On Methodologies for Analysing Sickness Absence Data: An Insight into a New Method
Sickness absence represents a major economic and
social issue. Analysis of sick leave data is a recurrent challenge to analysts because of the complexity of the data structure which is
often time dependent, highly skewed and clumped at zero. Ignoring these features to make statistical inference is likely to be inefficient
and misguided. Traditional approaches do not address these problems. In this study, we discuss model methodologies in terms of statistical techniques for addressing the difficulties with sick leave data. We also introduce and demonstrate a new method by performing a longitudinal assessment of long-term absenteeism using
a large registration dataset as a working example available from the Helsinki Health Study for municipal employees from Finland during the period of 1990-1999. We present a comparative study on model
selection and a critical analysis of the temporal trends, the occurrence
and degree of long-term sickness absences among municipal employees. The strengths of this working example include the large
sample size over a long follow-up period providing strong evidence in supporting of the new model. Our main goal is to propose a way to
select an appropriate model and to introduce a new methodology for analysing sickness absence data as well as to demonstrate model
applicability to complicated longitudinal data.
[1] D. Gimeno, F.G. benavides, J. Benach and B.C. Mick III, "Distribution
of sickness ansence on the European Union countries". Occupational
and Environmental Medicine, vol 61, pp867-869, 2004.
[2] S. Taimela, E. L├ñ├ñr├ñ, A. Malmivaara, J. Tiekso, H. Sintonen, S. Justén
and T. Aro, "Self-reported health problems and sickness absence in
different age groups predominantly engaged in physical work",
Occupational and Environmental Medicine, vol 64, no 11, pp739-746,
nov. 2007.
[3] K. Kondo, Y. Kobayashi, K. Hirokawa, A. Tsutsumi, F. Kobayashi, T.
Haratani, S. Araki and N. Kawakami, "Job strain and sick leave among
Japanese employees: a longitudinal study", Int Arch Occup Environ
Health., vol. 79, no 3, pp213-219, mar. 2006.
[4] M.L. Nielsen, R. Rugulies, L. Smith-Hansen, K.B. Christensen and T.S.
Kristensen, "Psychosocial work environment and registered absence
from work: estimating the etiologic fraction", Am J Ind Med., vol 49, no
3, pp187-196, mar. 2006a.
[5] M.L. Nielsen, R. Rugulies, K.B. Christensen, L. Smith-Hansen and T.S.
Kristensen, "Psychosocial work environment predictors of short and
long spells of registered sickness absence during a 2-year follow up", J
Occup Environ Med., vol 48, no 6, 591-598,jun. 2006b.
[6] J. Head, M. Kivimaki, P. Martikainen, J. Vahtera, J.E. Ferrie and M.G.
Marmot, "Influence of change in psychosocial work characteristics on
sickness absence: The Whitehall II Study", J Epidemiol Community
Health, vol 60, no 1, pp55-61, jan. 2006.
[7] A. Notenbomer, C.A. Roelen and J.W. Groothoff, "Job satisfaction and
short-term sickness absence among Dutch workers", Occup Med
(Lond), vol. 56, no 4, pp279-81, jun. 2006.
[8] C.A. Schroer, M. Janssen, L.G. van Amelsvoort, H. Bosma, G.M.
Swaen, F.J. Nijhuis and J. van Eijk, "Organizational characteristics as
predictors of work disability: a prospective study among sick employees
of for-profit and not-for-profit organizations", J Occup Rehabil, vol 15,
no 3, pp435-445, sep. 2005.
[9] L-G. Engström and T. Eriksen, "Can differences in benefit levels
explain duration and outcome of sickness absence?", Disability and
rehabilitation, vol. 24, no 14, pp713-718, sep. 2002.
[10] M. Goldberg, J. F. Chastang, A. Leclerc, M. Zins, S. Bonenfant, I.
Bugel, N. Kaniewski, A. Schmaus, I. Niedhammer, M. Piciotti, A.
