Sickness Absence in Drivers of London Taxis and Buses

Sickness absence data for periods of 1 week or more among 2385London taxi drivers were analysed over a period of 1 year. Thereasons, in order of decreasing prevalence, were accidents,disorders of bone and movement, circulatory disorders, and respiratorydisorders. In order to place the absence rates of taxi driversin perspective, a comparison over the same year was made withsimilar sickness absence data for the total work force (12 639)of bus drivers for London Transport. It was found that the busdrivers incurred about 3 times as many days of sickness absence(22.1 days per person compared with 65 days for taxi drivers)and 4 times as many spells of absence (0.73 spells per personcompared with 0.16 spells for taxi drivers) as compared withtaxi drivers. The main reason for these differences was consideredto be due to the terms of employment including sick pay arrangementsof the two groups. Accepted        1 August 1981 Requests for reprints should be addressed to: Dr A. R. Erlam, Medical Centre, 201 Hamilton Road, Felixstowe, Suffolk, IP2 7DT.     

Sickness Absence Following a Campaign of Vaccination against Influenza in the Workplace

This study was designed as a retrospective cohort study of thoseemployees vaccinated against influenza vs. unvaccinated employeesin a service company. The objective was to investigate whethervaccinating employees against influenza in an occupational settingwas of any benefit. There were 2,557 persons entered in thestudy who were in continuous employment between 1 October 1990and 31 March 1992 of which 23.5% (601) were vaccinated. Thestudy was carried out at First Data Resources Limited in Basildon,Essex UK. The main outcome measure was self-reported influenzasickness lasting four or more days and reduction in sicknessabsence due to vaccination against influenza. The results weresurprising. In the vaccinated members of staff, influenza illnesswas halved, Relative Risk=0.46, 95% confidence limits (0.27<RR<0.76).The conclusions were that the study showed a significant decreasein sickness absence due to influenza illness, as a result ofan active vaccination campaign carried out amongst otherwisehealthy individuals in the occupational health environment.This is the first study of this nature in the UK to show statisticallysignificant evidence of benefit from vaccinating healthy employees.It lends support to immunization against influenza in the workplace. Received       13 September 1994 Accepted       11 April 1995     

Respiratory ill-health in Dental Laboratory Technicians: A Comparative Study of GP Consultation Rates

Eighteen Royal Air Force dental laboratory technicians (DLTs)and 69 Service controls matched for age, sex and smoking statuswere compared by means of incidence rates of GP consultationfor respiratory, and all other, illness. By retrospectively calculating for each individual the timeserved (man-years at risk) at the RAF Station concerned, togetherwith the number of consultations that fell into each of thestudy categories, it was possible to produce an incidence rate,per man-year at risk, of consultations for both study and controlgroups. By calculating a relative risk (RR) it was observedthat DLTs were nearly three times (RR=2·95. Cl 1·69–5·13),more likely to attend their GP with respiratory problems thanmembers of the control group, and 1·7 times (RR=1·71.Cl 0·98–3·01) more likely to attend theirGP with other problems. Comparison of the numbers of individuals continuing to use bronchodilatortherapy in each of the two groups suggested that DLTs have ahigher prevalence of conditions that require this form of therapyas treatment. Requests for reprints should be addressed to: Squadron Leader R. Guest, Senior Medical Officer, Royal Air Force Kinloss, Forres, Moray IV36 0UJ, Scotland     

Occupational Mortality in the Armed Services

This article intends to show that the Services mortality experiencehas been somewhat misrepresented in recent publications, andthe reasons for this. I have also pointed out some areas wherewe are well aware that our experience is below average, andhave highlighted accidental deaths mainly due to road trafficaccidents and deaths in soldiers from ischaemic heart disease,as areas of concern. Accepted        1 October 1981 Requests for reprints should be addressed to: Col. P. J. Blackburn, Ministry of Defence (AMO 5), First Avenue House, High Holborn, London. ^*Paper presented at the Joint Services and Faculty of OccupationalMedicine Conference held at the Institute of Naval Medicine,Alverstoke, 29-30 January 1981.     

An evaluation of the Royal Air Force helicopter search and rescue services in Britain with reference to Royal Air Force Valley 1980-1989.

The Royal Air Force (RAF) operates a helicopter Search and Rescue (SAR) service in the United Kingdom and territorial waters; it also provides a similar service in several locations abroad. A 10-year retrospective study of the SAR helicopter service operating from the RAF base at Valley on the island of Anglesey in North Wales is presented, with national SAR statistics over a similar period provided for comparison. Analysis of records kept by SAR aircrew at RAF Valley shows that their assistance had been requested on 1490 occasions during the 10-year period studied; most of these requests were the result of incidents involving holidaymakers, particularly in the mountains or along the coast. The results illustrate the versatility and life-saving potential of a highly skilled and motivated service able to work in adverse weather and dangerous locations. In the light of current debate, the value of aeromedical evacuation of seriously ill patients using helicopters is discussed.     

