[Sore throats and streptococcal carriage in school children: an ecological study of absenteeism in Jerusalem schools].
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Adolescent↗
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[From regulated instruction to the open course principle. A suggestion for solving absenteeism tendencies using forensic medicine as an example].
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Attitude of Health Personnel↗
Thomas Ferrar, MB, LRCSI (1797-1837): the absentee professor of surgery at the Royal Belfast Academical Institution.
Thomas Ferrar was the second professor of surgery in the short-lived (1835-1849) medical school of the Royal Belfast Academical Institution. Appointed on 5 July 1836 he failed to turn up for the winter session and was accordingly discharged on 29 November. He died in Sligo in the following June aged 39. Nothing has been written about Ferrar who survives as a mere foot-note in Belfast medical history. The events leading to his dismissal are, however, unusual, equivocal, and worth recounting. The facts suggest that the Institution was clearly justified in its action but that Ferrar emerges with some credit for a certain if misplaced high-mindedness though overshadowed by his patent derelictions.
Academic Medical Centers↗
[Some occupational determinants of work disability].
Occupational determinants play a significant role in the studies of the causes of work disability. The duration of employment is that particular variable, frequently analysed, which reflects indirectly the effect of work conditions on the worker's health state and also on his her disease-related work disability. Therefore, the aim of this work was to show the difference in sick absenteeism between various occupational groups, depending on the duration of employment. The empirical material embraced data on work disability, among workers employed in the automative industry plant during the years 1989-94. Out of 8,599 persons covered with the study, 77% left the job, including 7% of those who left the job because of health problems. An analysis of the impact of occupational determinants on the sick absenteeism was carried out on the basis of the absenteeism rate adjusted by age, sex and occupational activity in groups of the production, auxilliary and administrative workers, as well as in occupational groups exposed to possibly similar harmful factors. The duration of worker's employment in the plant showed a positive influence on sick absenteeism, since together with extended period of employment the decrease in the rate of general sick absenteeism was observed. However, in a number of disease categories an increase in absenteeism together with extended duration of employment, and a high level of absenteeism among workers involved directly in the production, were noted. This proves an adverse effect of work conditions on work disability among workers. The effect of harmful factors present at workposts is also confirmed by the increasing sick absenteeism together with the prolonged duration of employment in various occupational groups. In the group of welders the highest level of sick absenteeism was observed among persons with duration of employment ranging from 11 to 20 years (rate: 10.52), and it was related to diseases of the respiratory (3.10) and circulatory (2.09) systems. In this group the increase in absenteeism together with prolonged duration of employment was related to diseases of the genitourinary system (about fourfold), musculoskeletal system (about threefold) and nervous system and sense organs (about 20%). It may be concluded that in selected high risk occupational groups, the duration of employment may reflect the effect of work conditions on workers' sick absenteeism, and the analysis of work disability caused by individual diseases provides an image of health effects due to hazards to which those groups are exposed.
Absenteeism↗
[Selected diseases of the spine and spinal cord as a cause of work disability].
Diseases of the musculo-skeletal and peripheral nervous systems has become one of the most serious health problems of the working population in Poland. They also make one third of the total sickness absenteeism. The analysis of the magnitude of temporary work disability due to diseases of the spine and spinal cord as well as changes observed over five recent years are presented. The reference material is derived from the national database on sickness absenteeism, covering a 17% random sample of punched cards of certified work disability. The sickness absenteeism is expressed by the number of work disability days per 100 persons employed in a given year. In 1955 the rheumatoid spine diseases proved to be the cause of 194 days of work disability per 100 employed and made 9% of the total sickness absenteeism. In the last five years sickness absenteeism due to these diseases have doubled. In rheumatoid pathologies of the spine, 50% of absenteeism was caused by discopathy. Among diseases of the peripheral nervous system, 78% of absenteeism was caused by diseases of nerve roots and plexus. During the period under discussion a 126% increase in absenteeism caused by these pathologies was noted and it applied mostly to males. In 1995 rheumatoid diseases of the spine as well as diseases of nerve roots and mostly plexus were the cause of 375 days of work disability per 100 employed what made 18% of the total sickness absenteeism. Sickness absenteeism due to these disease has increased by 134% over the last five years. The highest level and dynamics are observed among coal miners.
