title: Sickness absence due to otoaudiological diagnoses and risk of disability pension: a nationwide Swedish prospective cohort study.
abstract: BACKGROUND
  Hearing difficulties are a large public health problem. Knowledge is scarce regarding risk of disability pension among people who have been sickness absent due to these difficulties.
  
  
  METHODS
  A cohort including all 4,687,756 individuals living in Sweden in 2005, aged 20-64, and not on disability or old-age pension, was followed through 2009. Incidence rate ratios (RR) of disability pension with 95% confidence intervals (CI) were estimated using Cox proportional hazard models.
  
  
  RESULTS
  In multivariable models, individuals who had a sick-leave spell due to otoaudiological diagnoses in 2005 had a 1.52-fold (95% CI: 1.43-1.62) increased risk of being granted a disability pension compared to individuals on sick leave due to other diagnoses. Hearing and tinnitus sick-leave diagnoses were associated with risk of disability pension: RR 3.38, 95% CI: 3.04-3.75, and 3.30, 95% CI: 2.95-3.68, respectively. No association was observed between sick leave due to vertigo diagnoses and disability pension whereas otological diagnoses and no sick leave were inversely associated with risk of disability pension compared to non-otoaudiological sick-leave diagnoses. Sick leave due to otoaudiological diagnoses was positively associated with risk of disability pension due to otoaudiological diagnoses and sick leave due to a tinnitus diagnosis was also associated with risk of disability pension due to mental diagnoses. The risk of disability pension among individuals with hearing or tinnitus sick-leave diagnoses was highest in the age group 35-44. Moreover, men had a slightly higher risk.
  
  
  CONCLUSIONS
  This large cohort study suggests an increased risk of disability pension among those with sickness absence due to otoaudiological diagnoses, particularly hearing and tinnitus diagnoses, compared to those with sickness absence due to non-otoaudiological diagnoses.
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Emilie.Friberg@ki.se
authors.forename: Emilie
authors.initials: E
authors.lastname: Friberg
authors.forename: Catarina
authors.initials: C
authors.lastname: Jansson
authors.forename: Ellenor
authors.initials: E
authors.lastname: Mittendorfer-Rutz
authors.forename: Ulf
authors.initials: U
authors.lastname: Rosenhall
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016001:Confidence Intervals; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004427:Ear Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010415:Pensions / Q000706:statistics & numerical data*; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult