Lund T, Kivimäki M, Christensen K B, Labriola M
Danish National Centre for Social Research, Herluf Trolles Gade 11, Copenhagen, Denmark.
Occup Environ Med. 2009 Mar;66(3):150-3. doi: 10.1136/oem.2008.040154. Epub 2008 Sep 19.
To examine duration of sickness absence as a risk marker for future mortality by socio-economic position among all private sector employees in Denmark in 1998-2004.
All residents in Denmark employed in the private sector receiving sickness absence compensation in 1998 were investigated in a prospective cohort study. 236 207 persons (38.2% women, 61.8% men, age range 18-65, mean age 37.8 years) alive on 1 January 2001 were included in the study. Mortality from 1 January 2001 to 31 December 2004 was assessed using national register data. Deaths in 1999 and 2000 were excluded to determine the status of sickness absence duration as an early risk marker. For analyses within occupational grades, data were available for a sub-population of 137 607 study participants.
3040 persons died during follow-up. The age-adjusted risk of future mortality increased by duration of sickness absence in a graded fashion among men and non-blue collar workers. Among women and blue collar workers, there was no association of mortality with duration of sickness absences below 6 weeks. However, employees with > or =6 weeks of absence compared to those with 1-week absence had a substantial excess risk of death in all groups: adjusted hazard ratio 2.2 (95% CI 1.8 to 2.7) for women, 2.1 (95% CI 1.8 to 2.4) for men, 3.7 (95% CI 1.9 to 7.2) in white collar occupations, 3.3 (95% CI 2.2 to 5.0) in intermediate grade occupations and 2.0 (95% CI 1.7 to 2.3) in blue collar occupations.
Administratively collected data on sickness absence compensation for periods > or =6 weeks identified "at risk" groups for future excess mortality in male and female private sector employees across occupational grade levels.
通过社会经济地位，研究丹麦1998 - 2004年所有私营部门雇员病假时长作为未来死亡率风险标志物的情况。
在一项前瞻性队列研究中，对1998年丹麦私营部门中领取病假补贴的所有居民进行调查。纳入研究的是2001年1月1日仍存活的236207人（38.2%为女性，61.8%为男性，年龄范围18 - 65岁，平均年龄37.8岁）。使用国家登记数据评估2001年1月1日至2004年12月31日的死亡率。排除1999年和2000年的死亡病例以确定病假时长作为早期风险标志物的状态。对于职业等级内的分析，有137607名研究参与者的亚组数据可用。
随访期间有3040人死亡。在男性和非蓝领工人中，经年龄调整后的未来死亡风险随病假时长呈分级增加。在女性和蓝领工人中，病假时长低于6周与死亡率无关联。然而，与病假1周的员工相比，病假时长≥6周的员工在所有组中死亡风险大幅增加：女性调整后风险比为2.2（95%置信区间1.8至2.7），男性为2.1（95%置信区间1.8至2.4），白领职业为3.7（95%置信区间1.9至7.2），中级职业为3.3（95%置信区间2.2至5.0），蓝领职业为2.0（95%置信区间1.7至2.3）。
行政收集的病假补贴时长≥6周的数据识别出了不同职业等级水平的私营部门男女雇员未来超额死亡的“风险”群体。