The U.S. Air Force HEART Program: The Air Force perspective

The U.S. Air Force Health Evaluation and Risk Tabulation (HEART) Program was initiated to design and test a preventive cardiology program for active-duty Air Force members. Most cardiovascular incidents in active-duty personnel occur at a career point which significantly magnifies their operational and fiscal effect as the bulk of events disable or kill personnel during their years of peak productivity. A registered nurse managed the program at each of the four demonstration bases. The number of medical technicians and health counselors varied according to base population. The program includes risk factor screening, risk ranking, basewide education, and focal group intervention for those at high risk. Screening consisted of a health and habits questionnaire, blood pressure measurement, serum glucose, serum total and HDL cholesterol, as well as serum thiocyanate and exhaled carbon monoxide. The total population screened at first screen was 12,000 and 8,000 are expected at second screen. It is likely that due to the military capability for long-term follow-up, primary prevention begun at the time of entry to active duty could effectively reduce the number of cardiovascular events experienced yearly in the Air Force. The final product of HEART will be a detailed plan for an Air Force-wide preventive cardiology plan.     

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.     

Sickness Absence Due to Back Lesions in Coal Miners

By way of establishing some notion of the extent of the sicknessabsences due to back lesions among miners, a medical recordsurvey was carried out at twelve collieries in the South YorkshireArea of the National Coal Board. The study group comprised 12125 men, 9414 of whom were underground and the rest were surfaceworkers. The period covered by the study was from 1 February1976 to 31 January 1977. It was found that 1795 men (14.8 per cent) out of the totalwork force of 12 125 were absent due to back lesions at onetime or another during the study period. Among these 1795 men,there had been 2310 new spells of absence due to back lesionswhich accounted for 19.1 new spells of absence for every 100men employed. For the entire twelve collieries, the total working days lostdue to back lesions amounted to 48 870 days, averaging 4.03days per man employed per year which accounted for 119 per centof the total certified absences from any cause. The significanceof the various factors that influence the incidence and severityof back lesions among miners is discussed. Accepted        1 July 1981 Requests for reprints should be addressed to: Dr A. S. Afacan, Area Medical Officer (North East Area), National Coal Board, Doncaster.     

Prognostic factors for respiratory sickness absence and return to work among blue collar workers and office personnel

OBJECTIVES—To analyze factors that determine the occurrence of sickness absence due to respiratory disorders and the time it takes to return to work.
METHODS—A longitudinal study with 2 year follow up was conducted among 326 male blue collar and white collar workers. The survey started with an interview on respiratory complaints and spirometry. Sixty six (21%) workers were lost to follow up. Complete data on sickness absence among 251 workers during the follow up were collected from absence records and self reports. Regression analysis based on a proportional hazards model was applied to identify risk factors for the occurrence and duration of sickness absence due to respiratory disorders.
RESULTS—During the follow up 35% workers attributed at least one period of sickness absence to respiratory complaints, which accounted for 14.2% of all days lost. A history of chronic obstructive pulmonary disease (COPD) did not predict sickness absence for COPD; the same was true for chronic non-specific lung disease (CNSLD). Complaints about asthma contributed significantly to absence due to asthma (relative risk (RR) 3.96; 95% confidence interval (95% CI) 1.99 to 7.90). Job title was a significant predictor of sickness absence due to respiratory complaints. Decrease in forced vital capacity (FVC, <80% of the reference value) was also a significant predictor of absence due to asthma (RR 4.03; 95% CI 1.41 to 11.54) and of respiratory absence (RR 2.49; 95% CI 1.07 to 5.79). Absence with respiratory complaints was not associated with age, height, body mass index, or smoking. Duration of employment was a weak almost significant predictor against respiratory absenteeism (RR 0.94; 95% CI 0.91 to 0.97). Return to work after respiratory absence was worse for blue collar workers than office personnel (RR 5.74; 95% CI 1.90 to 17.4 for welders, and RR 6.43; 95% CI 2.08 to 19.85 for metal workers).
CONCLUSIONS—Asthmatic complaints in the 12 months before the study were associated with sickness absence for these complaints during the follow up. An abnormal level of FVC also influenced respiratory absenteeism. Blue collar workers had more often and more prolonged absences due to respiratory disorders than white collar workers. Workers with absence due to respiratory complaints were at higher risk of subsequent sickness absence in the next year.


