| 1. |
- Björkenstam, Charlotte, et al.
(författare)
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Sickness absence and disability pension before and after first childbirth and in nulliparous women : longitudinal analyses of three cohorts in Sweden
- 2019
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 9:9
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Tidskriftsartikel (refereegranskat)abstract
- Objective Childbirth is suggested to be associated with elevated levels of sickness absence (SA) and disability pension (DP). However, detailed knowledge about SA/DP patterns around childbirth is lacking. We aimed to compare SA/DP across different time periods among women according to their childbirth status.Design Register-based longitudinal cohort study.Setting Sweden.Participants Three population-based cohorts of nulliparous women aged 18–39 years, living in Sweden 31 December 1994, 1999 or 2004 (nearly 500 000/cohort).Primary and secondary outcome measures Sum of SA >14 and DP net days/year.Methods We compared crude and standardised mean SA and DP days/year during the 3 years preceding and the 3 years after first childbirth date (Y−3 to Y+3), among women having (1) their first and only birth during the subsequent 3 years (B1), (2) their first birth and at least another delivery (B1+), and (3) no childbirths during follow-up (B0).Results Despite an increase in SA in the year preceding the first childbirth, women in the B1 group, and especially in B1+, tended to have fewer SA/DP days throughout the years than women in the B0 group. For cohort 2005, the mean SA/DP days/year (95% CIs) in the B0, B1 and B1+ groups were for Y−3: 25.3 (24.9–25.7), 14.5 (13.6–15.5) and 8.5 (7.9–9.2); Y−2: 27.5 (27.1–27.9), 16.6 (15.5–17.6) and 9.6 (8.9–10.4); Y−1: 29.2 (28.8–29.6), 31.4 (30.2–32.6) and 22.0 (21.2–22.9); Y+1: 30.2 (29.8–30.7), 11.2 (10.4–12.1) and 5.5 (5.0–6.1); Y+2: 31.7 (31.3–32.1), 15.3 (14.2–16.3) and 10.9 (10.3–11.6); Y+3: 32.3 (31.9–32.7), 18.1 (17.0–19.3) and 12.4 (11.7–13.0), respectively. These patterns were the same in all three cohorts.Conclusions Women with more than one childbirth had fewer SA/DP days/year compared with women with one childbirth or with no births. Women who did not give birth had markedly more DP days than those giving birth, suggesting a health selection into childbirth.
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| 2. |
- Björkenstam, Charlotte, et al.
(författare)
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Sickness absence and disability pension in relation to first childbirth and in nulliparous women according to occupational groups : a cohort study of 492,504 women in Sweden
- 2020
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childbirth has been suggested to increase sickness absence (SA) and disability pension (DP). This may vary by occupation; however, knowledge in this field remains limited. We explored SA and DP in the years before and after childbirth among women in four occupational groups and those without occupation.Methods: We studied nulliparous women aged 18–39 years, living in Sweden on December 31, 2004 (n = 492,504). Women were categorized into five skill-level based occupational groups and three childbirth groups; no childbirths within 3 years (B0), first childbirth in 2005 with no childbirth within 3 years (B1), and first childbirth in 2005 with at least one more birth within 3 years (B1+). We compared crude and standardized annual mean SA (in spells> 14 days) and DP net days in the 3 years before and 3 years after first childbirth date.Results: Women in the highest skill level occupations and managers, had less mean SA/DP days during most study years than women in the lowest skill level occupations group. In B1 and B1+, absolute differences in mean SA/DP, particularly in SA, among occupational groups were highest during the year before childbirth. DP was most common in B0, regardless of group and year.Conclusions: We found that women’s mean SA/DP days before and after first childbirth was higher with decreasing skill-level of the occupational group and these differences were most pronounced in the year before childbirth. DP was most common among women not giving birth, regardless of occupational group.
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| 3. |
- Hallsten, Lennart, et al.
(författare)
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Job burnout and job wornout as risk factors for long-term sickness absence
- 2011
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 38:2, s. 181-192
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Contingent self-esteem has been assumed to be a risk for burnout-related disorders, and a contingent self-worth notion of job burnout was applied to study the prospective relationship between job burnout and registered episodes of sickness absence of >= 60 consecutive days. Methods: Job burnout was defined as being in the high quartiles on the Maslach Burnout Inventory - General Survey (MBI-GS) scales of exhaustion and cynicism and, in addition, as being above the median on a scale for performance-based self-esteem. Another high exhaustion-cynicism group, a "job wornout" group, was defined as being high on the same MBI-GS scales but having performance-based self-esteem scores below the median. Data were analyzed by a multivariate, logistic regression approach. Participants: 4,109 public employees in Sweden. Results: The job burnout group showed an over-risk of long-term sickness absence incidence, both compared with a low exhaustion-cynicism reference group and with the job wornout group after adjustment for several potential confounders. No association with incidence of long-term sickness absence was found for the job wornout group. Conclusions: The differential vulnerability to long-term sickness absence among high exhaustion-cynicism groups suggests that a self-worth perspective of job burnout can be advantageous for prevention of the costly long-term sickness absences.
