scholarly journals Sickness absence and disability pension among injured working-aged pedestrians - a population-based Swedish register study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linnea Kjeldgård ◽  
Helena Stigson ◽  
Maria Klingegård ◽  
Kristina Alexanderson ◽  
Emilie Friberg

Abstract Background The knowledge is scarce about sickness absence (SA) and disability pension (DP) among pedestrians injured in a traffic-related accident, including falls. Thus, the aim was to explore the frequencies of types of accidents and injuries and their association with SA and DP among working-aged individuals. Methods A nationwide register-based study, including all individuals aged 16-64 and living in Sweden, who in 2010 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Information on age, sex, sociodemographics, SA, DP, type of accident, injury type, and injured body region was used. Frequencies of pedestrians with no SA or DP, with ongoing SA or full-time DP already at the time of the accident, and with a new SA spell >14 days in connection to the accident were analyzed. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new SA were estimated by logistic regression. Results In total, 5576 pedestrians received healthcare due to a traffic-related accident (of which 75% were falls, with half of the falls related to snow and ice). At the time of the accident, 7.5% were already on SA and 10.8% on full-time DP, while 20% started a new SA spell. The most common types of injuries were fractures (45%) and external injuries (30%). The body region most frequently injured was the lower leg, ankle, foot, and other (in total 26%). Older individuals had a higher OR for new SA compared with younger (OR 1.91; 95% CI 1.44-2.53, for ages: 45-54 vs. 25-34). The injury type with the highest OR for new SA, compared with the reference group external injuries, was fractures (9.58; 7.39-12.43). The injured body region with the highest OR for new SA, compared with the reference group head, face, and neck, was lower leg, ankle, foot, and other (4.52; 2.78-7.36). Conclusions In this explorative nationwide study of the working-aged pedestrians injured in traffic-related accidents including falls, one fifth started a new SA spell >14 days. Fractures, internal injuries, collisions with motor vehicle, and falls related to snow and ice had the strongest associations with new SA.

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Kjeldgård ◽  
H Stigson ◽  
K Alexanderson ◽  
E Friberg

Abstract Background In recent years, bicycle injuries have increased, yet little is known about impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore the long-term patterns of SA and DP among injured bicyclists. Methods A longitudinal register-based study was conducted, including all individuals aged 18-59 years and living in Sweden, who in 2010 had incident in- or specialized out-patient healthcare for injuries sustained in a bicycle crash. Information about sociodemographics, the injury, SA, DP, and deaths were obtained from several nationwide registers. Weekly SA/DP data for four years: one year before and three years after the crash were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each sequence cluster. Results Among all 6465 individuals injured in a bicycle crash 2010, five clusters were identified: No SA or DP (60.2%), Immediate SA (17.7%), Episodic SA (15.3%), Part-time DP (1.6%), and Full-time DP (5.2%). Compared to the cluster No SA or DP, all other clusters had high ORs for female sex, older age, living in small cities/villages, and inpatient care. Immediate SA also had high ORs for cyclists who sustained a fracture (OR 5.53; CI 4.47-6.83), dislocation (3.26; 2.29-4.65), sprains and strains (2.29; 1.68-3.10), and internal injuries (4.39; 1.95-9.90). Episodic SA had high ORs for other traumatic brain injury than concussion (6.27; 2.23-17.64) and injuries located in the spine and back (3.52; 2.12-5.86), torso (1.78; 1.29-2.45), upper extremities (1.95; 1.54-2.46), and lower extremities (1.85; 1.43-2.41). Conclusions Having SA in direct connection to the crash was associated with type of injury, in contrast to Episodic SA where the injured body region was of more importance, in particular other traumatic brain injuries and injuries to the spine and back. Key messages This nationwide study of new bicycle crashes found five clusters of sickness absence (SA) and disability pension (DP) sequences; No SA or DP, Immediate SA, Episodic SA, Part-time DP, and Full-time DP. The type of injury was more important for SA in direct connection to the crash, while the injured body region was of more importance for continued and repeated SA up to three years after the crash.


Neurology ◽  
2020 ◽  
Vol 94 (21) ◽  
pp. e2213-e2221 ◽  
Author(s):  
Christina Sjöstrand ◽  
Kristina Alexanderson ◽  
Pontus Josefsson ◽  
Anna Steinberg

