National Institute of Occupational Health, Research Group for Occupational Medicine and Epidemiology, PB 5330 Majorstuen, 0304 Oslo, Norway.
Scand J Work Environ Health. 2023 Oct 1;49(7):466-476. doi: 10.5271/sjweh.4112. Epub 2023 Aug 7.
This study aimed to estimate the average individual effect of the company-level Norwegian Agreement on a More Inclusive Working Life (IA Agreement) on individuals' (i) sustained return to work after a sickness absence (SA) episode, and (ii) recurrent SA.
Using register data, 79 253 men and 94 914 women born in Norway 1967-1976 were followed for one year between 2005 and 2010 after returning to work from an SA episode (>16 days). Weighted Cox proportional hazard models analysed time to first exit from work by companies' IA status (IA/non-IA). Weighted cumulative incidence differences between IA and non-IA groups with 95% bootstrapped confidence intervals (CI) were calculated for the competing events of full SA, graded (<100%) SA, unemployment/economic inactivity, education, disability pension, and death/emigration. Stabilised inverse probability of treatment weights balanced IA/non-IA groups according to nine covariates. Analyses were stratified by gender, and separately for two initial SA diagnoses (musculoskeletal and psychological).
Both men [adjusted hazard ratio (HR) 0.96, 95% CI 0.93-0.99] and women (adjusted HR 0.97, 95% CI 0.94-0.99) in IA companies were less likely to exit work in the year following SA. Similar findings were seen among individuals with musculoskeletal diagnoses and women with psychological diagnoses. Men with psychological diagnoses were more likely to exit work. Recurrent full and graded SA were more likely, and unemployment/economic inactivity less likely, in IA companies. However, the estimated effects were small and the CI often included the null.
Individuals working in IA companies were more likely to remain in work. This was mainly due to reduced unemployment/economic inactivity, suggesting the IA Agreement may have influenced work participation through other means than reduced SA.
本研究旨在估计公司层面的挪威更包容工作生活协议（IA 协议）对个人的以下两个方面的平均个体效应：（i）病假（SA）后持续重返工作岗位，以及（ii）再次出现 SA。
使用登记数据，对 1967-1976 年出生于挪威的 79253 名男性和 94914 名女性进行了随访，随访期为 2005 年至 2010 年，这些人在因 SA 缺勤（超过 16 天）后返回工作岗位后的一年时间内。使用加权 Cox 比例风险模型分析了按公司 IA 状况（IA/非 IA）计算的首次退出工作的时间。计算了 IA 组和非 IA 组之间具有 95%Bootstrapped 置信区间（CI）的全 SA、分级（<100%）SA、失业/非经济活动、教育、残疾抚恤金和死亡/移民等竞争事件的加权累积发生率差异。稳定的逆概率治疗权重根据九个协变量平衡了 IA/非 IA 组。按性别进行分层分析，并分别针对两个初始 SA 诊断（肌肉骨骼和心理）进行分析。
IA 公司的男性[调整后的危险比（HR）0.96，95%置信区间（CI）0.93-0.99]和女性（调整后的 HR 0.97，95%CI 0.94-0.99）在 SA 后一年更不容易离职。在肌肉骨骼诊断的个体和女性心理诊断中也观察到类似的发现。心理诊断男性更有可能离职。IA 公司中，全级和分级 SA 复发的可能性更高，失业/非经济活动的可能性更低。然而，估计的效果较小，CI 通常包括零值。
在 IA 公司工作的个人更有可能继续工作。这主要是由于失业/非经济活动减少，这表明 IA 协议可能通过其他方式影响工作参与，而不仅仅是减少 SA。
