Sickness absence and disability pension in a cohort of employees initially on long-term sick leave due to psychiatric disorders in Sweden

Bakgrunn: Denne studien undersøker overgangen fra langtidssykmelding til uførepensjonering for å se om man her kan finne noe av forklaringen på den observerte overhyppighet av uførepensjonering blant kvinner.Metode og materiale: Prospektiv nasjonal kohortstudie som inkluderer 66 083 kvinner og 47 073 menn i alderen 16-62 år som var sykmeldt lenger enn åtte uker i 1997. Data er hentet fra FD-trygd. Kvinner som var sykmeldt med en W-diagnose (svangerskapsrelatert) ble ekskludert fra analysen pga alder og lav uførefrekvens. Kohorten ble fulgt opp i fem år med overgang til uførepensjon som endepunkt. Betydning av kjønn ble estimert ved hjelp av Cox' proporsjonal hasards analyse, kontrollert for sosiodemografiske faktorer. Vi gjorde separate analyser for de sykmeldte med muskel- og skjelettdiagnoser, psykiske diagnoser, hjerte/lungediagnoser og "andre" sykmeldingsdiagnoser, også med stratifisering for bostedsfylke.Resultater: 22% av de sykmeldte mennene og 24% av kvinnene var uførepensjonert etter fem års oppfølging. Etter justering for sosiodemografiske faktorer var risiko for uførepensjon fortsatt høyere for kvinner med muskel- og skjelettdiagnoser, men høyere for menn i de andre diagnosegruppene og totalt.Konklusjon: Risiko for uførepensjon blant langtidssykmeldte kvinner er ikke høyere enn hos langtidssykmeldte menn. Tvert imot, etter korreksjon for sosiodemografiske variabler, er det langtidssykmeldte menn som har størst risiko for å bli uførepensjonert, særlig innen gruppen som var sykmeldt for en psykisk lidelse. Siden langtidssykefraværet er høyere blant kvinner enn blant menn, er likevel totaleffekten en større uføretilgang blant kvinnelige langtidssykmeldte. Gjesdal S. Gender differences in transition from long-term sickness absence to permanent disability pension, 1997-2002. Nor J Epidemiol 2009; 19 (2): 193-202. ENGLISH SUMMARYBackground: The study investigates the transition from long-term sickness absence to permanent disability pension (DP) in Norway. The aim is to assess whether gender differences in this process explain the observed female excess in disability pensioning in Norway.Methods and data: Prospective national cohort study including 66,083 women and 47,073 men aged 16-62 years, with a spell of sick leave longer than 8 weeks in 1997. The data is obtained from a national research database (FD-trygd). Women on sick leave with a pregnancy related diagnosis were excluded. The endpoint was granting of a DP. The effect of gender on the risk of obtaining a DP was estimated by means of Cox' proportional hazards analysis, adjusted for sociodemographic factors. Separate analyses were carried out for those with diagnoses indicating diseases in the musculoskeletal, mental, and cardiovascular and respiratory groups combined. Stratified analyses for county of residence were also performed.Results: 22% of the male and 24% of the female sample obtained a DP during follow-up. Adjusted for sociodemographic factors the risk of DP was still higher for women with musculoskeletal diagnoses, but higher for men in the remaining diagnostic groups and overall.Conclusion: The risk of DP after sickness absence is not higher in women compared to men. On the contrary, after adjustment for relevant sociodemographic variables, men on sick-leave have the highest risk of a future DP. This is most evident among those on sick-leave with a mental diagnosis. However, since longterm sickness absence is much more frequent among women, the total effect is a higher rate of DP among Norwegian women.

