence. Because sleep problems affect role functioning they may also exacerbate any effects of psychosocial working conditions and vice versa. We examined whether sleep problems and psychosocial working conditions interact in their associations with long-term sickness absence. We linked questionnaire data from participants to two surveys of random samples of the Danish working population (N=10 752) with registries on long-term sick leave during five years after questionnaire response. We defined sleep problems by self-reported symptoms and/or register data on hypnotics purchases of hypnotics. Psychosocial working conditions included quantitative and emotional demands, influence, supervisor recognition and social support, leadership quality, and social support from colleagues. Using time-to-event models, we calculated hazard ratios (HR) and differences and examined interaction as departure from multiplicativity and additivity. During 40 165 person-years of follow-up, we identified 2313 episodes of long-terms sickness absence. Sleep problems predicted risk of long-term sickness absence [HR 1.54, 95% confidence interval (95% CI) 1.38-1.73]. This association was statistically significantly stronger among participants with high quantitative demands and weaker among those with high supervisor recognition (P<0.0001). High quantitative demands exacerbated the association of sleep problems with risk of long-term sickness absence whereas high supervisor recognition buffered this association. To prevent long-term sickness absence among employees with sleep problems, workplace modifications focusing on quantitative demands and supervisor recognition may be considered. Workplace interventions for these factors may more effectively prevent sickness absence when targeted at this group. The efficacy and effectiveness of such interventions needs to be established in future studies.

Evaluation of the Effects of Physical Activity, Cardiorespiratory Condition, and Neuromuscular Fitness on Direct Healthcare Costs and Sickness-Related Absence Among Nursing Personnel With Recurrent Nonspecific Low Back Pain.

PubMed

Kolu, Päivi; Tokola, Kari; Kankaanpää, Markku; Suni, Jaana

2017-06-01

A cross-sectional study, part of a randomized controlled trial. To evaluate the association of physical activity, cardiorespiratory fitness, and neuromuscular fitness with direct healthcare costs and sickness-related absence among nursing personnel with nonspecific low back pain. Low back pain creates a huge economic burden due to increased sick leave and use of healthcare services. Female nursing personnel with nonspecific low back pain were included (n = 219). Physical activity was assessed with accelerometry and a questionnaire. In addition, measurements of cardiorespiratory and muscular fitness were conducted. Direct costs and sickness-related absence for a 6-month period were collected retrospectively by questionnaire. Health care utilization and absence from work were analyzed with a general linear model. The mean total costs were 80.5% lower among women who met physical activity recommendations than inactive women. Those with a higher mean daily intensity level of 10-minute activity sessions showed lower total costs than women in the lowest tertile (middle: 64.0% of the lowest; highest: 54.3% of the lowest). Women with good cardiorespiratory fitness (the highest tertile) as measured with the 6-minute-walk test (based on walking distance) had 77.0% lower total costs when compared with the lowest tertile. Women in the highest third for the modified push-up test had 84.0% lower total costs than those with the poorest results (the bottom tertile). High cardiorespiratory and muscular fitness and meeting physical activity recommendations for aerobic and muscular fitness were strongly associated with lower total costs among nursing personnel with pain-related disorders of recurrent nonspecific low back pain. Actions to increase physical activity and muscle conditioning may significantly save on healthcare costs and decrease sick-leave costs due to low back pain.

Work ability index, absenteeism and depression among patients with burnout syndrome.

PubMed

Pranjic, Nurka; Males-Bilic, Ljiljana

2014-08-01

The aim of this study is to estimate the association of burnout syndrome and depression; burnout syndrome and sick leave; and burnout syndrome with Work Ability Index in patients who suffer from stress at work. The control clinical study was conducted in the Teaching Department for Professional Pathology and Toxicology at the Primary Health Care Center Tuzla in the period from 2009 to 2014. The study included 140 patients exposed to different levels of stress at work. Besides conducted interviews and anamnesis with working anamnesis, physical examination, all patients were subjected to diagnostic package of questionnaires for assessing exposure to stress at work and its effects on health and work ability and Hamilton Rating Scale for screening depression. All patients were referred to the Department with suspected distress and burnout syndrome. For this study we used a questionnaire for measuring intensity of burnout (two categories exclude suffering from burnout syndrome: successfully overcome stress at work and sometimes feel stress at work and the other two reveal the initial and very high burn-out syndrome. Studied group was consisted of patients categorized with burnout syndrome (n=88). The questionnaire on the Work Ability Index (WAI) estimated characteristics of sick leave and prognostic factors with current work ability index. Lack of support at work with poor personal relations is the most common factor with the mobbing in burnout syndrome. Significantly more patients with the burnout syndrome suffered very severe depression 49%:37%; more use long sick leaves 53%:21%; several of them have poor WAI 51%:31% compared to those who are only exposed to stress at work (p=0.001). We found that the burn-out syndrome is predictor for developing depression (β=0.312, 95% CI, 0.114-0.353, p=0.001); absenteeism (β=0.285, 95% CI, 0.093-0.334, p=0.001); and a decline in working ability (β=0.413, 95% CI, 0.297-0.648). All the patients in whom it is found burnout syndrome is to provide medical and non-medical assistance in order to achieve stabilization of health and positive work orientation, mental rehabilitation and reintegration at work place. The process involves serious emergency measures in work organization which include improved in working environment, communication and combat against mobbing.

Workload, work stress, and sickness absence in Swedish male and female white-collar employees.

