Showing papers by "Jussi Vahtera published in 2001"

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

Abstract: 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 o na2y earfollow 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 diVerences 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 eVect 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. (Occup Environ Med 2001;58:361‐366)

Downsizing, changes in work, and self-rated health of employees: A 7-year 3-wave panel study

Abstract: The question of whether changes in work and interpersonal relationships mediate the adverse effects of downsizing on health of employees was explored. Longitudinal data from a 7-year study of 550 municipal workers in a variety of jobs was collected before, immediately after, and 4 years after downsizing. The degree of downsizing for each job category was assessed using organizational records of contracted days worked. Downsizing predicted adverse changes in work characteristics and a long-lasting decline in self-rated health. Decreased job control, high job insecurity and increased physical demands, in combination, appeared to be the linking mechanism between downsizing and general health. Interestingly, social conflict did not play a role in the mediation process.

Organisational downsizing and musculoskeletal problems in employees: a prospective study.

Abstract: OBJECTIVES—To study the association between organisational downsizing and subsequent musculoskeletal problems in employees and to determine the association with changes in psychosocial and behavioural risk factors. METHODS—Participants were 764 municipal employees working in Raisio, Finland before and after an organisational downsizing carried out between 1991 and 1993. The outcome measures were self reports of severity and sites of musculoskeletal pain at the end of 1993 and medically certified musculoskeletal sickness absence for 1993-5. The contribution of changes in psychosocial work characteristics and health related behaviour between the 1990 and 1993 surveys was assessed by adjustment. RESULTS—After adjustment for age, sex, and income, the odds ratio (OR) for severe musculoskeletal pain between major and minor downsizing and the corresponding rate ratios for musculoskeletal sickness absence were 2.59 (95% confidence interval (95% CI) 1.5 to 4.5) and 5.50 (3.6 to 7.6), respectively. Differences between the mean number of sites of pain after major and minor downsizing was 0.99 (0.4 to 1.6). The largest contribution from changes in work characteristics and health related behaviour to the association between downsizing and musculoskeletal problems was from increases in physical demands, particularly in women and low income employees. Additional contributory factors were reduction of skill discretion (relative to musculoskeletal pain) and job insecurity. The results were little different when analyses were confined to initially healthy participants. CONCLUSIONS—Downsizing is a risk factor for musculoskeletal problems among those who remain in employment. Much of this risk is attributable to increased physical demands, but adverse changes in other psychosocial factors may also play a part. Keywords: ocupational health; musculoskeletal disorders; downsizing

Contingent employment, health and sickness absence

Abstract: OBJECTIVES: This study explored the health and sickness absences of contingent employees. METHODS: Analyses of self-reported health and recorded spells of sickness absence were based on a cohort of 5650 employees (674 men, 4976 women) in 10 Finnish hospitals. RESULTS: After adjustment for demographic and work-related characteristics, contingent employees had a better self-rated health status [odds ratio 0.76, 95% confidence interval (95% CI) 0.62-0.94 of poor or average health status]. There were no differences in the prevalence of diagnosed chronic diseases and minor psychiatric morbidity between the groups. After adjustment for self-rated health and confounding, female, but not male, contingent employees had a lower rate of self-certified (1-3 days) sickness absences than permanent employees (rate ratio 0.90, 95% CI 0.85-0.95). Contingent employees, irrespective of gender, had a 0.77 (95% CI 0.71-0.84) times lower rate of medically certified (>3 days) sickness absence than permanent employees. Poor self-rated health status, reported diagnosed chronic diseases, and minor psychiatric morbidity were associated with medically certified absences to a less extent among contingent employees than among permanent employees. CONCLUSIONS: These findings suggest better self-rated health and a lower sickness absence rate for contingent employees than for permanent employees. The difference in sickness absence between the groups seems not only to be associated with actual differences in health, but also with different thresholds of taking sick leave or working while ill.

The role of extended weekends in sickness absenteeism

Abstract: OBJECTIVES—Employees are thought to lengthen their weekends by voluntary absenteeism, but the magnitude of such potentially reversible behaviour is not known. METHODS—A follow up study based on employers' registers on the dates of work contracts and absences in 27 541 permanent full time municipal employees in five towns during 1993-7. The absence rate on each weekday separately for all sick leaves and for 1 day sick leaves was determined. RESULTS—3.4% of the male employees and 5.0% of the female employees were on sick leave daily. The mean rate of sickness absence was lowest on Mondays, after which it increased towards Wednesday, and remained on the same level for the rest of the week. This pattern applied to both sexes, to each year of the follow up, and across towns, age groups, and income groups. For 1 day sick leaves, representing 4.5% of the total sickness absenteeism, the rates of sick leave for Mondays and Fridays were 1.4 and 1.9 times greater than those for other weekdays. However, these excess rates account for less than 1% of all days lost due to sickness absenteeism. Extended weekend absences were more common in men, in young employees, and in those in a low socioeconomic position, and they varied between towns. CONCLUSION—Extended weekends seem to contribute only marginally to the days lost due to sickness absenteeism. Keywords: occupational health; sickness absence; management