Multicentre validation of frequent sickness absence predictions.

Sickness absence (SA) is a public health risk marker for morbidity and mortality. The aim of this study was to develop and validate prediction models to identify employees at risk of high SA. Two prediction models were developed using self-rated health (SRH) and prior SA as predictors. SRH was measured by the categories excellent, good, fair and poor in a convenience sample of 535 hospital employees. Prior SA was retrieved from the employer's register. The predictive performance of the models was assessed by logistic regression analysis with high (≥ 90 th percentile) vs. non-high (<90th percentile) SA days and SA episodes as outcome variables and by using bootstrapping techniques to validate the models. The overall performance as reflected in the Nagelkerke's pseudo R(2) was 11.7% for the model identifying employees with high SA days and 31.8% for the model identifying employees with high SA episodes. The discriminative ability, represented by the area (AUC) under the receiver operating characteristic (ROC), was 0.729 (95% CI 0.667-0.809) for the model identifying employees with high SA days and 0.831 (95% CI 0.784-0.877) for the model identifying employees with high SA episodes. The Hosmer-Lemeshow test showed acceptable calibration for both models. The prediction models identified employees at risk of high SA, but need further external validation in other settings and working populations before applying them in public and occupational health research and care.

BackgroundWe investigated whether changes in alcohol use predict changes in the risk of sickness absence in a case-crossover design.MethodsFinnish public sector employees were surveyed in 2000, 2004 and 2008 on...

&lt;sec&gt;&lt;st&gt;Objective&lt;/st&gt; Previous studies indicate that evening workers have increased risk of long-term sickness absence. The aim of the present study was to examine if evening work is associated with higher risk of sickness absence compared to daytime work. &lt;/sec&gt; &lt;sec&gt;&lt;st&gt;Methods&lt;/st&gt; The Danish Working Hour Database (DWHD) contains administrative payroll data from all Danish regions from 2007 to 2013. It includes 249,218 unique participants with 224,485,710 observations with starting and ending times for each worked shift and sickness absence on daily basis. For the present explorative study we selected all employees in a single hospital in 2009 (6,254 unique participants; 83% women; age: 40.8 years (SD = 11.9 years); 1,461,690 observations). The dataset was further restricted by excluding short (≤3 hours) and long (≥9 hours) shifts and observations with sickness absence or non-day/evening (e.g. night) shifts during the past 28 days. A sensitivity analysis with evening workers as their own controls, was carried out by excluding participants, who never worked evening. Evening work was defined as one or more evening shifts (≥3 hours between 18:00–23:00) during the past 28 days. The reference was dayshift (≥3 hours between 06:00–20:00). Using a multi-state model we analysed recurrent transitions between three states: work, sickness absence and temporary out of work e.g. holiday. Hazard ratios (HR) for sickness absence were calculated by Cox proportional hazards models adjusted for age and sex. &lt;/sec&gt; &lt;sec&gt;&lt;st&gt;Results&lt;/st&gt; Analyses showed that evening work was associated with lower risk of sickness absence (HR: 0.84, 95% CI: 0.73–0.96). The sensitivity analysis yielded similar results (HR: 0.87, 95% CI: 0.72–1.06). &lt;/sec&gt; &lt;sec&gt;&lt;st&gt;Conclusion&lt;/st&gt; When comparing periods with evening work to periods of day work the present study showed that evening work was associated with a decreased occurrence of sickness absence. This is in contrast to previous studies which compare evening workers with day workers. &lt;/sec&gt;

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".

To investigate nurse managers' leadership behaviour in relation to the sickness absence records of nursing staff. Sickness absence is high in healthcare and interferes with nursing efficiency and quality. Nurse managers' leadership behaviour may be associated with nursing staff sickness absence. Six nurse managers completed the Leadership Effectiveness and Adaptability Description (LEAD) questionnaire, which assesses leadership behaviour in terms of leadership flexibility (i.e. the range of leadership styles) and effectiveness (i.e. using the leadership style that is appropriate for a given situation). LEAD scores were linked to the number of recorded days of sickness absence and both short (1-7 days) and long (>7 days) episodes of sickness absence in the nursing teams. Leadership flexibility of nurse managers was not associated with sickness absence among nurses. High leadership effectiveness was associated with fewer days and fewer short episodes of sickness absence. Leadership effectiveness was unrelated to the number of long episodes of sickness absence. Effective nurse managers had less short-term sickness absence in their nursing teams. If these tentative cross-sectional associations are confirmed in longitudinal studies including more departments, then training effective leadership may improve the management of short-term sickness absence.

