Objective We aimed to investigate the influence of unobserved individual characteristics in explaining the effects of work-related factors on full (fSA) and part-time sickness absence (pSA). MethodsWe used register-based panel data for the period 2005-2016 on a 70% random sample of the Finnish working-age population. The relationships between employment sector and occupational exposures (% exposed to physically heavy work and job control score based on job exposure matrices) and the annual onset of fSA and pSA were investigated among men and women. First, random effects (RE) models were applied controlling for observed sociodemographic factors and then fixed effects (FE) models that examine within-individual changes over time and thereby further account for unobserved time-invariant individual characteristics. ResultsIn the RE analyses, public employment sector, physically heavy work and lower job control each increased the use of fSA and pSA among both genders. When unobserved individual characteristics were controlled for with the FE models, the effects on fSA attenuated. For pSA, the effects of employment sector and physical heaviness of work among women even reversed. The effect of lower job control on pSA remained especially among women. ConclusionsThe role of individuals' unobserved characteristics in explaining the effects of work-related factors on SA should not be neglected. The effects of work-related factors are likely to be overestimated when using traditional approaches that do not account for unobserved confounding, ie, selection of individuals with a high likelihood of SA into particular work environments.

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representative subject from each section using personal environmental monitor (SKC, USA). We evaluated lung functions of all workers using pneumotach sensor based Spirovit SP-1 (Schiller). Statistical analysis was performed with SPSS v26.0. The study was approved by Institutional Ethics Committee and funded by the Institute. Results Compared to respective international recommended limits, average personal exposure to PM4 was relatively high in spray drying (8 hour time weighted average -28.9 mg/m3) and ball milling (8 hour TWA -7.12 mg/m3) sections; whereas average respirable crystalline silica was higher in spray drying section only (0.08 mg/m3 TWA). We observed abnormal lung functions (obstructive/restrictive) in 17% workers. We found significant deteriorated spirometry measurements in workers as compared to administrative staff. Duration of job was associated with compromised spirometry measurements. Conclusion It is evident that ceramic tile workers have higher than recommended exposure to PM4 and crystalline silica at workplace and high prevalence of abnormal lung functions. Proper implementation of industrial hygiene for containing workplace dust and periodic screening programmes of workers for early detection of pulmonary compromise is recommended in ceramic tile industry.

Objectives The use of part-time sickness absence (pSA) instead of full-time sickness absence (fSA) is known to increase work participation. Yet, its effect on the total length of working lives remains unclear. We carried out a quasi-experiment to assess the impact of using pSA versus fSA on the length of working lives. MethodsWe used a register-based 70% random sample of the working-age population living in Finland on 31 December 2007 to (i) form propensity-score-matched groups of users of pSA and fSA and (ii) calculate their working life expectancy (WLE) and working years lost (WYL). We applied the Sullivan method based on daily measured time spent at work and other labor market statuses, followed up over a four-year period until the end of year 2017. The study population consisted of private and public sector employees with SA due to mental and musculoskeletal disorders, ie, the diagnostic groups where pSA has been primarily used. ResultsAmong both genders, the pSA group had a significantly higher WLE at age 30 than the fSA group, with larger differences seen in mental disorders compared to musculoskeletal diseases and in the private versus public sector. Overall, the pSA group had fewer WYL due to unemployment and disability retirement but more expected years working with partial disability benefits than the fSA group. ConclusionsBased on beneficial working career effects, the use of pSA instead of fSA should always be recommended for persons with mental or musculoskeletal disorders where feasible.

Background Information on factors driving work disability trends helps to evaluate the potential of interventions to improve the health and work ability of the workforce. We assessed whether the long-term decrease in sickness absences in Finland is explained by observed and unobserved compositional changes in the workforce. Methods Utilising register-based panel data on Finnish private and public sector employees aged 30-62, we examined the annual onset of compensated full sickness absence (granted after 10 working days) in the period 2005-2016. We applied random effects models adjusting for changes in observed sociodemographic factors of the study population. We also applied fixed effects models, with corrections of the estimates for cohort ageing, to additionally account for unobserved time-invariant characteristics of the study population over the years. Results Of the observed factors, increases in educational level partly explained the decreasing trend in sickness absences, and more so among women than men and among private than public sector employees. Changes in occupational class and industrial sector played little role in the public sector and only slightly further explained the sickness absence trend in the private sector. The decreasing trend in sickness absences appeared to be largely explained by unobserved time-invariant individual characteristics. Conclusions The decrease in sickness absences appeared to be more strongly influenced by compositional changes in factors that are established before fully entering the labour market - such as educational level as well as unmeasured individual characteristics that remain unchanged after childhood and early adulthood - than in the work environment or other factors contributing at working age. Attempts to improve the health and work ability of the workforce should not only rely on interventions directed at the working age population, but also on those carried out early during the life course. Key messages • Compositional changes in the workforce should be taken into account when assessing sickness absence trends. • Interventions aiming to improve the health and work ability of the workforce should be implemented already early in the life course and not only in working age.