Universal paid leave increases influenza vaccinations among employees in the U.S.

Objectives

We predict the impact of paid leave in increasing influenza vaccinations for employees, thus decreasing workdays lost and healthcare visits resulting from infection.

Methods

Nationally representative data from the 2006–2010 Medical Expenditure Panel Survey were used. We examined working adults aged 18 and above (N = 51,471). Logistic regression measured the association of paid leave with flu vaccination. We predicted the impact on labor and healthcare markets if universal paid leave were provided.

Results

The proportion of workers receiving vaccination annually was higher for those with paid leave versus without paid leave (34.0% vs. 21.0%, P < 0.001). Adjusted odds of having a vaccination increased with paid leave vs. without paid leave (OR = 1.42, CI: 1.31–1.53). Universal paid leave is predicted to increase vaccinations by 1.6 million, resulting in 63.8 thousand fewer absences from work and 18.2 thousand fewer healthcare visits for the flu annually.

Conclusions

Our study suggests that employees without paid leave are significantly less likely to have had a flu vaccination. Expanding paid leave could substantially increase flu vaccination, resulting in fewer workdays lost to influenza and savings in healthcare costs.     

Age-, sex-, and diagnosis-specific incidence rate of medically certified long-term sick leave among private sector employees: The Japan Epidemiology Collaboration on Occupational Health (J-ECOH) study

Background

Long-term sick-leave is a major public health problem, but data on its incidence in Japan are scarce. We aimed to present reference data for long-term sick-leave among private sector employees in Japan.

Job sick leave: Detecting opportunistic behavior

We utilize a large administrative dataset of sickness leave in Italy (a) to investigate whether private firms are more effective than the public insurer in choosing who to monitor and (b) to study the correlation between potentially opportunistic behavior and the observable characteristics of the employee. We find that private employers are more likely to select into monitoring employees who are fit for work despite being on sick leave, if the public insurer is not supported by any data‐driven tool. However, the use of a scoring mechanism, based on past records, allows the public insurer to be as effective as the employer. This result suggests that the application of machine learning to appropriate databases may improve the targeting of public monitoring to detect opportunistic behavior. Concerning the association between observable characteristics and potentially opportunistic behavior, we find that males, employees younger than 50, those on short leaves, or without a history of illness are more likely to be found fit for work.     

Health-related and work-related aspects associated with sick leave: a comparison of chronically ill and non-chronically ill workers

Objectives: Our aims were to study to what extent chronically ill workers (CIWs) take more sick leave than non-chronically ill workers (NCIWs) and to explore which health-related and work-related aspects are associated with the sick leave patterns of the two groups. Methods: A questionnaire on work, health and sick leave was sent to all employees of a university in The Netherlands (response: 49.1%). Analyses were conducted for 444 CIWs and 1,347 NCIWs. Odds ratios (ORs) were calculated to quantify the contribution of being chronically ill to sick leave in general, frequent sick leave, prolonged sick leave, and present sick leave. The contributions of health-related and work-related aspects to sick leave were investigated by multiple logistic regression analyses for both CIWs and NCIWs separately. Results: CIWs showed significantly increased ORs for general, frequent, prolonged and present sick leave when compared with NCIWs. Fatigue, emotional exhaustion and perceived health complaints showed stronger associations with sick leave for both CIWs and NCIWs than various work-related aspects. Workers of 46 years of age and older showed less sick leave than workers under the age of 36. Male respondents and scientific personnel showed less frequent sick leave than the other respondents, and so did respondents working more than 40 h a week, compared with part-timers. The final regression models explained 8%–16% of the variance in sick leave. Conclusions: CIWs take two to three times more and longer sick leave than NCIWs. Health-related aspects are more strongly associated with sick leave than work-related aspects for both CIWs and NCIWs. Sick leave patterns were, nevertheless, only partly explained by health-related and work-related aspects. In any case, future studies of sick leave should certainly take the presence of chronic disease into account as an important determinant of sick leave.     

Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints

Objectives To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Methods Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models. Results In the subgroup of patients who scored high on the pain copying scale “worrying” the hazard ratio of sick leave was 1.32 (95% CI 1.07–1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale “worrying” (adjusted HR = 0.17, 95%-CI 0.04–0.72). Other work-related risk factors were not significantly related to sick leave. Conclusions Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results.     

Paid sick leave benefits,influenza vaccination,and taking sick days due to influenza-like illness among U.S. workers

IntroductionStaying home when sick can reduce the spread of influenza. The objectives of this study were to quantify the percentage of workers who had paid sick leave (PSL) benefits, examine sociodemographic characteristics that may be associated with having these benefits, and examine the association between having PSL benefits and use of sick days and influenza vaccination status.MethodsThe public-use dataset from the 2009 National H1N1 Flu Survey (NHFS) were analyzed in 2017. Wald chi-square tests and t-tests were used to test for associations between having PSL benefits and sociodemographic characteristics and industry and occupation groups, the associations between having PSL benefits and seeking treatment when sick with influenza-like illness (ILI), and taking days off work when sick with ILI. Logistic regression was used to determine variables associated with having PSL benefits and the association between having PSL benefits and influenza vaccination status.ResultsSixty-one percent of employed adults reported having PSL benefits during the 2009–10 influenza season. Being younger, female, Hispanic, less educated, or a farm/blue collar worker were associated with reduced likelihood of having PSL benefits. Not having PSL benefits was associated with a lower likelihood of receiving an influenza vaccination and visiting a health professional when sick with ILI.ConclusionsThe percentage of workers who have PSL benefits differs by sociodemographic characteristics and industry/occupation groups. Offering PSL benefits along with promoting influenza vaccination and encouraging employees with ILI to stay home can increase influenza vaccination coverage and help control the spread of influenza.     

职业人群工作紧张对高血压患病影响的横断面研究

目的探讨职业人群工作紧张与高血压患病的关系,为高血压的预防提供依据。方法采用横断面研究方法,调查上海城区2 458名20~63岁职业人群。工作紧张评估采用中文版工作内容问卷(JDC)与工作付出-回报(ERI)问卷,同时调查社会人口与行为因素。多因素非条件logistic回归分析工作紧张与高血压患病的关系。结果在控制了年龄、受教育程度、职业、高血压家族史、吸烟、饮酒、锻炼与活动状况、BMI潜在混杂因素后,男性高工作紧张、高工作付出-回报失衡是高血压患病的危险因素;女性低工作控制、高工作付出、中/高工作付出-回报失衡是高血压患病的危险因素。职业分层分析结果显示:教师、社区医护人员、研究人员、公交车驾驶员高血压患病更易受工作紧张的影响。结论工作紧张可能增大职业人群高血压患病的风险,某些职业人群高血压患病更易受职业紧张影响。     

社会支持对工作压力与工作倦怠关系的调节作用

目的探讨社会支持在企业员工工作压力与工作倦怠之间关系的调节作用。方法采用工作压力量表、MBI-GS工作倦怠量表通用版和社会支持量表,随机抽取深圳市3家大型企业1 068名员工进行自填式问卷调查。采用相关分析、简单线性回归分析和复回归分析等统计方法,检验水准α为0.05。结果企业员工工作压力与工作倦怠显著正相关（r=0.39）,客观支持、主观支持和对支持的利用度与工作倦怠显著负相关（r=-0.31,-0.30,-0.16）。简单回归分析结果显示,工作压力对情绪衰竭（男β=0.62,女β=0.84）、消极怠慢（男β=0.47,女β=0.72）和专业低效能感（男β=0.18,女β=0.45）均有正向预测作用,且对女性员工的影响力度高于男性。复回归分析结果显示,引入客观支持、主观支持和对支持的利用度后,工作压力对工作倦怠、情绪衰竭、消极怠慢和专业低效能感的回归系数均显著下降（男β由0.41、0.62、0.47、0.18分别降为0.31、0.50、0.41、0.09,女β由0.55、0.84、0.72、0.45分别降为0.50、0.78、0.68、0.38）。在同等压力状态下,高客观支持和高主观支持员工的工作倦怠水平显著低于低客观支持和低主观支持的员工,工作压力由低到高,高、低客观支持差值分别为0.43、0.45、0.34,高、低主观支持差值分别为0.33、0.35、0.47。结论工作压力是工作倦怠的重要影响因素,社会支持是工作压力和工作倦怠的有效调节变量,女性员工的工作压力和社会支持对工作倦怠的影响大于男性。     

