Cumulative incidence of sickness absence and disease burden among the newly sick-listed, a cross-sectional population-based study

BMC Public Health

Gunnel Hensing²  Inger Haukenes¹  Ann-Charlotte Mårdby²  Brynja Ármannsdóttir² 

[1] Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway;Department of Community Medicine and Public Health, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

关键词: Socio-economic status;    Gender;    Chronic disease;    Incidence;    Sickness absence;   

Others  :  1162352
DOI  :  10.1186/1471-2458-13-329

 received in 2012-12-02, accepted in 2013-03-25,  发布年份 2013

【 摘 要 】

Background

Sickness absence is a public health problem with economic consequences for individuals and society. Although sickness absence and chronic diseases are correlated, few studies exist concerning the role of chronic disease in all-cause sickness absence. The aim was to assess the cumulative incidence of sickness absence and examine the accompanying burden of chronic diseases among the sick-listed.

Methods

A cross-sectional study was performed with data from 2008. Cumulative incidence of all-cause sickness absence (≥14 days) was calculated based on all newly sick-listed individuals (N = 12,543). The newly sick-listed sample and a randomized general population sample (n = 7,984) received a questionnaire (participation rates: 54% and 50%).To assess the burden of self-reported chronic diseases, standardized incidence ratios (SIR) were calculated.

Results

Estimated one-year cumulative incidence was 11.3% (95% CI: 11.2–11.3), 14.0% (13.9–14.1) for women and 8.6% (8.5–8.6) for men. Gender differences were consistent across all age groups, with highest cumulative incidence among women aged 51–64 years, 18.2% (18.0–18.5). For women, the burden of chronic disease was significantly higher for nine out of twelve disease groups, corresponding numbers for men were nine out of eleven disease groups (standardized for age and socio-economic status). Neoplastic diseases had the highest SIR with 4.3 (3.4–5.2) for women and 4.2 (2.8–5.6) for men. For psychiatric and rheumatic diseases the respective SIR’s were 1.7 for women and 1.8 for men. The remaining disease groups had an elevated risk of 20-60% (SIR 1.2–1.6). The risk of reporting a co-morbidity was increased for women (SIR 1.4 (95% CI 1.4–1.5)) and men (SIR 1.5 (1.4–1.7)) among the sick-listed.

Conclusions

Register data was used to estimate of the cumulative incidence of sickness absence in the general population. A higher burden of chronic disease among the newly sick-listed was found. Targeting long-term health problems may be an important public health strategy for reducing sickness absence.