Absenteeism↗
[Statistical methodologic comments on epidemiologic work disability trends].
The term "epidemiological absenteeism trend"-especially as used in Germany-was defined by Wagner in 1977 and has since entered the sickness-absence discussion as an outcome indicator of medical rehabilitation. In its key concepts, the term refers to the fact that although there is a constant trend in absenteeism over time, individuals show changes in absenteeism from one measurement to the next. Evaluations of those individuals who have very high (or low) absence rates change to a higher degree than do those of individuals with mean scores on the absenteeism index; nevertheless, the summation of all deviations will be zero. In evaluating absence reduction due to rehabilitation, this fact must be considered. Because people who take part in medical rehabilitation show high absenteeism before they start its intervention, there will be--according to Wagner's absenteeism trend--a higher rate of reduction in sickness absence in the time following rehabilitation than there will be for people with medium scores. This paper investigates the hypothesis that the epidemiological absenteeism trend is identical with Galton's discovery--roughly 100 years before Wagner's definition--generally referred to as "reversion". Galton developed this term as the fundamental concept for regression and correlation. It can be shown that the absenteeism trend does not give a special description of sickness-absence but is rather the results of applying regression analysis. With the help of the statistical method of log linear modelling, a re-analysis of Wagner's data is performed in which the term epidemiological absenteeism trend is not necessary. In consequence, it is argued that this term should be abandoned or given a new meaning.
Absenteeism↗
[Temporary work disability in Poland--analysis of morbidity causes in the years 1985-1994].
Observation and analysis of sickness absenteeism, its morbidity causes, range and trends in certain periods of time, help to identify major health problems in the working population and the dynamic of changes. They also permit to anticipate the consequences reflected in permanent work disability. Certificates recording temporary work disability serve as a reference source for the analysis. The material under study comes from the national sickness absenteeism data base developed and managed by the Nofer Institute of Occupational Medicine in Lodz. It covers a 15-percent random sample of those cards. During the last decade, temporary work disability showed a rapidly growing tendency. During the years 1985-1994 mean annual rate of sickness absenteeism growth accounted for 6.4%, and since 1990 this rate has evidently increased reaching 10% per year. The rate of sickness absenteeism growth was considerably higher among males (9.8%) than among females (4.1%). The highest mean annual rates of growth were noted in absenteeism caused by diseases of the musculoskeletal system (33%--males; 15%--females), the nervous system (18%--males; 4% females) and the circulatory system (12% in general) including arterial hypertension (52%--males; 17% females). A differentiated trend in work disability due to individual disease categories observed during the analysed decade was responsible for changes in the structure of sick absenteeism noted in the same period. Thus, sickness absenteeism because of diseases of the respiratory system has decreased while diseases of the musculoskeletal system have contributed to its increase (at present they account for 18.2% in males and 15.4% in females), the same applies to diseases of the nervous system (17.2% in males) and to gynecological diseases (17.1% of female absenteeism). During the past five years a high dynamics of sickness absenteeism growth can be mostly attributed to a modified system of sickness allowances as well as to social and economic transformations, restructuring of industry and an increased unemployment in our country.
Absenteeism↗
Financial impact of a comprehensive multisite workplace health promotion program.
