[The effect of systemic changes on sick-day absenteeism in the workplace. II. Causes of work disability among persons under termination of employment].

During the period of transformations and restructuring of workplaces in Poland, the reduction of employment becomes quite common, what seems to make a considerable impact on sick absenteeism. The analysis presented aimed at defining how far the risk of sick absenteeism increases among workers under termination of employment because of different reasons, and indicating morbidity causes in case of which sick absenteeism is most extensive. The study was carried out in one of the largest plants of the motor car industry (before the process of restructuring), and it covered a cohort of 5,373 men and 3,215 women employed during the years 1989-94. The workers who terminated their employment during those years made 77% of the whole cohort under study. The case index, calculated as the ratio of the number of cases to the number of man-days under observation, was taken as an analysis parameter. Poisson regression model involving a number of variables (age, departments, current workers, workers discharged according to particular reasons, and the period preceding the termination of employment) was used in the statistical analysis. The study indicated an increased risk of sick absenteeism in the group of workers approaching the termination of employment in comparison with that among current workers. The highest risk of work disability, both among men and women, was observed in persons leaving their jobs because of long-lasting illness or disability pension. The highest risk indices were noted in men whose sick absenteeism was caused by neoplasms (RR = 14.42); endocrine secretion disorders (RR = 4.83); cardiovascular disorders (RR = 3.60); mental disorders (RR = 3.04); and diseases of the musculoskeletal system (RR = 2.95); and in women with neoplasms (R = 6.42); diseases of the musculoskeletal system (RR = 4.01); and cardiovascular diseases (RR = 3.99). Risk of sick absenteeism was over 50% higher among retiring workers than among current workers (RR = 1.50 for men; and RR = 1.53 for women). Among workers discharged because of economic reasons, statistically significant risk of sick absenteeism was also observed (RR = 1.51 for men; and RR = 1.37 for women). In the group of workers leaving their jobs, following the agreement of the parties, an increased risk of sick absenteeism was noted in men (RR = 1.45). The economy transformation processes make a considerable impact on the occurrence of sick absenteeism in workplaces. Workers leaving their jobs because of health problems or of their own accord, as well as those discharged because of economic reasons belong to the highest risk groups.