【 授权许可】

   
2013 Ármannsdóttir et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Barmby TA, Ercolani MG, Treble JG: Sickness Absence: An International Comparison. Econ J 2002, 112(June):F315-F331.
• [2]Eurostat: Europe in figures - Eurostat yearbook. European Union: Luxembourgh; 2011.
• [3]Lund T, Christensen KB, Vaez M, Labriola M, Josephson M, Villadsen E, Voss M: Differences in sickness absence in Sweden and Denmark: the cross national HAKNAK study. Eur J Public Health 2009, 19(3):343-349.
• [4]OECD: Sickness, Disability and Work. Organisation for Economic Co-operation and Development: Edited by Directorate for Employment Labour and Social Affairs; 2006.
• [5]Hytti H: Why are Swedes sick but Finns unemployed? Int J Soc Welf 2006, 15(2):131-141.
• [6]Henderson M, Glozier N, Holland Elliott K: Long term sickness absence. BMJ 2005, 330(7495):802-803.
• [7]Meershoek A, Krumeich A, Vos R: Judging without criteria? Sickness certification in Dutch disability schemes. Sociol Health Illn 2007, 29(4):497-514.
• [8]Alexanderson K: Sickness absence: a review of performed studies with focused on levels of exposures and theories utilized. Scand J Soc Med 1998, 26(4):241-249.
• [9]Labriola M, Lund T, Burr H: Prospective study of physical and psychosocial risk factors for sickness absence. Occup Med (Lond) 2006, 56(7):469-474.
• [10]North FM, Syme SL, Feeney A, Shipley M, Marmot M: Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study. Am J Public Health 1996, 86(3):332-340.
• [11]Marmot M, Feeney A, Shipley M, North F, Syme SL: Sickness absence as a measure of health status and functioning: from the UK Whitehall II study. J Epidemiol Community Health 1995, 49(2):124-130.
• [12]Lidwall U, Marklund S: What is healthy work for women and men? - A case–control study of gender- and sector-specific effects of psycho-social working conditions on long-term sickness absence. Work 2006, 27(2):153-163.
• [13]Bekker MH, Rutte CG, van Rijswijk K: Sickness absence: A gender-focused review. Psychol Health Med 2009, 14(4):405-418.
• [14]Laaksonen M, Mastekaasa A, Martikainen P, Rahkonen O, Piha K, Lahelma E: Gender differences in sickness absence–the contribution of occupation and workplace. Scand J Work Environ Health 2010, 36(5):394-403.
• [15]Christensen KB, Labriola M, Lund T, Kivimaki M: Explaining the social gradient in long-term sickness absence: a prospective study of Danish employees. J Epidemiol Community Health 2008, 62(2):181-183.
• [16]North F, Syme SL, Feeney A, Head J, Shipley MJ, Marmot MG: Explaining socioeconomic differences in sickness absence: the Whitehall II Study. BMJ 1993, 306(6874):361-366.
• [17]Ferrie JE, Vahtera J, Kivimaki M, Westerlund H, Melchior M, Alexanderson K, Head J, Chevalier A, Leclerc A, Zins M: Diagnosis-specific sickness absence and all-cause mortality in the GAZEL study. J Epidemiol Community Health 2009, 63(1):50-55.
• [18]Kivimaki M, Head J, Ferrie JE, Shipley MJ, Vahtera J, Marmot MG: Sickness absence as a global measure of health: evidence from mortality in the Whitehall II prospective cohort study. BMJ 2003, 327(7411):364.
• [19]Vahtera J, Westerlund H, Ferrie JE, Head J, Melchior M, Singh-Manoux A, Zins M, Goldberg M, Alexanderson K, Kivimaki M: All-cause and diagnosis-specific sickness absence as a predictor of sustained suboptimal health: a 14-year follow-up in the GAZEL cohort. J Epidemiol Community Health 2010, 64(4):311-317.
• [20]Wallman T, Wedel H, Palmer E, Rosengren A, Johansson S, Eriksson H, Svardsudd K: 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. BMC Publ Health 2009, 9:104. BioMed Central Full Text
• [21]Ahola K, Virtanen M, Honkonen T, Isometsa E, Aromaa A, Lonnqvist J: Common mental disorders and subsequent work disability: a population-based Health 2000 Study. J Affect Disord 2011, 134(1–3):365-372.
• [22]Gustafsson K, Marklund S: Consequences of sickness presence and sickness absence on health and work ability: a Swedish prospective cohort study. Int J Occup Med Environ Health 2011, 24(2):153-165.
• [23]Bergh H, Baigi A, Mansson J, Mattsson B, Marklund B: Predictive factors for long-term sick leave and disability pension among frequent and normal attenders in primary health care over 5 years. Public Health 2007, 121(1):25-33.
• [24]Hemingway H, Vahtera J, Virtanen M, Pentti J, Kivimaki M: Outcome of stable angina in a working population: the burden of sickness absence. Eur J Cardiovasc Prev Rehabil 2007, 14(3):373-379.
• [25]Andrea H, Beurskens AJ, Metsemakers JF, van Amelsvoort LG, van den Brandt PA, van Schayck CP: Health problems and psychosocial work environment as predictors of long term sickness absence in employees who visited the occupational physician and/or general practitioner in relation to work: a prospective study. Occup Environ Med 2003, 60(4):295-300.
• [26]Roskes K, Donders CG, van der Gulden JW: Health-related and work-related aspects associated with sick leave: a comparison of chronically ill and non-chronically ill workers. Int Arch Occup Environ Health 2005, 78(4):270-278.
• [27]Kivimaki M, Leino-Arjas P, Kaila-Kangas L, Virtanen M, Elovainio M, Puttonen S, Keltikangas-Jarvinen L, Pentti J, Vahtera J: Increased absence due to sickness among employees with fibromyalgia. Ann Rheum Dis 2007, 66(1):65-69.
• [28]Erickson SR, Kirking DM: A cross-sectional analysis of work-related outcomes in adults with asthma. Ann Allergy Asthma Immunol 2002, 88(3):292-300.