INTRODUCTION: The purpose of this study is to determine if the Washoe County School District Wellness Program impacted employee health care costs and rates of absenteeism over a 2-year period. METHODS: Outcome variables included health care costs and absenteeism during 2001-2002. Data were collected on 6246 employees over a 6-year period from 1997-2002. Baseline health claims costs and absenteeism from 1997-2000, age, gender, job classification, and years worked at the school district were treated as covariates. Logistic regression was used to compare 2-year costs and absenteeism rates between nonparticipants and employees who participated for 1 and 2 years. RESULTS: No significant differences in health care costs were found between those who participated in any of the wellness programs and those who did not participate. There was a significant negative association between participation and absenteeism; program participants averaged three fewer missed workdays than those who did not participate in any wellness programs. The decrease in absenteeism translated into a cost savings of 15.60 US dollars for every dollar spent on the program. CONCLUSIONS: After controlling for several confounding variables, wellness program participation was associated with large reductions in employee absenteeism.
Absenteeism↗
[Temporary working disability among younger patients with back pain and its interaction with severity of pain, functional capacity, social factors and personality styles].
The relationships between sick absenteeism and clinical measures were studied for a group of younger patients with chronic back pain (mean years of age for women and men were 41.7 and 42.2, respectively) who were sent to a rehabilitation programme. The duration of sick absenteeism during the last year as well as the momentary status of working ability were correlated with different clinical variables and personality styles. At the beginning of the rehabilitation program, the measure of functional capacity (FFbH-R, Kohlmann u. Raspe, 1996) showed the strongest correlation with temporary working disability (r = -.46) and duration of sick absenteeism during the last year (r = -.44). The severity of pain showed a lower but significant correlation with temporary working disability (r =.24) and duration of sick absenteeism (r =.25). In contrast, depression, vitality and age did not show significant correlations with temporary working disability at the beginning of the rehabilitation. In addition, some of the personality styles from the PSSI (Kuhl u. Kazén, 1997) showed significant correlations with temporary working disability and duration of sick absenteeism. When entering the variables into regression analyses, the measure of functional capacity was the most important predictor of sick absenteeism. Severity of pain, depression, vitality and age did not significantly add to the variance accounted for. In contrast, distinct personality styles from the PSSI significantly contributed to an additional proportion of variance in sick absenteeism and temporary working disability. At the end of the rehabilitation program, there were stable relationships between temporary working disability and functional capacity (r = -.45) as well as severity of pain (r =.39). In, correlations between temporary working disability and depression (r =.30) and vitality (r = -.19) were significant. This was due to the stronger improvement during therapy among patients who were able to work compared to patients who were not.
Absenteeism↗
[Accidents and their health effects in firemen of rescue and firefighting teams].
Accidents, traumas and poisoning are the most frequent causes of health impairments among firemen, determined by the nature of their occupation. Their work is directly related with the exposure to various harmful chemical and physical factors, involving at the same time mental stress during rescue and firefighting actions. The aim of the analysis performed was to determine the accident rate, range and causes of accident-related absenteeism among firemen of the rescue and firefighting brigades, as well as to indicate major traumas resulting from accidents at work. The study was carried out in a group of 1503 firemen (7% of the total number of firemen in Poland) employed in the rescue and firefighting brigades, selected at random throughout the country. Workers' personal data, as well as the data on the number of accidents and the number of days of work disability during the years 1994-97 were analysed. Accidents and accident-related absenteeism by age, certified causes and sites (body parts) of traumas were also analysed using the following parameters: the accident rate (the number of accidents per 1000 workers), accident severity rate (the number of work disability days per one accident), and absenteeism rate (the number of accident-related work disability days per 100 employed). In the period under study (1994-97) 352 accidents, involving 301 persons were registered. Thus, the accident rate was 70.3. These accidents were responsible for the period of work disability three times higher (293.5 days/100 workers) than that observed in the male population employed in the national economy, and eight times higher (770.2 days/100 workers) in the 50-59 age group. Dislocations and distortions were the most frequent causes of accident-related absenteeism--48, whereas fractures occupied the second place--25%. Burns were classified among the most severe injuries, resulting in more than 90 days of absenteeism annually, but they made only 7% of absenteeism with frequency rate of 2.2/1000. Legs, ankles and feet were the most frequent sites of injuries (60% of accidents with 170.2 days of absenteeism per 100 workers) which may be of significance in preventing hazards occurring in this occupational group.