Risk factors for sick leave due to musculoskeletal disorders among self-employed Dutch farmers: a case-control study

BACKGROUND: In Dutch agriculture, musculoskeletal disorders are a main cause of sick leave. Among self-employed insured farmers, neck, shoulder, upper extremity, and back disorders accounted for 30% of the claims for sick leave of less than 1 year This case-control study set out to identify and quantify risk factors for sick leave due to musculoskeletal disorders among self-employed Dutch farmers. METHODS: Sick leave, claimed at an insurance company from 1998 to 2001 for back (SL-BP, n = 198) or neck/shoulder/upper extremity trouble (SL-EXT, n = 89) was analyzed; the controls did not file any claim in this period (n = 816). RESULTS: Multivariate analysis showed that risk factors for SL-BP were increased age (OR = 1.06 per year, CI = 1.04-1.09), body mass index (BMI) >27 (OR = 1.93, CI = 1.2-3.2), smoking (OR = 1.90, CI = 1.2-2.9), former pain (OR = 3.28, CI = 2.1-5.1), tractor driving >1,000 hr/year (OR = 2.44, CI = 1.0-6.4), and "high work pace and workload" (OR = 1.59, CI = 1.0-2.4). SL-EXT was associated with pig (OR = 3.63, CI = 1.4-9.7), mushroom (OR = 6.14, CI = 1.4-27.2), or dairy/pig farming (OR = 4.56, 1.1-19.5), while age (OR = 1.10, CI = 1.06-1.14), smoking (OR = 1.79, CI = 1.0-3.2), and former pain (OR = 3.37, CI = 1.9-6.1) were also contributing. CONCLUSIONS: Prevention of sick leave of self-employed farmers should focus on life style (obesity, smoking), reducing older farmers' exposure to physical load, exposure to long-term tractor driving. Specific attention should be paid to animal and mushroom farmers.     

Alcohol consumption and suicide mortality among Japanese men: the Ohsaki Study.

The risk of suicide is well known to be increased among heavy alcohol drinkers. However, whether the risk is increased or decreased among light drinkers is still under debate. We investigated this association in a population-based sample of men in Japan. The Ohsaki Study was a population-based, prospective cohort study among Japanese adults aged from 40 to 79 years. Between October and December, 1994, 22,804 men in Miyagi Prefecture, Japan, completed a questionnaire on various health-related lifestyles, including alcohol drinking. During the subsequent 7 years follow-up, 73 participants committed suicide. We used the Cox proportional hazards regression model to estimate the hazard ratio (HR) for suicide mortality according to the quantity of alcohol consumed daily, with adjustment for potential confounders. There was a statistically significant positive and linear association between the amount of alcohol consumed and the risk of suicide: the multivariate HRs in reference to nondrinkers (95% confidence interval) were 1.2 (0.5-2.7), 1.5 (0.7-3.4), and 2.4 (1.2-4.6) in current drinkers who consumed /=45.6g of alcohol per day, respectively (P-trend=.016). Even after the early death cases were excluded, a significant linear association was observed between alcohol consumption and the risk of suicide, with the risk of suicide also being nonsignificantly higher among the light drinkers than among nondrinkers (multivariate HR=1.7). This prospective cohort study indicated a positive linear association between alcohol consumption and the risk of suicide, and the suicide risk among the light drinkers was not decreased as compared with that in nondrinkers.     

