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Permanent work disability before and after ischaemic heart disease or stroke event: a nationwide population-based cohort study in Sweden.

ABSTRACT: OBJECTIVES:We examined the risk of disability pension before and after ischaemic heart disease (IHD) or stroke event, the burden of stroke compared with IHD and which factors predicted disability pension after either event. DESIGN:A population-based cohort study with follow-up 5?years before and after the event. Register data were analysed with general linear modelling with binary and Poisson distributions including interaction tests for event type (IHD/stroke). SETTING AND PARTICIPANTS:All people living in Sweden, aged 25?60 years at the first event year, who had been living in Sweden for 5?years before the event and had no indication of IHD or stroke prior to the index event in 2006?2008 were included, except for cases in which death occurred within 30 days of the event. People with both IHD and stroke were excluded, resulting in 18 480 cases of IHD (65%) and 9750 stroke cases (35%). PRIMARY OUTCOME MEASURES:Disability pension. RESULTS:Of those going to suffer IHD or stroke event, 25% were already on disability pension a year before the event. The adjusted OR for disability pension at first postevent year was 2.64-fold (95%?CI 2.25 to 3.11) for people with stroke compared with IHD. Economic inactivity predicted disability pension regardless of event type (OR=3.40; 95%?CI 2.85 to 4.04). Comorbid mental disorder was associated with the greatest risk (OR=3.60; 95%?CI 2.69 to 4.83) after an IHD event. Regarding stroke, medical procedure, a proxy for event severity, was the largest contributor (OR=2.27, 95%?CI 1.43 to 3.60). CONCLUSIONS:While IHD event was more common, stroke involved more permanent work disability. Demographic, socioeconomic and comorbidity-related factors were associated with disability pension both before and after the event. The results help occupational and other healthcare professionals to identify vulnerable groups at risk for permanent labour market exclusion after such an event.

SUBMITTER: Ervasti J

PROVIDER: S-EPMC5640121 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Permanent work disability before and after ischaemic heart disease or stroke event: a nationwide population-based cohort study in Sweden.

Ervasti Jenni J Virtanen Marianna M Lallukka Tea T Friberg Emilie E Mittendorfer-Rutz Ellenor E Lundström Erik E Alexanderson Kristina K

BMJ open 20170929 9

<h4>Objectives</h4>We examined the risk of disability pension before and after ischaemic heart disease (IHD) or stroke event, the burden of stroke compared with IHD and which factors predicted disability pension after either event.<h4>Design</h4>A population-based cohort study with follow-up 5 years before and after the event. Register data were analysed with general linear modelling with binary and Poisson distributions including interaction tests for event type (IHD/stroke).<h4>Setting and par ...[more]

PMID: 28965101

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Project description:Aims Social workers report high levels of stress and have an increased risk for hospitalisation with mental diagnoses. However, it is not known whether the risk of work disability with mental diagnoses is higher among social workers compared with other human service professionals. We analysed trends in work disability (sickness absence and disability pension) with mental diagnoses and return to work (RTW) in 2005-2012 among social workers in Finland and Sweden, comparing with such trends in preschool teachers, special education teachers and psychologists.MethodsRecords of work disability (>14 days) with mental diagnoses (ICD-10 codes F00-F99) from nationwide health registers were linked to two prospective cohort projects: the Finnish Public Sector study, years 2005-2011 and the Insurance Medicine All Sweden database, years 2005-2012. The Finnish sample comprised 4849 employees and the Swedish 119 219 employees covering four occupations: social workers (Finland 1155/Sweden 23 704), preschool teachers (2419/74 785), special education teachers (832/14 004) and psychologists (443/6726). The reference occupations were comparable regarding educational level. Risk of work disability was analysed with negative binomial regression and RTW with Cox proportional hazards.ResultsSocial workers in Finland and Sweden had a higher risk of work disability with mental diagnoses compared with preschool teachers and special education teachers (rate ratios (RR) 1.43-1.91), after adjustment for age and sex. In Sweden, but not in Finland, social workers also had higher work disability risk than psychologists (RR 1.52; 95% confidence interval 1.28-1.81). In Sweden, in the final model special education teachers had a 9% higher probability RTW than social workers. In Sweden, in the final model the risks for work disability with depression diagnoses and stress-related disorder diagnoses were similar to the risk with all mental diagnoses (RR 1.40-1.77), and the probability of RTW was 6% higher in preschool teachers after work disability with depression diagnoses and 9% higher in special education teachers after work disability with stress-related disorder diagnoses compared with social workers.ConclusionSocial workers appear to be at a greater risk of work disability with mental diagnoses compared with other human service professionals in Finland and Sweden. It remains to be studied whether the higher risk is due to selection of vulnerable employees to social work or the effect of work-related stress in social work. Further studies should focus on these mechanisms and the risk of work disability with mental diagnoses among human service professionals.

Dataset Information

Permanent work disability before and after ischaemic heart disease or stroke event: a nationwide population-based cohort study in Sweden.

Publications

Permanent work disability before and after ischaemic heart disease or stroke event: a nationwide population-based cohort study in Sweden.

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