• [29]Hensing G, Holmgren K, Mardby AC: Harmful alcohol habits were no more common in a sample of newly sick-listed Swedish women and men compared with a random population sample. Alcohol Alcohol 2011, 46(4):471-477.
• [30]Regeringskansliet: Social insurance in Sweden - Fact sheet. Ministry of health and social affairs: Stockholm; 2009.
• [31]Chronic diseases[http://www.who.int/topics/chronic_diseases/en/] webcite
• [32]Socio-economic classification(Socioekonomisk indelning (SEI)) [http://www.scb.se/sei webcite]
• [33]Merrill R: Introduction to Epidemiology. 5th edition. Sudbury: Jones and Bartlett Publishers; 2010.
• [34]Altman DG: Practical Statistics for Medical Research. London: Chapman & Hall; 1991.
• [35]Morris JA, Gardner MJ: Statistics in Medicin. Br Med J 1988, 296:1313-1316.
• [36]Hensing G: The measurements of sickness absence – a theoretical perspective. Norsk Epidemiologi 2009, 19(2):147-151.
• [37]Hensing G, Andersson L, Brage S: Increase in sickness absence with psychiatric diagnosis in Norway: a general population-based epidemiologic study of age, gender and regional distribution. BMC Med 2006, 4:19. BioMed Central Full Text
• [38]Hensing G, Alexanderson K, Akerlind I, Bjurulf P: Sick-leave due to minor psychiatric morbidity: role of sex integration. Soc Psychiatry Psychiatr Epidemiol 1995, 30(1):39-43.
• [39]Lidwall U, Bergendorff S, Voss M, Marklund S: Long-term sickness absence: changes in risk factors and the population at risk. Int J Occup Environ Med 2009, 22(2):157-168.
• [40]Lidwall U, Marklund S: Trends in long‐term sickness absence in Sweden 1992–2008: the role of economic conditions, legislation, demography, work environment and alcohol consumption. Int J Soc Welf 2011, 20(2):167-179.
• [41]Eriksson HG, von Celsing AS, Wahlstrom R, Janson L, Zander V, Wallman T: Sickness absence and self-reported health a population-based study of 43,600 individuals in central Sweden. BMC Publ Health 2008, 8:426. BioMed Central Full Text
• [42]Johansen K, Bihrmann K, Mikkelsen S, Lynge E: Trends in sickness absence in Denmark. Scand J Work Environ Health 2009, 35(5):334-341.
• [43]Silverstein M: Meeting the challenges of an aging workforce. Am J Ind Med 2008, 51(4):269-280.
• [44]Gjesdal S, Bratberg E, Maeland JG: Gender differences in disability after sickness absence with musculoskeletal disorders: five-year prospective study of 37,942 women and 26,307 men. BMC Musculoskelet Disord 2011, 12:37. BioMed Central Full Text
• [45]Bratberg E, Dahl SÅ, Risa AE: ‘The Double Burden’: Do Combinations of Career and Family Obligations Increase Sickness Absence among Women? Eur Sociol Rev 2002, 18(2):233-249.
• [46]Nyman CS, Spak L, Hensing G: Are there any associations between single and/or multiple social roles and self-rated physical health, psychiatric disorder and long-term sickness absence in women? Ital J Public Health 2012, 9(1):80-88.
• [47]Hensing G, Alexanderson K: The association between sex segregation, working conditions, and sickness absence among employed women. Occup Environ Med 2004, 61(2):e7.
• [48]Laaksonen M, Martikainen P, Rahkonen O, Lahelma E: Explanations for gender differences in sickness absence: evidence from middle-aged municipal employees from Finland. Occup Environ Med 2008, 65(5):325-330.
• [49]Molarius A, Janson S: Self-rated health, chronic diseases, and symptoms among middle-aged and elderly men and women. J Clin Epidemiol 2002, 55(4):364-370.
• [50]Maas AH, Appelman YE: Gender differences in coronary heart disease. Neth Heart J 2010, 18(12):598-603.
• [51]Sverker A, Ostlund G, Hallert C, Hensing G: 'I lose all these hours…'–exploring gender and consequences of dilemmas experienced in everyday life with coeliac disease. Scand J Caring Sci 2009, 23(2):342-352.
• [52]Aamland A, Malterud K, Werner EL: Phenomena associated with sick leave among primary care patients with Medically Unexplained Physical Symptoms: a systematic review. Scand J Prim Health Care 2012, 30(3):147-155.
• [53]Horneber M, Fischer I, Dimeo F, Ruffer JU, Weis J: Cancer-related fatigue: epidemiology, pathogenesis, diagnosis, and treatment. Dtsch Arztebl Int 2012, 109(9):161-171. quiz 172
• [54]Livanos I, Zangelidis A: Sickness absence. Munich Personal RePEc Archive: A Pan-European Study (Unpublished); 2010.
• [55]Pocock SJ: Harmonic Analysis Applied to Seasonal Variations in Sickness Absence. J R Stat Soc Ser C Appl Stat 1974, 23(2):103-120.
• [56]Mandell GL, Bennett JE, Dolin R: Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 7th edition. Philadelphia, PA: Churchill Livingstone/Elsevier; 2010.
• [57]Kehoe R, Wu SY, Leske MC, Chylack LT Jr: Comparing self-reported and physician-reported medical history. Am J Epidemiol 1994, 139(8):813-818.
• [58]Haapanen N, Miilunpalo S, Pasanen M, Oja P, Vuori I: Agreement between questionnaire data and medical records of chronic diseases in middle-aged and elderly Finnish men and women. Am J Epidemiol 1997, 145(8):762-769.
• [59]Sartorius N, Ustun TB, Lecrubier Y, Wittchen HU: Depression comorbid with anxiety: results from the WHO study on psychological disorders in primary health care. Br J Psychiatry Suppl 1996, 30:38-43.
• [60]Kessler RC: Psychiatric epidemiology: selected recent advances and future directions. Bull World Health Organ 2000, 78(4):464-474.