企业员工工作满意度及影响因素分析

目的 了解企业员工工作满意度状况,探讨影响工作满意度的主要因素。方法 采用横断面调查,于2010年9月,随机抽取沈阳市某企业的1 000名员工进行问卷调查;采用明尼苏达满意度问卷(MSQ)测量工作满意度,付出-回报失衡问卷(ER I)测量职业紧张,组织支持感量表(POS)测量组织支持感。应用分层回归分析影响员工工作满意度的因素。结果 该企业员工总体满意度平均为(63.81±11.44),分层回归显示,工作状况变量、职业紧张变量及组织变量对工作满意度解释的变异量分别为15.7%、9.9%、8.6%。结论 该企业员工的总体满意度不高,主要影响因素为工作状况、职业紧张及组织支持感。     

Reducing sick leave by minimal postal intervention: a randomised, controlled intervention study

Background

The lack of efficient medical interventions for combating increasing sickness absence rates has lead to the introduction of alternative measures initiated by the Norwegian National Insurance Service or at workplaces.

Aim

To determine whether minimal postal intervention had any effect on the length of sick leave.

Methods

Randomised, controlled trial with a one year follow up in Northern Norway in 1997 and 1998; 990 consecutive newly sick‐listed persons with musculoskeletal or mental disorders were studied. Within the intervention group, 495 eligible sick‐listed persons received a general information letter and a questionnaire as their sick leave passed 14 days. Possible intervention effects were analysed by survival analysis of the probability of returning to work within one year, and logistic regressions with benefits at one year as the dependent variable.

Results

The overall reduction of 8.3 (95% CI −22.5 to 6.0) calendar days in mean length of sick leaves in the intervention group compared to controls, was not statistically significant. However, intervention significantly reduced length of sick leaves in subgroups with mental disorders, and with rheumatic disorders and arthritis, and overall for sick leaves lasting 12 weeks or more. Young people with low back pain showed an adverse effect to intervention. The overall relative risk of receiving benefits due to sickness after one year in the intervention group was 0.69 (95% CI 0.51 to 0.93) compared to controls.

Conclusion

The results should encourage employers, insurance institutions, and authorities to initiate challenges as questions on the length of sick leave and possible modified work measures, during the first few weeks of sick leave, for at least some groups of sick‐listed persons.     

Predictive factors for long-term sick leave and disability pension among frequent and normal attenders in primary health care over 5 years

OBJECTIVES: To find predictive factors for long-term sick leave (SL) and disability pension (DP) among frequent attenders (FAs) and normal attenders (NAs) in primary health care. STUDY DESIGN: A cohort study with follow-up over 5 years. METHODS: Groups of FAs and NAs were followed over 5 years. Information about background, situation, sociodemography, life events, social support and sense of coherence were gathered at baseline. Multiple logistic regression analysis was used to determine the influence of each variable on long-term SL and receipt of a DP. RESULTS: During the study period, 18.9% of FAs received long-term SL/DP compared with 6% of NAs. Chronic disease was a predictive factor for long-term SL/DP among FAs [odds ratio (OR) 7.0] and NAs (OR 3.4). Among FAs, a life event was also a predictive factor (OR 2.1). Each additional life event increased the ratio of FAs with long-term SL/DP by 110%. Conflicts and losses had the greatest negative effects on FAs. CONCLUSIONS: FAs are a high-risk group for long-term SL/DP. Besides chronic disease, a life event was the only predictive factor for long-term SL/DP among FAs. These findings indicate that FAs are a vulnerable group for stressful events. Consequently, healthcare personnel should take more notice of life events among FAs.     