Absenteeism↗
[Work disability in certain occupations among workers in the electronics industry].
Occupational and working environment factors have always occupied an important place in studies on sickness absenteeism. The study performed during the years 1987-1988 in two electronic industry plants involved such elements of the working environment as the place of a worker in the production process and the occupation performed. Our analysis was aimed at indicating differences in the temporary work disability, in particular due to some groups of diseases, between occupations essential for the manufacturing process. The frequency of sickness absenteeism in general and due to main groups of diseases expressed in terms of percentage of sick persons with temporary work disability was analysed. The Chi 2 test was used to determine the relationship between individual groups. The analysis of sickness absenteeism in individual groups was performed according to sex and age. The analysis allowed to indicate groups of workers with increased risk of sickness absenteeism in the plants under study. They are mostly workers involved in the basic production and in chemical processes. Sickness absenteeism of those workers was higher than the average by 26% in Plant I and by 33% in Plant II. The highest sickness absenteeism rate for that group was due to diseases of the nervous system--71%; the gastrointestinal system--46%; and the musculo-skeletal system--81%. The relationship between the occurrence of sickness absenteeism and the type of activity was statistically significant (p < 0.05) in both Plants but in relation to selected groups of occupation it was significant only in Plant I.
Absenteeism↗
Analysis of job satisfaction, burnout, and intent of respiratory care practitioners to leave the field or the job.
BACKGROUND: Increased stress, burnout, and lack of job satisfaction may contribute to a decline in work performance, absenteeism, and intent to leave one's job or field. We undertook to determine organizational, job-specific, and personal predictors of level of burnout among respiratory care practitioners (RCPs). We also examined the relationships among burnout, job satisfaction (JS), absenteeism, and RCPs' intent to leave their job or the field. METHODS: A pilot-tested assessment instrument was mailed to all active NBRC-credentialed RCPs in Georgia (n = 788). There were 458 usable returns (58% response rate). A random sample of 10% of the nonrespondents (n = 33) was then surveyed by telephone, and the results were compared to those of the mail respondents. Variables were compared to burnout and JS scores by correlational analysis, which was followed by stepwise multiple regression analyses to determine the ability of the independent variables to predict burnout and JS scores when used in combination. RESULTS: There were no significant differences between respondents and sampled nonrespondents in burnout scores (p = 0.56) or JS (p = 0.24). Prediction of burnout: The coefficient of multiple correlation, R2, indicated that in combination the independent variables accounted for 61% of the variance in burnout scores. The strongest predictor of burnout was job stress. Other job-related predictors of burnout were size of department, satisfaction with work, satisfaction with co-workers and co-worker support, job independence and job control, recognition by nursing, and role clarity. Personal-variable predictors were age, number of previous jobs held, social support, and intent to leave the field of respiratory care. Prediction of job satisfaction: R2 indicated that, in combination, the independent variables accounted for 63% of the variance observed in satisfaction with work, 36% of the variance observed in satisfaction with pay, 36% of the variance in satisfaction with promotions, 62% of the variance in satisfaction with supervision, and 48% of the variance in satisfaction with co-workers. Predictors of work-satisfaction level were recognition by physicians and nursing, age, burn-out level, absenteeism, and intent to leave the field. Predictors of level of satisfaction with pay were actual salary, job independence, organizational climate, ease of obtaining time off, job stress, absenteeism, intent to leave the field, and number of dependent children. Predictors of level of satisfaction with promotions were recognition by nursing, participation in decision making, job stress, intent to leave the field, past turnover rates, and absenteeism. Predictors of level of satisfaction with supervision included supervisor support, role clarity, independence, and ease of obtaining time off. The strongest predictor of level of satisfaction with co-workers was co-worker support. As overall level of JS increased, level of burnout decreased significantly (r = -0.59, p less than 0.001). As burnout level increased, increases occurred in absenteeism (r = 0.22, p less than 0.001), intent to leave the job (r = 0.48, p less than 0.001), and intent to leave the field (r = 0.51, p less than 0.001). CONCLUSIONS: Reduced job stress, increased job independence and job control, improved role clarity, and higher levels of JS were all associated with lower levels of burnout. Managerial attention to these factors may improve patient care and reduce absenteeism and turnover among RCPs.
