| 1. |
- Ferrie, J E, et al.
(författare)
-
Diagnosis-specific sickness absence and all-cause mortality in the GAZEL study.
- 2009
-
Ingår i: Journal of epidemiology and community health. - : BMJ. - 1470-2738 .- 0143-005X. ; 63:1, s. 50-5
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study aims to examine diagnosis-specific sickness absence as a risk marker for all-cause mortality. METHODS: Prospective occupational cohort (the GAZEL study). Medically certified sickness absence spells >7 days for 15 diagnostic categories, 1990-1992, were examined in relation to all-cause mortality, January 1993-February 2007. The reference group for each diagnostic category was participants with no spell >7 days for that diagnosis. The participants were French public utility workers (5271 women and 13 964 men) aged 37-51 years in 1990, forming the GAZEL study. Over the follow-up period, there were 144 deaths in women and 758 in men. RESULTS: 7875 employees (41.0%) had at least one spell of sickness absence >7 days over the 3-year period. The commonest diagnoses were mental disorders, musculoskeletal diseases, respiratory diseases and external causes in both sexes; genitourinary diseases in women, and digestive and circulatory diseases in men. Of these common diagnoses, mental disorders in women, hazard ratio (95% confidence intervals) 1.24 (1.1 to 1.4), and mental disorders 1.35 (1.3 to 1.5), digestive diseases 1.29 (1.1 to 1.6) and circulatory diseases 1.35 (1.2 to 1.6) in men were associated with mortality after adjustment for age, employment grade and sickness absence in all other diagnostic categories. CONCLUSIONS: Employees with medically certified absence spells of 1 week or more over a 3-year period had a 60% excess risk of early death. In women and men this excess risk was associated with some of the commonest diagnoses of sickness absence, in particular mental disorders. Sickness absence for mental disorders may be a useful early indicator of groups at increased risk of fatal disease.
|
|
| 2. |
|
|
| 3. |
- Kivimäki, M, et al.
(författare)
-
Sickness absence as a prognostic marker for common chronic conditions : analysis of mortality in the GAZEL study.
- 2008
-
Ingår i: Occup Environ Med. - : BMJ. - 1470-7926 .- 1351-0711. ; 65:12, s. 820-6
-
Tidskriftsartikel (refereegranskat)abstract
- Sickness absence as a prognostic marker for common chronic conditions: analysis of mortality in the GAZEL study.Kivimäki M, Head J, Ferrie JE, Singh-Manoux A, Westerlund H, Vahtera J, Leclerc A, Melchior M, Chevalier A, Alexanderson K, Zins M, Goldberg M.Department of Epidemiology and Public Health, University College London, London, UK. m.kivimaki@ucl.ac.ukOBJECTIVES: To determine whether sickness absence is a prognostic marker in terms of mortality among people with common chronic conditions. METHODS: Prospective occupational cohort study of 13,077 men and 4871 women aged 37-51 from the National Gas and Electricity Company, France. Records of physician-certified sickness absences over a 3-year period were obtained from employers' registers. Chronic conditions were assessed in annual surveys over the same period. The main outcome measure was all-cause mortality (803 deaths, mean follow-up after assessment of sickness absence: 13.9 years). RESULTS: In Cox proportional hazard models adjusted for age, sex, socioeconomic position and co-morbidity, >28 annual sickness-absence days versus no absence days was associated with an excess mortality risk among those with cancer (hazard ratio 5.4, 95% CI 2.2 to 13.1), depression (1.7, 1.1 to 2.8), chronic bronchitis or asthma (2.7, 1.6 to 4.6) and hypertension (1.6, 1.0 to 2.6). The corresponding hazard ratios for more than five long (>14 days) sickness-absence episodes per 10 person-years versus no such episodes were 5.4 (2.2 to 13.1), 1.8 (1.3 to 2.7), 2.0 (1.3 to 3.2) and 1.8 (1.2 to 2.7), respectively. Areas under receiver operating characteristics curves for these absence measures varied between 0.56 and 0.73, indicating the potential of these measures to distinguish groups at high risk of mortality. The findings were consistent across sex, age and socioeconomic groups and in those with and without co-morbid conditions. CONCLUSION: Data on sickness absence may provide useful prognostic information for common chronic conditions at the population level.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Hyde, M, et al.