PubMed

Krantz, Gunilla; Lundberg, Ulf

2006-01-01

This study aimed to analyse, in a homogeneous population of highly educated men and women, gender differences in self-reported sickness absence as related to paid and unpaid work and combinations of these (double exposure), as well as to perceived work stress and work-home conflict, i.e. conflict between demands from the home and work environment. A total of 743 women and 596 men, full-time working white-collar employees randomly selected from the general Swedish population aged 32-58, were assessed by a Swedish total workload instrument. The influence of conditions in paid and unpaid work and combinations of these on self-reported sickness absence was investigated by multivariate regression analyses. Analysis of variance (ANOVA) was used to assess differences between men and women. Overtime was associated with lower sickness absence, not only for men but also for women, and a double-exposure situation did not increase the risk of sick leave. Contrary to what is normally seen, conflict between demands did not emerge as a risk factor for sickness absence for women, but for men. Our assumption that sickness absence patterns would be more similar for white-collar men and women than for the general population was not confirmed. However, the women working most hours were also the least sick-listed and assumed less responsibility for household chores. These women were mainly in top-level positions and therefore we conclude that men and women in these high-level positions seem to share household burdens more evenly, but they can also afford to employ someone to assist in the household.

7 CFR 56.52 - Charges for continuous grading performed on a resident basis.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS... Social Security System, retirement benefits, group life insurance, severance pay, sick leave, annual...

Distinct longitudinal patterns of absenteeism and their antecedents in full-time Australian employees.

PubMed

Magee, Christopher A; Caputi, Peter; Lee, Jeong Kyu

2016-01-01

This paper investigated distinct longitudinal trajectories of absenteeism over time, and underlying demographic, work, and health antecedents. Data from the Household, Income, and Labor Dynamics in Australia Survey were used; this is a panel study of a representative sample of Australian households. This paper focused on 2,481 full-time employees across a 5-year period. Information on annual sick leave and relevant sociodemographic, work, and health-related factors was collected through interviews and self-completed surveys. Growth mixture modeling indicated 4 distinct longitudinal patterns of absenteeism over time. The moderate absenteeism trajectory (34.8%) of the sample had 4-5 days of sick leave per year and was used as the reference group. The low absenteeism trajectory (33.5%) had 1-2 days of absenteeism per year, while the no absenteeism trajectory (23.6%) had very low rates of absenteeism (<1 day per year). Finally, a smaller trajectory accounting for 8.1% of the sample had high levels of absenteeism (>11 days per year). Compared with the moderate absenteeism trajectory, the high absenteeism trajectory was characterized by poor health; the no absenteeism and low absenteeism trajectories had better health but may also reflect processes relating to presenteeism. These results provide important insights into the nature of absenteeism in Australian employees, and suggest that different patterns of absenteeism over time could reflect a range of demographic, work, and health related factors. (c) 2016 APA, all rights reserved).

Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with back pain.

PubMed

Schaafsma, Frederieke G; Whelan, Karyn; van der Beek, Allard J; van der Es-Lambeek, Ludeke C; Ojajärvi, Anneli; Verbeek, Jos H

2013-08-30

Physical conditioning as part of a return to work strategy aims to improve work status for workers on sick leave due to back pain. This is the second update of a Cochrane Review (originally titled 'Work conditioning, work hardening and functional restoration for workers with back and neck pain') first published in 2003, updated in 2010, and updated again in 2013. To assess the effectiveness of physical conditioning as part of a return to work strategy in reducing time lost from work and improving work status for workers with back pain. Further, to assess which aspects of physical conditioning are related to a faster return to work for workers with back pain. We searched the following databases to March 2012: CENTRAL, MEDLINE (from 1966), EMBASE (from 1980), CINAHL (from 1982), PsycINFO (from 1967), and PEDro. Randomized controlled trials (RCTs) and cluster RCTs that studied workers with work disability related to back pain and who were included in physical conditioning programmes. Two review authors independently extracted data and assessed risk of bias. We used standard methodological procedures expected by The Cochrane Collaboration. We included 41 articles reporting on 25 RCTs with 4404 participants. Risk of bias was low in 16 studies.Three studies involved workers with acute back pain, eight studies workers with subacute back pain, and 14 studies workers with chronic back pain.In 14 studies, physical conditioning as part of a return to work strategy was compared to usual care. The physical conditioning mostly consisted of graded activity with work-related exercises aimed at increasing back strength and flexibility, together with a set date for return to work. The programmes were divided into a light version with a maximum of five sessions, or an intense version with more than five sessions up to full time or as inpatient treatment.For acute back pain, there was low quality evidence that both light and intense physical conditioning programmes made little or no difference in sickness absence duration compared with care as usual at three to 12 months follow-up (3 studies with 340 workers).For subacute back pain, the evidence on the effectiveness of intense physical conditioning combined with care as usual compared to usual care alone was conflicting (four studies with 395 workers). However, subgroup analysis showed low quality evidence that if the intervention was executed at the workplace, or included a workplace visit, it may have reduced sickness absence duration at 12 months follow-up (3 studies with 283 workers; SMD -0.42, 95% CI -0.65 to -0.18).For chronic back pain, there was low quality evidence that physical conditioning as part of integrated care management in addition to usual care may have reduced sickness absence days compared to usual care at 12 months follow-up (1 study, 134 workers; SMD -4.42, 95% CI -5.06 to -3.79). What part of the integrated care management was most effective remained unclear. There was moderate quality evidence that intense physical conditioning probably reduced sickness absence duration only slightly compared with usual care at 12 months follow-up (5 studies, 1093 workers; SMD -0.23, 95% CI -0.42 to -0.03).Physical conditioning compared to exercise therapy showed conflicting results for workers with subacute and chronic back pain. Cognitive behavioural therapy was probably not superior to physical conditioning as an alternative or in addition to physical conditioning. The effectiveness of physical conditioning as part of a return to work strategy in reducing sick leave for workers with back pain, compared to usual care or exercise therapy, remains uncertain. For workers with acute back pain, physical conditioning may have no effect on sickness absence duration. There is conflicting evidence regarding the reduction of sickness absence duration with intense physical conditioning versus usual care for workers with subacute back pain. It may be that including workplace visits or execution of the intervention at the workplace is the component that renders a physical conditioning programme effective. For workers with chronic back pain physical conditioning has a small effect on reducing sick leave compared to care as usual after 12 months follow-up. To what extent physical conditioning as part of integrated care management may alter the effect on sick leave for workers with chronic back pain needs further research.

