title: Increased absence due to sickness among employees with fibromyalgia.
abstract: BACKGROUND
  Little is known about the effect of fibromyalgia on absence due to sickness in working populations.
  
  
  OBJECTIVE
  To examine the risk of absence due to sickness among employees with fibromyalgia.
  
  
  METHODS
  A prospective cohort study with 1-year follow-up of recorded and certified absence due to sickness after a survey of chronic diseases among 34 100 Finnish public sector employees (27 360 women and 6740 men) aged 17-65 years at baseline in 2000-2.
  
  
  RESULTS
  20 224 days of absence due to sickness for the 644 employees with fibromyalgia and 454 816 days for others were documented. Of those with fibromyalgia, 67% had co-occurring chronic conditions such as osteoarthritis, rheumatoid arthritis, depression or other psychiatric disorders. Compared with employees with none of these chronic conditions, the hazard ratio (HR) adjusted for age, sex and occupational status was 1.85-fold (95% confidence interval (CI) 1.53 to 2.18) for people with fibromyalgia alone and 2.63-fold (95% CI 2.34 to 2.96) for employees with fibromyalgia with coexisting conditions. The excess rate of absence due to sickness was 61 episodes/100 person-years among people with fibromyalgia alone. Among employees with musculoskeletal and psychiatric disorders, secondary fibromyalgia was associated with a 1.4-1.5-fold increase in risk of absence.
  
  
  CONCLUSIONS
  Fibromyalgia is associated with a substantially increased risk of medically certified absence due to sickness that is not accounted for by coexisting osteoarthritis, rheumatoid arthritis or psychiatric disorders.
authors.affiliation: Finnish Institute of Occupational Health, Topeliuksenkatu 41 aA, FI-00250 Helsinki, Finland. mika.kivimaki@ttl.fi
authors.forename: M
authors.initials: M
authors.lastname: Kivimäki
authors.forename: P
authors.initials: P
authors.lastname: Leino-Arjas
authors.forename: L
authors.initials: L
authors.lastname: Kaila-Kangas
authors.forename: M
authors.initials: M
authors.lastname: Virtanen
authors.forename: M
authors.initials: M
authors.lastname: Elovainio
authors.forename: S
authors.initials: S
authors.lastname: Puttonen
authors.forename: L
authors.initials: L
authors.lastname: Keltikangas-Järvinen
authors.forename: J
authors.initials: J
authors.lastname: Pentti
authors.forename: J
authors.initials: J
authors.lastname: Vahtera
mesh_terms: D000367:Age Factors; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D005387:Finland / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D016272:Occupational Health; D010003:Osteoarthritis / Q000150:complications / Q000523:psychology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D018582:Sick Leave / Q000706:statistics & numerical data*