(författare)
-
Bridges, pathways and valleys: labour market position and risk of hospitalization in a Swedish sample aged 55-63
- 2004
-
Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 32:5, s. 368-373
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The combination of population ageing and increasingly early labour market exit (LME) throughout Europe has made older age a key issue in social policy and research. There is increasing awareness that older people are a heterogeneous group in which health inequalities persist. However, the effects of different types of LME on health have received relatively little attention. Existing studies reach different conclusions. This might be due to several reasons: different types of LME are rarely explored in conjuncture; studies often lack objective assessments of health and frequently rely on small populations. This paper aims to test the relative effects of different LME on the risk of hospitalization compared with those who remained in paid employment. Methods: Using Government register data on pooled cross-section samples of Swedish workers aged 55 - 63 years (n=7,024) the authors have compared the likelihood of hospitalization for three types of LME - disability pension (förtidpension), unemployment, and early retirement - with those who continue working. Results: Controlling for previous hospitalization, sex, age, social class, and health at work a significant increased risk of hospitalization was found following LME for the unemployed (OR=1.98). Conclusion: Early LME is a varied process with mixed effects on health, and hence is of possible importance for policy, which, therefore, requires more attention. Programmes to help older unemployed workers back into work will have positive health effects for individuals and reduce welfare costs of hospitalization.
|
|
| 8. |
- Kivimäki, M, et al.
(författare)
-
Job strain and ischaemic disease : does the inclusion of older employees in the cohort dilute the association? The WOLF Stockholm Study.
- 2008
-
Ingår i: J Epidemiol Community Health. - : BMJ. - 1470-2738 .- 0143-005X. ; 62:4, s. 372-4
-
Forskningsöversikt (populärvet., debatt m.m.)abstract
- Job strain and ischaemic disease: does the inclusion of older employees in the cohort dilute the association? The WOLF Stockholm Study.Kivimäki M, Theorell T, Westerlund H, Vahtera J, Alfredsson L.International Institute for Society and Health, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK. m.kivimaki@ucl.ac.ukOBJECTIVE: Evidence on the association between job strain and ischaemic disease is mixed. This study examined whether including older age individuals in a cohort used to assess job strain attenuates findings towards the null. DESIGN: A prospective cohort study with baseline screening in 1992-5. A follow-up for ischaemic disease until 2003 was based on linkages to national registries. Ischaemic disease was corroborated by objective criteria (hospitalisation as a result of acute myocardial infarction, unstable angina or ischaemic stroke; or death from ischaemic heart disease, cardiac arrest or ischaemic stroke). PARTICIPANTS: 3160 male employees aged 19-65 years without pre-existing or current ischaemic disease. RESULTS: 93 cases of incident ischaemic disease were recorded. In the 19-55 year age group, the participants with job strain had a 1.76 (95% CI 1.05 to 2.95) times higher age-adjusted risk of incident ischaemic disease than those free of strain. Further adjustment for conventional cardiovascular risk factors had little effect on this association, but the impact of job strain was reduced by 70% to non-significant after the inclusion of employees older than 55 years in the cohort (hazard ratio 1.22, 95% CI 0.75 to 1.96). CONCLUSIONS: Including older employees in a cohort may dilute the effect of job strain on cardiovascular disease and is a potential reason for inconsistent findings in previous studies.
|
|
| 9. |
- Oxenstierna, G, et al.
(författare)
-
Dual source support and control at work in relation to poor health
- 2005
-
Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 33:6, s. 455-463
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Social support and decision authority in relation to health has been examined in extensive research. However, research on the role of different constellations of support sources is conspicuously lacking. The aim of the present study is to describe the health of employees in eight contrasting situations that differ with regard to support from superiors and from workmates and with regard to decision authority. Men and women were studied separately. Study sample and methods: A large sample of Swedish employees (n=53,371, after exclusion of supervisors) who participated in a national work environment survey was utilized. In addition prospective long-term sick leave data (60 days or more during the 12 months after questionnaire completion) were collected from the national insurance register. Results: Employees who reported below median decision authority had higher prevalence of pains after work and general physical symptoms as well as a higher incidence of long-term sick leave than those with higher decision authority in all subgroups. Those with good support from both workmates and superiors had lower symptom prevalence and long-term sick leave incidence than those with poor support. The groups with either poor support from superiors or from workmates were in an intermediate category with regard to symptom prevalence. The group with good support from superiors but weak support from workmates, however, had as high long-term sick leave incidence as the group with poor support from both superiors and workmates. The patterns were similar for men and women. Conclusion: Long-term sick leave was related mainly to poor support from workmates. Prevalence of symptoms, on the other hand, was related to both sources of support and absence of both sources was associated with particularly high prevalence of physical symptoms. This illustrates that it is meaningful to separate the social support sources.
|
|
| 10. |
|
|