Analysis of Variance↗
A cross-sectional analysis of work-related outcomes in adults with asthma.
BACKGROUND: Asthma is a disease with physical symptoms that can impair a person's functioning to the point of interfering with school, work, and social activities. OBJECTIVE: Describe how disease (asthma) and patient characteristics affect perceived work performance and absenteeism. METHODS: Using a cross-sectional study design, 369 adults with asthma from a managed care organization responded to a mailed questionnaire which included a perceived work performance scale (WPS) and an item assessing absenteeism. Analysis consisted of psychometric testing of the scale (internal consistency and construct validity); trend observation of influence of perceived and symptom-derived severity on WPS and absenteeism distribution; and regression analysis to examine the relationship between patient/disease characteristics and the work-related outcomes. RESULTS: The mean WPS score was 88.0 +/- 16.2 (of a possible 100), with a Cronbach's alpha of 0.79. Most respondents (84.7%) did not miss any work in the previous 4 weeks. WPS scores declined and the percentage of respondent absenteeism increased as perceived and symptom-derived severity worsened. The regression model for WPS produced an adjusted R2 of 0.32 and included the number of other illnesses, health beliefs, race, income, and perceived and symptom-derived asthma severity. The regression model for absenteeism included number of other illnesses, race, health beliefs, and symptom-derived severity. Perceived work performance and absenteeism are outcomes measures that are distinctive and complementary. CONCLUSIONS: Disease severity, race, income, and health beliefs also contribute and should be considered in health services research related to asthma.
Absenteeism↗
Occupational stress, physician-excused absences, and absences not excused by a physician.
PURPOSE: This study explores two possible mechanisms through which occupational stress is linked to absenteeism. The extent to which physician-excused absenteeism and absenteeism not excused by a physician are related to employee reports of perceived stress is assessed. DESIGN: A plant wide survey was conducted in January 1990. Employee reports of occupational stress gained from this survey were linked with 1990 absenteeism data from the employees' records. SETTING: A mid-sized manufacturing plant. SAMPLE: Complete data were available for 998 of the 1534 (65%) unionized employees in the plant. MEASURES: Measures of both physician-excused absences and absences not excused by a physician were created. Stressors included role ambiguity, lack of control over work pace, and being paid on a piece-rate basis. Perceived stresses included role conflict, physical environment stresses, and overall work stress. RESULTS: For physician-excused absenteeism, role conflict (OR, 1.54, p < .01), overall work stress (OR, 1.24, p < .05), and physical environment stress (OR, 1.34, p < .05) had significantly elevated odds ratios, even after adjusting for demographics. For absences not excused by a physician, none of the stressors or stresses had significant odds ratios after controlling for demographic characteristics. CONCLUSIONS: Employees in this plant were not using short-term voluntary absenteeism as a way of coping with work stress. However, high levels of perceived work stress were associated with subsequent physician-excused absences.
Absenteeism↗
Why nurses are calling in sick: the impact of health-care restructuring.
Absenteeism among registered nurses is a major concern for employers; it is costly and results in decreased standards of care. Despite the international interest in and research on absenteeism, there is relatively little cumulative knowledge regarding its determinants. This quantitative, non-experimental study profiled the reasons for absenteeism in a random sample of 2,000 front-line nurses in the Canadian province of Saskatchewan. Absence was defined as time away from work excluding holidays, strike, or layoff. Major causes of absenteeism were identified, including minor ailment and fatigue related to work overload. A total of 450 respondents had seriously considered leaving the nursing profession, with 50.4% citing overwork and stress as the primary causes. Higher rates of absenteeism were found to be associated with lower job satisfaction, longer shifts, working in acute care, and working full-time. Moderate job dissatisfaction was found to be associated with longer shifts and working in acute care. In light of the current nursing shortage, strategies for reducing absenteeism and increasing job satisfaction are warranted.
