Objectives We aimed to provide previously unestablished information on population-based differences in cause-specific sickness absence trends between occupational classes and further between four large industrial sectors within the different occupational classes while controlling for other socioeconomic factors and employment patterns. We focused on the period 2005–2013, during which the labour market underwent large economic and structural changes in many countries.
Design Register-based panel data study.
Setting Large representative datasets on Finnish wage earners aged 25–59 years.
Outcome measure Annual risk of sickness absence (>10 working days) based on repeated logistic regression.
Results Between 2005 and 2013, the proportion of employees with sickness absence decreased. Occupational class differences in sickness absence trends varied by disease group. Overall, the decrease in absences was smallest among lower non-manual employees. Sickness absence levels were highest in the health and social work sector and in the manufacturing sector within the non-manual and manual classes, respectively. Absences due to musculoskeletal diseases decreased temporarily during the peak of the economic recession in 2009, particularly in the manufacturing sector within the manual class. The decrease in absences due to musculoskeletal diseases was smallest in the trade sector within the lower occupational classes. Overall, education, income and employment patterns partly explained the differences in the absence levels, but not in the trends.
Conclusions We found a complex interplay between the associations of occupational class and industrial sector with sickness absence trends. During the economic recession, absences due to musculoskeletal diseases decreased temporarily in a segment of wage earners who were known to have been hit hard by the recession. However, the trend differences were not explained by the measured structural changes in the characteristics of the study population. Both occupational class and industrial sector should be taken into account when tackling problems of work disability.
- sick leave
- socioeconomic status
- economic recession
- structural change
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Contributors EV-J obtained the data. SS and EV-J conceived the study. TL, SS, EV-J and KH-P designed the study. SS and TL prepared the data for analyses. TL conducted the statistical analyses. TL, SS, EV-J and KH-P contributed to interpretation of the results. TL wrote the first drafts of the article. TL, SS, EV-J and KH-P discussed and revised the drafts and prepared the final manuscript.
Funding This work was supported by the Academy of Finland (project numbers 267589 and 303534 to Viikari-Juntura), NordForsk (project number 76659 to Solovieva) and the Finnish Work Environment Fund (project number 115105 to Solovieva).
Competing interests None declared.
Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.
Ethics approval The researchers used fully anonymous register data. Research using such data does not need to undergo review by an ethics committee according to Finnish legislation. Statistics Finland linked its data to those of the Social Insurance Institution of Finland and the Finnish Centre for Pensions, after which the data were anonymised and stored by Statistics Finland. The researchers analysed the anonymous data using a remote access system. The output extracted from the system was approved by Statistics Finland to ensure compliance with data protection regulations. The data can only be accessed by the individual researchers who have obtained permission from each of the administrative sources providing the data.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Due to data protection regulations of the administrative sources providing the register data, the authors do not have the permission to share the data. Permissions to use the register data can be applied from the Social Insurance Institution of Finland (http://www.kela.fi/web/en/research-data-requests), the Finnish Centre for Pensions (http://www.etk.fi/en/statistics-2/statistics/producer-of-statistics/) and Statistics Finland (http://www.stat.fi/meta/tietosuoja/kayttolupa_en.html).
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