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| 4. |
- Josephson, Malin, et al.
(författare)
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Influence of self-reported work conditions and health on full, partial and no return to work after long-term sickness absence
- 2008
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 34:6, s. 430-437
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study aimed at describing the frequency of full, partial, and no return to work after long-term sick leave and at ascertaining the influence of psychosocial work conditions, work ability and health, reported before the onset of sick leave, on full and partial return to work. METHODS: Altogether 853 public-sector employees in Sweden, mainly women, with at least one sick leave lasting > or = 28 days, were studied. The outcome was the level of sick leave 2 years after the sick leave began. Potential predictors were self-rated health, work ability, and psychosocial work conditions assessed by questionnaire before the sick leave. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated by multinomial regression analyses. RESULTS: Altogether 41% of the participants went directly from full sick leave to full return to work; 21% had periods of partial return to work, but, at the 2-year follow-up, were fully back to work; 15% had partial return to work; and 23% were still not working. A relaxed work situation, a combination of low demands and high decision latitude, increased the odds for full (OR 2.72, 95% CI 1.60-4.62) and partial (OR 2.42, 95% CI 1.21-4.85) return to work. Negative consequences of organizational changes were associated with decreased odds for full return to work (OR 0.54, 95% CI 0.38-0.77). Good self-rated health and work ability were associated with full return to work. CONCLUSIONS: Partial return to work often precedes full return to work, but also operates as a long-term solution for remaining occupationally active. Promoting relatively low demands and high decision latitude at work may support both full and partial return to work after long sick leaves.
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| 5. |
- Josephson, Malin, et al.
(författare)
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The same factors influence job turnover and long spells of sick leave : a 3-year follow-up of Swedish nurses
- 2008
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 18:4, s. 380-385
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In many countries, a general shortage of nurses is a public health problem, and retention of nurses in active work is a challenge. The aim of this study was to ascertain whether the same individual factors, working conditions and health problems had led to increased probability of both leaving jobs and prolonged sickness absence in a cohort of Swedish nurses over a period of 3 years. METHODS: A baseline questionnaire was answered by 2293 nurses, representing a response rate of 86%. Exposed and unexposed nurses were compared with regard to two outcomes. During the 3-year follow-up, exposed and unexposed nurses were compared with regard to two outcomes: resigning and having at least one sick leave spell that lasted 28 days or longer. RESULTS: We found that 18% of the nurses left their employment, and 16% had sick leave spells > or =28 days. Work in geriatric care, being socially excluded by superiors and/or workmates, negative effects of organizational changes and poor self-rated general health were factors that increased the likelihood of both leaving jobs and long-term sick leave. CONCLUSIONS: The present results underline the importance of improving working conditions and supporting sustainable health in order to prevent high turnover and prolonged sick leave among nurses. Resigning and moving to another institution can be interpreted as a way to actively cope with an unhealthy work environment.
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| 6. |
- Lund, Thomas, et al.
(författare)
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Differences in sickness absence in Sweden and Denmark : the cross national HAKNAK study
- 2009
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 19:3, s. 343-349
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate potential differences in sickness absence among public sector employees in Sweden and Denmark, and to what extent a difference was associated with age, gender, physical and psychosocial work environment exposures, lifestyle factors, self-rated health or work ability. METHODS: In 2000, two cross-sectional samples of 8562 public sector employees in Sweden and Denmark were surveyed. The study outcome, self-reported number of sick-leave days the year preceding interview, was dichotomized into 7 days or less, and more than 7 days. Chi square test was used to analyse distribution of dependent and independent variables in the two sub-cohorts. Stratified logistic regression analysis was performed to identify causes for absence within the two sub-cohorts, and logistic regression analysis was performed to study differences in sickness absence levels between the two sub-cohorts. RESULTS: More subjects from the Swedish study population reported more than 7 days of sickness absence. Factors associated with sickness absence were largely similar in the two countries. The difference in absence level between Sweden and Denmark was not associated with differences in age, gender, skill level, lifestyle, psychosocial or physical work environment, musculoskeletal symptoms or self-rated health, whereas work ability score decreased the difference in sickness absence level. CONCLUSION: The results could indicate an increased retention of employees with health problems in the Swedish labour market compared with the Danish labour market. A possible explanation for the differences in sickness absence ascertained in this study could be due to differences in the sickness insurance legislation.
