Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, PB 5330 Majorstuen, 0304, Oslo, Norway.
Department of Occupational Health Surveillance, National Institute of Occupational Health, Oslo, Norway.
BMC Public Health. 2022 Feb 4;22(1):235. doi: 10.1186/s12889-022-12636-9.
The Norwegian Agreement for a More Inclusive Working Life (the IA Agreement) aims to reduce sickness absence (SA) and increase work participation. Potential impacts of the IA Agreement have not been thoroughly evaluated. The study aimed to estimate the impact of the IA Agreement on musculoskeletal and psychological SA prevalence and duration among young adult men and women, and to identify whether the impact was modified by economic activity or SA grade.
Data from national registries were combined for 372,199 individuals born in Norway 1967-1976. ICPC-2 codes identified musculoskeletal (L) and psychological (P) diagnoses. A difference-in-difference method compared prevalence and mean duration of first SA > 16 days between 2000 and 2005 separately for men and women working in IA companies relative to non-IA companies. Analyses were adjusted for mean company size and stratified by economic activity and SA grade (full/graded). Average marginal change was calculated with 95% confidence intervals (CI).
The impacts of the IA Agreement on SA prevalence were mixed as the direction and size of marginal changes varied according to diagnosis, gender, and economic activity. However, there was a general tendency towards reduced mean SA duration for both diagnosis groups, and in particular men with musculoskeletal SA (- 16.6 days, 95% CI -25.3, - 7.9). Individuals with full SA in IA companies had greater reductions in mean SA duration. Only the wholesale and retail economic activity indicated a beneficial contribution of the IA Agreement for both SA prevalence and duration, in both diagnoses and genders.
Potential impacts of the IA Agreement on SA in young men and women varied according to diagnosis and economic activity. However, results indicated that the IA Agreement could reduce SA duration. Further research should identify reasons for gender and economic activity differences.
挪威更具包容性的工作生活协议（IA 协议）旨在减少病假（SA）并增加工作参与度。IA 协议的潜在影响尚未得到彻底评估。本研究旨在评估 IA 协议对年轻成年男性和女性肌肉骨骼和心理 SA 患病率和持续时间的影响，并确定这种影响是否因经济活动或 SA 等级而改变。
将来自全国登记处的数据合并为 1967-1976 年在挪威出生的 372199 人。ICPC-2 代码确定了肌肉骨骼（L）和心理（P）诊断。差异法分别比较了 2000 年至 2005 年男性和女性在 IA 公司工作的人中首次 SA > 16 天的患病率和平均持续时间，相对于非 IA 公司。分析根据平均公司规模进行了调整，并按经济活动和 SA 等级（全/分级）进行了分层。使用 95%置信区间（CI）计算了平均边际变化。
IA 协议对 SA 患病率的影响不一，因为边际变化的方向和大小因诊断、性别和经济活动而异。然而，对于两个诊断组，SA 持续时间的平均减少趋势普遍存在，特别是肌肉骨骼 SA 的男性（-16.6 天，95%CI -25.3，-7.9）。IA 公司中全 SA 的个体的 SA 持续时间平均减少幅度更大。只有批发和零售经济活动表明，IA 协议对两种诊断和两种性别都有积极影响，既能降低 SA 患病率，又能降低 SA 持续时间。
IA 协议对年轻男性和女性 SA 的潜在影响因诊断和经济活动而异。然而，结果表明，IA 协议可以减少 SA 持续时间。进一步的研究应确定性别和经济活动差异的原因。
