Sickness absence due to common mental disorders in young employees in Sweden: are there differences in occupational class and employment sector?

Contribution of age, gender and occupational group to the higher risk of disability retirement among Finnish public sector employees

BACKGROUND

The aim of this study was to examine the differences in disability retirement between public and private sector employees and to examine the contribution of age, gender and occupational group to the differences between the sectors.

METHODS

Our Finnish register data consisted of about two million non-retired men and women aged 30-62 years. Cox proportional hazard models were used to calculate hazard ratios for any, full and partial disability retirement in the public sector compared with the private sector.

RESULTS

The risk of any disability retirement was higher in the public sector than in the private sector in all occupational groups. The unadjusted hazard ratio ranged from 1.29 (95% CI 1.16-1.44) among teaching professionals to 2.25 (95% CI 1.95-2.58) among skilled agricultural, forestry and fishery workers. Adjustment for age and gender attenuated the differences between the sectors. After adjusting for age, gender and occupational group, the hazard ratio was 1.29 (95% CI 1.27-1.32) for any disability retirement and 2.02 (95% CI 1.96-2.08) for partial disability retirement, but there was no difference between the public sector and private sector employees for full disability retirement.

CONCLUSIONS

Adjustment of age and gender attenuated the higher risk of disability retirement in the public sector, while adjustment for occupational group widened the sector differences in any and full disability retirement. The risk of partial disability retirement was higher in all occupational groups in the public sector than in the private sector. For full disability retirement, the differences between the sectors were small or non-existent.

Moderating effect of cardiorespiratory fitness on sickness absence in occupational groups with different physical workloads

Sickness absence from work has a large adverse impact on both individuals and societies in Sweden and the costs for sickness absence were calculated to 64.6 billion Swedish kronor (approx. 5.6 billion in Euros) in 2020. Although high cardiorespiratory fitness may protect against potential adverse effects of high physical workload, research on the moderating effect of respiratory fitness in the relation between having an occupation with high physical workload and sickness absence is scarce. To study the moderating effect of cardiorespiratory fitness in the association between occupation and psychiatric, musculoskeletal, and cardiorespiratory diagnoses. Data was retrieved from the HPI Health Profile Institute database (1988-2020) and Included 77,366 participants (mean age 41.8 years, 52.5% women) from the Swedish workforce. The sample was chosen based on occupational groups with a generally low education level and differences in physical workload. Hurdle models were used to account for incident sickness absence and the rate of sickness absence days. There were differences in sickness absence between occupational groups for musculoskeletal and cardiorespiratory diagnoses, but not for psychiatric diagnoses. In general, the association between occupation and musculoskeletal and cardiorespiratory diagnoses was moderated by cardiorespiratory fitness in most occupational groups with higher physical workload, whereas no moderating effect was observed for psychiatric diagnoses. The study results encourage community and workplace interventions to both consider variation in physical workload and to maintain and/or improve cardiorespiratory fitness for a lower risk of sickness absence, especially in occupations with high physical workload.

Sequence analysis of sickness absence and disability pension days in 2012-2018 among privately employed white-collar workers in Sweden: a prospective cohort study

OBJECTIVE

The aim of the study is to explore sequences of sickness absence (SA) and disability pension (DP) days from 2012 to 2018 among privately employed white-collar workers.

DESIGN

A 7-year prospective cohort study using microdata from nationwide registers.

SETTING

Sweden.

PARTICIPANTS

All 1 283 516 privately employed white-collar workers in Sweden in 2012 aged 18-67.

METHODS

Sequence analysis was used to describe clusters of individuals who followed similar development of SA and DP net days/year, and multinomial logistic regression to analyse associations between sociodemographic variables and belonging to each observed cluster of sequences. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for baseline sociodemographics.

RESULTS

We identified five clusters of SA and DP sequences: (1) 'low or no SA or DP' (88.7% of the population), (2) 'SA due to other than mental diagnosis' (5.2%), (3) 'SA due to mental diagnosis' (3.4%), (4) 'not eligible for SA or DP' (1.4%) and (5) 'DP' (1.2%). Men, highly educated, born outside Sweden and high-income earners were more likely to belong to the first and the fourth cluster (ORs 1.13-4.49). The second, third and fifth clusters consisted mainly of women, low educated and low-income (ORs 1.22-8.90). There were only small differences between branches of industry in adjusted analyses, and many were not significant.

CONCLUSION

In general, only a few privately employed white-collar workers had SA and even fewer had DP during the 7-year follow-up. The risk of belonging to a cluster characterised by SA or DP varied by sex, levels of education and income, and other sociodemographic factors.

Managers' experience of causes and prevention of sick leave among young employees with Common Mental Disorders (CMDs)-A qualitative interview study with a gender perspective

BACKGROUND

Young adults entering the workforce have an almost 40% greater risk of work-related mental health problems than other working age groups. Common mental disorders (CMDs) constitute the majority of such mental health problems. Managers are crucial in promoting a good psychosocial work environment and preventing sick leave. The study aims to explore managers' experience of 1) causes of sick leave in the personal and work-life of young employees with CMDs, and 2) prevention of such sick leave. A gender perspective is applied to examine managers' experience of causes and prevention of sick leave in relation to male and female employees and male and female-dominated occupations.

MATERIAL AND METHODS

A qualitative design was applied and 23 semi-structured interviews were conducted with Swedish managers experienced in supervising young employees with CMDs. The interviews were analysed with conventional content analysis and the managers' experience of similarities and differences between young female and male employees and occupations were explored through reflective notes.