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| 7. |
- Plym, Anna, et al.
(författare)
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Causes of sick leave, disability pension, and death following a breast cancer diagnosis in women of working age
- 2019
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Ingår i: Breast. - : CHURCHILL LIVINGSTONE. - 0960-9776 .- 1532-3080. ; 45, s. 48-55
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Women diagnosed with breast cancer during working age are at increased risk of permanent absence from work, but the underlying medical causes have rarely been studied. We examined the risk of cause-specific sick leave, disability pension, and the competing event death after a breast cancer diagnosis in a population-based cohort study.Materials and methods: From the Breast Cancer Data Base Sweden, we identified 16,603 women diagnosed with stage I-III breast cancer between 2000 and 2012, and 63,773 control women. Using multi-state modelling, we calculated probabilities and durations of sick leave, disability pension, and death by registered cause, together with cause-specific hazard ratios.Results: Five years after diagnosis, causes other than cancer accounted for around half of all sick leave (3.5% out of 6.8% of women) and disability pension (1.4% out of 2.6%) in women with breast cancer. Compared with control women, women with breast cancer were at increased risk of sick leave and disability pension due to mental disorders (HR 1.24, 95% CI 1.15-1.33 and HR 1.54, 95% CI 1.29-1.85, respectively) and disability pension due to inflammatory diseases (HR 1.46, 95% CI 1.05-2.03). The risk of sick leave and disability pension due to cardiovascular disease was also elevated, although only statistically significant for disability pension in women diagnosed after 2005 (HR 2.24, 95% CI 1.22-4.13).Conclusion: Follow-up, support, and rehabilitation programs for women diagnosed with breast cancer must address a wide range of psychological and physical conditions to limit the consequences on working life.
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| 8. |
- Plym, Anna, et al.
(författare)
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Duration of sick leave after active surveillance, surgery or radiotherapy for localised prostate cancer : a nationwide cohort study
- 2020
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Ingår i: BMJ Open. - : BMJ PUBLISHING GROUP. - 2044-6055. ; 10:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare the loss of working time due to sick leave by treatment strategy for localised prostate cancer.Design: Nationwide cohort study.Setting: Sweden.Participants: A total of 15 902 working-aged men with localised low or intermediate-risk prostate cancer diagnosed during 2007-2016 from the Prostate Cancer Data Base Sweden, together with 63 464 prostate cancer-free men. Men were followed until 2016.Primary and secondary outcome measures: Using multistate Markov models, we calculated the proportion of men on work, sick leave, disability pension and death, together with the amount of time spent in each state. All-cause and cause-specific estimates were calculated.Results: During the first 5 years after diagnosis, men with active surveillance as their primary treatment strategy spent a mean of 17 days (95% CI 15 to 19) on prostate cancer-specific sick leave, as compared with 46 days (95% CI 44 to 48) after radical prostatectomy and 44 days (95% CI 38 to 50) after radiotherapy. The pattern was similar after adjustment for cancer and sociodemographic characteristics. There were no differences between the treatment strategies in terms of days spent on sick leave due to depression, anxiety or stress. Five years after diagnosis, over 90% of men in all treatment strategies were free from sick leave, disability pension receipt and death from any cause.Conclusions: Men on active surveillance experienced less impact on working life compared with men who received radical prostatectomy or radiotherapy. From a long-term perspective, there were no major differences between treatment strategies. Our findings can inform men diagnosed with localised prostate cancer on how different treatment strategies may affect their working lives.
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| 9. |
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| 10. |
- Plym, Anna, et al.
