The influence of lifestyle and gender on sickness absence in Brazilian workers.
BACKGROUND
Despite an increasing body of knowledge concerning gender and lifestyle factors as determinants of sickness absence in well-developed countries, the relationship between these variables has not been elucidated in emerging economic power countries, where the burden of non-communicable diseases is particularly high. This study aimed to analyze the relationships among lifestyle-related factors and sick leave and to examine whether gender differences in sickness absence can be explained by differences in socio-demographic, work and lifestyle-related factors among Brazilian workers.


METHODS
In this longitudinal study with a one year follow-up among 2.150 employees of a Brazilian airline company, sick leave was the primary outcome of interest. Independent variables collected by interview at enrolment in the study were gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity and smoking). In addition, the risk for coronary heart disease was determined based on measurement of blood pressure, total cholesterol and glucose levels. The total number of days on sick leave during 12 months follow-up was available from the company register. Logistic regression analysis was used to determine the influence of socio-demographic, type of work and lifestyle-related factors on sick leave.


RESULTS
Younger employees, those with lower educational level, those who worked as air crew members and those with higher levels of stress were more likely to have sick leave. Body mass index and level of physical activity were not associated with sick leave. After adjustment by socio-demographic variables, increased odds for 10 or more days of sick leave were found in smokers (OR=1.51, CI=1.05-2.17), and ex-smokers (OR=1.45, CI=1.01-2.10). Women were more likely to have 10 or more days of sick leave. Gender differences were reduced mainly when adjusted for type of work (15%) and educational level (7%).


CONCLUSIONS
The higher occurrence of sick leave among women than among men was partly explained by type of work and educational level. Our results suggest that type of work, a stressful life, and smoking are important targets for health promotion in this study population.
Department of Preventive Medicine, University of São Paulo, School of Medicine, FMUSP, Avenida Dr Arnaldo, 455-2° andar, 01246-903 São Paulo, SP, Brazil. fabianamr@usp.br.
Fabiana Maluf
FM
Rabacow
Renata Bertazzi
RB
Levy
Paulo Rossi
PR
Menezes
Olinda
O
do Carmo Luiz
Ana Maria
AM
Malik
Alex
A
Burdorf
D000041:Absenteeism; D000328:Adult; D000367:Age Factors; D001938:Brazil; D004522:Educational Status; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009790:Occupations; D012307:Risk Factors; D012737:Sex Factors; D018582:Sick Leave; D012907:Smoking; D013315:Stress, Psychological; D014937:Work; D055815:Young Adult