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| 2. |
- Head, Jenny, et al.
(författare)
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Diagnosis-specific sickness absence as a predictor of mortality : the Whitehall II prospective cohort study.
- 2008
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Ingår i: BMJ (Clinical research ed.). - : BMJ. - 1468-5833 .- 0959-8138 .- 1756-1833. ; 337, s. a1469-
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether knowing the diagnosis for sickness absence improves prediction of mortality. DESIGN: Prospective cohort study established in 1985-8. Sickness absence records including diagnoses were obtained from computerised registers. SETTING: 20 civil service departments in London. PARTICIPANTS: 6478 civil servants aged 35-55 years. MAIN OUTCOME MEASURES: All cause, cardiovascular, and cancer mortality until 2004, average follow-up 13 years. RESULTS: After adjustment for age, sex, and employment grade, employees who had one or more medically certified spells of sickness absence (>7 days) in a three year period had a mortality 1.7 (95% CI 1.3 to 2.1) times greater than those with no medically certified spells. Inclusion of diagnoses improved the prediction of all cause mortality (P=0.03). The hazard ratio for mortality was 4.7 (2.6 to 8.5) for absences with circulatory disease diagnoses, 2.2 (1.4 to 3.3) for surgical operations, and 1.9 (1.2 to 3.1) for psychiatric diagnoses. Psychiatric absences were also predictive of cancer mortality (2.5 (1.3 to 4.7)). Associations of infectious, respiratory, and injury absences with overall mortality were less marked (hazard ratios from 1.5 to 1.7), and there was no association between musculoskeletal absences and mortality. CONCLUSIONS: Major diagnoses for medically certified absences were associated with increased mortality, with the exception of musculoskeletal disease. Data on sickness absence diagnoses may provide useful information to identify groups with increased health risk and a need for targeted interventions.
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| 3. |
- Kivimäki, Mika, et al.
(författare)
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Diagnosis-specific sick leave as a risk marker for disability pension in a Swedish population.
- 2007
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Ingår i: J Epidemiol Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 61:10, s. 915-20
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Diagnosis-specific sick leave as a risk marker for disability pension in a Swedish population.Kivimäki M, Ferrie JE, Hagberg J, Head J, Westerlund H, Vahtera J, Alexanderson K.Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK. m.kivimaki@ucl.ac.ukOBJECTIVE: To investigate diagnosis-specific sick leave as a risk marker for subsequent disability pension. DESIGN: A prospective population based cohort study. Exposure to a new medically certified sick leave episode of more than seven days by diagnosis during 1985 was examined in relation to incident cause-specific disability pension through 1996. PARTICIPANTS: The total non-retired population of one Swedish county aged 16 to 49 years, alive and not in receipt of a disability pension at the end of 1985 (176 629 persons; 51% men). MAIN RESULTS: To eliminate confounding by sick leaves that translate into a disability pension, the follow up period for disability pension was started five years after the assessment of sick leave. After adjustment for demographic characteristics, the risk of disability pension from mental disorders was 14.1 times higher (95% confidence interval (CI), 12.1 to 16.4) for those with sick leave for mental disorders than for those with no sick leave. The corresponding hazard ratio for sick leave and disability pension within diagnostic category was 5.7 (95% CI, 5.3 to 6.2) for musculoskeletal diseases and 13.0 (7.7 to 21.8) for gastrointestinal diseases. Irrespective of diagnoses, the hazard ratio for sick leave and disability pension was 3.0 (2.9 to 3.1). CONCLUSIONS: Sick leave may provide an important risk marker for identifying groups at high risk of a disability pension, especially for psychiatric diagnoses.
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| 4. |
- Melchior, Maria, et al.
(författare)
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Using sickness absence records to predict future depression in a working population : prospective findings from the GAZEL cohort.
- 2009
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Ingår i: American journal of public health. - 1541-0048. ; 99:8, s. 1417-22
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: We tested the hypothesis that sickness absence from work predicts workers' risk of later depression. METHODS: Study participants (n = 7391) belonged to the French GAZEL cohort of employees of the national gas and electricity company. Sickness absence data (1996-1999) were obtained from company records. Participants' depression in 1996 and 1999 was assessed with the Center for Epidemiologic Studies-Depression (CES-D) scale. The analyses were controlled for baseline age, gender, marital status, occupational grade, tobacco smoking status, alcohol consumption, subthreshold depressive symptoms, and work stress. RESULTS: Among workers who were free of depression in 1996, 13% had depression in 1999. Compared with workers with no sickness absence during the study period, those with sickness absence were more likely to be depressed at follow-up (for 1 period of sickness absence, fully adjusted odds ratio [OR] = 1.53, 95% confidence interval [CI] = 1.28, 1.82; for 2 or more periods, fully adjusted OR = 1.95, 95% CI = 1.61, 2.36). Future depression was predicted both by psychiatric and nonpsychiatric sickness absence (fully adjusted OR = 3.79 [95% CI = 2.81, 5.10] and 1.41 [95% CI = 1.21, 1.65], respectively). CONCLUSIONS: Sickness absence records may help identify workers vulnerable to future depression.