[Can epidemiological factors affect the 2-year outcomes after surgery for degenerative lumbar disease in terms of quality of life, disability and post-surgical pain?].

PubMed

Lozano-Álvarez, C; Pérez-Prieto, D; Saló-Bru, G; Molina, A; Lladó, A; Cáceres, E; Ramírez, M

2014-01-01

To evaluate the influence of epidemiological factors on the outcomes of surgery for degenerative lumbar disease in terms of quality of life, disability and chronic pain. A total of 263 patients who received surgery for degenerative lumbar disease (2005-2008) were included in the study. The epidemiological data collected were age, gender, employment status, and co-morbidity. The SF-36, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), and VAS score for lumbar and sciatic pain were measure before and 2 years after surgery. The correlation between epidemiological data and questionnaire results, as well as any independent prognostic factors, were assessed in the data analysis. The mean age of the patients was 54.0 years (22-86), and 131 were female (49.8%). There were 42 (16%) lost to follow-up. Statistically significant correlations (P<.05) were observed between age, gender, co-morbidity, permanent sick leave, and pre-operative pain with changes in the ODI, COMI, physical and SF-36 mental scales, and lumbar and sciatic VAS. Linear regression analysis showed permanent sick leave and age as predictive factors of disability (β=14.146; 95% CI: 9.09 - 29.58; P<.01 and β=0.334; 95% CI: 0.40 - 0.98, P<.05, respectively), and change in quality of life (β=-8.568; 95% CI: -14.88 - -2.26; p<.01 and β=-0.228, IC 95% CI: -0.40 - -0.06, P<.05, respectively). Based on our findings, age and permanent sick leave have to be considered as negative epidemiologic predictive factors of the outcome of degenerative lumbar disease surgery. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

Individual Cognitive Social Capital and Its Relationship with Pain and Sick Leave Due to Pain in the Austrian Population

PubMed Central

Muckenhuber, Johanna; Pollak, Lorenz; Stein, Katharina Viktoria; Dorner, Thomas Ernst

2016-01-01

Background Individual cognitive social capital has repeatedly been shown to be linked to health disparities in many dimensions. The aim of the study was to investigate the association between social capital and pain-related measures. Methods 15,474 subjects older than 15 years were personally interviewed on subjective health, quality of life, health behaviour, and utilisation of healthcare in the Austrian Health Interview Survey. An indicator for cognitive social capital at the individual level consisting of nine questions targeted at different social resources was built and its association with pain-related items analysed. Results Odds ratios, adjusted for age, chronic diseases, and educational level for having suffered from severe pain in the last 12 months were 2.02 (95% CI 1.77–2.03) in the lowest tertile and 1.30 (95% CI 1.14–1.47) in the middle tertile of social capital for men. The corresponding odds ratios for women were 2.28 (95% CI 2.01–2.59) and 1.30 (95% CI 1.15–1.46). In both sexes, pain intensity increased significantly with decreasing level of social capital. The proportion of subjects that have been on sick leave in the last 12 months due to pain were 16.3%, 12.0%, and 7.7% (P<0.001) from lowest to highest tertile of social capital in men, and 16.5%, 12.3%, and 6.7%, respectively (P<0.001) in women. Conclusion Our findings indicate that low cognitive social capital at individual level is significantly associated not only with higher prevalence of pain and higher pain intensity, but also with a higher chance for sick leave due to pain in employed subjects. PMID:27322649

Precision and accuracy in measuring absence from work as a basis for calculating productivity costs in The Netherlands.

PubMed

Severens, J L; Mulder, J; Laheij, R J; Verbeek, A L

2000-07-01

The impact of disease on the ability of a person to perform work should be part of an economic evaluation when a societal viewpoint is used for the analysis. This impact is reflected by calculating productivity costs. Measurement of these costs is often performed retrospectively. The purpose of our study was to study precision and accuracy of a retrospective self-administered questionnaire on sick leave. Employees of a company were asked to indicate the number of days absent from work due to illness during the past 2 weeks, 4 weeks, 2 months, 6 months, and the past 12 months. The percentage of respondents with an absolute difference of a maximum of respectively 0, 1, 2, 3, 4, 5, 6, 7, 8, and 9 or more days between reported, and company-registered absence due to illness was determined. Besides this, the proportional difference was calculated. A systematic difference was tested with a signed rank test. Of the reported data, 95% matched the registered data perfectly when the recall period was limited to 2 and 4 weeks. This percentage decreased to 87%, 57%, and 51% for 2 months, 6 months, and 12 months. The weighted mean proportional differences for the recall periods were respectively 32.9, 35.2, 45.3, 34.9, and 113.6%. No systematic positive or negative difference was found between registered and reported sick leave. The results suggest that the recall period for retrospective measurement of sick leave is limited according to the precision level, which seems to be appropriate for the subject and the purpose of the study. We recommend using a recall period of no more than 2 months.

