Per Lindberg

Long-term sick-listing among women in the public sector and its associations with age, social situation, lifestyle, and work factors: A three-year follow-up study

Background: Since 1997 the number of long-term sick-listed people in Sweden has increased dramatically, especially among women employed in the public sector. Aims: The aim of this study was to investigate associations between age, social situation, lifestyle, work factors, and long-term sick-listing (≥28 days), regardless of diagnosis, during a period of three years among women employed in the public sector. Methods: Exposure information at baseline was recorded by a questionnaire. All new spells of sick-listing ≥28 days were consecutively reported from the employer for three years from baseline. In total 6,246 women from the public sector in Sweden answered the questionnaire (85% response rate); 5,224 were classified as having good or rather good health for working and were included. Of these, 918 persons had spells of sick-listing ≥28 days during follow-up. Results: Univariate and multivariate analyses for calculating relative risks (RR) were carried out. In the Cox regression model age (RR 1.4), strained financial situation (RR 1.3), obesity (RR 1.3), bullying (RR 1.5), physical demands at work higher than own capacity (RR 1.5), and mental demands at work higher than own capacity (1.2) remained risk indicators for long-term sick-listing. Conclusion: This study suggests prevention of some work and lifestyle factors as general measures to reduce long-term sick-listing among women in the public sector.

The same factors influence job turnover and long spells of sick leave—a 3-year follow-up of Swedish nurses

BACKGROUNDnIn many countries, a general shortage of nurses is a public health problem, and retention of nurses in active work is a challenge. The aim of this study was to ascertain whether the same individual factors, working conditions and health problems had led to increased probability of both leaving jobs and prolonged sickness absence in a cohort of Swedish nurses over a period of 3 years.nnnMETHODSnA baseline questionnaire was answered by 2293 nurses, representing a response rate of 86%. Exposed and unexposed nurses were compared with regard to two outcomes. During the 3-year follow-up, exposed and unexposed nurses were compared with regard to two outcomes: resigning and having at least one sick leave spell that lasted 28 days or longer.nnnRESULTSnWe found that 18% of the nurses left their employment, and 16% had sick leave spells > or =28 days. Work in geriatric care, being socially excluded by superiors and/or workmates, negative effects of organizational changes and poor self-rated general health were factors that increased the likelihood of both leaving jobs and long-term sick leave.nnnCONCLUSIONSnThe present results underline the importance of improving working conditions and supporting sustainable health in order to prevent high turnover and prolonged sick leave among nurses. Resigning and moving to another institution can be interpreted as a way to actively cope with an unhealthy work environment.

Promoting excellent work ability and preventing poor work ability: the same determinants? Results from the Swedish HAKuL study.

Aim: Health has been described as a continuum between the two poles of excellent health and ill health. Research has so far focused on the negative pole, leaving knowledge about the positive pole vague. With a main focus on working life, the authors aim was to identify determinants promoting excellent work ability and determinants preventing poor work ability. Methods: 5638 (73% answering rate) employees in the public sector in Sweden answered a questionnaire both at baseline and at follow up 18 months later. The employees were divided into three groups based on sick leave at follow up: excellent work ability (13%), poor work ability (15%), and a middle group (72%). Self reported sociodemographic data, lifestyle data, and working life exposures at baseline were fitted into logistic regression models to determine which factors, if any, promoted excellent work ability or protected against poor work ability. Results: Some determinants were mutual, but more than half of the determinants in the final model were associated solely with promoting excellent work ability or preventing poor work ability, thus creating different patterns of associations. Promotion of excellent work ability seemed more dependent on physical factors, clear work tasks, and positive feedback, while prevention of poor work ability seemed more dependent on job security and psychosocial factors. Conclusions: This explorative longitudinal study showed slightly different patterns of determinants promoting excellent work ability and preventing poor work ability. As most of the identified determinants are amenable to influence, our results open up the possibility of interventions for promoting excellent work ability and preventing poor work ability.