(författare)
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Work Disability After Robot-assisted or Open Radical Prostatectomy : A Nationwide, Population-based Study
- 2016
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Ingår i: European Urology. - : Elsevier BV. - 0302-2838 .- 1873-7560. ; 70:1, s. 64-71
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Tidskriftsartikel (refereegranskat)abstract
- Background: Robot-assisted radical prostatectomy (RARP) has been associated with reduced bleeding and shorter hospital stays than open retropubic radical prostatectomy (RRP), but it is unclear whether these differences translate into shorter absence from work. Objective: To investigate short-and long-term rates of work disability following RARP and RRP. Design, setting, and participants: We conducted a nationwide population-based cohort study of 2571 men of working age treated with RARP or RRP between 2007 and 2009 identified in the National Prostate Cancer Register of Sweden. Information about physician-certified sick leave and disability pension was retrieved from the Swedish Social Insurance Agency through 2012. Outcome measurements and statistical analysis: We used Cox regression to calculate time to return to work (RTW, or duration of sick leave) after surgery and used generalised estimating equations to analyse days lost from work (because of sick leave and disability pension) after RTW. Results and limitations: Men treated with RARP returned to work after a median of 35 d, whereas the corresponding time for RRP was 48 d (p < 0.001). The difference was seen early; within the first month, men treated with RARP returned to work nearly four times faster than men treated with RRP (adjusted relative RTW rate 3.76; 95% confidence interval [CI], 3.04-4.66). During a median of 3.6 yr after return to work, men treated with RARP lost fewer days from work per person-year than men treated with RRP-12 d versus 15 d-but the association was not statistically significant (p = 0.10). The adjusted rate ratio was 1.08 (95% CI, 0.82-1.42). One limitation is the nonrandomised design of this study. Conclusions: RARP was associated with a faster RTW compared with RRP, but the surgical method did not influence long-term rates of work disability in terms of days lost from work after RTW. Patient summary: We compared disease-related absence from work between two surgical methods for the removal of the prostate. Robot-assisted surgery was associated with a faster return to work compared with open surgery but did not influence absence from work in a long-term perspective.
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| 11. |
- Vaez, Marjan, et al.
(författare)
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Work-related violence and its association with self-rated general health among public sector employees in Sweden
- 2014
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 49:1, s. 163-171
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Work-related violence is one of the most serious threats to employee safety and health.OBJECTIVE:To ascertain the extent of self-reported violence or threats of violence at work in relation to the general health of public sector employees.METHODS:The study population comprised 9,611 female (83%) and male public employees in Sweden. A questionnaire based on items derived mainly from validated instruments was constructed to cover aspects such as health, lifestyle, and physical and psychosocial work conditions.RESULTS:One in three employees reported work-related violence, with the highest proportions among psychiatric nurses (79%) and psychiatric attendants (75%). Work-related violence more often affected those who were < 45 years old, worked < 40 hours/week, worked nights, or reported poor health. Regardless of gender, age, hours of work, night work, and type of occupation, exposure to work-related violence was associated with less than good general health, and this relationship was strongest for psychiatric nurses (OR=3.19; 95% CI=1.28-7.98), medical doctors/dentists (OR=2.46; 95% CI=1.35-4.49), compulsory school teachers (OR=2.14; 95% CI=1.33-3.45), and other nurses (OR=1.87; 95% CI=1.23-2.84).CONCLUSIONS:Work-related violence was frequently reported by employees in the most common public sector occupations, and it was associated withpoor health in both genders.
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| 12. |
- Vingård, Eva, et al.
(författare)
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A physical fitness programme during paid working hours - impact on health and work ability among women working in the social service sector : a three year follow up study
- 2009
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 34:3, s. 339-344
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Tidskriftsartikel (refereegranskat)abstract
- In order to study the influence of a physical fitness programme on work ability among women employed in the social sector an intervention was offered to 205 women working in the social care sector in a municipality in Sweden. The reference group comprised 165 women from the same sector working in another municipality. All participants were employed and answered questionnaires at baseline and after 36 months. For women younger than 45 years, work ability and general health improved significantly while for women, 45 years or older, future work expectations improved. For women with less musculoskeletal pain, improvements were observed regarding future work expectations, as well as work ability and general health while for women with more musculoskeletal pain, improvements were observed for general health and future work expectations. Well-structured physical fitness programmes at the worksite can be useful in contributing to individual's experiences of improvements in their own capacity as well as increased health and wellbeing.
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| 13. |
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| 14. |
- Voss, Margaretha, et al.
(författare)
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Comparisons of self-reported and register data on sickness absence among public employees in Sweden
- 2008
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 65:1, s. 61-67
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Self-reported assessments of sickness absence are often performed in epidemiological studies. The objective of this study was to compare the number of sick-leave days according to self-reported data over 12 months with data from the employer's register for the same period. An additional aim was to ascertain whether the self-reported information and the recorded data would show equivalent associations with self-reported general health. METHODS: The study was based on a cohort of 4869 municipal employees in Sweden, about 80% women, who answered a questionnaire in 2001-2. The responses provided by the employees included information on number of sick-leave days and self-rated health. Data on sick-leave days, occupation and age were derived from the employers' computerised registers. The questionnaire information on sick-leave days was compared with the corresponding information retrieved from the employer register by means of calculating sensitivity and specificity, using the employers' data as the "gold standard". RESULTS: The annual number of sick-leave days was lower according to the self-reported information than to the register data. For women the agreement between the two sickness absence measures for no sick-leave days, 1-7 days and >/=28 days were 74%, 72% and 67%, respectively. The sensitivity of questionnaire versus register information regarding any self-reported sick-leave day was 91% and the specificity was 74%. Sensitivity and specificity for sickness absence >/=28 days were 67% and 98%, respectively. The results for men were similar to those for women. Self-reported and recorded sickness absence were both associated with self-rated health. The odds ratios were 7.27 and 8.25, for subjects with >/=28 recorded and self-reported number of sick-leave days respectively, compared to subjects with no sickness absence. CONCLUSIONS: Good agreement was found between self-reported and register information on sickness absence. Self-reported data on sickness absence may be useful in common epidemiological applications.