RESULTS

Four main categories and eight subcategories describe the managers' experience of the causes of sick leave due to CMD among young employees. The main categories are: 1) entering work life when already worn-out, 2) struggling with too high expectations at work, 3) having a challenging personal life, and 4) being unable to manage specific occupational challenges and demands. Gender differences were found in six subcategories regarding, e.g., work demands and problems in personal relationships. One main category and three subcategories describe how this type of sick leave might be prevented, with managers emphasizing the need to ease the transition into work life. Gender differences in the prevention of sick leave were found in one subcategory regarding communication about workers' health and problems at work.

CONCLUSION

Our findings show that gender norms and the expectations of young men and women are factors of importance in managers' experience of the development and prevention of CMDs. These results can inform their preventive work and their supervision and introduction of newly-employed young adults.

Utilizing a Nordic Crosswalk for Occupational Coding in an Analysis on Occupation-Specific Prolonged Sickness Absence among 7 Million Employees in Denmark, Finland, Norway and Sweden

We identified occupations with a high incidence of prolonged sickness absence (SA) in Nordic employees and explored similarities and differences between the countries. Utilizing data from national registers on 25-59-year-old wage-earners from Denmark, Finland, Norway and Sweden, we estimated the gender- and occupation-specific age-adjusted cumulative incidence of SA due to any cause, musculoskeletal diseases and mental disorders. To increase the comparability of occupations between the countries, we developed a Nordic crosswalk for occupational codes. We ranked occupational groups with the incidence of SA being statistically significantly higher than the population average of the country in question and calculated excess fractions with the employee population being the reference group. We observed considerable occupational differences in SA within and between the countries. Few occupational groups had a high incidence in all countries, particularly for mental disorders among men. In each country, manual occupations typically had a high incidence of SA due to any cause and musculoskeletal diseases, while service occupations had a high incidence due to mental disorders. Preventive measures targeted at specific occupational groups have a high potential to reduce work disability, especially due to musculoskeletal diseases. Particularly groups with excess SA in all Nordic countries could be at focus.

Sickness absence among young employees in private and public sectors with a history of depression and anxiety

The aim was to investigate occurrence and duration of sickness absence (SA) among young employees with previous depression/anxiety in private and public sectors. This population-based prospective study included 11,519 Swedish twin individuals of age 19-29 years that were followed regarding SA during 2006-2016. Data on previous depression/anxiety came from two screening surveys in 2005. Data on SA and employment sector were received from national registries. Descriptive statistics and logistic regression were used, also controlling for familial factors. Proportion of employees with SA was significantly higher among those with, as compared to those without, previous depression/anxiety, regardless the employment sector. Individuals with previous depression/anxiety had increased risk for future SA, in both private (OR 2.25, 95% CI 1.90-2.66) and public sectors (OR 2.10, 95% CI 1.73-2.54). Familial factors played a role in the association among employees in the private sector. A higher proportion of long-term SA was observed among employees with previous depression/anxiety in the private as compared to the public sector. To conclude, previous depression/anxiety tends to increase risk for SA among young employees in both employment sectors, whereas long-term SA seemed to be more prevalent among those in the private as compared to the public sector.

Study protocol of EMPOWER: A cluster randomized trial of a multimodal eHealth intervention for promoting mental health in the workplace following a stepped wedge trial design

Objective: This article describes the EMPOWER study, a controlled trial aiming to determine the effectiveness and cost-effectiveness of an eHealth intervention to prevent common health problems and reduce presenteeism and absenteeism in the workplace. Intervention: The EMPOWER intervention spans universal, secondary and tertiary prevention and consists of an eHealth platform delivered via a website and a smartphone app designed to guide employees throughout different modules according to their specific profiles. Design: A stepped-wedge cluster randomized trial will be implemented in four countries (Finland, Poland, Spain and UK) with employees from small and medium enterprises (SMEs) and public agencies. Companies will be randomly allocated in one of three groups with different times at which the intervention is implemented. The intervention will last 7 weeks. Employees will answer several questionnaires at baseline, pre- and post-intervention and follow-up. Outcome measures: The main outcome is presenteeism. Secondary outcomes include depression, anxiety, insomnia, stress levels, wellbeing and absenteeism. Analyses will be conducted at the individual level using the intention-to-treat approach and mixed models. Additional analyses will evaluate the intervention effects according to gender, country or type of company. Cost-effectiveness and cost-utility analyses [based on the use of quality-adjusted life-years (QALYS)] will consider a societal, employers' and employees' perspective.

Occupational Branch and Labor Market Marginalization among Young Employees with Adult Onset of Attention Deficit Hyperactivity Disorder-A Population-Based Matched Cohort Study

We compared labor market marginalization (LMM), conceptualized as days of unemployment, sickness absence and disability pension, across occupational branches (manufacturing, construction, trade, finance, health and social care, and education), among young employees with or without attention deficit hyperactivity disorder (ADHD) and examined whether sociodemographic and health-related factors explain these associations. All Swedish residents aged 19–29 years and employed between 1 January 2005 and 31 December 2011 were eligible. Individuals with a first ADHD diagnosis (n = 6030) were matched with ten controls and followed for five years. Zero-inflated negative binomial regression was used to model days of LMM with adjustments for sociodemographic and health-related factors. In total, 20% of those with ADHD and 59% of those without had no days of LMM during the follow-up. The median of those with LMM days with and without ADHD was 312 and 98 days. Having an ADHD diagnosis was associated with a higher incidence of LMM days (incident rate ratios (IRRs) 2.7–3.1) with no differences across occupational branches. Adjustments for sociodemographic and health-related factors explained most of the differences (IRRs: 1.4–1.7). In conclusion, young, employed adults with ADHD had a higher incidence of LMM days than those without, but there were no substantial differences between branches, even after adjusting for sociodemographic and health-related factors.