title: Overweight and distress have a joint association with long-term sickness absence among Dutch employees.
abstract: OBJECTIVE
  To examine separate and joint associations of overweight and distress with long-term sickness absence (LTSA).
  
  
  METHODS
  We included a total of 2724 Dutch employees participating in occupational health checks between 2008 and 2012. Overweight was defined as a body mass index of 25 kg/m2 or more; distress concerned a score of 10 or more on the Four-Dimensional Symptom Questionnaire. Long-term sickness absence was defined as sickness absence lasting more than 2 consecutive weeks. Synergy was estimated from logistic regression models using the synergy index.
  
  
  RESULTS
  The joint association of overweight and distress with LTSA was significant in women (odds ratio, 2.35; 95% confidence interval, 1.31 to 4.24), but not in men (odds ratio, 1.58; 95%confidence interval, 0.74 to 3.37). In women, we found a synergy index of 1.04 (95%confidence interval, 0.34 to 3.15).
  
  
  CONCLUSIONS
  The joint association of overweight and distress with LTSA was not synergistic. Addressing comorbid overweight and distress may help reduce the burden of LTSA in women.
authors.affiliation: From the Department of Health Sciences (Mr Nigatu and Drs Roelen, Reijneveld, and Bültmann), Community and Occupational Medicine, University Medical Center Groningen, University of Groningen; and ArboNed Occupational Health Service (Dr Roelen), Utrecht, The Netherlands.
authors.forename: Yeshambel T
authors.initials: YT
authors.lastname: Nigatu
authors.forename: Corné A M
authors.initials: CA
authors.lastname: Roelen
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
authors.forename: Ute
authors.initials: U
authors.lastname: Bültmann
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D012737:Sex Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013997:Time Factors