Sickness absence and return to work among employees with knee osteoarthritis with and without total knee arthroplasty: a prospective register linkage study among Finnish public sector employees

Objective:This study aimed to examine duration of sickness absence due to knee osteoarthritis (OA) and sustained return to work (RTW) among municipal employees who had at least one compensated sickness absence period due to knee OA. The contribution of sociodemographic characteristics, diabetes and previous sickness absence were assessed. We differentiated between participants with and without total knee arthroplasty (TKA).Methods:Data from 123 506 employees in the Finnish Public Sector Study were linked with national health and mortality register information. There were 3 231 sickness absence periods (2372 participants) due to knee OA in 2005−2011. Kaplan-Meier curves for sustained RTW were obtained and median time with inter-quartile range (IQR) calculated for those with and without TKA. Cox regression analyses were carried out in multivariable analyses.Results:The median time to RTW from the beginning of sickness absence was 21–28 days when TKA was not related to sickness absence and 92–145 days when it was. Among participants with no TKA, age 60−64, non-sedentary work, diabetes, and previous sickness absences predicted longer time to RTW, while pain medication predicted a shorter time. Among participants with TKA, non-sedentary work and previous sickness absences predicted a longer time to RTW.Conclusions:The clinical relevance of the difference in time to RTW between employees with or without TKA was substantial. Employees with knee OA working in physically demanding jobs need work modifications after TKA, and this calls for a dialog between occupational health care professionals and workplaces.     

Patterns of working hour characteristics and risk of sickness absence among shift-working hospital employees: a data-mining cohort study

Objectives:Data mining can complement traditional hypothesis-based approaches in characterizing unhealthy work exposures. We used it to derive a hypothesis-free characterization of working hour patterns in shift work and their associations with sickness absence (SA).Methods:In this prospective cohort study, complete payroll-based work hours and SA dates were extracted from a shift-scheduling register from 2008 to 2019 on 6029 employees from a hospital district in Southwestern Finland. We applied permutation distribution clustering to time series of successive shift lengths, between-shift rest periods, and shift starting times to identify clusters of similar working hour patterns over time. We examined associations of clusters spanning on average 23 months with SA during the following 23 months.Results:We identified eight distinct working hour patterns in shift work: (i) regular morning (M)/evening (E) work, weekends off; (ii) irregular M work; (iii) irregular M/E/night (N) work; (iv) regular M work, weekends off; (v) irregular, interrupted M/E/N work; (vi) variable M work, weekends off; (vii) quickly rotating M/E work, non-standard weeks; and (viii) slowly rotating M/E work, non-standard weeks. The associations of these eight working-hour clusters with risk of future SA varied. The cluster of irregular, interrupted M/E/N work was the strongest predictor of increased SA (days per year) with an incidence rate ratio of 1.77 (95% confidence interval 1.74–1.80) compared to regular M/E work, weekends off.Conclusions:This data-mining suggests that hypothesis-free approaches can contribute to scientific understanding of healthy working hour characteristics and complement traditional hypothesis-driven approaches.     

Exposure to bullying behaviours,resilience, and return to work self-efficacy in patients on or at risk of sick leave

The study investigated relationships between exposure to bullying behaviours, return to work self-efficacy (RTW-SE) and resilience, and if resilience moderates the bullying-RTW-SE relationship among patients on sick leave or at risk of sick leave due to common mental disorders (CMD). A sample of 675 patients treated in an outpatient clinic was analysed using regressions and moderation analyses by employing SPSS and the Process macro SPSS supplement. The results showed a negative relationship between exposure to bullying behaviours and RTW-SE. There was also a positive main effect for resilience, as patients with high resilience score significantly higher on RTW-SE than patients with low resilience irrespective of levels of bullying. Further, the resilience sub-dimension personal resilience moderated the bullying-RTW-SE relationship, while the sub-dimension interpersonal resilience did not. Patients high on personal resilience showed relatively lower RTW-SE scores when exposed to bullying behaviours, compared to those that were not bullied with high personal resilience levels. Hence, one should take note of the fact that even if resilience may strengthen RTW-SE, bullying is an adverse event which particularly affects individuals who present with relatively high levels of resilience resources, at least when it comes to RTW-SE.     