ObjectiveTo determine whether patients with cluster headache have more sickness absence and disability pension days compared to matched references and possible associations with sociodemographic characteristics.MethodsWe performed a registry study of all patients who had received specialized health care for cluster headache (ICD-10 code G44.0) aged 16–64 years and living in Sweden in 2010 (n = 3,240; 34% women) and matched references from the total population (n = 16,200) regarding their sickness absence and disability pension days in 2010.ResultsMean number of sickness absence days in 2010 was 16.13 (95% confidence interval, 14.05–18.20) among patients with cluster headache and 6.54 (5.97–7.11) among references. When combining sickness absence and disability pension days, patients with cluster headache had 63.15 (58.84–67.45) days, references 34.08 (32.59–35.57) days. Among patients, women had twice as many sickness absence days than men: 23.71 (19.36–28.06) vs 12.41 (10.19–14.63). When adding disability pension days, those numbers were 83.71 (75.57–91.84) vs 52.56 (47.62–57.51). Patients with cluster headache had significantly more sickness absence days in all ages compared to the reference group. Patients with elementary education had more sickness absence/disability pension days (85.88 [75.34–96.42]) compared to those with high school (64.89 [58.82–70.97]) and college/university (41.42 [34.70–48.15]) education.ConclusionThis nationwide study shows that patients with cluster headache have significantly more sickness absence and disability pension days compared to matched references. Furthermore, among patients, women had more sickness absence and disability pension days than men.


Neurology ◽  
2019 ◽  
Vol 93 (4) ◽  
pp. e404-e413 ◽  
Author(s):  
Anna Steinberg ◽  
Pontus Josefsson ◽  
Kristina Alexanderson ◽  
Christina Sjöstrand

ObjectiveTo estimate the prevalence of cluster headache in working-aged people, compare sickness absence rates and disability pension in cluster headache patients to rates in a matched comparison group, and explore associations of sociodemographic factors with such rates.MethodsThrough population-based registers, we identified 3,240 people aged 16–64, living in Sweden in 2010, who at least once during 2001–2010 received inpatient or specialized outpatient health care with cluster headache (ICD-10 code G44.0) as main diagnosis. A comparison group (n = 16,200), matched for age, sex, type of living area, and educational level, from the total population aged 16–64 (n = 5,945,895) was used. Outcomes were sickness absence (>14 days) and disability pension during 2010. Crude and adjusted prevalence rates and odds ratios with 95% confidence intervals were computed.ResultsThe prevalence of cluster headache in working-aged people was 0.054%. In 2010, 17.30% of the cluster headache group and 9.16% of the comparison group had been on sickness absence. In the cluster headache group, female patients had higher sickness absence rates (25.31%) and full-time disability pension (13.17%) than male patients (13.38% and 8.79%). Cluster headache patients older than 35 had higher rates than those of the same age in the comparison group. Further, cluster headache patients born outside Sweden were more likely to have full-time disability pension than patients born in Sweden.ConclusionsMuch higher rates of the patients had sickness absence or disability pension than in the comparison group. Further shown differences related to sex, age, and other sociodemographic factors need to be addressed.


2015 ◽  
Vol 21 (13) ◽  
pp. 1730-1741 ◽  
Author(s):  
Michael Wiberg ◽  
Emilie Friberg ◽  
Magnus Stenbeck ◽  
Kristina Alexanderson ◽  
Anders Norlund ◽  
...  

Introduction: Multiple sclerosis (MS) is associated with reduced work capacity, but there is limited knowledge about MS patients’ sources of income. Objectives: The purpose of this study was to elucidate MS patients’ earnings and social benefits compared to those of the general population. Methods: From nationwide registers of all residents in Sweden aged 21–64 years in 2010 ( n=5,291,764), those with an MS diagnosis ( n=13,979) were compared to a propensity score matched reference group ( n=69,895). Descriptive statistics and regression models were used to estimate the percentage difference between the MS patients and the matched references regarding the following annual incomes: earnings, disability pension, sickness absence, disability allowance, unemployment compensation and social assistance. Results: Both MS patients and the matched references received most of their income from earnings followed by disability pension and sickness absence. MS patients that were diagnosed in 2010 had 15% lower earnings than the matched references, while MS patients diagnosed before 2005 had 38% lower earnings. Corresponding figures regarding summed social benefits were 33% and 130% higher for MS patients, respectively. Conclusion: The results indicate that MS patients are overrepresented, in relative and absolute terms, regarding health-related benefits and have lower levels of earnings. However, the redistributing welfare systems appear to financially compensate the MS patients considerably.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Linnea Kjeldgård ◽  
Helena Stigson ◽  
Kristina Alexanderson ◽  
Emilie Friberg

Abstract Background Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries. Aims To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor vehicles (1.9;1.1–3.2) and traumatic brain injury, not concussion (18.4;2.2–155.2). Conclusion Sequence analysis enabled exploration of the large heterogeneity of SA and DP following a bicycle crash. More knowledge is needed on how to prevent bicycle crashes and especially those crashes/injuries leading to long-term consequences.


Author(s):  
Ashley A. Weaver ◽  
Callistus M. Nguyen ◽  
Joel D. Stitzel

Thoracic injury ranks second only to head injury in motor vehicle crash injuries in terms of the number of fatalities and serious injuries, the body region most often injured, and the overall economic cost [1, 2]. Skeletal and physiological resilience are known to decline with age, resulting in a decreased ability for the body to withstand traumatic insults [3]. Adults 65 years of age and older constitute more than 12% of the current population and with increases in life expectancy, the elderly population is projected to reach nearly 20% by 2030 [4].