Chevalier, C. Godard, and E. Imbernon, "Socioeconomic, Demographic,
Occupational, and Health Factors Associated with Participation in a
Long-term Epidemiologic Survey: A Prospective Study of the French
GAZEL Cohort and Its Target Population", American Journal of
Epidemiology, vol 154, no. 4, pp373-384, 2002.
[11] P. Kristensen, T. Bjerkedal and L.M. Irgens, "Early life determinants of
musculoskeletal sickness absence in a cohort of Norwegians born in
1967-1976", Social Science & Medicine, vol 64 no 3, pp646-655, feb.
2007.
[12] J. Sundquist, A. Al-Windi, S-E. Johansson and K. Sundquist, "Sickness
absence poses a threat to the Swedish Welfare State: a cross-sectional
study of sickness absence and self-reported illness", BMC public health,
vol 7, pp45, jan. 2007
[13] M. Hansson, C. Boström and K. Harms-Ringdahl, "Sickness absence
and sickness attendanceÔÇöWhat people with neck or back pain think?",
Social Science & Medicine, vol. 62, no 9, pp2183-2195, 2006.
[14] A. Burdorf and J.P. Jansen, "Predicting the long term course of low
back pain and its consequences for sickness absence and associated
work disability", Occup Environ Med., vol. 63, no 8, pp522-529. aug.
2006.
[15] A. Torres Lana, A. Cabrera de León, M.T. Marco García and A.
Aguirre Jaime, "Smoking and sickness absence among public health
workers", Public Health, vol 19, no 2, pp144-149, 2005.
[16] W. Jzelenberg and A. Burdorf, "Risk factors for musculoskeletal
symptoms and ensuing health care use and sick leave", Spine, vol 30, no
13, pp1550-1556, 2005.
[17] E. L Horneij, I. B Jensen, E. B Holmström and C. Ekdahl, "Sick leave
among home-care personnel: a longitudinal study of risk factors", BMC
Musculoskelet Disord, vol. 5, no 38.. 8. doi: 10.1186/1471-2474-5-38,
2004.
[18] W.N. Burton, C.Y. Chen, A.B. Schultz and D.W. Edington, "The
economic costs associated with body mass index in a workplace",
Journal of Occupational and Environmental Medicine, vol 40, no 9, pp786-792, 1998.
[19] P. Lundborg, "Does smoking increase sick leave? Evidence using
register data on Swedish workers", Tobacco Control, vol 16, pp114-118, 2007.
[20] J. Vahtera, K. Poikolainen, M. Kivimäki, L. Ala-Mursula and J. Pentti,
"Alcohol Intake and Sickness Absence: A Curvilinear Relation", Am. J.
Epidemiol., vol 156, pp969 - 976, nov. 2002.
[21] M. Labriola, T. Lund and H. Burr, "Prospective study of physical and
psychosocial risk factors for sickness absence", Occup Med (Lond), vol
56, no 7, pp469-474, oct. 2006.
[22] P. Allebeck and A. Mastekaasa, "Risk factors for sick leave -general
studies", Scand J Public Health, vol 32, Suppl 63, pp49-108, 2004.
[23] K. Piha, P. Martikainen, O. Rahkonen, E. Roos and E. Lahelma,
"Trends in socioeconomic differences in sickness absence among
Finnish municipal employees 1990-99", Scandinavian Journal of Public
Health, vol. 35, pp348-355, 2007.
[24] L.T. Yen, D.W. Edington and P. Witting, "Prediction of prospective
medical claims and absenteeism costs for 1284 hourly workers from a
manufacturing company", J Occup Med, vol 34, no 4, pp428-435, 1992.
[25] P.G. Smulders and F.J.N. Nijhuis, "The job demands--job control model
and absence behaviour: results of a 3-year longitudinal study", Work &
Stress, vol 13, pp115-131, 1999.
