Accidental food-allergic reactions are associated with higher costs and more sick leave but not with quality of life.
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ABSTRACT:
SUBMITTER: Versluis A
PROVIDER: S-EPMC8048496 | biostudies-literature | 2021 Apr
REPOSITORIES: biostudies-literature
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Accidental food-allergic reactions are associated with higher costs and more sick leave but not with quality of life.
Versluis Astrid A Knulst Andre C AC Michelsen-Huisman Anouska D AD Houben Geert F GF Blom W Marty WM Le Thuy-My TM van Os-Medendorp Harmieke H
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 20210213 4
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Project description:IntroductionThe phase 3 trial PALISADE, comparing peanut (Arachis hypogaea) allergen powder-dnfp (PTAH) oral immunotherapy versus placebo in peanut-allergic children, reported that a significantly higher percentage of PTAH-treated participants tolerated higher doses of peanut protein after 1 year of treatment. This study used PALISADE data to estimate the reduction in the risk of systemic allergic reaction (SAR) after accidental exposure following 1 year of PTAH treatment.MethodsParticipants (aged 4-17 years) enrolled in PALISADE were included. Parametric interval-censoring survival analysis with the maximum likelihood estimation was used to construct a real-world distribution of peanut protein exposure using lifetime SAR history and highest tolerated dose (HTD) from a double-blind, placebo-controlled food challenge conducted at baseline. The SAR risk reduction was extrapolated using the exposure distribution and the HTD were collected at baseline and trial exit for PTAH- and placebo-treated participants.ResultsAssuming a maximum peanut protein intake of 1500 mg, participants were estimated to have < 1% probability of ingesting > 0.01 mg during daily life. The mean annual SAR risk at trial entry was 9.25-9.98%. At trial exit, the relative SAR risk reduction following accidental exposure was 94.9% for PTAH versus 6.4% for placebo. For PTAH-treated participants with exit HTD of 600 or 1000 mg without dose-limiting symptoms, the SAR risk reduction increased to 97.2%. The result was consistent in the sensitivity analysis across different parametric distributions.ConclusionOral immunotherapy with PTAH is expected to result in a substantially greater reduction in risk of SAR following accidental exposure compared to placebo among children with peanut allergy.
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Project description:ObjectiveTo explore the association between the psychosocial work environment and the risk of sick leave among governmental employees with symptom-defined post-traumatic stress disorder (PTSD) after a workplace bomb attack.DesignA prospective study on employees who met the symptom criteria for PTSD. Questionnaire data on the psychosocial work environment 10 months after the terrorist attack was linked to registry data on doctor-certified sick leave in the period 12-22 months after the attack.SettingThe bombing of the government ministries in Oslo, Norway, 22 July 2011.ParticipantsThe study sample consists of 94 Norwegian governmental employees, all with symptom-defined PTSD from the Norwegian version of the PTSD checklist (Post-traumatic Stress Disorder Checklist-Specific) measured 10 months after the attack.ResultsAfter adjustment for sex and severity of PTSD symptoms, predictability at work reduced the odds of sick leave (adjusted OR=0.62, 95% CI 0.40 to 0.98). Sense of control over decisions at work was associated with fewer absence days for employees with sick leave (adjusted rate ratio=0.61, 95% CI 0.38 to 0.98).ConclusionsEmployees with PTSD after workplace terrorism would benefit from control over their workplace conditions and increased predictability to reduce the risk of sick leave. The findings suggest that the work environment can facilitate employees' work ability after stressful events, independent of severity of PTSD symptoms.
