Sickness Absence due to Skin Disorders in the Coal Mining Industry

I have examined sickness absence due to skin disorders at fivecollieries in the North East of England between 1978 and 1984,through sickness certificates kept for each man. A mean of 36·7days per 100 men per year were lost through skin disease, with2·3 men per 100 absent each year, of whom 36 per centhad bacterial infection of the skin, 25 per cent dermatitis,and 11 per cent epidermophytosis. However, dermatitis was thecause of the most days lost, with 2·9 days lost per manper year, compared with 1·5 for bacterial infection and1·7 for epidermophytosis. Dermatitis was responsiblefor longer spells of absence (median 10 days) and recurrentlong absences, which were rarely found for bacterial infection.Foot dermatitis was the most troublesome presentation in thisindustry, with a median duration of absence of 14 days; 25 percent of men this diagnosis had recurrent absences of which 21per cent lasted over 6 weeks. The number of spells of absencedue to skin disorders fell, from 3·2 per 100 per yearin 1978 to 2·2 per 100 in 1983. Requests for reprints should he addressed to: Dr Linda Puttick, Doncaster Royal Infirmary, Armthorpe Road, Doncaster DN2 5LT, UK     

Back Extensor Muscle Endurance Test Scores in Coal Miners in Australia

Study Design: A cross-sectional analytic study was conducted. Objectives: To collect normative data on back extensor endurance holding times and evaluate the discriminative validity of the Biering–Sorensen test in a group of coal miners in Australia. Summary of Background Data: Low back pain is a common complaint among those working in the Australian coal mining industry. One test that may be predictive of first-time episodes of low back pain is the Biering–Sorensen test of back extensor endurance strength. While this test has been evaluated in overseas sedentary populations, normative data and the discriminative ability of the test have not been evaluated with coal miners. Methods: Eighty-eight coal miners completed a questionnaire for known risk factors for low back pain, performed the Biering–Sorensen test, and undertook a test of aerobic fitness. Data analysis was performed to describe the groups and to determine whether any significant difference existed between those with a past history of low back pain and those without. Results: Significantly lower than expected holding times were found in this group of coal miners (mean 113 s). This result was significantly lower than demonstrated in previous studies (mean 138 s, t ₈₇ = 6.32, p < 0.001). When holding times for those with a past history of low back pain were compared with times for those with no history of low back pain, the difference was not statistically significant (t ₈₆ = 1.56, p = 0.12), nor was there a significant difference in fitness between those with a past history of low back pain and those without (t ₈₆ = 0.47, p = 0.64). Discussion/Conclusions: Coal miners in Australia have lower than normal Biering– Sorensen holding times. This lower back holding time does not differ between coal miners with a past history of low back pain and those without.     

Sickness Absence in Teachers

This paper is based on the records of 738 male teachers and 1,684 female teachers employed by Edinburgh Corporation during the academic year September 1, 1954 to July 31, 1955. The amount and distribution of sickness absence has been assessed by age and sex; and comparisons have been made with similar rates in the academic year 1950/51 to determine trends in absence. An interesting feature is that the amount and duration of sickness absence experienced by single and married women teachers is equivalent.

One finding of importance is that in both male and female teachers the highest inception rates for sickness are found at the beginning of a career in teaching. It is suggested that this supplies additional evidence that man's reactions to the situations he encounters in his daily life may affect his internal processes; that man's susceptibility to illness during adult life is, to a large degree, influenced by his relation to the society in which he works. The influence of promotion has been assessed in terms of this hypothesis.

