Background There is inconsistent evidence that long working hours and night work are risk factors for sickness absence, but few studies have considered variation in the length of exposure time window as a potential source of mixed findings. We examined whether the association of long working hours and night work with sickness absence is dependent on the length of exposure to the working hour characteristics. Methods We analysed records of working hours, night work and sickness absence for a cohort of 9226 employees in one hospital district in Finland between 2008 and 2019. The exposure time windows ranged from 10 to 180 days, and we used Cox’s proportional hazards models with time-dependent exposures to analyse the associations between working-hour characteristics and subsequent sickness absence. Results Longer working hours for a period of 10 to 30 days was not associated with the risk of sickness absence whereas longer working hours for a period of 40 to 180 days was associated with a lower risk of sickness absence. Irrespective of exposure time window, night work was not associated with sickness absence. Conclusions It is important to consider the length of exposure time window when examining associations between long working hours and sickness absence, whereas the association between night work and sickness absence is not similarly sensitive to exposure times.
Background:Little is known about the work patterns of re-employed people. We investigated the
Purpose The purpose of this paper is to analyse whether high responsibility for housework or childcare is related to weak labour market attachment. Design/methodology/approach Survey data on domestic responsibilities in 1998 and 2003 were linked to register data on respondents’ employment spells for 2004-2011. Effects of the responsibilities on labour market trajectories – identified with latent class growth analyses – were analysed with multinomial logistic regression analyses. Findings Four trajectories for labour market attachment were identified among both genders. When adjusted for prior labour market attachment and other control variables, a high responsibility for housework predicted weak labour market attachment, compared to the trajectory of strong attachment, only among men. Compared to the trajectory of strengthening attachment, a high responsibility for housework was related to weak attachment among both men and women. Research limitations/implications Personal orientations may, to some extent, explain both the division on domestic responsibilities and attachment to the labour market. In the Finnish type of welfare state, domestic responsibilities have long-term effects, especially on men’s careers. More attention should be given to men’s roles in families and their possible consequences. Originality/value This is the first study analysing the division of domestic responsibilities on later labour market attachment among both genders. The strength of this study is the long follow-up time and methodology; it combines survey data at two time points and register data on employment spells over eight years, identifying patterns in employment with latent class growth analyses.
Background Mental disorders are a major cause of work disability among the working-age population. Psychotherapy has shown to be an effective treatment for mental disorders, but the evidence is mainly based on small-scale randomised trials with relatively short follow-ups. We used population-based register data to examine the association between statutory rehabilitative psychotherapy and change in depression or anxietyrelated work disability. Methods We drew a nationally representative sample of the working-age population (aged 18-55 in 2010). The study group comprised all those who started rehabilitative psychotherapy in 2011-2014. A total of 10 436 participants who were followed from 3 years prior to 4 years after the onset of rehabilitative psychotherapy. This resulted in 83 488 observations. The annual total number of mental health-related work disability months (0 to 12) was calculated from the total number of annual compensated sickness absence and disability pension days. A quasi-experimental interrupted time series analysis was applied. ResultsThe onset of rehabilitative psychotherapy marked a decline in work disability in comparison to the counterfactual trend. Specifically, a 20% decrease in the level (incidence rate ratio, IRR 0.80; 95% CI 0.76 to 0.85) and a 48% decrease in the slope (IRR 0.52; 95% CI 0.50 to 0.54) of work disability were detected in comparison to the counterfactual scenario. No significant gender differences were observed. The decline in work disability was the steepest in the oldest age group. Conclusions This study suggests that statutory psychotherapy may decrease work disability at the population level. However, further evidence of causal inference and the potential heterogeneity of the association is required.
Aims: Psychotherapy is a widely used treatment for mental disorders, but whether it also improves employment and other labour market outcomes remains inconclusive. This study examined the effectiveness of a nationwide subsidized psychotherapy programme using extensive register-based data. Methods: The sample consisted of individuals who applied for rehabilitative psychotherapy in Finland in 2009–2012 ( n = 35,083). Prior to 2011, some applications were rejected due to the limited budget that the central government provided for the programme. From 2011, all eligible applicants were granted rehabilitation. We used propensity score matching to create balanced samples of those who received a negative decision in 2009–2010 ( n = 2047) and those who were granted rehabilitative psychotherapy in 2011–2012 ( n = 12,046) in terms of their sociodemographic background characteristics, prior labour market attachment and health status. Results: We found that compared to the applicants who were not accepted to the programme, the granted applicants with similar background characteristics had, on average, a six-percentage-point higher employment rate, €2100 higher annual earnings and a six-percentage-point lower probability of becoming a disability benefit recipient five years after their first application. Further sensitivity analyses confirmed that these results were not biased, for example, by differences in macroeconomic conditions during the follow-up. Conclusions: Quasi-experimental research design showed that rehabilitative psychotherapy was significantly associated with better labour market outcomes. Although several relevant background factors were included in the matching analysis, it is possible that some unobserved factors explain both access to psychotherapy and subsequent labour market outcomes.
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