Changes in drinking as predictors of changes in sickness absence: a case-crossover study

BackgroundWe investigated whether changes in alcohol use predict changes in the risk of sickness absence in a case-crossover design.MethodsFinnish public sector employees were surveyed in 2000, 2004 and 2008 on alcohol use and covariates. Heavy drinking was defined as either a weekly intake that exceeded recommendations (12 units for women; 23 for men) or having an extreme drinking session. The responses were linked to national sickness absence registers. We analysed the within-person relative risk of change in the risk of sickness absence in relation to change in drinking. Case period refers to being sickness absent within 1 year of the survey and control period refers to not being sickness absent within 1 year of the survey.ResultsPeriods of heavy drinking were associated with increased odds of self-certified short-term (1–3 days) sickness absence (multivariable-adjusted OR 1.21, 95% CI 1.07 to 1.38 for all participants; 1.62, 95% CI 1.19 to 2.21 for men and 1.15, 95% CI 1.00 to 1.33 for women). A higher risk of short-term sickness absence was also observed after increase in drinking (OR=1.27, 95% CI 1.07 to 1.52) and a lower risk was observed after decrease in drinking (OR=0.83, 95% CI 0.69 to 1.00). Both increase (OR=1.38, 95% CI 1.21 to 1.57) and decrease (OR=1.27, 95% CI 1.19 to 1.43) in drinking were associated with increased risk of long-term (>9 days) medically certified all-cause sickness absence.ConclusionIncrease in drinking was related to increases in short-term and long-term sickness absences. Men and employees with a low socioeconomic position in particular seemed to be at risk.

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A systematic review and meta-analysis uncovering the relationship between alcohol consumption and sickness absence. When type of design, data, and sickness absence make a difference

PLoS ONE ◽

10.1371/journal.pone.0262458 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262458

Author(s):

Neda S. Hashemi ◽

Jens Christoffer Skogen ◽

Aleksandra Sevic ◽

Mikkel Magnus Thørrisen ◽

Silje Lill Rimstad ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Sickness Absence ◽

Meta Analysis ◽

Experimental Studies ◽

Strong Relationship ◽

Short Term ◽

Design Data ◽

Cross Sectional ◽

Increased Risk

Aim Earlier research has revealed a strong relationship between alcohol use and sickness absence. The aim of this review was to explore and uncover this relationship by looking at differences in type of design (cross-sectional vs. longitudinal), type of data (self-reported vs. registered data), and type of sickness absence (long-term vs. short term). Method Six databases were searched through June 2020. Observational and experimental studies from 1980 to 2020, in English or Scandinavian languages reporting the results of the association between alcohol consumption and sickness absence among working population were included. Quality assessment, and statistical analysis focusing on differences in the likelihood of sickness absence on subgroup levels were performed on each association, not on each study. Differences in the likelihood of sickness absence were analyzed by means of meta-analysis. PROSPERO registration number: CRD42018112078. Results Fifty-nine studies (58% longitudinal) including 439,209 employees (min. 43, max. 77,746) from 15 countries were included. Most associations indicating positive and statistically significant results were based on longitudinal data (70%) and confirmed the strong/causal relationship between alcohol use and sickness absence. The meta-analysis included eight studies (ten samples). The increased risk for sickness absence was likely to be found in cross-sectional studies (OR: 8.28, 95% CI: 6.33–10.81), studies using self-reported absence data (OR: 5.16, 95% CI: 3.16–8.45), and those reporting short-term sickness absence (OR: 4.84, 95% CI: 2.73–8.60). Conclusion This review supports, but also challenges earlier evidence on the association between alcohol use and sickness absence. Certain types of design, data, and types of sickness absence may produce large effects. Hence, to investigate the actual association between alcohol and sickness absence, research should produce and review longitudinal designed studies using registry data and do subgroup analyses that cover and explain variability of this association.