     

Recurrence of Medically Certified Sickness Absence According to Diagnosis: A Sickness Absence Register Study

Introduction Sickness absence is a major public health problem. Research on sickness absence focuses on interventions aimed at expediting return to work. However, we need to know more about sustaining employees at work after return to work. Therefore, this study investigated the recurrence of sickness absence according to diagnosis. Methods We analyzed the registered sickness absence data of 137,172 employees working for the Dutch Post and Telecom. Episodes of sickness absence were medically certified, according to the ICD-10 classification of diseases, by an occupational physician. The incidence density (ID) and recurrence density (RD) of medically certified absences were calculated per 1,000 person-years in each ICD-10 category. Results Sickness absence due to musculoskeletal disorders had the highest recurrence (RD = 118.7 per 1,000 person-years), followed by recurrence of sickness absence due to mental disorders (RD = 80.4 per 1,000 person-years). The median time to recurrent sickness absence due to musculoskeletal disorders was 409 days after the index episode. Recurrences of sickness absence due to musculoskeletal disorders accounted for 37% of the total number of recurrent sickness absence days. For recurrences of sickness absence due to mental disorders this was 328 days and 21%, respectively. Unskilled employees with a short duration (<5 years) of employment had a higher risk of recurrent sickness absence. Conclusions Interventions to expedite return to work of employees sick-listed due to musculoskeletal or mental disorders should also aim at reducing recurrence of sickness absence in order to sustain employees at work.     

Individual Variations in Sickness Absence

Records of personal sickness absence, including all spells of one day's duration or more, have been kept at this refinery for more than 20 years. The distributions of sickness spells and also calendar days of absence have been analysed for single years and also for periods of up to 20 years' continuous service for the 1,350 hourly paid male employees. It is shown that both these measures of sickness absence are distributed among the men in an unequal fashion (negative binomial) rather than at random (Poisson) and thus resemble the distribution of industrial accidents first described almost 50 years ago. This pattern of distribution is not related to occupation or to length of service. Analysis of the distribution of lateness and absenteeism for reasons other than sickness or holidays shows that these also follow this pattern. It is postulated that this could be a principle applicable to all forms of industrial absenteeism as well as to accidents.

The personal records of 187 men with continuous service from 1946 to 1965 have been studied to investigate the trends in their sickness absence over this 20-year period. In contrast to the well-recognized pattern that in any one period of time young men have more spells of absence than their older fellows, this secular study shows that sickness spells have not decreased with age. This apparent paradox is explicable by the rising national trend in sickness absence and by a high labour turnover in young men with frequent sickness spells.

     

Prediction of Sickness Absence in Patients with Chronic Low Back Pain: A Systematic Review

OBJECTIVES: To provide evidence of predictors for sickness absence in patients with non-specific chronic low back pain (CLBP), distinguishing predictors aimed at the decision to report sick (absence threshold) and decision to return to work (return to work threshold). METHODS: Medical and psychological databases were searched, as well as citations from relevant reviews. In- and exclusion criteria were applied. Two reviewers assessed the methodological quality of the papers independently. RESULTS: Many different predictors were studied, and few factors were studied more than once. Consistent evidence was found for own expectations of recovery only as predictor for the decision to return to work. Patients with higher expectations had less sickness absence at the moment of follow-up measurement. As expected, different predictors were found aiming at the absence threshold or the return to work threshold. Furthermore, predictors varied also with the measurement instruments used, timing of follow-up measurements, and definition of outcomes. Until now, too few studies are available to overcome several potential sources of heterogeneity. CONCLUSIONS: No core set of predictors exists for sickness absence in general. The characteristics of the study including the decision to report sick or to return to work determined the influence of several predictors on sickness absence in patients with CLBP. Further research and use of a core set of measurements and uniform definitions are needed to predict sickness absence and return to work in patients with CLBP.     

Overtime Work and the Incidence of Long-term Sickness Absence Due to Mental Disorders: A Prospective Cohort Study

