Mid Sweden University

OBJECTIVES: The objective was to study the relationship between a situation characterized as being in a "locked-in" position (LIP) in occupation and/or place of work, Effort-reward imbalance (ERI), and long-term sick leave. METHODS: The study population derived from one section of a cross-sectional study SKA (sick-leave, culture and attitudes), and comprised all employees at the Swedish Social Insurance Agency responsible for management and compensation of illness in the working population. The analyses were performed for 2,951 women and 534 men who had complete data. Logistic regression was used to calculate odds ratio (OR) for ERI and sick-leave, the latter only for women. RESULTS: The results showed a strong association between LIP within the place of work and ERI (for women OR = 3.28 95% CI 2.65-4.07, and for men 2.74 1.75-4.30). Also LIP within occupation resulted in high ERI (for women OR = 1.96 1.57-2.41, and for men 1.92 1.22-3.03). In women, ERI (OR = 1.40 1.15-1.70) as well as LIP within place of work (1.88 1.50-2.36) and within occupation (1.48 1.12-1.86) were associated with sick leave. ERI showed a significant mediating effect between LIP and sick leave, within place of work and within occupation (Z value 2.20 and 2.88, respectively). CONCLUSIONS: High ERI is associated with a situation characterized by being locked-in within an occupation or/and within a place of work. The results thereby support the theoretical model of Effort-reward imbalance. The results show that high ERI and being locked in are associated with long-term sick leave. ERI is a potential mediator of the association between being locked in and sick leave.

The objective was to compare the applicability of and results provided by the two measures of sickness absence used most often within the Swedish social insurance administration (that is, unadjusted sick-leave rate and adjusted sick-leave rate) and five measures suggested by epidemiological researchers. Data consisted of four cross-sectional data sets of registry sick-leave data covering four separate years (1997-2000) in three counties. In total 454,000 persons qualified for sickness insurance and aged 20-64 years were included. The two measures used within the social insurance administration and three of the five measures suggested by epidemiological researchers revealed sex-related dissimilarities in absence patterns that indicated that women had more sickness absence than men. However, in marked contrast to those results, two of the epidemiologically based measures (i.e., length of sickness absence and duration of sickness absence) instead showed highly comparable rates of sick leave for men and women, and such information is seldom obtained, albeit definitely of importance, when trying to make a correct assessment of sickness absence. The measure of sickness absence that is used influences the findings and should therefore be chosen with care. Complementing the measures used in the social insurance administration by five measures suggested by epidemiological researchers provided a more informative and comprehensive picture of sickness absence in a population. Further investigations into the effect of using different measures is needed, as well as international consensus on what to call different measures.

This study sought to compare sickness absence and early retirement at two workplaces in Sweden before and after they had received financial support from the Working Life Fund and implemented vocational rehabilitation activities. Two paper and pulp manufacturing plants were compared and a cohort study was set up. The cohort included everyone born in 1934 or later who was employed in December 1988 (918 employees at Plant A and 1543 at Plant B). For 10 years (1989-98), sick leave and disability pensions were monitored. The periods before and after the intervention (1989-93 and 1994-98, respectively) were compared. Cumulative incidence was calculated for short-, long-term and very long-term sick leave, company pension and early retirement. There was no difference between the plants in terms of the three different outcomes when sick leave was measured before and after the intervention. Sick leave in Period 1 was strongly correlated with an elevated risk of sick leave in Period 2. The cumulative incidence of short-term sick leave decreased from 0.92 (95% CI, 0.91-0.93) in Period 1 to 0.79 (95% CI, 0.77-0.80) in Period 2. For employees in the upper age groups, relative risk for long-term and very long-term sick leave was elevated in both periods. The incidence of early retirement and company pension differed between the companies. We conclude that the size of financial investments in rehabilitation programmes has no significant impact on sickness absence or disability pension, based on a comparison between two paper and pulp manufacturing plants in Sweden during the early 1990s. Sickness absence and early retirement at two workplaces--effects of organisational intervention in Sweden.Goine H, Knutsson A, Marklund S, Karlsson B.Department of Public Health and Clinical Medicine, Occupational Medicine, University of Umea, Sweden. hans@goine.pp.seThis study sought to compare sickness absence and early retirement at two workplaces in Sweden before and after they had received financial support from the Working Life Fund and implemented vocational rehabilitation activities. Two paper and pulp manufacturing plants were compared and a cohort study was set up. The cohort included everyone born in 1934 or later who was employed in December 1988 (918 employees at Plant A and 1543 at Plant B). For 10 years (1989-98), sick leave and disability pensions were monitored. The periods before and after the intervention (1989-93 and 1994-98, respectively) were compared. Cumulative incidence was calculated for short-, long-term and very long-term sick leave, company pension and early retirement. There was no difference between the plants in terms of the three different outcomes when sick leave was measured before and after the intervention. Sick leave in Period 1 was strongly correlated with an elevated risk of sick leave in Period 2. The cumulative incidence of short-term sick leave decreased from 0.92 (95% CI, 0.91-0.93) in Period 1 to 0.79 (95% CI, 0.77-0.80) in Period 2. For employees in the upper age groups, relative risk for long-term and very long-term sick leave was elevated in both periods. The incidence of early retirement and company pension differed between the companies. We conclude that the size of financial investments in rehabilitation programmes has no significant impact on sickness absence or disability pension, based on a comparison between two paper and pulp manufacturing plants in Sweden during the early 1990s

The study was aimed to describe the prevalence of long term sickness absence in common male and female occupations and to determine the relative importance of unemployment rates for sickness absence. The prevalence of long term sick leave was investigated among 12 male and female occupations (N = 84,319) in two counties of Sweden. The age-adjusted sickness absence rate ranged between 0.5 and 9.5% among women and between 1.2 and 9.1% in men. When controlling for age and occupation there was no relationship between unemployment rates and sickness absence rate among females. Among males, however, an inverse relationship between unemployment rates and long term sickness absence was found. An unemployment rate of 6.1% or higher was associated with a relative risk for sickness absence of 0.4 compared with reference level 1.0 in the group with the lowest unemployment rate (0-1.1%). There was a strong positive correlation between age and absenteeism. Musculoskeletal symptoms was the dominating diagnostic group in all age groups Knutsson A, Goine H. Department of Occupational and Environmental Medicine, Umea University, Sweden. The study was aimed to describe the prevalence of long term sickness absence in common male and female occupations and to determine the relative importance of unemployment rates for sickness absence. The prevalence of long term sick leave was investigated among 12 male and female occupations (N = 84,319) in two counties of Sweden. The age-adjusted sickness absence rate ranged between 0.5 and 9.5% among women and between 1.2 and 9.1% in men. When controlling for age and occupation there was no relationship between unemployment rates and sickness absence rate among females. Among males, however, an inverse relationship between unemployment rates and long term sickness absence was found. An unemployment rate of 6.1% or higher was associated with a relative risk for sickness absence of 0.4 compared with reference level 1.0 in the group with the lowest unemployment rate (0-1.1%). There was a strong positive correlation between age and absenteeism. Musculoskeletal symptoms was the dominating diagnostic group in all age groups. PMID: 9683376 [PubMed - indexed for MEDLINE]