Department of Occupational Health Surveillance, National Institute of Occupational Health, POB 5330 Majorstuen, N-0304, Oslo, Norway.
Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.
BMC Public Health. 2020 Jul 24;20(1):1157. doi: 10.1186/s12889-020-09205-3.
The study objective was to evaluate the impact of a population-level intervention (the IA Agreement) on the of one-year risk for long-term sickness absence spells (LSAS) among young and middle aged workers in Norway.
Using an observational design, we conducted a quasi-experimental study to analyse registry data on individual LSAS for all employed individuals in 2000 (n = 298,690) and 2005 (n = 352,618), born in Norway between 1976 and 1967. The intervention of interest was the tripartite agreement for a more inclusive working life (the IA Agreement). We estimated difference in pre-post differences (DID) in LSAS between individuals working in IA companies with the intervention and companies without, in 2000 and 2005. We used logistic regression models and present odds ratios (DID OR) with accompanying 95% CI. We stratified analyses by sex, industry and company size.
We found no significant change in the overall risk of long-term sickness absence spells after implementing the intervention among young and middle aged workers. Stratified by sex, the intervention resulted in a slight decrease in LSAS risk among female workers (DID OR 0.93 (0.91-0.96)) while the intervention showed no impact among male workers (DID OR 1.01 (0.97-1.06)). We found that companies signing the IA Agreement were large (≥50 employees) and often within the manufacturing and health and social sectors. In large manufacturing companies, we found a reduction in LSAS, among workers both in companies with and without the intervention, resulting in no statistically significant impact of the IA intervention. In large health and social companies, we found an increase in LSAS among workers both in companies with and without the intervention. The increase was smaller among the workers in companies offering the IA intervention compared with workers in companies without, resulting in a positive impact of the IA intervention in the health and social industry. This impact was statistically significant only among female workers.
The results indicate that the impact of the IA Agreement on the risk of long-term sickness absence spells varies considerably depending on sex and industry. These findings suggest that reducing LSAS may warrant industry-specific interventions.
本研究旨在评估一项人群干预措施（IA 协议）对挪威年轻和中年工人一年长期病假风险的影响。
我们采用观察性设计，对所有 2000 年（n=298690）和 2005 年（n=352618）就业的个体的个人长期病假记录进行了准实验研究，这些个体出生于 1976 年至 1967 年之间。我们感兴趣的干预措施是三方协议，以实现更具包容性的工作生活（IA 协议）。我们估计了 2000 年和 2005 年在有干预措施的 IA 公司和没有干预措施的公司工作的个体之间 LSAS 的前后差异（DID）。我们使用逻辑回归模型并呈现伴随 95%CI 的比值比（DID OR）。我们按性别、行业和公司规模进行了分层分析。
我们发现，在年轻和中年工人中实施干预措施后，长期病假风险没有显著变化。按性别分层，该干预措施导致女性工人的 LSAS 风险略有下降（DID OR 0.93（0.91-0.96）），而男性工人则没有影响（DID OR 1.01（0.97-1.06））。我们发现，签署 IA 协议的公司规模较大（≥50 名员工），通常位于制造业和卫生与社会部门。在大型制造公司中，我们发现无论是否存在干预措施，工人的 LSAS 都有所减少，因此 IA 干预没有产生统计学上的显著影响。在大型卫生和社会公司中，我们发现无论是否存在干预措施，工人的 LSAS 都有所增加。在提供 IA 干预的公司中，工人的增加幅度较小，与没有干预的公司相比，IA 干预对卫生和社会行业产生了积极影响。这种影响仅在女性工人中具有统计学意义。
结果表明，IA 协议对长期病假风险的影响因性别和行业而异。这些发现表明，减少 LSAS 可能需要针对特定行业的干预措施。