Return to work for patients with diffuse large B-cell lymphoma and transformed indolent lymphoma undergoing autologous stem cell transplantation

PubMed Central

Arboe, Bente; Olsen, Maja Halgren; Goerloev, Jette Soenderskov; Duun-Henriksen, Anne Katrine; Johansen, Christoffer; Dalton, Susanne Oksbjerg; Brown, Peter de Nully

2017-01-01

Background Autologous stem cell transplantation (ASCT) is the standard treatment for patients with relapsed diffuse large B-cell lymphoma (DLBCL) or transformed indolent lymphoma (TIL). The treatment is mainly considered for younger patients still available for the work market. In this study, social outcomes after ASCT in terms of return to work (RTW) are described. Patients and methods Information from national administrative registers was combined with clinical information on patients, who received ASCT for relapse of DLBCL or TIL between 2000 and 2012. A total of 164 patients were followed until RTW, disability or old-age pension, death, or December 31, 2015, whichever came first. A total of 205 patients were followed with disability pension as the event of interest. Cox models were used to determine cause-specific hazards. Results During follow-up, 82 (50%) patients returned to work. The rate of returning to work in the first year following ASCT was decreased for patients being on sick leave at the time of relapse (hazard ratio [HR] 0.3 [0.2;0.5]) and increased for patients aged ≥55 years (HR 1.9 [1.1;3.3]). In all, 56 (27%) patients were granted disability pension. Being on sick leave at the time of relapse was positively associated with receiving a disability pension in the first 2 years after ASCT (HR 3.7 [1.8;7.7]). Conclusion Patients on sick leave at the time of relapse have a poorer prognosis regarding RTW and have a higher rate of disability pension. Furthermore, patients >55 are more likely to RTW compared to younger patients. These results indicate an unmet need for focused social rehabilitation. PMID:28652814

Physiotherapy in Primary Care Triage - the effects on utilization of medical services at primary health care clinics by patients and sub-groups of patients with musculoskeletal disorders: a case-control study.

PubMed

Bornhöft, Lena; Larsson, Maria E H; Thorn, Jörgen

2015-01-01

Primary Care Triage is a patient sorting system used in some primary health care clinics (PHCCs) in Sweden where patients with musculoskeletal disorders (MSD) are triaged directly to physiotherapists. The purpose of this study was to investigate whether sorting/triaging patients seeking a PHCC for MSD directly to physiotherapists affects their utilization of medical services at the clinic for the MSD and to determine whether the effects of the triaging system vary for different sub-groups of patients. A retrospective case-control study design was used at two PHCCs. At the intervention clinic, 656 patients with MSD were initially triaged to physiotherapists. At the control clinic, 1673 patients were initially assessed by general practitioners (GPs). The main outcome measures were the number of patients continuing to visit GPs after the initial assessment, the number of patients receiving referrals to specialists/external examinations, doctors' notes for sick-leave or prescriptions for analgesics during one year, all for the original MSD. Significantly fewer patients triaged to physiotherapists required multiple GP visits for the MSD or received MSD-related referrals to specialists/external examinations, sick-leave recommendations or prescriptions during the following year compared to the GP-assessed group. This applies to all sub-groups except for the group with lower extremity disorders, which did not reach significance for either multiple GP visits or sick-leave recommendations. The reduced utilization of medical services by patients with MSD who were triaged to physiotherapists at a PHCC is likely due to altered management of MSD with initial assessment by physiotherapists.

Predicting Persistent Back Symptoms by Psychosocial Risk Factors: Validity Criteria for the ÖMPSQ and the HKF-R 10 in Germany.

PubMed

Riewe, E; Neubauer, E; Pfeifer, A C; Schiltenwolf, M

2016-01-01

10% of all individuals in Germany develop persistent symptoms due to nonspecific back pain (NSBP) causing up to 90% of direct and indirect expenses for health care systems. Evidence indicates a strong relationship between chronic nonspecific back pain and psychosocial risk factors. The Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) and the German Heidelberger Kurzfragebogen Rückenschmerz (HKF-R 10) are deemed valid in prediction of persistent pain, functional loss or amount of sick leave. This study provides and discusses validity criteria for these questionnaires using ROC-curve analyses. Quality measurements included sensitivity and specificity, likelihood-ratio related test-efficiencies and clinical utility in regard to predictive values. 265 patients recruited from primary and secondary care units completed both questionnaires during the same timeframe. From the total, 133 patients returned a 6-month follow-up questionnaire to assess the validity criteria for outcomes of pain, function and sick leave. Based on heterogeneous cut-offs for the ÖMPSQ, sensitivity and specificity were moderate for outcome of pain (72%/75%). Very high sensitivity was observed for function (97%/57%) and high specificity for sick leave (63%/85%). The latter also applied to the HKF-R 10 (pain 50%/84%). Proportions between sensitivity and specificity were unbalanced except for the ÖMPSQ outcome of pain. Likelihood-ratios and positive predictive values ranged from low to moderate. Although the ÖMPSQ may be considered useful in identification of long-term functional loss or pain, over- and underestimation of patients at risk of chronic noncspecific back pain led to limited test-efficiencies and clinical utility for both questionnaires. Further studies are required to quantify the predictive validity of both questionnaires in Germany.