Employees in health and social care are often simultaneously exposed to both physical and psychosocial challenges that may increase their risk for sickness absence. The study examines interaction effects of physical and psychosocial work conditions on the future risk for sickness absence among nurses and care assistants in Sweden. The study was based on 14,372 participants in any of the Swedish Work Environment Surveys conducted during the years 1993–2013 with linked register information on background factors and compensated sickness absence. Adjusted hazard ratio (HR), stratified by occupation, and measures of additive interaction effects were estimated. The combinations of high psychosocial job demands and heavy physical work and strenuous postures, respectively, significantly increased the risks for sickness absence among nurses (HR 1.43; CI 1.09–1.88 and HR 1.42; CI 1.16–1.74, respectively), as well as among care assistants (HR 1.51; CI 1.36–1.67 and HR 1.49; CI 1.36–1.63, respectively). The combinations of low job control and both heavy physical work (HR 1.44; CI 1.30–1.60) and strenuous postures (HR 1.42; CI 1.30–1.56) were also associated with excess risk for sickness absence among care assistants. We also found interaction effects among care assistants but not among nurses. The results indicate that the high sickness absence rate among care workers in Sweden can be reduced if the simultaneous exposures of high psychosocial and high physical challenges are avoided. Management policies for reduced time pressure, improved lifting aids, and measures to avoid awkward work postures are recommended. For care assistants, increased influence over work arrangements is likely to lower their sickness absence risk.

The aim of this cohort study was to investigate associations between parity, pre-pregnancy body mass index (BMI), assisted reproductive therapy (ART), time to pregnancy (TTP), and engagement in physical exercise and the risk of sickness absence in pregnancy from 10-29 completed pregnancy weeks. Data from 51 874 pregnancies in the Danish National Birth Cohort collected from 1996 until 2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on questionnaires. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated by Cox regression, using time of first episode of sickness absence as the primary outcome. Multiparity 1.26 (95% CI 1.10-1.45), overweight 1.13 (95% CI 1.08-1.18), obesity 1.23 (95% CI 1.15-1.31), ART 1.10 (95% CI 1.01-1.20), and TTP >12 months 1.06 (95% CI 0.99-1.13) were associated with higher HR of sickness absence. Physical exercise of >120 minutes per week was associated with lower HR 0.84 (95% CI 0.75-0.95). Risk for sickness absence was higher among women who were multiparous, overweight, obese, received ART, and had prolonged TTP, and lower among women engaged in leisure-time physical exercise. Few studies have investigated these associations, and the results should be confirmed in other studies of pregnant women.

Sickness absence is one of the most important working population health indicators. It is a complex phenomenon that is investigated by health care and occupational health specialists, economists, and work psychologists. Sickness absence is used as a predictor for morbidity and mortality, but besides the health status of an individual, sickness absence is influenced by demographic, socio-economic factors, and work environment factors. Conflicts at work are a common psychosocial risk factor that can affect sickness absence. The aim of the study was to investigate the association between different types of workplace conflict and self-reported medically certified sickness absence using cross-sectional survey data pooled from four periodic national surveys—Work conditions and risks in Latvia (2006–2018). The sample is representative of the working population of Latvia, as respondents were randomly drawn from different regions and industries. In total, the study sample (n = 8557) consisted of employees between 16 and 80 years old (average 42.8 +/− 12.6) of which 46.2% were males and 53.8% were females. Researchers used the computer-assisted personal interviewing (CAPI) method for collecting data. The association between workplace conflicts and sickness absence was analysed by using binomial logistic regression and calculated as odds ratios (OR) with 95% confidence intervals (CI), with adjustment for gender, age, education and survey year. The risk of sickness absence was higher among women (OR = 1.24, CI 1.13–1.35), employees aged 25–44 years old and employees with higher income. Controlling for socio-demographic factors and survey year, the odds of sickness absence increased significantly for all types of workplace conflict analysed. The strongest association with sickness absence was related to conflicts between managers and employees (OR = 1.51, CI 1.37–1.66) and conflicts between groups of employees (OR = 1.45, CI 1.31–1.61). Conflicts between employees and with customers also increased the odds of sickness absence (OR = 1.39, CI 1.27–1.52 and OR = 1.11, CI 1.01–1.23, respectively). Our findings suggest that tailored interventions at a company level for reducing workplace conflicts as risk factors of sickness absence are required. Those should focus on the improvement of managers’ leadership and human resource management skills.

