Mental disorders are a key cause of sickness absence (SA) and challenge prolonging working careers. Thus, evidence on the development of SA trends is needed. In this study, educational differences in long SAs due to mental disorders were examined in two age groups among employees of the City of Helsinki from 2004 to 2013.
All permanently and temporarily employed staff aged 18-34 and 35-49 were included in the analyses (n=~27800 per year). SA spells of =14 days due to mental disorders were examined annually. Education was classified to higher and lower levels. Joinpoint regression was used to identify major turning points in SA trends.
Joinpoint regression models showed that lower educated groups had more long SAs spells due to mental disorders than those groups with higher education. SA trends decreased during the study period in all studied age and educational groups. Lower educated age groups had similar SA trends. Younger employees with higher education had the fewest SAs.
A clear educational gradient was found in long SAs due to mental disorders during the study period. SA trends decreased from 2004 to 2013.
Disability retirement (DR) among young employees is an increasing problem affecting work life and public health, given the potential major loss of working time. Little is known about educational differences in the risk of DR among young employees, despite the need for such knowledge in targeting preventive measures. We examined the association between education and DR due to any cause and to mental and non-mental causes among young employees.
Personnel register data of the City of Helsinki from the years 2002-2013 for 25-to-34-year-old employees (n= 41225) were linked to register data from the Finnish Centre for Pensions on DR (n= 381), and from Statistics Finland on education. Education was categorised into four hierarchical groups. The mean follow-up time was 5.7 years. Cox regression analysis was used.
There were 381 DR events and of the events, over 70% were due to mental disorders and 72% were temporary. A consistent educational gradient was found. Those with a basic education were at the highest risk of DR due to any cause (HR 4.64, 95% CI 3.07, 7.02), and to mental (HR 4.79, 95% CI 2.89, 7.94) and non-mental causes (HR 4.32, 95% CI 2.10, 8.91).
DR due to any cause, and to mental and non-mental causes, followed a clear educational gradient. Early intervention, treatment and rehabilitation with a view to maintaining work ability are needed among young employees, especially those with low education. Adapting working conditions to their health and work ability may also help to avoid premature exit from work.
Interrelationships between education, occupational class and income as determinants of sickness absence among young employees in 2002-2007 and 2008-2013.
A low socioeconomic position (SEP) is consistently associated with ill health, sickness absence (SA) and permanent disability, but studies among young employees are lacking. We examined the interrelationships between education, occupational class and income as determinants of SA among 25-34-year-old employees. We also examined, whether the association between SEP and SA varied over time in 2002-2007 and 2008-2013.
The analyses covered young, 25-34-year-old women and men employed by the City of Helsinki over the time periods 2002-2007 and 2008-2013. Four-level education and occupational class classifications were used, as well as income quartiles. The outcome measure was the number of annual SA days.
Education had the strongest and most consistent independent association with SA among women and men in both periods under study. Occupational class had weaker independent and less consistent association with SA. Income had an independent association with SA, which strengthened over time among the men. The interrelationships between the SEP indicators and SA were partly explained by prior or mediated through subsequent SEP indicators. Socioeconomic differences followed only partially a gradient for occupational class and also for income among men.
Preventive measures to reduce the risk of SA should be considered, especially among young employees with a basic or lower-secondary education.
Notes
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Project Researcher at South-Eastern Finland University of Applied Sciences, Advanced Level Paramedic at Kymsote - Kymenlaakso Social and Health Services, Doctoral Candidate at University of Helsinki, Faculty of Medicine, Finland. Electronic address: anssi.koski@xamk.fi.
Paramedics face several safety risks in their occupation, and crashes during emergency response driving (ERD) are quite common. However, there is a need for more research to develop educational and implementation suggestions to determine how these risks can be reduced and managed. In this study, we examined what risk factors Finnish paramedics recognize when performing ERD.
The study material consisted of 161 pages of material that had been written by experienced paramedics (n?=?44) who were master's degree students of South-Eastern Finland University of Applied Sciences in fall 2017. They wrote essays based solely on their own thoughts and experiences regarding the risk factors associated with ERD. The material was analyzed via inductive content analysis.
Two main categories were found: Crew-related risk factors and environmental risk factors. These categories could be further divided into eight sub-categories. The crew-related risk factors consisted of lack of education and training for ERD, insufficient concentration on driving, irresponsibility and indifference, crew member's inability to take collective responsibility for safety as a team, and excessive load experienced by the driver. Environmental risk factors consisted of demanding handling of ambulance, poor visibility, and other road users.
Finnish paramedics recognized several risk factors in ERD. Some of the factors have been noted in previous literature regarding ambulance crashes and should be addressed as a matter of urgency to improve safety. Overall, better knowledge regarding these risks needs to be developed worldwide. The results led to several further study suggestions.
Mental disorders are common diagnostic causes for longer sickness absence and disability retirement in OECD-countries. Short sickness absence spells are also common, and neither trivial for health and work ability. We studied how prior short sickness absence spells and days are associated with subsequent longer sickness absence due to mental disorders in two age-groups of municipal employees during a 2-, 5- and 9-year follow-up.
The analyses covered 20-34 and 35-49-year-old employees of the City of Helsinki in 2004. Those with prior =14 day sickness absence in 2002, 2003 or 2004 were excluded. Women and men were pooled together. Short, 1-13-day sickness absence spells and days were calculated per the actual time of employment during 2004. Logistic regression analysis was used to calculate odds ratios (OR) and their 95% confidence intervals (CI) for the subsequent long (=14 days) sickness absence due to mental disorders during three follow-ups.
The risk for long sickness absence due to mental disorders increased with increasing amount of short sickness absence spells and days. 3 or more short sickness absence spells and 8-14 sickness absence days from short spells in 2004 were strongly associated with subsequent long sickness absence in all three follow-ups. The associations were strongest for the 2-year follow-up; the younger employees tended to have higher risks than the older ones.
Three spells or 8 days of short sickness absence per year constitutes a high risk for subsequent long sickness absence due to mental disorders and preventive measures should be considered.
Notes
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Young adults entering employment are a key group in extending work careers, but there is a lack of research on trends in work ability among young employees. Prolonged sickness absence (SA) constitutes a risk for permanent work disability. We examined 12-year trends in SA spells among young female and male municipal employees.
The data were obtained from the employers' registers in the City of Helsinki, Finland. The data included employees aged 18-24, 25-29, 30-34, and 35-54 from 2002 to 2013 (the average number for each year was 31,600). Self-certified (1-3 days) and medically certified intermediate (4-14 days) and long (15+ days) SAs were examined. Joinpoint regression models were used to identify major changes in SA trends.
Younger employees had more short SAs but fewer long SAs than older employees. During the study period, SAs of almost any length first increased and later decreased among both genders, except for young men. The turning points for short SA were in 2007-2011 among younger and older employees. In intermediate and long SAs the respective turning points were in 2008-2009 and 2005-2009. Women had more SAs in all categories.
Age is related to the length of absences. Given the relatively low chronic morbidity among younger employees, it is likely that reasons other than ill health account for increased SA. More evidence on factors behind the changing trends is needed in order to reduce SA and extend the working careers of young people.
