Theorell T, Oxenstierna G, Westerlund H, Ferrie J, Hagberg J, Alfredsson L
Department of Public Health Sciences, Karolinska Institutet, and National Institute for Psychosocial Factors and Health, Box 230, Stockholm S-171 77, Sweden.
Occup Environ Med. 2003 Sep;60(9):E9. doi: 10.1136/oem.60.9.e9.
To determine whether changes in number of staff in work sites are associated with medically certified sick leave among employees with an increased risk of developing cardiovascular disease.
The 5720 employees (aged 18-65) were from the WOLF study of cardiovascular risk factors in working men and women in greater Stockholm during the years 1992-95. From the medical examination a cardiovascular score was calculated for each participant. The WOLF study base was linked to a Statistics Sweden registry of economic and administrative activities. Sick leave spells lasting for at least 15 days during the calendar year following downsizing/expansion were identified for each subject.
In multiple logistic regression an increased likelihood of having no medically certified sick leave (15 days or more) was found in women during the year following both downsizing and expansion. These analyses were adjusted for age and cardiovascular score. A high cardiovascular risk score reduced the likelihood of having no medically certified sick leave. The inclusion of psychosocial work environment variables did not change the results markedly. Separate analyses of women with and without high cardiovascular score showed that downsizing had a more pronounced effect on reduced long term sick leave among those with high than among those without low cardiovascular score. There were no consistent findings in men.
There is evidence of a reduction of long term sick leave in women after downsizing and this is particularly evident among those with high cardiovascular score.
确定工作场所员工数量的变化是否与患心血管疾病风险增加的员工中经医学认证的病假相关。
5720名员工(年龄在18 - 65岁之间)来自1992 - 1995年期间对大斯德哥尔摩地区职业男性和女性心血管危险因素进行的WOLF研究。通过医学检查为每位参与者计算心血管疾病评分。WOLF研究数据库与瑞典统计局的经济和行政活动登记处相关联。确定了每位受试者在裁员/扩员后日历年中持续至少15天的病假记录。
在多因素逻辑回归分析中,发现女性在裁员和扩员后的年份中,无经医学认证病假(15天或更长时间)的可能性增加。这些分析对年龄和心血管疾病评分进行了校正。高心血管疾病风险评分降低了无经医学认证病假的可能性。纳入社会心理工作环境变量后,结果没有明显变化。对心血管疾病评分高和低的女性分别进行分析显示,裁员对心血管疾病评分高的女性长期病假减少的影响比对心血管疾病评分低的女性更为显著。男性中未发现一致的结果。
有证据表明裁员后女性长期病假减少,这在心血管疾病评分高的女性中尤为明显。