Exercise-based cardiac rehabilitation after heart valve surgery: cost analysis of healthcare use and sick leave.

PubMed

Hansen, T B; Zwisler, A D; Berg, S K; Sibilitz, K L; Thygesen, L C; Doherty, P; Søgaard, R

2015-01-01

Owing to a lack of evidence, patients undergoing heart valve surgery have been offered exercise-based cardiac rehabilitation (CR) since 2009 based on recommendations for patients with ischaemic heart disease in Denmark. The aim of this study was to investigate the impact of CR on the costs of healthcare use and sick leave among heart valve surgery patients over 12 months post surgery. We conducted a nationwide survey on the CR participation of all patients having undergone valve surgery between 1 January 2011 and 30 June 2011 (n=667). Among the responders (n=500, 75%), the resource use categories of primary and secondary healthcare, prescription medication and sick leave were analysed for CR participants (n=277) and non-participants (n=223) over 12 months. A difference-in-difference analysis was undertaken. All estimates were presented as the means per patient (95% CI) based on non-parametric bootstrapping of SEs. Total costs during the 12 months following surgery were €16 065 per patient (95% CI 13 730 to 18 399) in the CR group and €15 182 (12 695 to 17 670) in the non-CR group. CR led to 5.6 (2.9 to 8.3, p<0.01) more outpatient visits per patient. No statistically significant differences in other cost categories or total costs €1330 (-4427 to 7086, p=0.65) were found between the groups. CR, as provided in Denmark, can be considered cost neutral. CR is associated with more outpatient visits, but CR participation potentially offsets more expensive outpatient visits. Further studies should investigate the benefits of CR to heart valve surgery patients as part of a formal cost-utility analysis.

Importance of Contextual Factors When Measuring Work Outcome in Ankylosing Spondylitis: A Systematic Review by the OMERACT Worker Productivity Group.

PubMed

Stolwijk, Carmen; Castillo-Ortiz, José-Dionisio; Gignac, Monique; Luime, Jolanda; Boonen, A

2015-09-01

To review the literature on contextual factors (CoFas) and their relationship to work outcomes in individuals with ankylosing spondylitis (AS). Articles that quantified the relationship between CoFas and employment status, sick leave, or presenteeism in individuals with AS were systematically identified. CoFas were classified into 5 domains for personal factors and 8 domains for environmental factors. We defined criteria for best-evidence synthesis for each CoFa domain based on the number of studies exploring that domain, and the quality of evidence of individual studies based on the risk of bias, adjustment of multivariable analyses for disease activity and physical function, and sample size. Twenty-five studies met our inclusion criteria: 20 addressed employment status, 6 examined sick leave, and 3 presenteeism. For employment, there was strong evidence for the role of age, moderate evidence for related skills/abilities, the absence of work accommodations, the nature of work and absence of workplace support, and poor evidence for the role of marital status. Evidence was insufficient for sex, education, and physical environment. For sick leave and presenteeism there were too few studies to perform a best-evidence synthesis for the role of CoFas. Using a newly proposed set of criteria for determining the best-evidence of the association between CoFa domains and work outcome, the following factors emerged: age, related skills/abilities, work accommodations, nature of work, and workplace support. In addition to disease-related variables, these CoFa domains seem important to include when designing and interpreting studies on work outcomes. © 2015, American College of Rheumatology.

Work disability in non-radiographic axial spondyloarthritis patients before and after start of anti-TNF therapy: a population-based regional cohort study from southern Sweden.

PubMed

Wallman, Johan K; Jöud, Anna; Olofsson, Tor; Jacobsson, Lennart T H; Bliddal, Henning; Kristensen, Lars E

2017-05-01

The aim was to assess work-loss days before and after commencement of anti-TNF treatment in patients with non-radiographic axial spondylarthritis (nr-axSpA). Bionaïve nr-axSpA patients (n = 75), aged 17-62 years, fulfilling the Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis and starting anti-TNF treatment during 2004-11, were retrieved from the observational South Swedish Arthritis Treatment Group study. Patient information was linked to Swedish Social Insurance Agency data on sick leave and disability pension from 1 year before to 2 years after anti-TNF initiation. Matched population references were included for comparison and to adjust for secular trends. The nr-axSpA patients had a median age of 35 years and disease duration of 6 years at the start of treatment. During the 2 years after anti-TNF initiation, mean work-loss days (including both sick leave and disability pension) in the nr-axSpA group decreased significantly from 3.4 to 1.9 times more than among the population references. The effect was seen on sick leave, whereas disability pension levels remained similar in both groups throughout. Anti-TNF therapy in nr-axSpA was associated with a significant and sustained improvement of work disability over 2 years. However, the proportion of work-loss days remained almost twice as high as in the general population at the end of follow-up. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Development of a Korean Version of the Perceived Deficits Questionnaire-Depression for Patients with Major Depressive Disorder