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Abstract 20635: Dipeptidyl-Peptidiase 4 Inhibitors and the Risk of Heart Failure - A Nationwide Case-Crossover Study

Circulation ◽

10.1161/circ.130.suppl_2.20635 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Yi-Cheng Chang ◽

Chia-Hsuin Chang ◽

Jou Wei Lin ◽

Lee-Ming Chuang ◽

Mei-Shu Lai

Keyword(s):

Heart Failure ◽

Crossover Study ◽

Index Date ◽

Control Period ◽

Hypoglycemic Agents ◽

Dpp4 Inhibitors ◽

Case Crossover ◽

Increased Risk ◽

Case Period ◽

And Control

Introduction: Dipeptidyl-peptidiase 4 (DPP4) inhibitors, a new type of oral hypoglycemic agents, have been widely used in the treatment of type 2 diabetes mellitus (DM). However, recent studies showed that the use of DPP4 inhibitors, especially saxagliptin, could be associated with an increased risk of heart failure (HF). Methods: We conducted a retrospective case-crossover study by identifying DM patients aged 20 years and above hospitalized for HF between 2009 and 2011 from Taiwan National Health Insurance Database. Diagnosis codes from inpatient claims databases were used to ascertain the index date of hospitalization. For each patient, we defined case period as 1 to 30 days before the index date and control period as 91 to 120 days before the index date. The use of DPP4 inhibitors during the case and control periods were identified from the pharmacy claims database. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated by a conditional logistic regression model. Results: A total of 47,506 patients hospitalized for HF (48.2% mean and 51.8% women) was included in the analysis (mean age: 72.7±12.4 years). Among them, 2,874 patients (6.05%) used sitagliptin in the case period, and 2,318 (4.88%) did in the control period. Use of other DPP4 inhibitors, i.e., saxagliptin and vildagliptin, was rare. The analysis of the discordant medication in the two periods showed that sitagliptin use was associated with an increased risk of HF (OR: 2.85, 95% CI: 2.46-3.30). Additional analyses using different time frames as the control period showed similar results. In contrast, there was no increased risk for HF in the use of sulfonylureas or metformin. Conclusions: The nationwide case-crossover study demonstrated that sitagliptin was associated with an increased risk of hospitalization for HF. Further studies are needed to examine whether the potential risk of HF is a class effect of DPP4 inhibitors.

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Shift work and sickness absence at a Norwegian hospital: a longitudinal multilevel study

Occupational and Environmental Medicine ◽

10.1136/oemed-2019-106240 ◽

2020 ◽

Vol 77 (8) ◽

pp. 555-563

Author(s):

Vilde Hoff Bernstrøm ◽

Inge Houkes

Keyword(s):

Sickness Absence ◽

Shift Work ◽

Parental Status ◽

Short Term ◽

Increased Risk ◽

Shift Schedules ◽

The Individual ◽

The Relationship ◽

Night Shifts

ObjectiveShift work is known to be related to several negative health consequences and sickness absence. Research results regarding the relationship between types of shift schedules and sickness absence and whether and how individual factors moderate this relationship, are mixed though. The present paper aims to provide more insight in these relationships.MethodsWe used registry data from a large Norwegian hospital gathered for the years 2012–2016, for >14 000 employees. With random effects at the individual and unit levels, we analysed the relationship between shift schedule worked and sickness absence in the same year.ResultsThe results showed increased risk of short-term sickness absence for two-shift and three-shift rotations, as well as fixed night shifts compared with fixed-day shifts. We also found an increased number of absence periods for two-shift rotations without nights and three-shift rotations. Results for long-term sickness absence were mixed, with increased odds for two-shift rotations without nights, but reduced odds for three-shift rotations. We found partial support for a moderating influence of age, gender and parental status.ConclusionsThere is a clear relationship between working shifts and increased risk of short-term sickness absence. The relationship persists across gender, age group and parental status. The relationship between shift work and long-term sickness absence appears to be schedule and population specific. These findings may have implications for HR policies and the organisation of shift work in healthcare organisations.

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Within-individual analysis of pain and sickness absence among employees from low and high occupational classes: a record linkage study

BMJ Open ◽

10.1136/bmjopen-2018-026994 ◽

2019 ◽

Vol 9 (3) ◽

pp. e026994

Author(s):

Aapo Hiilamo ◽

Peter Butterworth ◽

Rahman Shiri ◽

Annina Ropponen ◽

Olli Pietiläinen ◽

...

