Arcas M Marta, Delclos George L, Torá-Rocamora Isabel, Martínez José Miguel, Benavides Fernando G
Department of Preventive Medicine and Public Health, Educational Unit Hospital del Mar- Universitat Pompeu Fabra - Agència de Salut Pública de Barcelona, Barcelona, Catalonia, Spain.
Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Catalonia, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Catalonia, Spain The University of Texas School of Public Health, Houston, Texas, USA IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain.
J Epidemiol Community Health. 2016 Nov;70(11):1065-1073. doi: 10.1136/jech-2014-204331. Epub 2016 May 13.
There is wide evidence that women present longer duration of sickness absence (SA) than men. Musculoskeletal disorders are influenced by gender due to the sexual division of work.
354 432 episodes of non-work-related SA due to musculoskeletal disorders, which were registered in Catalonia between 2005 and 2008, were selected. The outcome variable was the duration of SA. Frailty survival models, stratified by sex and adjusted for explanatory variables (age, employment status, case management, economic activity and repeated episode), were fitted to study the association between each variable and the duration of SA, obtaining HRs.
Women presented longer SA episodes than men in all variable categories. A trend from shorter to longer duration of SA with increasing age was observed in men, whereas in women, it had a fluctuating pattern. Analysing most frequent diagnostic subgroups from the sample, only 'non-specific lumbago' and 'sciatic lumbago' showed these age patterns. Frailty survival models applied to these 2 subgroups confirmed the described age patterns in SA duration.
Women have longer non-work-related SA due to musculoskeletal disorders than men. However, while men have longer absences as their age increases, in women some older groups have shorter absences than younger ones. These findings could be explained by gender differences in the interaction between paid work and family demands. Our results highlight the need for continued research on SA from a gender perspective, in order to improve management of SA in terms of clinical practice and public policies.
有充分证据表明,女性的病假时长比男性更长。由于工作的性别分工,肌肉骨骼疾病受到性别影响。
选取了2005年至2008年在加泰罗尼亚登记的354432起因肌肉骨骼疾病导致的非工伤病假案例。结果变量为病假时长。采用按性别分层并针对解释变量(年龄、就业状况、病例管理、经济活动和复发病例)进行调整的脆弱性生存模型,以研究每个变量与病假时长之间的关联,得出风险比(HRs)。
在所有变量类别中,女性的病假时长均长于男性。男性中观察到随着年龄增长病假时长从短到长的趋势,而女性则呈现出波动模式。分析样本中最常见的诊断亚组,只有“非特异性腰痛”和“坐骨神经痛性腰痛”呈现出这些年龄模式。应用于这两个亚组的脆弱性生存模型证实了病假时长中所描述的年龄模式。
因肌肉骨骼疾病导致的非工伤病假,女性比男性更长。然而,虽然男性随着年龄增长病假时长增加,但在女性中,一些年龄较大的群体病假时长比年轻群体短。这些发现可以通过有偿工作和家庭需求之间相互作用的性别差异来解释。我们的结果强调了从性别角度持续研究病假的必要性,以便在临床实践和公共政策方面改善病假管理。