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| 5. |
- Vahtera, Jussi, et al.
(författare)
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Effect of retirement on sleep disturbances : the GAZEL prospective cohort study.
- 2009
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 32:11, s. 1459-66
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Changes in health following retirement are poorly understood. We used serial measurements to assess the effect of retirement on sleep disturbances. DESIGN: Prospective cohort study. SETTING: The French national gas and electricity company. PARTICIPANTS: Fourteen thousand seven hundred fourteen retired employees (79% men). MEASUREMENTS AND RESULTS: Annual survey measurements of sleep disturbances ranging from 7 years before to 7 years after retirement (a mean of 12 measurements). Before retirement 22.2% to 24.6% of participants reported having disturbed sleep. According to repeated-measures logistic-regression analysis with generalized estimating equations estimation, the odds ratio (OR) for having a sleep disturbance in the postretirement period was 0.74 (95% confidence interval 0.71-0.77), compared with having a sleep disturbance in the preretirement period. The postretirement improvement in sleep was more pronounced in men (OR 0.66 [0.63-0.69]) than in women (OR 0.89 [0.84-0.95]) and in higher-grade workers than lower-grade workers. Postretirement sleep improvement was explained by the combination of preretirement risk factors suggesting removal of work-related exposures as a mechanism. The only exception to the general improvement in sleep after retirement was related to retirement on health grounds. In this group of participants, there was an increase in sleep disturbances following retirement. CONCLUSIONS: Repeated measurements provide strong evidence for a substantial and sustained decrease in sleep disturbances following retirement. The possibility that the health and well-being of individuals are significantly worse when in employment than following retirement presents a great challenge to improve the quality of work life in Western societies in which the cost of the aging population can only be met through an increase in average retirement age.
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| 6. |
- Westerlund, Hugo, et al.
(författare)
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Does working while ill trigger serious coronary events? The Whitehall II study.
- 2009
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Ingår i: Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine. - 1536-5948. ; 51:9, s. 1099-104
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Working while ill has been found to predict coronary heart disease. We tested if this association was due to triggering. METHODS: We used a nested case-control study in an occupational cohort to examine sickness absences during a 2-year period immediately before the first coronary event for 133 cases and 928 matched controls without a history of coronary events. Working while ill was defined as no absence despite being unhealthy (suboptimal self-rated health or psychological distress). RESULTS: The odds of a coronary event were not higher for cases who worked while ill than for correspondingly unhealthy controls who took >0 to 14 days of absence per year (OR = 0.62; 95% CI = 0.28 to 1.38). These results were little affected by multiple adjustments. CONCLUSIONS: We found no evidence that working while ill acts as a short-term trigger for coronary events.
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| 7. |
- Westerlund, Hugo, et al.
(författare)
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Self-rated health before and after retirement in France (GAZEL) : a cohort study.
- 2009
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Ingår i: Lancet. - 1474-547X. ; 374:9705, s. 1889-96
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Governments need to increase the proportion of the population in work in most developed countries because of ageing populations. We investigated longitudinally how self-perceived health is affected by work and retirement in older workers. METHODS: We examined trajectories of self-rated health in 14 714 employees (11 581 [79%] men) from the French national gas and electricity company, the GAZEL cohort, for up to 7 years before and 7 years after retirement, with yearly measurements from 1989 to 2007. We analysed data by use of repeated-measures logistic regression with generalised estimating equations. FINDINGS: Overall, suboptimum health increased with age. However, between the year before retirement and the year after, the estimated prevalence of suboptimum health fell from 19.2% (95% CI 18.5-19.9) to 14.3% (13.7-14.9), corresponding to a gain in health of 8-10 years. We noted this retirement-related improvement in men (odds ratio 0.68, 95% CI 0.64-0.73) and women (0.74, 0.67-0.83), and across occupational grades (low 0.72, 0.63-0.82; high 0.70, 0.63-0.77), and it was maintained throughout the 7 years after retirement. A poor work environment and health complaints before retirement were associated with a steeper yearly increase in the prevalence of suboptimum health while still in work, and a greater retirement-related improvement; however, people with a combination of high occupational grade, low demands, and high satisfaction at work showed no such retirement-related improvement. INTERPRETATION: These findings suggest that the burden of ill-health, in terms of perceived health problems, is substantially relieved by retirement for all groups of workers apart from those with ideal working conditions, and that working life for older workers needs to be redesigned to achieve higher labour-market participation. FUNDING: Swedish Council for Working Life and Social Research, Academy of Finland, INSERM (France), BUPA Foundation (UK), European Science Foundation, and Economic and Social Research Council (UK).
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