Diagnosis-specific Cumulative Incidence of Return-to-work, Resignation, and Death Among Long-term Sick-listed Employees: Findings From the Japan Epidemiology Collaboration on Occupational Health Study

• Published in: Journal of Epidemiology 2022/09/05, Vol.32(9), pp.431-437
• Main Authors: Nishiura, Chihiro, Inoue, Yosuke, Kashino, Ikuko, Nanri, Akiko, Endo, Motoki, Eguchi, Masafumi, Kochi, Takeshi, Kato, Noritada, Shimizu, Makiko, Imai, Teppei, Nishihara, Akiko, Yamamoto, Makoto, Okazaki, Hiroko, Tomita, Kentaro, Miyamoto, Toshiaki, Yamamoto, Shuichiro, Nakagawa, Tohru, Honda, Toru, Ogasawara, Takayuki, Sasaki, Naoko, Hori, Ai, Kabe, Isamu, Mizoue, Tetsuya, Dohi, Seitaro
• Format: Article
• Language: English
• Subjects: Affective disorders; Death; Employee benefits; Epidemiology; Illnesses; Mental disorders; Mortality; Neoplasms; Occupation; Occupational health; Original; Resignations; retirement; return to work; Risk analysis; Schizophrenia; Sick leave; sickness absence
• ISSN: 0917-5040; 1349-9092
• DOI: 10.2188/jea.JE20200541

Background: While it is essential to understand how long is sufficient for return-to-work when designing paid sick-leave systems, little attempt has been done to collect cause-specific information on when and how many of sickness absentees returned to work, became unemployed, or passed away.Methods: We studied the first sick-leave episode of ≥30 consecutive days in those ≤55 years of age during 2012–2013 among employees of 11 Japanese private companies (n = 1,209), which were followed until 2017. Overall and disease-specific cumulative incidences of return-to-work, resignations, and deaths were estimated using competing risk analysis.Results: During the 3.5-year period (follow-up rate: 99.9%), 1,014 returned to work, 167 became unemployed, and 27 died. Overall, return-to-work occurred within 1 year in 74.9% of all absentees and in 89.3% of those who successfully returned to work. Resignation occurred within 1 year in 8.7% of all absentees and in 62.9% of all subjects who resigned. According to ICD-10 chapters, the cumulative incidence of return-to-work ranged from 82.1% for mental disorders (F00–F99) to 95.3% for circulatory diseases (I00–I99). The cumulative incidence of return-to-work due to mental disorders ranged from 66.7% in schizophrenia (F20) to 95.8% in bipolar affective disorders (F31). Death was rarely observed except for cases of neoplasms (C00–D48), of which the cumulative incidence of death reached 14.2% by 1.5 years.Conclusion: Return-to-work and resignations occurred commonly within 1 year of sick leave among long-term sickness absentees in the Japanese private companies. Our findings may assist occupational physicians and employers in developing effective social protection schemes.