Diagnosis-specific sick leave as a long-term predictor of disability pension: a 13-year follow-up of the GAZEL cohort study. Issue 2 (14th October 2011)

• Record Type: Journal Article
• Authors: Alexanderson, K; Kivimäki, M; Ferrie, J E; Westerlund, H; Vahtera, J; Singh-Manoux, A; Melchior, M; Zins, M; Goldberg, M; Head, J
• Is Part Of: Journal of epidemiology and community health. Volume 66:Issue 2(2012)
• Page Start: 155
• Page End: 159
• Publication Date: 2011-10-14
• Subjects: Sick leave -- sick-leave diagnoses -- disability pension -- ill-health retirement -- psychiatric -- disabling disease -- occupational health -- psychiatric -- sickness absence; Public health -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1136/jech.2010.126789
• Languages: English
• ISSNs: 0143-005X

Abstract

Abstract : Background: Factors that increase the risk of labour market exclusion are poorly understood. In this study, we examined the extent to which all-cause and diagnosis-specific sick leave predict subsequent disability pension (DP). Methods: Prospective cohort study of 20 434 persons employed by the French national gas and electric company (the GAZEL study). New sick-leave spells >7 days in 1990–1992 were obtained from company records. Follow-up for DP was from 1994 to 2007. Results: The HR, adjusted for age and occupational position, for DP was 3.5 (95% CI 2.7 to 4.5) in men and 2.6 (95% CI 1.9 to 3.5) in women with one or more sick-leave spells >7 days compared with those with no sick leave. The strongest predictor of DP was sick leave with a psychiatric diagnosis, HR 7.6 (95% CI 5.2 to 10.9) for men and 4.1 (95% CI 2.9 to 5.9) for women. Corresponding HRs for sick leave due to circulatory diagnoses in men and women were 5.6 (95% CI 3.7 to 8.6) and 3.1 (95% CI 1.8 to 5.3), for respiratory diagnoses 3.9 (95% CI 2.6 to 5.8) and 2.6 (95% CI 1.7 to 4.0), and musculoskeletal diagnoses 4.6 (95% CI 3.4 to 6.4) and 3.3 (95% CI 2.2 to 4.8), respectively. Conclusions: Sick leave with a psychiatric diagnosis is a major risk factor for subsequent DP, especially among men. Sick leave due to musculoskeletal or circulatory disorders was also a strong predictor of DP. Diagnosis-specific sick leave should be recognised as an early risk marker for future exclusion from the labour market.