Keyword(s):

Chronic Pain ◽

Sickness Absence ◽

Record Linkage ◽

Negative Binomial ◽

Occupational Class ◽

Short Term ◽

Increased Risk ◽

Multisite Pain ◽

Time Invariant

ObjectivesPain is linked to an increased risk of sickness absence (SA); however, the extent to which unmeasured time-invariant differences explain this association is yet unknown. Therefore, we determined the within-individual associations between pain and short-term (in the survey year) and long-term (2 years following the survey years) SA risk in high and low occupational classes while controlling for the potential bias due to unobservable time-invariant characteristics.MethodsThe Helsinki Health Study data consisting of midlife public sector employees with mailed surveys from up to four time points, and SA record linkage were used (3983 persons). The within-individual estimates were calculated using hybrid negative binomial regression models.ResultsAcute/subacute pain was associated with a 13% increase in the rate of short-term SA days (incidence rate ratio 1.13 [95% CI 1.01 to 1.27]), while the association was somewhat stronger for chronic pain (1.32 [1.19–1.47]). For the employees in the low occupational class, these associations were robust (1.29 [1.10–1.50] for acute/subacute and 1.43 [1.23–1.66] for chronic pain), whereas only chronic pain was associated with SA among those in the high occupational class (1.25 [1.08–1.46]). Chronic pain was also associated with SA days in the long term without occupational class differences. Similar results were obtained for multisite pain (pain in several locations).ConclusionsThese results indicate that particularly chronic and multisite pain have a within-individual link to SA but ignoring unobservable differences between those reporting pain and those not might yield overstated effect sizes. Pain might have a different relation to SA in low and high occupational classes.

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Awareness and correlates of short-term and long-term consequences of alcohol use among Australian drinkers

Australian and New Zealand Journal of Public Health ◽

10.1111/1753-6405.12634 ◽

2017 ◽

Vol 41 (3) ◽

pp. 237-242 ◽

Cited By ~ 9

Author(s):

Kerri Coomber ◽

Richelle Mayshak ◽

Ashlee Curtis ◽

Peter G. Miller

Keyword(s):

Alcohol Use ◽

Short Term ◽

Long Term Consequences

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Labor market affiliation after deployment: Danish soldiers fare well, but face increased risk of long-term sickness absence when returning from Afghanistan

Scandinavian Journal of Work Environment & Health ◽

10.5271/sjweh.3773 ◽

2018 ◽

Vol 45 (3) ◽

pp. 289-297 ◽

Cited By ~ 1

Author(s):

Andreas Elrond ◽

Christian Stoltenberg ◽

Lars Nissen ◽

Anni Nielsen ◽

Jacob Pedersen

Keyword(s):

Labor Market ◽

Sickness Absence ◽

Increased Risk

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Health and work disability outcomes in parents of patients with schizophrenia associated with antipsychotic exposure by the offspring

Scientific Reports ◽

10.1038/s41598-020-58078-4 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Heidi Taipale ◽

Syed Rahman ◽

Antti Tanskanen ◽

Juha Mehtälä ◽

Fabian Hoti ◽

...

Keyword(s):

Sickness Absence ◽

Work Disability ◽

Healthcare Service ◽

Service Use ◽

Antipsychotic Treatment ◽

Healthcare Use ◽

Swedish Population ◽

Increased Risk ◽

Healthcare Service Use

AbstractThis study aimed to identify if antipsychotic exposure in offspring is associated with psychiatric and non-psychiatric healthcare service use and work disability of their parents. This Swedish population-based cohort study was based on data comprising 10,883 individuals with schizophrenia, who had at least one identifiable parent in the nationwide registers, and their parents (N = 18,215). The register-based follow-up during 2006–2013 considered the level of antipsychotic exposure and persistence of use of the offspring, further categorized into first (FG) and second generation (SG) antipsychotics, and orals versus long-acting injections (LAIs). The main outcome measure was parental psychiatric healthcare service use, secondary outcomes were non-psychiatric healthcare use and long-term sickness absence. SG-LAI use was associated with a decreased risk (relative risks [RR] 0.81-0.85) of parental psychiatric healthcare use compared with not using SG-LAI, whereas oral antipsychotics were associated with an increased risk (RRs 1.10–1.29). Both FG- and SG-LAI use by the offspring were associated with a lower risk of long-term sickness absence (range of odds ratios 0.34–0.47) for the parents, compared with non-use of these drugs. The choice of antipsychotic treatment for the offspring may have an impact on work disability and healthcare service use of their parents.

