Vahtera Jussi, Kivimäki Mika, Pentti Jaana, Linna Anne, Virtanen Marianna, Virtanen Pekka, Ferrie Jane E
Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland.
BMJ. 2004 Mar 6;328(7439):555. doi: 10.1136/bmj.37972.496262.0D. Epub 2004 Feb 23.
To examine whether downsizing, the reduction of personnel in organisations, is a predictor of increased sickness absence and mortality among employees.
Prospective cohort study over 7.5 years of employees grouped into categories on the basis of reductions of personnel in their occupation and workplace: no downsizing (< 8% reduction), minor downsizing (8-18%), and major downsizing (> 18%).
Four towns in Finland.
5909 male and 16 521 female municipal employees, aged 19-62 years, who kept their jobs.
Annual sickness absence rate based on employers' records before and after downsizing by employment contract; all cause and cause specific mortality obtained from the national mortality register.
Major downsizing was associated with an increase in sickness absence (P for trend < 0.001) in permanent employees but not in temporary employees. The extent of downsizing was also associated with cardiovascular deaths (P for trend < 0.01) but not with deaths from other causes. Cardiovascular mortality was 2.0 (95% confidence interval 1.0 to 3.9) times higher after major downsizing than after no downsizing. Splitting the follow up period into two halves showed a 5.1 (1.4 to 19.3) times increase in cardiovascular mortality for major downsizing during the first four years after downsizing. The corresponding hazard ratio was 1.4 (0.6 to 3.1) during the second half of follow up.
Organisational downsizing may increase sickness absence and the risk of death from cardiovascular disease in employees who keep their jobs
研究组织裁员（即人员精简）是否会导致员工病假缺勤率上升及死亡率增加。
一项为期7.5年的前瞻性队列研究，根据员工所在职业和工作场所的人员裁减情况将员工分为几类：无裁员（裁减比例<8%）、小幅裁员（8%-18%）和大幅裁员（>18%）。
芬兰的四个城镇。
5909名男性和16521名女性市政雇员，年龄在19至62岁之间，均为在职人员。
根据裁员前后雇主记录的雇佣合同计算年度病假缺勤率；从国家死亡率登记处获取全因死亡率和特定病因死亡率。
大幅裁员与长期雇员病假缺勤率上升相关（趋势P值<0.001），但与临时雇员无关。裁员程度还与心血管疾病死亡相关（趋势P值<0.01），但与其他病因死亡无关。大幅裁员后心血管疾病死亡率比无裁员后高2.0倍（95%置信区间1.0至3.9）。将随访期分为两半显示，大幅裁员后前四年心血管疾病死亡率增加了5.1倍（1.4至19.3）。随访后半期相应的风险比为1.4（0.6至3.1）。
组织裁员可能会增加在职员工的病假缺勤率以及心血管疾病死亡风险。