[26] M. Kivimaki, J. Vahtera, L. Thomson, A. Griffith, T. Cox, J. Pentti,
"Psychosocial factors predicting employee sickness absence during
economic decline", J Appl Psychol., vol 82, pp858-872, 1997.
[27] V. Kujala, T. Tammelin, J. Remes, E.E. Vammavaara and J. Laitinen,
"Work ability index of young employees and their sickness absence
during the following year", Scand J Work Environ Health., vol 32, vol
1, 75-84, feb. 2006.
[28] N. Duan, W.G. Manning, C.N. Morris and J.P. Newhouse, "A
comparison of alternative models for demand for medical care", Journal
of Economic and Business Statistics, vol 1, pp115-126, 1983.
[29] W. Manning, N. Duan and W. Rogers, "Monte Carlo evidence on the
choice between sample selection and two-part models", Journal of
Econometrics, vol 35, pp59-82, 1987.
[30] G.K. Grunwald and R.H. Jones, "Markov models for time series with
mixed distribution", Environmetrics, vol 11, pp327-329, 2000.
[31] P. Lachenbruch, "Utility if regression analysis in epidemiologic studies
of the elderly", in The epidemiologic study of the elderly, R. Wallace
and E. Woolson eds. Oxford University Press, 1992, pp. 371-381.
[32] J.A. Tooze, G.K. Grunwald and R.H. Jones, "Analysis of repeated
measures data with clumping at zero", Statistical Methods in Medical
Research, vol 11, pp341-355, 2002.
[33] H. Akaike, "Information theory as an extension of the maximum likelihood principle", in B.N. Petrov and F. Csaksi, ed. 2nd International Symposium on Information Theory. Akademiai Kiado,
Budapest, Hungary. 1973, pp 267-281.
[1] D. Gimeno, F.G. benavides, J. Benach and B.C. Mick III, "Distribution
of sickness ansence on the European Union countries". Occupational
and Environmental Medicine, vol 61, pp867-869, 2004.
[2] S. Taimela, E. L├ñ├ñr├ñ, A. Malmivaara, J. Tiekso, H. Sintonen, S. Justén
and T. Aro, "Self-reported health problems and sickness absence in
different age groups predominantly engaged in physical work",
Occupational and Environmental Medicine, vol 64, no 11, pp739-746,
nov. 2007.
[3] K. Kondo, Y. Kobayashi, K. Hirokawa, A. Tsutsumi, F. Kobayashi, T.
Haratani, S. Araki and N. Kawakami, "Job strain and sick leave among
Japanese employees: a longitudinal study", Int Arch Occup Environ
Health., vol. 79, no 3, pp213-219, mar. 2006.
[4] M.L. Nielsen, R. Rugulies, L. Smith-Hansen, K.B. Christensen and T.S.
Kristensen, "Psychosocial work environment and registered absence
from work: estimating the etiologic fraction", Am J Ind Med., vol 49, no
3, pp187-196, mar. 2006a.
[5] M.L. Nielsen, R. Rugulies, K.B. Christensen, L. Smith-Hansen and T.S.
Kristensen, "Psychosocial work environment predictors of short and
long spells of registered sickness absence during a 2-year follow up", J
Occup Environ Med., vol 48, no 6, 591-598,jun. 2006b.
[6] J. Head, M. Kivimaki, P. Martikainen, J. Vahtera, J.E. Ferrie and M.G.
Marmot, "Influence of change in psychosocial work characteristics on
sickness absence: The Whitehall II Study", J Epidemiol Community
Health, vol 60, no 1, pp55-61, jan. 2006.
[7] A. Notenbomer, C.A. Roelen and J.W. Groothoff, "Job satisfaction and
short-term sickness absence among Dutch workers", Occup Med
(Lond), vol. 56, no 4, pp279-81, jun. 2006.
[8] C.A. Schroer, M. Janssen, L.G. van Amelsvoort, H. Bosma, G.M.
