Alavinia Seyed M, van den Berg Tilja I J, van Duivenbooden Cor, Elders Leo A M, Burdorf Alex
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Scand J Work Environ Health. 2009 Oct;35(5):325-33. doi: 10.5271/sjweh.1340. Epub 2009 Jun 23.
The objective of this study was to evaluate the relative contribution of individual characteristics, lifestyle factors, work-related risk factors, and work ability on the occurrence of short (<2 weeks), moderate (2-12 weeks), and long (>12 weeks) durations of sickness absence.
Altogether 5867 Dutch construction workers with complete sick leave registration were followed from the day of their medical examination in 2005 until the end of 2006. The main outcome of the study was the duration of sickness absence, as registered by an occupational health service. Independent variables consisted of individual characteristics, lifestyle factors, work-related factors, and the work ability index. We used Poisson regression analyses with repeated occurrence of sick leave to calculate rate ratios (RR) and 95% confidence intervals of independent variables for the three categories of sick leave duration.
Predictors for sick leave lasting 2-12 weeks and >12 weeks were: older age, obesity, smoking, manual materials handling, lack of job control, lung restriction, and a less than excellent work ability. For most predictors, higher RR values were observed with a longer duration of sickness absence. Obesity, smoking, manual materials handling, and lack of job control remained important risk factors for moderate and long durations of sick leave after adjusting for the strong effects of work ability on sickness absence. The highest population-attributable fractions were observed for: age over 50 years (18%), manual materials handling (20%), and good (18%), moderate (28%), and poor (2%) work ability.
This study suggests that a variety of preventive measures targeted at smoking, obesity, physical load, psychosocial work factors as well as work ability will contribute to a reduction in the occurrence of sick leave.
本研究的目的是评估个体特征、生活方式因素、工作相关风险因素以及工作能力对短期(<2周)、中期(2 - 12周)和长期(>12周)病假发生情况的相对贡献。
从2005年进行医学检查之日起至2006年底,对5867名荷兰建筑工人进行随访,这些工人的病假记录完整。研究的主要结果是职业健康服务机构记录的病假时长。自变量包括个体特征、生活方式因素、工作相关因素以及工作能力指数。我们使用泊松回归分析,结合病假的重复发生情况,计算三类病假时长的自变量的率比(RR)和95%置信区间。
持续2 - 12周和>12周病假的预测因素为:年龄较大、肥胖、吸烟、手工搬运材料、缺乏工作控制、肺部受限以及工作能力欠佳。对于大多数预测因素,病假时长越长,观察到的RR值越高。在调整工作能力对病假的强烈影响后,肥胖、吸烟、手工搬运材料和缺乏工作控制仍然是中期和长期病假的重要风险因素。观察到的人群归因分数最高的因素为:50岁以上(18%)、手工搬运材料(20%)以及良好(18%)、中等(28%)和较差(2%)的工作能力。
本研究表明,针对吸烟、肥胖、身体负荷、心理社会工作因素以及工作能力采取的各种预防措施将有助于减少病假的发生。