title: Consequences of sickness presence and sickness absence on health and work ability: a Swedish prospective cohort study.
abstract: OBJECTIVE
  To determine whether self-reported sickness presence (SP) and self-reported sickness absence (SA) are specific risk factors for future health problems or reduced work ability in the active workforce.
  
  
  METHODS
  The study population consisted of a cohort based on a random sample (n = 2181) with data for 2004, 2005, and 2006. The subjects were employees aged from 25 to 50 years in 2004. Cross-tabulations were calculated to identify significant background factors (sex, age, education, socioeconomic position), work factors (work demands, control, adjustment latitude), and outcome factors. Block-wise multiple logistic regression analyses were performed for outcome factors (SP, SA, self-rated health, physical complaints, work ability, mental well-being).
  
  
  RESULTS
  SA and SP were found to have negative health consequences; this was particularly pronounced for those with frequent SP or SA. There was a dose-response relationship between the degree of SA, SP and the different health outcomes. The health risks remained, after control for background factors, prior working conditions and initial health. SP also appeared to lead to SA, whereas SA did not have a significant impact on future SP.
  
  
  CONCLUSIONS
  The results suggest that both SP and SA are strong predictors of future poor health, physical complaints, low mental well-being and low work ability. The detrimental influence of frequent SP was most pronounced in relation to work ability and physical complaints, although all of the measured health factors were affected. The negative effects of SA on the different health outcomes were similar.
authors.affiliation: Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden. klas.gustafsson@ki.se
authors.forename: Klas
authors.initials: K
authors.lastname: Gustafsson
authors.forename: Staffan
authors.initials: S
authors.lastname: Marklund
mesh_terms: D000041:Absenteeism; D000328:Adult; D004526:Efficiency; D005260:Female; D006304:Health Status; D006801:Humans; D055809:Illness Behavior; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018582:Sick Leave; D013548:Sweden; D014937:Work; D016526:Workload / Q000523:psychology