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Project description:BackgroundWe aimed to estimate the effect of the voluntary Norwegian Agreement on a More Inclusive Working Life (IA Agreement) on use of sickness absence (SA) and pregnancy benefits among pregnant women.MethodsPregnant women (n = 112,486) with a birth during 1.12.2003-31.12.2010 were followed from 6 to 37 gestational weeks in a continuous time multistate model with the following states: work, full SA, graded SA, pregnancy benefits, maternity leave, and other. Women working in IA companies were compared to those in non-IA companies regarding incidence and duration of SA and pregnancy benefits. Differences between groups with respect to calendar year, age, civil status, education, industry, and number of employees in the company were adjusted for using inverse probability of treatment weighting. Absolute differences in probabilities over time, expected length of stay (ELOS) in each state and differences in ELOS between IA and non-IA were calculated. 95% confidence intervals (CI) were generated using bootstrapping (1,000 repetitions).ResultsAdjusted analyses suggest that women working in IA companies were more likely to be in full SA in the first and last trimesters, but less likely between 14 and 28 weeks, than those in non-IA companies. The probability of being in work mirrored this, with women in IA companies tending to spend half a day more in work (ELOS difference 0.55, 95% CI -1.79, 3.02). Differences were not statistically significant. The use of graded SA was slightly higher (ELOS difference 0.46, 95% CI -0.87, 1.72) and the use of pregnancy benefits slightly lower (ELOS difference - 0.43, 95% CI -1.32, 0.42) among those in IA companies compared to non-IA companies.ConclusionsWomen in IA companies tended to spend more time in work and graded SA, but less time on pregnancy benefits. Differences in full SA varied during pregnancy and were most positive mid-pregnancy. This indicates that IA measures could be more effective for conditions experienced at this point. However, effects were small and not statistically significant, which may indicate the IA Agreement has not focused much on pregnant women.Key termsIA Agreement, MBRN, MoBa, multistate models, pregnancy, pregnancy benefits, sickness absence, work participation.
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Project description:Many survivors after trauma suffer from long-term morbidity. The aim of this observational cohort study was to develop a prognostic prediction tool for early assessment of full-time sick leave one year after trauma. Potential predictors were assessed combining individuals from a trauma register with national health registers. Two models were developed using logistic regression and stepwise backward elimination. 4458 individuals were included out of which 488 were on sick leave full-time 12 months after the trauma. One comprehensive and one simplified model were developed including nine and seven predictors respectively. Both models showed excellent discrimination (AUC 0.81). The comprehensive model had very good calibration, and the simplified model good calibration. Prediction models can be used to assess post-trauma sick leave using injury-related variables as well as factors not related to the trauma per se. Among included variables, pre-injury sick leave was the single most important predictor for full-time sick leave one year after trauma. These models could facilitate a more efficient use of resources, targeting groups for follow-up interventions to improve outcome. External validation is necessary in order to evaluate generalizability.
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Project description:Paid sick leave provides workers with paid time off to receive COVID-19 vaccines and to recover from potential vaccine adverse effects. We hypothesized that US cities with paid sick leave would have higher COVID-19 vaccination coverage and narrower coverage disparities than those without such policies. Using county-level vaccination data and paid sick leave data from thirty-seven large US cities in 2021, we estimated the association between city-level paid sick leave policies and vaccination coverage in the working-age population and repeated the analysis using coverage in the population ages sixty-five and older as a negative control. We also examined associations by neighborhood social vulnerability. Cities with a paid sick leave policy had 17 percent higher vaccination coverage than cities without such a policy. We found stronger associations between paid sick leave and vaccination in the most socially vulnerable neighborhoods compared with the least socially vulnerable ones, and no association in the population ages sixty-five and older. Paid sick leave policies are associated with higher COVID-19 vaccination coverage and narrower coverage disparities. Increasing access to these policies may help increase vaccination and reduce inequities in coverage.
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Project description:BackgroundMusculoskeletal disorders are an extensive burden to society, yet few studies have explored and replicated modifiable prognostic factors associated with high societal costs. This study aimed to replicate previously identified associations between nine modifiable prognostic factors and high societal costs among people on sick leave due to musculoskeletal disorders.MethodsPooled data from a three-arm randomised controlled trial with 6 months of follow-up were used, including 509 participants on sick leave due to musculoskeletal disorders in Norway. Consistent with the identification study, the primary outcome was societal costs dichotomised as high (top 25th percentile) or low. Societal costs included healthcare utilization (primary, secondary, and tertiary care) and productivity loss (absenteeism, work assessment allowance and disability benefits) collected from public records. Binary unadjusted and adjusted logistic regression analyses were used to replicate previously identified associations between each modifiable prognostic factor and having high costs.ResultsAdjusted for selected covariates, a lower degree of return-to-work expectancy was associated with high societal costs in both the identification and replication sample. Depressive symptoms and health literacy showed no prognostic value in both the identification and replication sample. There were inconsistent results with regards to statistical significance across the identification and replication sample for pain severity, self-perceived health, sleep quality, work satisfaction, disability, and long-lasting disorder expectation. Similar results were found when high costs were related to separately healthcare utilization and productivity loss.ConclusionThis study successfully replicated the association between return-to-work expectancy and high societal costs among people on sick leave due to musculoskeletal disorders. Other factors showed no prognostic value or inconsistent results.Trial registrationClinicalTrials.gov NCT03871712, 12th of March 2019.
