Organisational downsizing, sickness absence, and mortality: 10-town prospective cohort study.
OBJECTIVE
To examine whether downsizing, the reduction of personnel in organisations, is a predictor of increased sickness absence and mortality among employees.


METHODS
Prospective cohort study over 7.5 years of employees grouped into categories on the basis of reductions of personnel in their occupation and workplace: no downsizing (< 8% reduction), minor downsizing (8-18%), and major downsizing (> 18%).


METHODS
Four towns in Finland.


METHODS
5909 male and 16 521 female municipal employees, aged 19-62 years, who kept their jobs.


METHODS
Annual sickness absence rate based on employers' records before and after downsizing by employment contract; all cause and cause specific mortality obtained from the national mortality register.


RESULTS
Major downsizing was associated with an increase in sickness absence (P for trend < 0.001) in permanent employees but not in temporary employees. The extent of downsizing was also associated with cardiovascular deaths (P for trend < 0.01) but not with deaths from other causes. Cardiovascular mortality was 2.0 (95% confidence interval 1.0 to 3.9) times higher after major downsizing than after no downsizing. Splitting the follow up period into two halves showed a 5.1 (1.4 to 19.3) times increase in cardiovascular mortality for major downsizing during the first four years after downsizing. The corresponding hazard ratio was 1.4 (0.6 to 3.1) during the second half of follow up.


CONCLUSIONS
Organisational downsizing may increase sickness absence and the risk of death from cardiovascular disease in employees who keep their jobs
Vahtera
Jussi
J
Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland. jussi.vahtera@ttl.fi
Kivimäki
Mika
M
Pentti
Jaana
J
Linna
Anne
A
Virtanen
Marianna
M
Virtanen
Pekka
P
Ferrie
Jane E
JE
D000041:Absenteeism; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000401:mortality*; D020415:Personnel Downsizing / Q000523:psychology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data*; D012923:Social Class