Absenteeism↗
Benefits and limitations of the Witwatersrand influenza and acute respiratory infections surveillance programme.
OBJECTIVE: To establish an ongoing active surveillance programme for acute respiratory infections in general, and influenza in particular. DESIGN: A network of 16 sentinel primary health care providers furnished morbidity information and clinical specimens for virus characterisation supplemented by school absenteeism and regional mortality data. SETTING: General practices, hospital outpatient departments and staff clinics in the Witwatersrand area. PARTICIPANTS: Subjects treated for acute respiratory infections by 7 general practitioners, 1 specialist pulmonologist, 4 paediatric outpatient departments, 1 mine hospital and university, factory and institutional staff clinics. Absenteeism data were obtained from 8 primary and 6 high schools in the region (representing 9,000 pupils). OUTCOME MEASURES: Morbidity information and strain characterisation of influenza isolates as well as other viral respiratory pathogens, school absenteeism, seasonal excess mortality. RESULTS: The most sensitive indicator of influenza activity was virus isolation, which gives an earlier warning signal of an impending epidemic than morbidity or absenteeism parameters. Both morbidity and school absenteeism provided quantitative indicators of the severity of the epidemic. Mortality from all causes showed characteristic winter increases in the 65-year-old and older population which were not seen in younger individuals. Circulating influenza viral strains matched the strains recommended for the vaccine in 1991 and 1992, but not in 1993. CONCLUSIONS: The course and extent of the annual winter influenza epidemic can be charted by means of an active surveillance programme, with sentinel primary health care providers furnishing morbidity data and clinical material from which virus isolations can be made. Antigenic characterisation of the isolates demonstrated that circulating strains may not match recommended strains in northern hemisphere-formulated vaccines and stresses the need for a southern hemisphere vaccine formulation for South Africa. Absenteeism information provides an indicator of the impact of influenza on the economy and excess mortality data emphasise the need for routine immunisation of the elderly.
Absenteeism↗
Can a handwashing intervention make a difference? Results from a randomized controlled trial in Jerusalem preschools.
BACKGROUND: Preschools are often focal points for the spread of illness among young children. The objective of this preschool intervention trial was to determine whether a hygiene program can promote handwashing and thereby reduce illness absenteeism. METHODS: This cluster randomized trial included 40 Jerusalem preschools with 1029 children for 6 baseline days and 66 study days, yielding 73,779 child days. The main outcomes were rates of handwashing and illness absenteeism. The intervention included an educational program and environmental changes. A simultaneous subtrial was run to test a home component. RESULTS: This multi-site intervention program produced sustained behavioral and environmental changes over a 6-month period. An approximately threefold increase in handwashing with soap was observed among preschool children exposed to the intervention. Neither the preschool nor the home intervention program reduced illness absenteeism or overall absenteeism. CONCLUSIONS: This trial illuminates the potential of the preschool as a promising venue for health promotion activities leading to sustained behavioral change, yet suggests the need for enhanced approaches for reducing illness absenteeism.
Absenteeism↗
Morbidity and psycho-social reasons for absence among high school students in Holon, Israel.
Absence of children from school for either health or social reasons, can serve as a parameter for general well-being. Minimal school absence rates reflect a good physical and psycho-social status. The present survey compares the rate of absenteeism as a result of various diseases among 972 adolescent pupils in a high school. The average absenteeism of a pupil during the year is 8.67 +/- 2.93 days. Medical circumstances responsible for absenteeism are discussed. The incidence of absenteeism in chronic diseases is 5.5 times greater than that of healthy children. The ratio of absence caused by medical reasons decreases with maturity, probably as a result of increasing efficiency in coping with the diseases together with stronger motivation for studies. The school physician cognizant of pupil absenteeism can fulfil a valuable role in the early recognition and treatment of psychosocial pathologies.
Absenteeism↗