Need for recovery after work predicts sickness absence: A 2-year prospective cohort study in truck drivers

BackgroundIt is unclear if objective selection of employees, for an intervention to prevent sickness absence, is more effective than subjective 'personal enlistment'. We hypothesize that objectively selected employees are 'at risk' for sickness absence and eligible to participate in the intervention program.MethodsThe dispatch of 8603 screening instruments forms the starting point of the objective selection process. Different stages of this process, throughout which employees either dropped out or were excluded, were described and compared with the subjective selection process. Characteristics of ineligible and ultimately selected employees, for a randomized trial, were described and quantified using sickness absence data.ResultsOverall response rate on the screening instrument was 42.0%. Response bias was found for the parameters sex and age, but not for sickness absence. Sickness absence was higher in the 'at risk' (N = 212) group (42%) compared to the 'not at risk' (N = 2503) group (25%) (OR 2.17 CI 1.63–2.89; p = 0.000). The selection process ended with the successful inclusion of 151 eligible, i.e. 2% of the approached employees in the trial.ConclusionThe study shows that objective selection of employees for early intervention is effective. Despite methodological and practical problems, selected employees are actually those at risk for sickness absence, who will probably benefit more from the intervention program than others.

AB1394-HPR CAN SUPPORT FROM SIGNIFICANT OTHERS RECUDE SICKNESS ABSENCE IN EARLY RHEUMATOID ARTHRITIS?

ObjectivesThe MoBa study includes data from mothers on several occasions during pregnancy and after birth. The purpose of this study was to compare education level and mid-pregnancy sickness absence in...

Introduction Limitations associated with Multiple Sclerosis (MS) can restrain work capacity and productivity, reducing the possibility to remain in work. Whilst access to sickness compensation might be an option, transitions to other types of employment, such as self-employment, might be considered. We aim to investigate the association of Sickness Absence (SA) and Disability Pension (DP) with employment status among people with multiple sclerosis (PwMS) before and after MS diagnosis compared with people without MS. Methods A prospective longitudinal study was conducted using Swedish register data of 2,779 MS patients diagnosed with MS in 2008-2012 in working ages (20-59 years) and 13,863 population-based matched references. Levels of SA and DP one year before and four years after MS diagnosis were analyzed. Risk of annual SA and DP levels of more than 180 days were compared among the MS patients and references and, their different types of employment, by means of Cox proportional hazard models and adjusted for socio-demographic variables and SA and DP before MS diagnosis. Results In general, people with MS had higher levels of SA and DP before and shortly after MS diagnosis compared to references. PwMS showed a significantly higher probability of reaching over 180 days of SA (Hazard Ratio [HR]=4.89, 95% Confidence interval [CI]=4.43-5.40) and over 180 days of DP (HR = 6.31, 95% CI = 5.46-7.30)) than the references, regardless of type of employment. Moreover, when compared to employed references, self-employed PwMS had similar likelihood to reach over 180 days of SA than employed PwMS, (HR = 4.27, 95% CI = 3.81-4.77) and (HR = 3.83, 95% CI = 2.73-5.38), respectively. In contrast, self-employed references showed less probability (HR = 0.49, 95% CI = 0.31-0.78) to reach over 180 days of SA compared to the employed references. Conclusions In contrast to references, employed and self-employed PwMS had similar probabilities of reaching over 180 days of SA. Key messages This study emphasizes that in Sweden also self-employed have access to sickness compensation, independently of employment status condition. Access to sickness compensation is utilized by PwMS.

To assess the prospective associations between self-reported physical capacity and risk of long-term sickness absence among female health care workers. Female health care workers answered a questionnaire about physical capacity and were followed in a national register of sickness absence lasting for two or more consecutive weeks during 1-year follow-up. Using Cox regression hazard ratio analyses adjusted for age, smoking, body mass index, physical workload, job seniority, psychosocial work conditions, and previous sickness absence, we modeled risk estimates for sickness absence from low and medium physical capacity. Low and medium aerobic fitness, low muscle strength, low flexibility, and low overall physical capacity significantly increased the risk for sickness absence with 20% to 34% compared with health care workers with high capacity. Low physical capacity increases the risk of long-term sickness absence among female health care workers.

The aim of the study was to examine the associations of changes in exposure to physical and psychosocial working conditions on subsequent sickness absence among ageing municipal employees of the City of Helsinki, Finland. Changes in exposure to working conditions were assessed between baseline (2000-2002) and follow-up (2007) surveys. Register-based sickness absence information was linked to the survey data (N=3739) and followed-up from the return of the questionnaire in 2007 to the end of 2010. The study included six measures of physical and two measures of psychosocial working conditions. Negative binomial regression analysis was used to assess the associations and adjust for covariates. Favorable changes in physical working conditions lowered the risk for sickness absence whereas adverse changes increased the risk. Adverse changes in psychosocial working conditions only slightly increased the risk for sickness absence whereas favorable changes were unassociated with sickness absence. Changes in exposure to physical working conditions in particular are associated with subsequent sickness absence. Preventing an increase in exposure to both psychosocial and physical working conditions and promoting a decrease in exposure to physical working conditions likely helps reduce the risk of sickness absence.