BackgroundAlthough previous research has focused on the association between long working hours and several mental health outcomes, little is known about the association in relation to mental health-related sickness absence, which is a measure of productive loss. We aimed to investigate the association between overtime work and the incidence of long-term sickness absence (LTSA) due to mental disorders.MethodsData came from the Japan Epidemiology Collaboration on Occupational Health Study (J-ECOH). A total of 47,422 subjects were followed-up in the period between April 2012 and March 2017. Information on LTSA was obtained via a study-specific registry. Baseline information was obtained at an annual health checkup in 2011; overtime working hours were categorized into <45; 45–79; 80–99; and ≥100 hours/month.ResultsDuring a total follow-up period of 211,443 person-years, 536 people took LTSA due to mental disorders. A Cox proportional hazards model showed that compared to those with less than 45 hours/month of overtime work, those with 45–79 hours/month were at a lower risk of LTSA due to mental health problems (hazard ratio [HR] 0.63; 95% confidence interval [CI], 0.56–0.71) while those with overtime work of ≥100 hours/month had a 2.11 (95% CI, 1.12–3.98) times higher risk of LTSA due to mental health problems.ConclusionEngaging in excessive overtime work was linked with a higher risk of LTSA due to mental health problems while the lower risk observed among individuals working 45–79 hours/month of overtime work might have been due to a healthy worker effect.Key words: workplace, occupational health, healthy workers effect, prospective studies, Asia     

Sickness Absence in an Ambulance Service

Sickness absence in the West Midlands Metropolitan AmbulanceService was studied in comparison with the Post Office and FireService. During the 2 years studied the trend was towards morefrequent but shorter spells of absence, with an overall dropin the number of days per person. During both years, 44 percent of staff took under 6 days absence. In 1979 15 per centtook more than 6 weeks, in 1980 12.5 per cent. Ambulance workerstake more time off than the driving/nursing staff in one healthdistrict and GPO workers, and slightly more than firemen. Amongthese groups, only firemen provide a match for stress, theyare much younger and are almost all men. Ambulance women takeapproximately two-thirds as much again sickness absence as men.(Except for the over fifties, where the relationship is almostexactly reversed, but where the number of women was only 8.)The main cause of sickness absence is musculoskeletal injury,which, although not necessarily incurred at work, is clearlyexacerbated by the nature of the ambulance worker's duties.Some of these spells of absence are very long, and it is clearthat this is the area where the payoff to better training orequipment would be the greatest. Requests for reprints should be addressed to: J. A. Stilwell, Principal Research Fellow, Centre for Research in Industry, Business and Administration, University of Warwick, Coventry CV4 7AL     

External Validation and Update of a Prediction Rule for the Duration of Sickness Absence Due to Common Mental Disorders

Purpose The objective of the present study was to validate an existing prediction rule (including age, education, depressive/anxiety symptoms, and recovery expectations) for predictions of the duration of sickness absence due to common mental disorders (CMDs) and investigate the added value of work-related factors. Methods A prospective cohort study including 596 employees who reported sick with CMDs in the period from September 2013 to April 2014. Work-related factors were measured at baseline with the Questionnaire on the Experience and Evaluation of Work. During 1-year follow-up, sickness absence data were retrieved from an occupational health register. The outcome variables of the study were sickness absence (no = 0, yes = 1) at 3 and 6 months after reporting sick with CMDs. Discrimination between workers with and without sickness absence was investigated at 3 and 6 months with the area under the receiver operating characteristic curve (AUC). Results A total of 220 (37 %) employees agreed to participate and 211 (35 %) had complete data for analysis. Discrimination was poor with AUC = 0.69 and AUC = 0.55 at 3 and 6 months, respectively. When ‘variety in work’ was added as predictor variable, discrimination between employees with and without CMD sickness absence improved to AUC = 0.74 (at 3 months) and AUC = 0.62 (at 6 months). Conclusions The original prediction rule poorly predicted CMD sickness absence duration. After adding ‘variety in work’, the prediction rule discriminated between employees with and without CMD sickness absence 3 months after reporting sick. This new prediction rule remains to be validated in other populations.     