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Work ability score and future work ability as predictors of register-based disability pension and long-term sickness absence: A three-year follow-up study

Scandinavian Journal of Public Health ◽

10.1177/1403494817745190 ◽

2017 ◽

Vol 46 (3) ◽

pp. 321-330 ◽

Cited By ~ 20

Author(s):

Ulla Kinnunen ◽

Jouko Nätti

Keyword(s):

Sickness Absence ◽

Work Ability ◽

Disability Pension ◽

Negative Binomial ◽

Work Ability Index ◽

Rate Ratios ◽

Future Work ◽

Work Ability Score

Aims: We investigated two single items of the Work Ability Index – work ability score, and future work ability – as predictors of register-based disability pension and long-term sickness absence over a three-year follow-up. Methods: Survey responses of 11,131 Finnish employees were linked to pension and long-term (more than 10 days) sickness absence register data by Statistics Finland. Work ability score was divided into poor (0–5), moderate (6–7) and good/excellent (8–10) and future work ability into poor (1–2) and good (3) work ability at baseline. Cox proportional hazard regressions were used in the analysis of disability pension, and a negative binomial model in the analysis of long-term sickness absence. The results were adjusted for several background, work- and health-related covariates. Results: Compared with those with good/excellent work ability scores, the hazard ratios of disability pension after adjusting for all covariates were 9.84 (95% CI 6.68–14.49) for poor and 2.25 (CI 95% 1.51–3.35) for moderate work ability score. For future work ability, the hazard ratio was 8.19 (95% CI 4.71–14.23) among those with poor future work ability. The incidence rate ratios of accumulated long-term sickness absence days were 3.08 (95% CI 2.19–4.32) and 1.59 (95% CI 1.32–1.92) for poor and moderate work ability scores, and 1.51 (95% CI 0.97–2.36) for poor future work ability. Conclusions: The single items of work ability score and future work ability predicted register-based disability pension equally well, but work ability score was a better predictor of register-based long-term sickness absence days than future work ability in a three-year follow-up. Both items seem to be of use especially when examining the risk of poor work ability for disability but also for long sick leave.

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Sleep disturbance and work-related mental strain: A national prospective cohort study of the prediction of subsequent long-term sickness absence, disability pension and mortality

Scandinavian Journal of Public Health ◽

10.1177/1403494820911813 ◽

2020 ◽

Vol 48 (8) ◽

pp. 888-895

Author(s):

Torbjörn Åkerstedt ◽

Ellenor Mittendorfer-Rutz ◽

Syed Rahman

Keyword(s):

Sleep Disturbance ◽

Sickness Absence ◽

Work Disability ◽

Disability Pension ◽

Sleep Disturbances ◽

Workplace Stress ◽

Mental Strain ◽

Work Related ◽

Synergy Effects

Aims: Sleep disturbances and work-related mental strain are linked to increased sickness absence and disability pension (DP), but we have no information on synergy effects. The aim of this study was to examine the combined (and separate) association of the two predictors with subsequent long-term work disability and mortality. Methods: A total of 45,498 participants aged 16–64 years were interviewed in the Swedish Surveys of Living Conditions between 1997 and 2013, and were followed up on long-term sickness absence (LTSA; >90 days/year), DP and mortality via national registers until 2016. Crude and multivariable Cox analyses were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: For LTSA, the HRs for sleep disturbances and work-related mental strain were 1.6 (95% CI 1.5–1.7) and 1.3 (95% CI 1.2–1.4), respectively. For DP, the HRs were 2.0 (95% CI 1.8–2.2) and 1.4 (95% CI 1.2–1.5). Mortality was only predicted by sleep disturbances (HR=1.2, 95% CI 1.1–1.4). No synergy effect was seen. Conclusions: Work-related mental strain and, in particular, sleep disturbances were associated with a higher risk of subsequent LTSA and DP, but without synergy effects. Sleep disturbances were also associated with mortality. Exposure to interventions tackling sleep disturbance and prevention of workplace stress may reduce work disability.

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Associations of job demands and job control with long-term sickness absence and disability pension

European Journal of Public Health ◽

10.1093/eurpub/cky213.178 ◽

2018 ◽

Vol 28 (suppl_4) ◽

Author(s):

K Farrants ◽

J Norberg ◽

A Sondén ◽

R Rugulies ◽

E Framke ◽

...

