Key result
Sickness absence over 30 days linked to ~6-fold higher initial mortality that vanishes after 6 years.
Why the study?
No study to date has investigated in detail how the risk of premature death varies over the time course of a sick-leave spell exceeding 30 days.
Does sickness absence exceeding 30 days increase the risk of premature death in the general population aged 16-64 years?
Cohort (n=5,600,000)
Does sickness absence exceeding 30 days increase the risk of premature death in the general population aged 16-64 years?
Absolute Event Rate: 13.58% vs 2.29%
Sickness absence exceeding 30 days is associated with a significantly higher initial risk of premature death that attenuates and vanishes over a 6-year period.
Sickness absence >30 days was associated with high early mortality that resolved by 6 years; hypothesis-generating for causality and monitoring in observational cohorts.
BACKGROUND: Previous studies have found that sickness absentees have an excess risk of premature death. Most of the studies compared sickness absentees with non-sickness absentees, with 1 report including the total population. However, no study to date has investigated in detail how the risk of premature death varies over the time course of a sick-leave spell. METHODS: A population-based cohort of all 5.6 million people aged 16-64 years was followed up for 6 years. Hazard rates with 95% CI for mortality in the total population, sickness absentees with sick-leave spells exceeding 30 days and non-sickness absentees, were estimated over time and were standardised so that the distribution of background variables in all 3 groups was as close as possible to that in the total population. RESULTS: The standardised hazard rate of premature death at the first day under risk for the sickness absentees was 13.58 (95% CI 13.26 to 13.95) deaths per 1000 person-years, 2.29 (2.24 to 2.35) in the total population and 0.90 (0.87 to 0.94) among non-sickness absentees. The standardised hazard rates of premature death at 6 years was 3.42 (3.22 to 3.62) among sickness absentees, 3.48 (3.43 to 3.52) in the total population and 2.61 (2.57 to 2.66) among the non-sickness absentees. The hazard rates varied greatly across sick-leave diagnoses. CONCLUSIONS: Right after start of a sick-leave spell exceeding 30 days, sickness absentees were at higher risk of premature death than the total population. The difference in risk, however, decreased over time and vanished completely after 6 years of follow-up.
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Olsson et al. (2015) conducted a cohort in Sickness absence (n=5,600,000). Sickness absence (>30 days) vs. Total population and non-sickness absentees was evaluated on Premature death. Sickness absentees with spells >30 days had a higher initial hazard rate of premature death (13.58 per 1000 person-years) compared to the total population (2.29), which vanished after 6 years.
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