Swaen, F.J. Nijhuis and J. van Eijk, "Organizational characteristics as
predictors of work disability: a prospective study among sick employees
of for-profit and not-for-profit organizations", J Occup Rehabil, vol 15,
no 3, pp435-445, sep. 2005.
[9] L-G. Engström and T. Eriksen, "Can differences in benefit levels
explain duration and outcome of sickness absence?", Disability and
rehabilitation, vol. 24, no 14, pp713-718, sep. 2002.
[10] M. Goldberg, J. F. Chastang, A. Leclerc, M. Zins, S. Bonenfant, I.
Bugel, N. Kaniewski, A. Schmaus, I. Niedhammer, M. Piciotti, A.
Chevalier, C. Godard, and E. Imbernon, "Socioeconomic, Demographic,
Occupational, and Health Factors Associated with Participation in a
Long-term Epidemiologic Survey: A Prospective Study of the French
GAZEL Cohort and Its Target Population", American Journal of
Epidemiology, vol 154, no. 4, pp373-384, 2002.
[11] P. Kristensen, T. Bjerkedal and L.M. Irgens, "Early life determinants of
musculoskeletal sickness absence in a cohort of Norwegians born in
1967-1976", Social Science & Medicine, vol 64 no 3, pp646-655, feb.
2007.
[12] J. Sundquist, A. Al-Windi, S-E. Johansson and K. Sundquist, "Sickness
absence poses a threat to the Swedish Welfare State: a cross-sectional
study of sickness absence and self-reported illness", BMC public health,
vol 7, pp45, jan. 2007
[13] M. Hansson, C. Boström and K. Harms-Ringdahl, "Sickness absence
and sickness attendanceÔÇöWhat people with neck or back pain think?",
Social Science & Medicine, vol. 62, no 9, pp2183-2195, 2006.
[14] A. Burdorf and J.P. Jansen, "Predicting the long term course of low
back pain and its consequences for sickness absence and associated
work disability", Occup Environ Med., vol. 63, no 8, pp522-529. aug.
2006.
[15] A. Torres Lana, A. Cabrera de León, M.T. Marco García and A.
Aguirre Jaime, "Smoking and sickness absence among public health
workers", Public Health, vol 19, no 2, pp144-149, 2005.
[16] W. Jzelenberg and A. Burdorf, "Risk factors for musculoskeletal
symptoms and ensuing health care use and sick leave", Spine, vol 30, no
13, pp1550-1556, 2005.
[17] E. L Horneij, I. B Jensen, E. B Holmström and C. Ekdahl, "Sick leave
among home-care personnel: a longitudinal study of risk factors", BMC
Musculoskelet Disord, vol. 5, no 38.. 8. doi: 10.1186/1471-2474-5-38,
2004.
[18] W.N. Burton, C.Y. Chen, A.B. Schultz and D.W. Edington, "The
economic costs associated with body mass index in a workplace",
Journal of Occupational and Environmental Medicine, vol 40, no 9, pp786-792, 1998.
[19] P. Lundborg, "Does smoking increase sick leave? Evidence using
register data on Swedish workers", Tobacco Control, vol 16, pp114-118, 2007.
[20] J. Vahtera, K. Poikolainen, M. Kivimäki, L. Ala-Mursula and J. Pentti,
"Alcohol Intake and Sickness Absence: A Curvilinear Relation", Am. J.
Epidemiol., vol 156, pp969 - 976, nov. 2002.
[21] M. Labriola, T. Lund and H. Burr, "Prospective study of physical and
psychosocial risk factors for sickness absence", Occup Med (Lond), vol
56, no 7, pp469-474, oct. 2006.
[22] P. Allebeck and A. Mastekaasa, "Risk factors for sick leave -general
studies", Scand J Public Health, vol 32, Suppl 63, pp49-108, 2004.
