Frentzel-Beyme R, Marcolini M, Steinhäuser A
Deutsches Krebsforschungszentrum Heidelberg.
Soz Praventivmed. 1990;35(3):117-24. doi: 10.1007/BF01358985.
The usefulness of data on absence from work due to sickness (absenteeism) as an indicator of specific and detailed information of diagnoses is widely discussed in the international literature. In occupational health indicators for health risks (e g sickness absence of more than 14 days), details on diagnosis and workplace are very useful, if analysed by epidemiological means. A pilot project, initiated by a high sickness absence in the automobile industry, led to a test of an industrial health information system, which was abruptly stopped by data protection arguments. The epidemiologic approach of an age-adjusted comparison of incidences relies on the access to morbidity data of the health insurance system. With the diagnostic information at hand differences of incidences in one production branch (as recognized by the incidence ratio SIR) are to be discovered if related to certain specific diagnoses. Thus, a direct comparison of comparable rates helps to identify specific reasons for increased absence from work. Practical solutions were found if the owner of the data, the National Federation of Enterprise Sickness Funds, conducted the analyses. First results showed as yet unknown associations of myocardial infarction and obstructive lung diseases in the metallurgical industry. In such cases not only the validity of such results has to be verified, but also other epidemiological tools, such as a case-referent approach to determine risk ratios, are required for the identification of any causally important relationship.
因病缺勤数据作为诊断具体详细信息的指标，其有用性在国际文献中得到了广泛讨论。在职业健康风险指标中（例如缺勤超过14天），如果通过流行病学方法进行分析，诊断和工作场所的详细信息非常有用。一个由汽车行业高缺勤率引发的试点项目，促成了一个工业健康信息系统的测试，但该测试因数据保护问题而突然终止。发病率年龄调整比较的流行病学方法依赖于获取健康保险系统的发病数据。手头有诊断信息的情况下，如果将发病率差异与某些特定诊断相关联，就能在一个生产部门（如通过发病率比SIR识别）中发现差异。因此，可比率的直接比较有助于确定缺勤增加的具体原因。如果数据所有者——全国企业疾病基金联合会进行分析，就能找到实际解决方案。初步结果显示了冶金行业中心肌梗死与阻塞性肺病之间尚未为人所知的关联。在这种情况下，不仅要验证此类结果的有效性，还需要其他流行病学工具，如用于确定风险比率的病例对照方法，以识别任何具有因果重要性的关系。