2018 ◽  
Vol 9 ◽  
pp. 275-281 ◽  
Author(s):  
Maria Ohlin ◽  
Linnea Kjeldgård ◽  
Rasmus Elrud ◽  
Helena Stigson ◽  
Kristina Alexanderson ◽  
...  

2015 ◽  
Vol 42 (10) ◽  
pp. 1794-1800 ◽  
Author(s):  
Gunnel Sandqvist ◽  
Roger Hesselstrand ◽  
Ingemar F. Petersson ◽  
Lars Erik Kristensen

Objective.To study work disability (WD) with reference to levels of sick leave and disability pension in early systemic sclerosis (SSc).Methods.Patients with SSc living in the southern part of Sweden with onset of their first non-Raynaud symptom between 2003 and 2009 and with a followup of 36 months were included in a longitudinal study. Thirty-two patients (26 women, 24 with limited SSc) with a median age of 47.5 years (interquartile range 43–53) were identified. WD was calculated in 30-day intervals from 12 months prior to disease onset until 36 months after, presented as the prevalence of WD per year (0–3) and as the period prevalence of mean net days per month (± SD). Comparisons were made between patients with different disease severity and sociodemographic characteristics, and between patients and a reference group (RG) from the general population.Results.Seventy-eight percent had no WD 1 year prior to disease onset, which decreased to 47% after 3 years. The relative risk for WD in patients with SSc compared with RG was 0.95 (95% CI 0.39–2.33) at diagnosis, and increased to 2.41 (1.28–4.55) after 3 years. There were no significant correlations between WD and disease severity, but between WD and years at workplace (rs= −0.72; p = 0.002), education (rs= −0.51; p = 0.004), and sickness absence the month before disease onset (rs= 0.58; p = 0.001), respectively.Conclusion.Considerable increase in WD was noted 3 years after disease onset. Limited education, fewer years at workplace, and sickness absence before disease onset may be risk factors for sustained WD.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Chen ◽  
K Alexanderson

Abstract Background Working-aged colorectal cancer (CRC) patients have a much better survival nowadays, indicating the importance of their future work situation. We aimed to investigate trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis and in references, and risk factors associated with different trajectories. Methods A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19-62 when first diagnosed with CRC in 2008-2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi2 test and multinomial logistic regression. Results Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all, n = 2481), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level (R2=0.022), Charlson's Comorbidity Index (R2=0.029), and prediagnostic mental disorders (R2=0.066) were the strongest factors determining the SADP trajectory groups. In references, three trajectories (”constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified. Conclusions Approximately 80% of CRC survivors return to a low level of SADP (0-60 days/year) at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for CRC survivors. Key messages Most of working-age colorectal cancer survivors have low levels of sickness absence and disability pension days five years after their diagnosis. Trajectory analyses based on population-based register data can be used as a good approach in understanding future work situation regarding sick leave among working-age cancer survivors.


2021 ◽  
pp. 140349482110027
Author(s):  
Tea Lallukka ◽  
Rahman Shiri ◽  
Kristina Alexanderson ◽  
Jenni Ervasti ◽  
Ellenor Mittendorfer-Rutz ◽  
...  

Aims: The aim of this study was to examine sickness absence and disability pension (SA/DP) during working lifespan among individuals diagnosed with carpal tunnel syndrome (CTS) and their matched references, accounting for sociodemographic factors. Methods: We used a register cohort of 78,040 individuals aged 19–60 years when diagnosed with CTS in secondary health care (hospitals and outpatient specialist health care) and their 390,199 matched references from the general population in 2001–2010. Sociodemographic factors and SA/DP net days during a three-year follow-up were included. Negative binomial regression was used. Results: For those not on DP at inclusion, the average number of SA/DP days per person-year was 58 days (95% confidence interval (CI) 56–60 days) among individuals with CTS and 20 days (95% CI 19–21 days) among the matched references. Among both groups, these numbers increased with age and were higher among women than among men. The rate ratio (RR) of SA/DP days was threefold higher among people with CTS than among the matched references (adjusted RR=3.00, 95% CI 2.91–3.10) Moreover, compared to the matched references, the RR for SA/DP was higher among men with CTS (RR=3.86, 95% CI 3.61–4.13) than among women with CTS (RR=2.69, 95% CI 2.59–2.78). The association between CTS and the number of SA/DP days was smaller among older age groups. Sociodemographic factors were similarly associated with SA/DP among people with and without CTS. Conclusions: Numbers of SA/DP days were higher among people with CTS than their matched references in all age groups, particularly among individuals in their early work careers, highlighting public-health relevance of the findings.


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