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Epidemiology
Research
Trends in diagnosis-specific work disability before and after ischaemic heart disease: a nationwide population-based cohort study in Sweden
  1. Jenni Ervasti1,
  2. Marianna Virtanen1,2,
  3. Tea Lallukka1,3,
  4. Emilie Friberg4,
  5. Ellenor Mittendorfer-Rutz4,
  6. Erik Lundström5,
  7. Kristina Alexanderson4
  1. 1 Finnish Institute of Occupational Health, Helsinki, Finland
  2. 2 Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden
  3. 3 Faculty of Medicine, University of Helsinki, Helsinki, Finland
  4. 4 Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  5. 5 Division of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Jenni Ervasti; jenni.ervasti{at}ttl.fi

Abstract

Objectives We examined trends of diagnosis-specific work disability before and after ischaemic heart disease (IHD).

Design Participants were followed 4 years before and 4 years after an IHD event for diagnosis-specific work disability (sickness absence and disability pension).

Setting and participants A Swedish population-based cohort study using register data on all individuals aged 25–60 years, living in Sweden, and who suffered their first IHD event in 2006–2008 (n=23 971) was conducted.

Results Before the event, the most common diagnoses of work disability were musculoskeletal disorders (21 annual days for men and 44 for women) and mental disorders (19 men and 31 for women). After multivariable adjustments, we observed a fivefold increase (from 12 to 60 days) in work disability due to diseases of the circulatory system in the first postevent year compared with the last pre-event year among men. Among women, the corresponding increase was fourfold (from 14 to 62 days). By the second postevent year, the number of work disability days decreased significantly compared with the first postevent year among both sexes (to 19 days among men and 23 days among women). Among women, mean days of work disability due to diseases of the circulatory system remained at a higher level than among men during the postevent years. Work disability risk after versus before an IHD event was slightly higher among men (rate ratio (RR) 2.49; 95% CI 2.36 to 2.62) than among women (RR 2.29, 95% CI 2.12 to 2.49). When pre-event long-term work disability was excluded, diseases of the circulatory system were the most prevalent diagnosis for work disability after an IHD event among both men and women.

Conclusions An IHD event was strongly associated with an increase in work disability due to diseases of the circulatory system, especially among men and particularly in the first postevent year.

  • comorbidity
  • disability pension
  • sex differences
  • sick leave
  • sickness absence
  • trajectories

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-019749

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    Footnotes

    • Contributors JE, TL, MV, EM-R and KA contributed to conception and design. JE analysed the data and drafted the manuscript. MV, TL, EF, EM-R, EL and KA contributed to interpretation of the results and critically revised the manuscript. All gave final approval and agree to be accountable for all aspects ensuring integrity and accuracy.

    • Funding This work was supported by Forskningsrådet om Hälsa, Arbetsliv och Välfärd (The Swedish Research Council for Health, Working Life and Welfare). JE, MV and TL were supported by Suomen Akatemia (Academy of Finland), project numbers 258598, 292824, 287488, 294096.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval The project was approved by the Regional Ethical Review Board, Stockholm, Sweden.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.