The effect of pre-employment factors on job control, job strain and psychological distress: a 31-year longitudinal study

This study examined the role of pre-employment factors, such as maternal antenatal depression, low birth weight, childhood socioeconomic position, early adolescence health risk behaviours and academic performance, in the relationship between work characteristics (low job control and high job demands, or job strain) and psychological distress at age 31. The data of 2062 women and 2231 men was derived from the prospective unselected population-based Northern Finland 1966 Birth Cohort study. Results of linear regression models showed that being female, father's low socioeconomic position, and poor academic achievement in adolescence were linked to low control and high job strain jobs at age 31, and that low control and high job strain were associated with psychological distress at age 31. Although having lower school grades, high absence rate from school, and moderate alcohol consumption at age 14 were significant predictors of psychological distress at age 31, the associations between job control, job strain and psychological distress remained after controlling for these and other pre-employment effects. As such, pre-employment factors do seem to link people to risky work environments, which in turn seem to relate strongly to psychological distress. However, the relationship between pre-employment factors and later psychological distress in adulthood is not completely explained by job environment.     

Job stress and depressive symptoms among Korean employees: the effects of culture on work

Objective  This study was conducted to investigate the association between depressive symptoms and job stress, as measured by the KOSS, among Korean employees in small- and medium-sized enterprises, and examined which components of stress are involved in the risk for depression among males and females. Methods  Data were collected from a work-stress survey of full-time employees of small- and medium-sized enterprises in Incheon, South Korea. A total of 3,013 participants were included in the analysis. Job stress was measured using 24 items (7 sub-scales) of the short form of Korean occupational stress scale (KOSS-SF), and depressive symptoms were evaluated using Center for epidemiologic studies depression scale (CES-D). Results  After adjustment for confounding variables, most of subscales of job stress contributed to an increased risk of depressive symptoms, and job insecurity (male; OR = 2.02, 95%CI: 1.61–2.40, female; OR = 1.95, 95%CI: 1.42–2.70) and occupational climate (male; OR = 1.84, 95%CI: 1.49–2.28, female; OR = 1.78, 95%CI: 1.30–2.49) showed strong associations in both male and female. Other subscales revealed different effects for males and females; for males, job demands (OR = 1.68, 95%CI: 1.43–2.20), inadequate social support (OR = 1.55, 95%CI: 1.23–1.94), and lack of rewards (OR = 1.88, 95%CI: 1.48–2.37) were associated with depressive symptoms, whereas for females, organizational injustice (OR = 1.62, 95%CI: 1.14–2.30) was associated with depressive symptoms. Conclusion  These results indicate that job stress may play a significant role in increasing the risk of depressive symptoms, and that further preventive efforts and research are needed to reduce job stress and address health problems caused by job stress among Korean employees.     

Relationships of job demand,job control,and social support on intention to leave and depressive symptoms in Japanese nurses

This study aims to elucidate the relationships among the factors of thedemand-control-support model (DCS) on the intention to leave a hospital job and depressivesymptoms. Participants included 1,063 nurses. Job demand, job control, and support fromsupervisors were found to be significantly related to both the intention to leave anddepressive symptoms. Based on the odds ratios per 1 SD change in the DCS factors, lowsupport from supervisors was found to be most related to the intention to leave, and lowjob control was found to be most related to depressive symptoms. In models that did notinclude “job demand” as an independent variable, 60-h working weeks were found to have asignificantly higher odds ratio for depressive symptoms. Support from supervisors is moreimportant in preventing intention to leave and depressive symptoms among nurses than issupport from co-workers. Improving job control and avoiding long working hours may beimportant to prevent depressive symptoms.