PubMed Central

Kim, Jae-Min; Hong, Jin-Pyo; Kim, Sang-Dae; Kang, Hee-Ju; Lee, Yong-Sung

2016-01-01

Objective Cognitive symptoms are an important component of depression and the Perceived Deficits Questionnaire-Depression is one of only a few instruments available for the subjective assessment of cognitive dysfunction in depression. Thus, the present study aimed to validate a Korean version of the PDQ-D (K-PDQ-D) using patients with major depressive disorder (MDD). Methods This study included 128 MDD patients who were assessed at study entry and 86 of these patients were then completed 12 weeks of antidepressant monotherapy. All subjects were assessed with the K-PDQ-D, the Montgomery-Asberg Depression Rating Scale (MADRS), the Sheehan Disability Scale (SDS), the EuroQol-5 dimensions questionnaire (EQ-5D), and the number of sick leave days taken in the previous week. The internal consistency, Guttman’s split-half and test-retest reliabilities, factorial analyses, and concurrent and predictive validities of the K-PDQ-D were investigated. Results The K-PDQ-D exhibited excellent internal consistency and reliabilities, and was composed of four factors with high coefficients of determination. The concurrent validity analyses revealed that the K-PDQ-D scores were significantly correlated with the MADRS, SDS, and EQ-5D scores and the number of sick leave days taken. The K-PDQ-D scores at study entry significantly predicted changes in sick leave days and EQ-5D score from study entry to the 12-week endpoint. Conclusion The newly developed K-PDQ-D is a reliable and valid instrument for the evaluation of subjective cognitive symptoms in MDD patients. The K-PDQ-D may assist in the gathering of unique information regarding subjective cognitive complaints, which is important for the comprehensive evaluation of patients with MDD. PMID:26792037

[Part-time Work and Men's Health : Results based on Routine Data of a Statutory Health Insurance Scheme].

PubMed

Grobe, Thomas G

2016-08-01

With the introduction of a new occupational classification at the end of 2011, employment characteristics are reported by employees to social insurance agencies in Germany in more detail than in previous years. In addition to other changes, the new classification allows a distinction between full- and part-time work to be made. This provided a reason to consider the health-related aspects of part-time work on the basis of data from a statutory health insurance scheme. Our analysis is based on the data of 3.8 million employees insured with the Techniker Krankenkasse (TK), a statutory health insurance scheme, in 2012. In addition to daily information on employment situations, details of periods and diagnoses of sick leave and the drugs prescribed were available. Although approximately 50 % of women of middle to higher working age worked part-time in 2012, the corresponding percentage of men employed in part-time work was less than 10 %. Overall, part-time employees were on sick leave for fewer days than full-time employees, but among men, sick leave due to mental disorders was longer for part-time employees than for full-time employees, whereas women working part time were affected to a lesser extent by corresponding periods of absence than those working full time. The results provide indications for the assertion that men in gender-specifically atypical employment situations are more frequently affected by mental disorders. Further evidence supports this assertion. With the long-term availability of these new employment characteristics, longitudinal analyses could help to clarify this cause-effect relationship.

Risk adjustment and the fear of markets: the case of Belgium.

PubMed

Schokkaert, E; Van de Voorde, C

2000-02-01

In Belgium the management and administration of the compulsory and universal health insurance is left to a limited number of non-governmental non-profit sickness funds. Since 1995 these sickness funds are partially financed in a prospective way. The risk adjustment scheme is based on a regression model to explain medical expenditures for different social groups. Medical supply is taken out of the formula to construct risk-adjusted capitation payments. The risk-adjustment formula still leaves scope for risk selection. At the same time, the sickness funds were not given the instruments to exert a real influence on expenditures and the health insurance market has not been opened for new entrants. As a consequence, Belgium runs the danger of ending up in a situation with little incentives for efficiency and considerable profits from cream skimming.

The attribution of work environment in explaining gender differences in long-term sickness absence: results from the prospective DREAM study.

PubMed

Labriola, Merete; Holte, Kari Anne; Christensen, Karl Bang; Feveile, Helene; Alexanderson, Kristina; Lund, Thomas

2011-09-01

To identify differences in risk of long-term sickness absence between female and male employees in Denmark and to examine to what extent differences could be explained by work environment factors. A cohort of 5026 employees (49.1% women, mean age 40.4years; 50.9% men, mean age 40.2years) was interviewed in 2000 regarding gender, age, family status, socio-economic position and psychosocial and physical work environment factors. The participants were followed for 18months in order to assess their incidence of long-term sickness absence exceeding 8 consecutive weeks. 298 workers (5.9%) received sickness absence compensation for 8weeks or more. Women had an excess risk of 37% compared to men, when adjusting for age, family status and socio-economic position. Physical work environment exposures could not explain this difference, whereas differences in psychosocial work environment exposures explained 32% of the differences in risk of long-term sickness absence between men and women, causing the effect of gender to become statistically insignificant. The combined effect of physical and psychosocial factors was similar, explaining 30% of the gender difference. Differences in psychosocial work environments in terms of emotional demands, reward at work, management quality and role conflicts, explained roughly 30% of women's excess long-term sickness absence risk. Assuming women and men had identical working conditions would leave the larger part of the gender difference in long-term sickness absence from work unexplained.

Using administrative sickness absence data as a marker of future disability pension: the prospective DREAM study of Danish private sector employees.

