Alexopoulos E C, Burdorf A
Department of Public Health, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
Occup Environ Med. 2001 Apr;58(4):246-52. doi: 10.1136/oem.58.4.246.
To analyze factors that determine the occurrence of sickness absence due to respiratory disorders and the time it takes to return to work.
A longitudinal study with 2 year follow up was conducted among 326 male blue collar and white collar workers. The survey started with an interview on respiratory complaints and spirometry. Sixty six (21%) workers were lost to follow up. Complete data on sickness absence among 251 workers during the follow up were collected from absence records and self reports. Regression analysis based on a proportional hazards model was applied to identify risk factors for the occurrence and duration of sickness absence due to respiratory disorders.
During the follow up 35% workers attributed at least one period of sickness absence to respiratory complaints, which accounted for 14.2% of all days lost. A history of chronic obstructive pulmonary disease (COPD) did not predict sickness absence for COPD; the same was true for chronic non-specific lung disease (CNSLD). Complaints about asthma contributed significantly to absence due to asthma (relative risk (RR) 3.96; 95% confidence interval (95% CI) 1.99 to 7.90). Job title was a significant predictor of sickness absence due to respiratory complaints. Decrease in forced vital capacity (FVC, <80% of the reference value) was also a significant predictor of absence due to asthma (RR 4.03; 95% CI 1.41 to 11.54) and of respiratory absence (RR 2.49; 95% CI 1.07 to 5.79). Absence with respiratory complaints was not associated with age, height, body mass index, or smoking. Duration of employment was a weak almost significant predictor against respiratory absenteeism (RR 0.94; 95% CI 0.91 to 0.97). Return to work after respiratory absence was worse for blue collar workers than office personnel (RR 5.74; 95% CI 1.90 to 17.4 for welders, and RR 6.43; 95% CI 2.08 to 19.85 for metal workers).
Asthmatic complaints in the 12 months before the study were associated with sickness absence for these complaints during the follow up. An abnormal level of FVC also influenced respiratory absenteeism. Blue collar workers had more often and more prolonged absences due to respiratory disorders than white collar workers. Workers with absence due to respiratory complaints were at higher risk of subsequent sickness absence in the next year.
分析导致因呼吸系统疾病而缺勤的因素以及恢复工作所需的时间。
对326名男性蓝领和白领工人进行了一项为期2年随访的纵向研究。调查从对呼吸系统症状的访谈和肺活量测定开始。66名(21%)工人失访。从缺勤记录和自我报告中收集了251名工人在随访期间完整的缺勤数据。应用基于比例风险模型的回归分析来确定因呼吸系统疾病导致缺勤的发生和持续时间的风险因素。
在随访期间,35%的工人将至少一段缺勤时间归因于呼吸系统症状,这些症状占所有缺勤天数的14.2%。慢性阻塞性肺疾病(COPD)病史并不能预测因COPD而缺勤;慢性非特异性肺病(CNSLD)也是如此。哮喘相关症状对因哮喘而缺勤有显著影响(相对风险(RR)3.96;95%置信区间(95%CI)1.99至7.90)。职业是因呼吸系统症状而缺勤的一个重要预测因素。用力肺活量(FVC,<参考值的80%)降低也是因哮喘而缺勤(RR 4.03;95%CI 1.41至11.54)和因呼吸系统疾病而缺勤(RR 2.49;95%CI 1.07至5.79)的一个重要预测因素。因呼吸系统症状而缺勤与年龄、身高、体重指数或吸烟无关。工作年限是预防呼吸系统缺勤的一个微弱但几乎显著的预测因素(RR 0.94;95%CI 0.91至0.97)。因呼吸系统疾病缺勤后,蓝领工人比办公室人员恢复工作的情况更差(焊工的RR为5.74;95%CI 1.90至17.4,金属工人的RR为6.43;95%CI 2.08至19.85)。
研究前12个月内的哮喘相关症状与随访期间因这些症状而缺勤有关。FVC异常水平也影响呼吸系统缺勤情况。蓝领工人因呼吸系统疾病缺勤的频率更高、时间更长。因呼吸系统症状而缺勤的工人在次年再次缺勤的风险更高。