Keyword(s):

Sickness Absence ◽

Disability Pension ◽

Job Demands ◽

Job Control

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Do workplace health-promotion interventions targeting employees with poor health reduce sick-leave probability and disability rates?

Scandinavian Journal of Public Health ◽

10.1177/1403494820946543 ◽

2020 ◽

pp. 140349482094654

Author(s):

Roy A. Nielsen ◽

Tove I. Midtsundstad

Keyword(s):

Health Promotion ◽

Sick Leave ◽

Labour Market ◽

Sickness Absence ◽

Older Workers ◽

Financial Incentives ◽

Disability Pension ◽

Workplace Health Promotion ◽

Workplace Health ◽

Health Promotion Interventions

Aims: This study aimed to investigate whether introducing workplace health-promotion interventions targeting employees with health problems or reduced work ability affected overall sick leave and disability risk. Methods: The study population comprised data from an establishment survey from 2010 identifying who had introduced workplace health promotion (the intervention) linked to register data on all employees and their sickness absence and disability pension uptake from 2000 through 2010. Results: Interventions had moderate effects due to varying efficacy in different parts of the labour market. Intervention success was more likely among white-collar workers (e.g. in public administration) compared to blue-collar workers (e.g. in manufacturing), probably due to variations in both organisational and technological constraints. Effects were small among men and moderate among older workers, particularly among women. Overall, disability risk reduction was accompanied by an increase in sickness absence. Sometimes, sickness absence increased in groups with no change in disability risk, suggesting that presenteeism in one group may increase absenteeism in other groups. Conclusions: Introducing workplace health-promotion interventions may prolong work careers in some labour-market segments. Financial incentives for Norwegian establishments to continue offering workplace health-promotion interventions may be improved, given the current financial model for disability pension and sickness benefits.

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Reduction in Personnel and Long-Term Sickness Absence for Psychiatric Disorders Among Employees in Swedish County Councils

Journal of Occupational and Environmental Medicine ◽

10.1097/jom.0b013e31821aa706 ◽

2011 ◽

Vol 53 (6) ◽

pp. 658-662 ◽

Cited By ~ 4

Author(s):

Anna Bryngelson ◽

Ellenor Mittendorfer-Rutz ◽

Johan Fritzell ◽

Marie Åsberg ◽

Åke Nygren

Keyword(s):

Psychiatric Disorders ◽

Sickness Absence

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Sick leave and disability pension before and after diagnosis of multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458516667567 ◽

2016 ◽

Vol 22 (14) ◽

pp. 1859-1866 ◽

Cited By ~ 15

Author(s):

Erik Landfeldt ◽

Anna Castelo-Branco ◽

Axel Svedbom ◽

Emil Löfroth ◽

Andrius Kavaliunas ◽

...

Keyword(s):

Multiple Sclerosis ◽

Sick Leave ◽

Disability Pension ◽

Disease Diagnosis ◽

First Year ◽

Final Sample ◽

Before And After ◽

Considerable Morbidity ◽

Long Term Impact

Background: Multiple sclerosis (MS) is associated with considerable morbidity and serious disability, but little is known of the long-term impact of the disease on work ability. Objectives: To assess sick leave (short-term absence) and disability pension (long-term absence) before and after diagnosis of MS. Methods: Patients with MS in Sweden were identified in a nationwide disease-specific register and matched with general population controls. Sick leave and disability pension were measured before and after index (i.e. the MS diagnosis date). Results: The final sample comprised 6092 patients and 60,345 controls (mean age 39 years; 70% female). The mean annual prevalence of sick leave ranged from 12% the first year after index to 23% after 11 years among patients and from 13% to 13% among controls. Corresponding estimates for disability pension were 12% and 55% for patients and 7% and 9% for controls. Significant differences in sick leave were observed up to 15 years before index and 3 years for disability pension. Conclusion: Patients with MS in Sweden have elevated levels of sick leave and disability pension up to 15 years before disease diagnosis. Our results highlight the burden of disease on affected patients and society and underscore the substantial unmet medical need.

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