PubMed

Lund, Thomas; Kivimäki, Mika; Labriola, Merete; Villadsen, Ebbe; Christensen, Karl Bang

2008-01-01

The aim of this study was to examine duration of sickness absence as a risk marker for future disability pension among all private sector employees in Denmark 1998-2004. All private sector employees receiving sickness absence compensation from the municipality in 1998, a total of 225 056 persons (39.2% women 61.8% men, age range 18-65, mean age 37.2), were followed in a national register to determine granted disability pension during the period 1 January 2001 through 31 December 2004. The authors excluded pensions in 1999 and 2000 to determine the status of sickness absence duration as an early risk marker. 5694 persons (2.5%) received disability pension during follow-up, more men (53.4%) than women (46.6%). There was a strong graded association between increasing length of absence and increasing risk of future disability pension. Significant differences were found between the younger and older age strata: men below 40 experiencing more than 26 weeks of sickness absence had a 16-fold risk of disability pension. The corresponding figure for men 40 years or older was approximately 7. For women, the corresponding figures were 12.6 and 6.7 respectively. The findings suggest that administratively collected data on sickness absence compensation are an important predictor of disability pension among private sector employees. The use of information on sick leave may improve the effectiveness of early interventions by policy makers, case managing authorities, employers and physicians.

PTSD Trajectory, Comorbidity, and Utilization of Mental Health Services Among Reserves

DTIC Science & Technology

2009-10-01

unemployed 4 Retired 5 A homemaker 6 A student 7 On maternity or paternity leave 8 On illness or sick leave 9 On disability 10 Other (SPECIFY...with ongoing civilian life . The central goal of this work is to identify the changeable factors that can improve resilient mental health outcomes...AUTHOR(S) 5d. PROJECT NUMBER Sandro Galea, M.D., PH.D. 5e. TASK NUMBER E-Mail: sgalea@umich.edu 5f. WORK UNIT NUMBER 7. PERFORMING

7 CFR 70.76 - Charges for continuous poultry grading performed on a nonresident basis.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS... under the Social Security System, retirement benefits, group life insurance, severance pay, sick leave...

42 CFR 413.100 - Special treatment of certain accrued costs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific...) If the sick leave plan grants employees the nonforfeitable right to demand cash payment for unused... reporting periods that produce the highest average contribution(s), out of the five most recent Medicare...

42 CFR 413.100 - Special treatment of certain accrued costs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific...) If the sick leave plan grants employees the nonforfeitable right to demand cash payment for unused... reporting periods that produce the highest average contribution(s), out of the five most recent Medicare...

Medical consequences of a factory closure: illness and disability in a four-year follow-up study.

PubMed

Westin, S; Norum, D; Schlesselman, J J

1988-03-01

The effect of a factory shut-down on sick leave and disability pensions was investigated in a four-year controlled follow-up study in a general practice setting. The study population consisted of 85 people, 72 women and 13 men, who lost their jobs when a sardine factory near Bergen in Norway was shut down in 1975. The employees of a nearby sister factory' within the same company were chosen as a control population, consisting of 87 people, 66 women and 21 men. The average amount of sick leave for the study group within the first year of follow-up showed a twofold increase compared to the controls. The rate of disability pensions, estimated by the life table method with appropriate adjustments, was more than three times higher in the study group than in the control group from the second through the fourth year of follow-up. The results of this investigation provide further evidence in support of a causal relationship between job loss and illness.

Rheumatoid arthritis and work: The impact of rheumatoid arthritis on absenteeism and presenteeism.

PubMed

Verstappen, Suzanne M M

2015-06-01

For patients with rheumatoid arthritis (RA), being in paid work is very important, and it increases self-esteem and financial independence. Although the management of RA has changed in the last 15 years to early aggressive treatment and the introduction of biologic treatments, many patients still have to take sick leave or even stop working because of their RA (i.e., absenteeism). For those remaining in paid work, patients may experience problems due to RA resulting in productivity loss while at work (i.e., presenteeism). The costs attributed to absenteeism and presenteeism (i.e., indirect costs) have been estimated to be very high, and they even exceed direct costs. However, there is no consensus on how to calculate these costs. This manuscript examines the relationship between the use of biologic therapy and absenteeism, with a focus on sick leave, and on presenteeism, and it provides an overview of indirect costs of absenteeism and presenteeism in those treated with biologic therapies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Green tobacco sickness among tobacco farmers in southern Brazil.

PubMed

Fassa, Anaclaudia G; Faria, Neice M X; Meucci, Rodrigo D; Fiori, Nadia Spada; Miranda, Vanessa Iribarrem; Facchini, Luiz Augusto

2014-06-01

Despite being the second largest tobacco producer in the world, Brazil does not have prevalence studies about green tobacco sickness (GTS). A cross-sectional study was carried out on a sample of Brazilian tobacco workers. The sample was described according to socio-demographic, behavioral, and occupational variables. Gender-stratified multivariate analyses examined variables associated with GTS. GTS prevalence among men in the previous month was 6.6%, while among women it was 11.9%. Among men, age, being a non-smoker, hanging tobacco sticks in the barn, harvesting wet leaves, and exposure to physical exertion were risk factors for GTS. Among women, tying hands of tobacco, transporting bales, harvesting wet leaves, having had contact with pesticides, and exposure to physical exertion were positively associated with GTS. Research is required to improve methods for GTS screening, as well as the ability to distinguish GTS from pesticide poisoning. Health professionals should be trained to diagnose and treat GTS. © 2014 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Assessment of long-term work attendance within human service organisations.

PubMed

Dellve, Lotta; Eriksson, Jesper; Vilhelmsson, Rebecka

2007-01-01

Terms and theories of work attendance vary according to their use and focus. This paper analyzes long-term work attendance in relation to social, psychosocial, and health-related factors. Register-based and questionnaire-based data covering 3,804 human service organisation workers over a three-year period were analyzed at individual and work-unit level. The results showed positive relationships between work attendance and male gender, high income, work commitment, job satisfaction, and having positive feelings towards work. High work attendance combined with work commitment, stress, or pain did not show any negative long-term effects upon short-term or long-term sick leave. Instead, work attendance seemed to be more associated with stable patterns of behaviour. Register-based measures of work attendance (at most 4-7 days of sick leave per worker per year) may be a useful tool in managing psychosocial work environment and related behaviour, but their inability to encompass information regarding individual health and disease must be borne in mind.