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Project description:BackgroundWork-life interference has been associated with adverse health outcomes. Here, we quantify the association between work-life interference and subsequent sick leave.MethodsRespondents from a randomly drawn cohort of the general working Norwegian population were interviewed in 2009, 2013 and/or 2016. Mixed-effects logistic regression models were used to assess prospective associations of self-reported work-life interference and risk of subsequent physician-certified sick leave of 1-16 days (low-level) and >16 days (high-level) in strata of men and women. To quantify the importance of work-life interference as risk factors for sick leave, we estimated the population attributable risk (PAR).ResultsBoth low- and high-level sick leave were most prevalent among women while the prevalence of work-life interference was similar between sexes. Risk of sick leave was higher among women reporting work-life interference sometimes or often in comparison with seldom or never {low- and high-level sick leave odds ratio (OR) = 1.21 [95% confidence interval (CI) = 1.07-1.37] and 1.30 (95% CI = 1.14-1.49), respectively}. The associations for high-level sick leave progressively increased with the level of work-life interference [highest OR = 1.44 (95% CI = 1.19-1.75)]. In men, there was no consistent higher risk of sick leave according to more frequent work-life interference [low- and high-level sick leave OR = 1.00 (95% CI = 0.87-1.14) and 0.98 (95% CI = 0.84-1.16), respectively], but the risk of high-level sick leave tended to be higher among men reporting work-life interference often (OR = 1.21, 95% CI = 0.98-1.50). Estimating PAR, 6.69% (95% CI = 1.52-11.74) of low-level and 9.94% (95% CI = 4.22-15.45) of high-level sick leave could be attributed to work-life interference among women.ConclusionsSelf-reported work-life interference was associated with a higher risk of sick leave, with the most consistent results among women.
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Project description:BackgroundThe COVID-19 pandemic has caused difficulties and changes in many aspects of people's health and lives. Although infection affected work capacity, during the first wave policies for sick leave due to COVID-19 were unclear. The aim of this study was to investigate the impact of sick leave diagnoses in the year before the COVID-19 diagnosis on sick leave duration due to COVID-19 in a nationwide non-hospitalised population.MethodsData from three Swedish registries were analysed for sick leave commencing between 1 March and 31 August 2020, with a follow-up period of 4 months. Sick leave due to COVID-19 was considered the number of days that sickness benefits were used and included at least one registered COVID-19 diagnosis. Sick leave in the year before COVID-19 diagnosis were categorised into five diagnostic groups and one reference group (participants without prior sick leave).ResultsThe study comprised 8935 individuals who received sickness benefits due to COVID-19 in Sweden during the first pandemic wave (mean age 46.7 years, 67% females, and 24% had diagnoses for sick leave in the year before COVID-19 diagnosis). The duration of sick leave due to COVID-19 was significantly higher in the groups with prior sick leave owing to musculoskeletal system diseases (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 1.01-1.15); respiratory system diseases (OR: 1.22, 95% CI: 1.14-1.31); all other isolated diagnoses (OR: 1.08, 95% CI: 1.03-1.14); and multiple diagnoses (OR: 1.32, 95% CI: 1.21-1.43).ConclusionsThe results of this nationwide registry-based study indicate that individuals with premorbid conditions are more prone to longer sick leave durations due to COVID-19. Prediction of sick leave duration during the first wave of the COVID-19 pandemic is complex and several factors played a role.
| S-EPMC9884157 | biostudies-literature
Project description:ObjectiveTo compare a structuralized sick-leave programme with usual care sick-leave management in patients after an acute myocardial infarction. We hypothesize that a structured sick-leave programme will yield a faster return to work without negatively affecting quality of life.MethodsPatients admitted to Oslo University Hospital due to an acute myocardial infarction were included in the study. Patients were randomized into an intervention group or a conventional care group. Patients randomized to the intervention group were provided with a standard programme with full-time sick leave for 2 weeks after discharge and then encouraged to return to work. The sick leave of the conventional group was mainly managed by their general practitioner.ResultsA total of 143 patients were included in the study. The conventional care group had a mean of 20.4 days absent from work, while that of the intervention group was significantly lower, with a mean of 17.2 days (p < 0.001) absent. There was no significant change in quality of life between the groups.ConclusionThese findings strengthen the case for structuralized follow-up of patients with acute myocardial infarction, as this will have positive economic consequences for the patient and society as a whole, without making quality of life worse. Further investigation, with a larger study population, is warranted to determine the extent of health benefits conferred by early return to work.
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