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| 15. |
- Voss, Margaretha, et al.
(författare)
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The influence of household work and of having children on sickness absence among publicly employed women in Sweden
- 2008
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 36:6, s. 564-572
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate whether family obligations influence the risk of sickness absence among female municipal employees in Sweden. Methods: 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 (>= 4 spells) and long-term sickness absence (>= 28 days) were calculated by applying Poisson regression models. Results: 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. Conclusions: 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.
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| 16. |
- Voss, Margaretha
(författare)
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Work and health : epidemiological studies of sickness absence and mortality with special reference to work environment, factors outside work and unemployment
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The level and costs of sickness absence in Sweden have fluctuated over time and there are also important regional variations within the country with a higher rate of sickness absence in the northern part. Sickness absence tend to be more common in women than in men and several factors, besides ill health, at a societal, organisational, social and individual level have been discussed as possible causes of sickness absence. Sweden has had a long tradition of low unemployment. During the last decade there have been substantial changes in the Swedish labour market that have resulted in an increased unemployment rate. Large studies have shown an increased mortality associated with unemployment but it is still controversial to what extent this represents a causal association. The general aim of this thesis was twofold: Firstly, to study factors at work and outside work in relation to sickness absence in an integrated fashion and keeping a gender perspective. Secondly, to analyse unemployment in relation to subsequent mortality taking into account sociodemographic, lifestyle, personality and early childhood factors. In the analyses of sickness absence the study population consisted of all employees in three of Sweden Post's regional organisations (n=3 470). Incidence of sickness absence in the study population was recorded during the period 1992-1994. An extensive questionnaire was sent out in 1994 including questions about factors at work and outside work of possible importance for sickness absence. The association between unemployment and mortality was analysed using the younger cohort of the Swedish twin registry including all same sexed twin pairs born 1926-1958. The study population encompassed those responding to a comprehensive mailed questionnaire in 1973 reporting a job title (n=20 632 individuals). All causes of death as well as specific causes of death were followed between 1973 and 1996. A decrease in the incidence of sickness absence was observed after the introduction of a qualifying day in 1993. The proportion of long-term sick-leave events (15-365 days) increased and among men, long-term events of sickness absence increased also in absolute terms. Long-lasting or serious illness and frequent colds showed strong associations with sickness absence. Subjects with high sickness absence frequently reported physical exhaustion after work and tiredness prohibiting leisure time activities. Among women, m particular complaints due to work in a forward-bent position, complaints due to heavy lifting, occurrence of bullying at the workplace and working while ill (sickness presenteeism) was associated with a high sickness absence. Among men, a high sickness absence was related to anxiety about reorganisation of the workplace, working while ill, no supervisor position and complaints due to heavy lifting. Concerning factors outside work, use of tranquillizers, and a need to recover from staying at home with sick children was associated with high sickness absence among women. In addition, for married/cohabitant women with children a high domestic workload increased the occurrence of sickness absence. Among men, experience of a relative's serious sickness, accident or death, use of alcohol as sedative, and divorce were suggested to be important determinants. Unemployment was found to increase the risk of early death even after adjustment for several social, behavioural, health, personality and early childhood factors among both women and men. Use of tranquillisers or sleeping pills, certain personality characteristics, low education, and serious or long lasting illness was found to further strengthen the association between unemployment and mortality The increased mortality among unemployed subjects was in part attributable to an increased mortality from suicides and accidents or injuries with uncertainty if caused by accident or by intention. In conclusion the results of this thesis suggest that changes in the sickness benefit system as well as several factors at work and outside work, besides Ill health, influence the incidence of sickness absence. In addition, the results indicate that unemployment increases the risk of early death, in part due to an increased risk of suicides, in both men and women taking several sociodemographic, lifestyle, personality and early childhood factors into account.
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