Test-Retest Reliability, Agreement and Responsiveness of Productivity Loss (iPCQ-VR) and Healthcare Utilization (TiCP-VR) Questionnaires for Sick Workers with Chronic Musculoskeletal Pain.

PubMed

Beemster, Timo T; van Velzen, Judith M; van Bennekom, Coen A M; Reneman, Michiel F; Frings-Dresen, Monique H W

2018-03-16

The purpose of this study was to assess test-retest reliability, agreement, and responsiveness of questionnaires on productivity loss (iPCQ-VR) and healthcare utilization (TiCP-VR) for sick-listed workers with chronic musculoskeletal pain who were referred to vocational rehabilitation. Methods Test-retest reliability and agreement was assessed with a 2-week interval. Responsiveness was assessed at discharge after a 15-week vocational rehabilitation (VR) program. Data was obtained from six Dutch VR centers. Test-retest reliability was determined with intraclass correlation coefficient (ICC) and Cohen's kappa. Agreement was determined by Standard Error of Measurement (SEM), smallest detectable changes (on group and individual level), and percentage observed, positive and negative agreement. Responsiveness was determined with area under the curve (AUC) obtained from receiver operation characteristic (ROC). Results A sample of 52 participants on test-retest reliability and agreement, and a sample of 223 on responsiveness were included in the analysis. Productivity loss (iPCQ-VR): ICCs ranged from 0.52 to 0.90, kappa ranged from 0.42 to 0.96, and AUC ranged from 0.55 to 0.86. Healthcare utilization (TiCP-VR): ICC was 0.81, and kappa values of the single healthcare utilization items ranged from 0.11 to 1.00. Conclusions The iPCQ-VR showed good measurement properties on working status, number of hours working per week and long-term sick leave, and low measurement properties on short-term sick leave and presenteeism. The TiCP-VR showed adequate reliability on all healthcare utilization items together and medication use, but showed low measurement properties on the single healthcare utilization items.

Absenteeism due to mental health problems and systems for return to work: an internet-based unmatched case-control study.

PubMed

Doki, Shotaro; Sasahara, Shinichiro; Hirai, Yasuhito; Oi, Yuichi; Matsuzaki, Ichiyo

2016-11-01

The aim of this study was to investigate the risk factors for absenteeism due to mental health problems with regard to company characteristics and systems for return to work in Japan. This was an Internet-based unmatched case-control study. Two hundred and fifty-eight workers who experienced over 28 days of sick leave due to mental health problems (cases) and 258 workers who have not taken sick leave (controls) were recruited. Company characteristics and the awareness and presence of systems for return to work were analysed as indicators of absenteeism. A total of 501 workers were included in the analysis. Females were less likely to experience absenteeism when adjustments were made for both the awareness and presence of systems [odds ratio (OR) = 0.51 and 0.41, respectively]. Large companies showed an increased risk of having absentee workers than small companies. The awareness of a gradual resumption system and the presence of a sick pay system were related to absenteeism (OR = 2.75 and 2.40, respectively). The awareness and presence of systems for return to work are related to the long-term absenteeism. The predictors of sex and company size are also related to the experience of the long-term absenteeism. To understand the effect of systems for return to work on absenteeism due to mental problems, further studies are needed.

Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions.

PubMed

Carroll, Christopher; Rick, Jo; Pilgrim, Hazel; Cameron, Jackie; Hillage, Jim

2010-01-01

Long-term sickness absence among workers is a major problem in industrialised countries. The aim of the review is to determine whether interventions involving the workplace are more effective and cost-effective at helping employees on sick leave return to work than those that do not involve the workplace at all. A systematic review of controlled intervention studies and economic evaluations. Sixteen electronic databases and grey literature sources were searched, and reference and citation tracking was performed on included publications. A narrative synthesis was performed. Ten articles were found reporting nine trials from Europe and Canada, and four articles were found evaluating the cost-effectiveness of interventions. The population in eight trials suffered from back pain and related musculoskeletal conditions. Interventions involving employees, health practitioners and employers working together, to implement work modifications for the absentee, were more consistently effective than other interventions. Early intervention was also found to be effective. The majority of trials were of good or moderate quality. Economic evaluations indicated that interventions with a workplace component are likely to be more cost effective than those without. Stakeholder participation and work modification are more effective and cost effective at returning to work adults with musculoskeletal conditions than other workplace-linked interventions, including exercise.

When School Makes Us Sick

ERIC Educational Resources Information Center

Blodget, Alden S.

2010-01-01

There's something wrong when attending a really good workshop leaves one sad. In mid-October, 80 dedicated, bright teachers and administrators met with some workshop leaders and speakers in Vermont to explore the growing difficulties that students with "executive function" problems have in school--problems that affect such things as…

50 CFR 600.120 - Employment practices.

Code of Federal Regulations, 2014 CFR

2014-10-01

... funded in lieu of life and medical/dental policies are not permitted. (d) Unused sick leave may be... ADMINISTRATION, DEPARTMENT OF COMMERCE MAGNUSON-STEVENS ACT PROVISIONS Regional Fishery Management Councils § 600.120 Employment practices. (a) Council staff positions must be filled solely on the basis of merit...