Keywords: respiratory complaints; sickness absence; return to work     

Sickness absence in hospital physicians: 2 year follow up study on determinants

OBJECTIVES—To identify determinants of sickness absence in hospital physicians.
METHODS—The Poisson regression analyses of short (1-3 days) and long (>3 days) recorded spells of sickness absence relating to potential determinants of sickness absence were based on a 2 year follow up period and cohorts of 447 (251 male and 196 female) physicians and 466 controls (female head nurses and ward sisters).
RESULTS—There were no differences in health outcomes, self rated health status, prevalence of chronic illness, and being a case on the general health questionnaire (GHQ), between the groups but physicians took one third to a half the sick leave of controls. All the health outcomes were strongly associated with sickness absence in both groups. Of work related factors, teamwork had the greatest effect on sickness absence in physicians but not in the controls. Physicians working in poorly functioning teams were at 1.8 (95% confidence interval (95% CI) 1.3 to 3.0) times greater risk of taking long spells than physicians working in well functioning teams. Risks related to overload, heavy on call responsibility, poor job control, social circumstances outside the workplace, and health behaviours were smaller.
CONCLUSION—This is the first study of hospital physicians to show the association between recorded sickness absence and factors across various areas of life. In this occupational group, sickness absence is strongly associated with health problems, and the threshold for taking sick leave is high. Poor teamwork seems to contribute to the sickness absenteeism of hospital physicians even more than traditional psychosocial risks—such as overload and low job control. These findings may have implications for training and health promotion in hospitals.


Keywords: health care personnel; occupational health; psychosocial factors     

A Survey of Hearing Loss in Army Aircrew

Military aircrew are exposed to excessive noise at work, withthe concurrent risks of acquiring Noise Induced Hearing Loss(NIHL). Past studies have related aircrew NIHL to a varietyof factors; however, no clear causal relationship has been shown.The difficulty of establishing NIHL due to flying remains whenmany other confounders are present, especially age and exposureto firearms noise in the military environment. A cross sectionalprevalence study of hearing loss in Army Air Corps aircrew hasbeen undertaken. One hundred and twenty one aircrew who hadmore than ten years flying experience were studied and the resultsshow that there appears to be a threshold shift in excess ofthat expected from the ISO levels for otologically normal malesof the same age. The hearing threshold shift was found to correlatewith the number of years flying and aircrew age, with the numberof flying hours being less significant. Received       28 June 1995 Accepted       12 September 1995     

Respiratory Mycotic Affection: Sputum Examination of Workers in a Flax Plant in Egypt

The flax industry is very old in Egypt. A very primitive plantused in the industry has been chosen for this study. The sputumof 150 individuals exposed to flax dust were collected on threesuccessive days and inoculated on both Sabourand's dextroseagar and brain heart infusion agar to test for fungal growth.Skin tests were performed for the positive culture of Aspergillusspecies. Of the 150 workers, 74 showed fungal growth on 3 successivedays' samples. The following strains were discovered in orderof frequency. A. mucor; A. niger, A. fumigatus; A Jlavus; Candidaalbicans; yeast; Trichithisum; and Penicillium. This is the first time A. fumigatus has been recorded in Egypt. A. fumigatus has not been discovered in this study among thecontrol subjects in the same plant not exposed to flax dust. The prevalence of particular fungi in the sputum of workersexposed to flax fibres has to be further studied for their probablerole in initiating the occurrence of byssinosis. Differentiationmust be made also between truly byssinotic subjects and thosehaving extrinsic allergic alveolitis. Accepted        1 June 1981     

Developments in the darkroom: a cross-sectional study of sickness absence, work-related symptoms and environmental monitoring of darkroom technicians in a hospital in Glasgow

Nine female technicians using both manual and automatic processingmethods were matched by age, sex and smoking habits with controlsfrom the occupational therapy department. All were interviewedusing a questionnaire about symptoms experienced during theday in question and the preceding month. Sickness absence informationfor 1987 was obtained, and the working environment was assessedby standard occupational hygiene methods. The technicians andcontrols had similar numbers of episodes of sickness absence(23 versus 24, respectively) but aggregated substantially moredays absence attributed to sickness (204 versus 41). The totalnumber of ‘monthly’ symptoms experienced by thetechnicians was greater than the controls (44 versus 30) aswas the number of ‘daily’ complaints (26 versus6). In all cases, respiratory symptoms were responsible forabout one-third of problems, but statistical analysis (Wilcoxonmatched pairs signed ranks tests) showed that the differenceswere not statistically significant. Occupational hygiene resultswere all within normal limits.     