[23] K. Piha, P. Martikainen, O. Rahkonen, E. Roos and E. Lahelma,
"Trends in socioeconomic differences in sickness absence among
Finnish municipal employees 1990-99", Scandinavian Journal of Public
Health, vol. 35, pp348-355, 2007.
[24] L.T. Yen, D.W. Edington and P. Witting, "Prediction of prospective
medical claims and absenteeism costs for 1284 hourly workers from a
manufacturing company", J Occup Med, vol 34, no 4, pp428-435, 1992.
[25] P.G. Smulders and F.J.N. Nijhuis, "The job demands--job control model
and absence behaviour: results of a 3-year longitudinal study", Work &
Stress, vol 13, pp115-131, 1999.
[26] M. Kivimaki, J. Vahtera, L. Thomson, A. Griffith, T. Cox, J. Pentti,
"Psychosocial factors predicting employee sickness absence during
economic decline", J Appl Psychol., vol 82, pp858-872, 1997.
[27] V. Kujala, T. Tammelin, J. Remes, E.E. Vammavaara and J. Laitinen,
"Work ability index of young employees and their sickness absence
during the following year", Scand J Work Environ Health., vol 32, vol
1, 75-84, feb. 2006.
[28] N. Duan, W.G. Manning, C.N. Morris and J.P. Newhouse, "A
comparison of alternative models for demand for medical care", Journal
of Economic and Business Statistics, vol 1, pp115-126, 1983.
[29] W. Manning, N. Duan and W. Rogers, "Monte Carlo evidence on the
choice between sample selection and two-part models", Journal of
Econometrics, vol 35, pp59-82, 1987.
[30] G.K. Grunwald and R.H. Jones, "Markov models for time series with
mixed distribution", Environmetrics, vol 11, pp327-329, 2000.
[31] P. Lachenbruch, "Utility if regression analysis in epidemiologic studies
of the elderly", in The epidemiologic study of the elderly, R. Wallace
and E. Woolson eds. Oxford University Press, 1992, pp. 371-381.
[32] J.A. Tooze, G.K. Grunwald and R.H. Jones, "Analysis of repeated
measures data with clumping at zero", Statistical Methods in Medical
Research, vol 11, pp341-355, 2002.
[33] H. Akaike, "Information theory as an extension of the maximum likelihood principle", in B.N. Petrov and F. Csaksi, ed. 2nd International Symposium on Information Theory. Akademiai Kiado,
Budapest, Hungary. 1973, pp 267-281.
@article{"International Journal of Information, Control and Computer Sciences:56062", author = "Xiaoshu Lu and Päivi Leino-Arjas and Kustaa Piha and Akseli Aittomäki and Peppiina Saastamoinen and Ossi
Rahkonen and Eero Lahelma", title = "On Methodologies for Analysing Sickness Absence Data: An Insight into a New Method", abstract = "Sickness absence represents a major economic and
social issue. Analysis of sick leave data is a recurrent challenge to analysts because of the complexity of the data structure which is
often time dependent, highly skewed and clumped at zero. Ignoring these features to make statistical inference is likely to be inefficient
and misguided. Traditional approaches do not address these problems. In this study, we discuss model methodologies in terms of statistical techniques for addressing the difficulties with sick leave data. We also introduce and demonstrate a new method by performing a longitudinal assessment of long-term absenteeism using
a large registration dataset as a working example available from the Helsinki Health Study for municipal employees from Finland during the period of 1990-1999. We present a comparative study on model
selection and a critical analysis of the temporal trends, the occurrence
and degree of long-term sickness absences among municipal employees. The strengths of this working example include the large
sample size over a long follow-up period providing strong evidence in supporting of the new model. Our main goal is to propose a way to
select an appropriate model and to introduce a new methodology for analysing sickness absence data as well as to demonstrate model
applicability to complicated longitudinal data.", keywords = "Sickness absence, longitudinal data, methodologies, mix-distribution model.", volume = "2", number = "5", pages = "1497-6", }