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Perceived and content-related emotional demands at work and risk of long-term sickness absence in the Danish workforce: a cohort study of 26 410 Danish employees

Occupational and Environmental Medicine ◽

10.1136/oemed-2019-106015 ◽

2019 ◽

Vol 76 (12) ◽

pp. 895-900 ◽

Cited By ~ 3

Author(s):

Elisabeth Framke ◽

Jeppe Karl Sørensen ◽

Mads Nordentoft ◽

Nina Føns Johnsen ◽

Anne Helene Garde ◽

...

Keyword(s):

Depressive Symptoms ◽

Sickness Absence ◽

Cox Regression ◽

Environment And Health ◽

Frequency Of Contact ◽

Increased Risk ◽

Unit Increase ◽

Estimated Risk ◽

Emotional Demands

ObjectivesThis study aimed to examine whether high emotional demands at work predict long-term sickness absence (LTSA) in the Danish workforce and whether associations differ by perceived and content-related emotional demands.MethodsWe included 26 410 individuals from the Work Environment and Health in Denmark Study, a nationwide sample of the Danish workforce. Emotional demands at work were measured with two items: one assessing perceived emotional demands (asking how often respondents were emotionally affected by work) and one assessing content-related emotional demands (frequency of contact with individuals in difficult situations). LTSA was register based and defined as spells of ≥6 weeks. Respondents with LTSA during 2 years before baseline were excluded. Follow-up was 52 weeks. Using Cox regression, we estimated risk of LTSA per one-unit increase in emotional demands rated on a five-point scale.ResultsDuring 22 466 person-years, we identified 1002 LTSA cases. Both perceived (HR 1.20, 95% CI 1.12 to 1.28) and content-related emotional demands (HR 1.07, 95% CI 1.01 to 1.13) predicted risk of LTSA after adjustment for confounders. Further adjustment for baseline depressive symptoms substantially attenuated associations for perceived (HR 1.08, 95% CI 1.01 to 1.16) but not content-related emotional demands (HR 1.05, 95% CI 1.00 to 1.11). Individuals working in occupations with above-average values of both exposures had an increased risk of LTSA (HR 1.32, 95% CI 1.14 to 1.52) compared with individuals in all other job groups.ConclusionsPerceived and content-related emotional demands at work predicted LTSA, also after adjustment for baseline depressive symptoms, supporting the interpretation that high emotional demands may be hazardous to employee’s health.

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Distribution of sickness absence risk across different levels and patterns of drinking: findings from the Stockholm Public Health Cohort

Nordic Studies on Alcohol and Drugs ◽

10.1177/1455072520972303 ◽

2020 ◽

pp. 145507252097230

Author(s):

Jonas Landberg ◽

Mats Ramstedt

Keyword(s):

Public Health ◽

Alcohol Use ◽

Sickness Absence ◽

Selection Bias ◽

Risk Function ◽

Heavy Episodic Drinking ◽

Confounding Factors ◽

Health Selection ◽

Moderate Drinking

Aim: This study estimated (i) the risk function between different indicators of alcohol use and long-term sickness absence, adjusting for possible confounding factors, (ii) whether the risk function between average volume of consumption and sickness absence is modified by heavy episodic drinking (HED), and (iii) to what extent the risk for sickness absence among abstainers is due to health selection bias. Data and methods: The study was based on data from the Stockholm Public Health Cohort 2006, with an analytical sample of 16,477 respondents aged 18–64 years. The outcome included register-based long-term (> 14 days) sickness absence. Negative binominal regression was used to estimate the association between sickness absence and average weekly volume of consumption, frequency of HED, and both in interaction. Results: Abstainers, chronic heavy drinkers and respondents with the highest frequency of HED had approximately two-fold higher rates of sickness absence relative to the reference groups, i.e., moderate drinkers and those with HED one to 6 times per year. Adjustment for confounding factors did not materially affect the shape of the risk function. After exclusion of abstainers with alcohol-related problems, or poor health, the estimates for abstainers became non-significant. Moderate drinkers with HED did not have significantly higher rates of sickness absence than moderate drinkers without HED. Conclusions: Our results suggest a significant association between alcohol use and sickness absence. There were indications that the U-shaped risk function may largely be due to health selection bias among abstainers. We found no indication of effect modification of HED on moderate drinking.

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