煤矿井下工人寿命研究

目的：研究煤矿井下工人的主要死因及其对寿命的影响程度。方法：采用寿命表法对唐山市某煤矿井下工人（1990－1999年）的寿命及死因进行分析。结果：煤矿井下工人15岁年龄段的平均预期寿命为59．49岁,较当地男性居民低0．52岁,除脑血管疾病,恶性肿瘤,心血管疾病人群常见疾病外,呼吸系统疾病,煤工尘肺,肺心病及工伤事故是造成煤矿井下工人死亡的主要死因。结论：煤矿井下作业环境存在着职业危《丰因素,长期在此环境下工作,其呼吸等系统会受到一定的损害。     

Sickness Absence Among Railway Clerical Staff

This paper examines in detail the sickness absence experience within one well-defined railway occupation, identified in a previous paper for further study, namely clerks. The clerks consist of three hierarchical grades. The differences between them are described. The measures of sickness absence are identical with those of the previous communication. A gradient of sickness experience between the three grades is demonstrated. This occurs in inverse relation to the amount of responsibility associated with the posts. The gradient is accounted for by a small number of diagnostic categories. The implication of this is discussed. Comparisons are made with a similar population in London Transport and the results discussed. It is concluded that psychological factors might provide some explanation of the striking differences in sickness experience operating within one sub-class of the Registrar General's classification (IIIc) and within a limited salary scale.     

Avoidable Sickness Absence in a Dutch Working Population

Introduction Sickness absence has an important impact on employers (e.g. reduced productivity, high costs) and employees (e.g. replacement, job loss). Therefore, we investigated possible reduction by exploring avoidable sickness absence. Methods A questionnaire was filled out by 2,954 Dutch workers (internet panel of a marketing research company, 2005). We obtained data on self reported sickness absence (6.5 months), including the main reason for each sickness absence spell (4 health and 3 non-health reasons), self-reported work-relatedness of absence and workers’ opinion on whether their absence could have been shorter or prevented, and on 12 listed factors that might have contributed to sickness absence. For each of these factors we calculated the avoidable absence fraction (AAF), analogous to the epidemiological population attributable risk. Results A total of 1,233 workers reported sickness absence. The absence rate was 4.46%. For 11% of the absence rate health was not the main reason. Yet, when non-health was reported as the main reason for absence, health still contributed in half the cases. 35% of the absence rate was mainly work-related. 15% of the workers mentioned that their sickness absence could have been shorter or prevented. The AAFs of contributory factors were 0.129 for home related factors, 0.136 for work-related factors and 0.101 for (occupational) health care and guidance factors. In total, the AAF showed that 21.5% of the absence rate can be considered possibly avoidable. Conclusion According to the studied workers sickness absence rate can be reduced. In reducing the absence, one should not only consider factors from the home and work situation, but also from (occupational) health care.     

Patterns of Sickness Absence in a Railway Population

This investigation was carried out in order to obtain morbidity statistics in a large industrial population with special reference to the effects of ageing.

The population chosen, the “railway research population,” consisted of a sample of Scottish railwaymen, drawn from five of the eight areas in the Scottish Region of British Railways. Only certain occupational grades were studied.

Information was obtained over a period of one year by means of a detailed monthly return of (a) sickness absence data and (b) job changes. Indices of sickness absence were defined. The sickness absence experience of the railway research population was compared with that of other populations. It is a healthier group than the total insured population but differs in some respects from that of London Transport.

The nature of sickness absence within the railway research population was then studied. It was shown in all but one measure used that sickness tends to increase with age, the most important factor being the increase of long episodes. Examination of the frequency distribution of the duration of sickness episodes revealed that sickness absence tends to be taken in terms of weeks off rather than days off.

Analysis of the daily variation in sickness absence showed that the total absence rate increased from Monday to Friday. There was a well defined tendency for sickness to start on Mondays, and in longer episodes an additional tendency to start on Fridays. This was interpreted in terms of morale, both positive and negative.

Marked differences of the same order of magnitude as those due to age were noted in the sickness experience of the various grades, related to both conditions of work and responsibility.

The reasons for job changes were analysed and the grades to which men were transferred were identified. The choice of suitable grades for older workers was discussed.

It was concluded that working conditions might be important factors in the type of sickness absence experienced and that comparisons with other populations might be helpful in this context. More detailed work was also called for on the psychological as well as physical aspects of the work situation for both the individual and the grade.