Work and health among immigrants and native Swedes 1990–2008: a register-based study on hospitalization for common potentially work-related disorders, disability pension and mortality

BackgroundThere are many immigrants in the Swedish workforce, but knowledge of their general and work-related health is limited. The aim of this register-based study was to explore whether documented migrant residents in Sweden have a different health status regarding receipt of a disability pension, mortality and hospitalization for lung, heart, psychiatric, and musculoskeletal disorders compared with the native population, and if there were variations in relation to sex, geographical origin, position on the labor market, and time since first immigration.MethodsThis study included migrants to Sweden since 1960 who were 28–47 years old in 1990, and included 243 860 individuals. The comparison group comprised a random sample of 859 653 native Swedes. These cohorts were followed from 1991 to 2008 in national registers. The immigrants were divided into four groups based on geographic origin. Hazard ratios for men and women from different geographic origins and with different employment status were analyzed separately for the six outcomes, with adjustment for age, education level, and income. The influence of length of residence in Sweden was analyzed separately.ResultsNordic immigrants had increased risks for all investigated outcomes while most other groups had equal or lower risks for those outcomes than the Swedes. The lowest HRs were found in the EU 15+ group (from western Europe, North America, Australia and New Zealand). All groups, except Nordic immigrants, had lower risk of mortality, but all had higher risk of disability pension receipt compared with native Swedes. Unemployed non-Nordic men displayed equal or lower HRs for most outcomes, except disability pension receipt, compared with unemployed Swedish men. A longer time since first immigration improved the health status of men, while women showed opposite results.ConclusionsEmployment status and length of residence are important factors for health. The contradictory results of low mortality and high disability pension risks need more attention. There is great potential to increase the knowledge in this field in Sweden, because of the high quality registers.

A physical fitness programme during paid working hours - impact on health and work ability among women working in the social service sector: a three year follow up study.

In order to study the influence of a physical fitness programme on work ability among women employed in the social sector an intervention was offered to 205 women working in the social care sector in a municipality in Sweden. The reference group comprised 165 women from the same sector working in another municipality. All participants were employed and answered questionnaires at baseline and after 36 months. For women younger than 45 years, work ability and general health improved significantly while for women, 45 years or older, future work expectations improved. For women with less musculoskeletal pain, improvements were observed regarding future work expectations, as well as work ability and general health while for women with more musculoskeletal pain, improvements were observed for general health and future work expectations. Well-structured physical fitness programmes at the worksite can be useful in contributing to individuals experiences of improvements in their own capacity as well as increased health and wellbeing.

Different working and living conditions and their associations with persistent neck/shoulder and/or low back disorders

Objectives: To investigate whether different combinations of working and living conditions are associated with the risk for persistent neck/shoulder and/or low back disorders. The underlying purpose of this contextual approach was to identify target groups for primary/secondary prevention. Methods: In a baseline study, 11 groups with different working and living conditions were identified by cluster analysis. In this study, these 11 groups were followed up by a postal questionnaire 5 years after baseline (response rate 82%, nu200a=u200a1095). Results: Five of the groups—the onerous human services job, the free agent, the family burden, the mentally stretched and the physically strained groups—had an increased risk for persistent disorders (OR 2.38–2.70). Four of these groups had rather sex-specific working and living conditions. Conclusions: The results support the hypothesis that different combinations of working and living conditions may increase the risk for persistent neck/shoulder and/or low back disorders to different degrees. Sex-specific working and living conditions increased the risk for women as well as for men, irrespective of whether the conditions were specific to women or men.

Work and health among native and foreign-born residents in Sweden 1990-2008 : a register-based study on hospitalization due to common potentially work-related disorders, disability pension and mortality

Objectives To study the health status expressed in terms of hospitalisation due to lung, ischemic heart, psychiatric, and musculoskeletal disorders, disability pension and mortality for immigrants compared to native Swedes. Methods All foreign-born persons in Sweden, 28–47 years old 1990, (n=312 349) were compared to a random sample of native Swedes (n= 926 805) in national registers from 1991 to 2008. HRs for men and women from different geographic origin and with different labour market positions were analysed adjusted for age, education, income and years since first immigration. Results To be a white collar worker in 1990 was more frequent among Swedes and to be outside the labour market both with and without official unemployment status was more frequent among immigrants. Immigrants from the Nordic countries had the least and persons outside the labour market the most favourable health results with regard to studied diseases and disorders. Immigrants from other geographical origin had equal or lower risks of the studied disorders as well as mortality than the Swedes. However, almost all immigrant groups had an increased risk for disability pension. No major differences between men and women were found. Conclusions To be an immigrant does not mean less good health than being a native Swede, except for immigrants from the Nordic countries. Why immigrants from all origins and in all labour market positions receive more disability pensions ought to be examined more thoroughly, both from a medical point of view and in the context of labour market and social security policies.