Unique Risk and Protective Factors for Partner Aggression in a Large Scale Air Force Survey

The objective of this study is to examine risk factors of physical aggression against a partner in a large representative Active Duty Air Force sample. A stratified sample of 128,950 United States Active Duty members were invited to participate in an Air Force-wide anonymous online survey across 82 bases. The final sample (N = 52,780) was weighted to be representative of the United States Air Force. Backward stepwise regression analyses were conducted to identify unique predictors of partner physical aggression perpetration within and across different ecological levels (individual, family, organization, and community levels). Relationship satisfaction, alcohol problems, financial stress, and number of years in the military were identified as unique predictors of men’s and women’s perpetration of violence against their partner across ecological levels. Parental status, support from neighbors, personal coping, and support from formal agencies also uniquely predicted men’s but not women’s perpetration of violence across ecological levels. This study identified specific risk factors of partner violence that may be targeted by prevention and intervention efforts aimed at different levels of impact (e.g., family interventions, community-wide programs).     

Sickness Absence and Control of Insulin-treated Diabetes as Assessed by Glycosylated Haemoglobin

The sickness absence records for 1986 were obtained for 63 employedinsulin-treated diabetic patients who had glycosylated haemoglobin(HbA1) measurements during that year. One subject whose absencewas associated with attempts to improve control because of pregnancywas excluded from the analysis. Fifteen had good control (HbA18.5 per cent or less) and 47 had poor control (HbA1>8.5%).The groups were similar for age, sex, duration of diabetes andoccupation. The distribution of sickness absence showed greaterfrequency of absence (p<0.05), greater number of workingdays lost (p<0.02), and greater average duration of absence(p<0.04) among those diabetic workers with poor control comparedto those with good control. Because some individuals with poorcontrol had no absence, HbA1 measurement cannot be recommendedon its own to identify those workers who will be absent fromwork. Its use may lie in indicating a level below which sicknessabsence is minimized. Requests for reprints should be addressed to: E. R. Waclawski, Institute of Occupational Medicine Ltd, 8 Roxburgh Place, Edinburgh EH8 9SU, UK     

Disorientation in Army Helicopter Operations

A brief summary of orientation error accidents during the period1962–79 is made with particular relevance to aircrew experienceand training, cockpit design and workload, and environmentaland operational factors. The present situation regarding aircrewtraining in service aircraft and operations is reviewed. The use of modern avionics in light helicopters is discussedand recommendations are made regarding the reduction of orientationerror accidents in Army helicopter operations. In particular,the helicopter disorientation training sortie currently in useon the Army Pilots Course is described in detail. Accepted        1 October 1981 Lt Col. K. Edgington RAMC, Headquarters, Director Army Air Corps, Middle Wallop, Stockbridge, Hants, SO20 8DY ^*Paper presented at the Joint Services and Faculty of OccupationalMedicine Conference held at the Institute of Naval Medicine,Alverstoke     

Translation problems of the Spanish version of the Readiness to Change Questionnaire

The Readiness to Change Questionnaire instrument by Rollnicket al. (1992) has become a standard in assessing stages of changeamong substance users. It has found such widespread acceptancethat recently it has been translated into Spanish by Rodriguez-Martoset al. (2000). . . . [Full Text of this Article]FOOTNOTESREFERENCES     

The Contribution of High Levels of Somatic Symptom Severity to Sickness Absence Duration,Disability and Discharge

Introduction: The primary objectives were to compare the duration of sickness absence in employees with high levels of somatic symptom severity (HLSSS) with employees with lower levels of somatic symptom severity, and to establish the long-term outcomes concerning return to work (RTW), disability and discharge. Secondary objective was to evaluate determinants of the duration of sickness absence in employees with HLSSS. Methods: 489 sick-listed employees registered with five Occupational Health Physician (OHP) group practices were included in this study. We measured their baseline scores for somatic symptoms severity, depressive disorders, anxiety disorders, health anxiety, distress and functional impairment. The OHPs filled in a questionnaire on their diagnosis. A prospective 2-year follow-up was carried out to assess the long-term outcomes concerning sickness absence, and retrospective information was gathered with regard to sickness absence during the 12 months before the employees were sick-listed. Results: The median duration of sickness absence was 78 days longer for employees with HLSSS. They more often remained disabled and were discharged more often, especially due to problems in the relationship between the employer and the employee. HLSSS, health anxiety and older age contributed to a longer duration of sickness absence of employees. Conclusion: High levels of somatic symptom severity are a determinant of prolonged sickness absence, enduring disabilities and health-related job loss. Occupational health physicians should identify employees who are at risk and adhere to guidelines for medically unexplained somatic symptoms.     

Establishing a physical criterion for assigning personnel to U.S. Air Force jobs

The Air Force has had problems with personnel being physically unable to perform the tasks within their assigned Air Force Specialty Code (AFSC). An assignment criterion was developed based on a single isoinertial strength score (X1): the incremental 1.83 m lift. The job assignment criterion was developed through three phases of work: Phase I analyzed AFSC tasks; Phase II developed strength/stamina tests; and Phase III established the assignment criteria.