Work load,job control and risk of leaving work by sickness certification before delivery,Norway 1989

Abstract

Sickness absence in pregnancy has been shown to be associated with strenuous working conditions and parity. So far, few studies have made adjustments for possible interaction and confounding. Such adjustments are needed to more precisely identify targets for preventive measures. We have, therefore, in a representative population of pregnant employees in Norway 1989, computed adjusted odds ratios for leaving work by sickness absence more than three (LSC> 3) and eight (LSC> 8) weeks before delivery according to working conditions identified as risk factors in earlier studies; adjusted for job control, domestic conditions and sickness absence the year prior to pregnancy. The cumulative percentage of LSC>8 and LSC>3 was 26.4 and 51.1. Economically strenuous postures and heavy lifting increased the risk of both outcomes. In addition, shift work and hectic work pace increased the risk of LSC > 3. Influence on breaks reduced risk. Only para experienced reduced risk of LSC when working part-time. Sicklisting the year prior to pregnancy had no confounding effect, which suggest that pregnancy represents a new incompatibility with work. Preventive measures should address work postures and heavy lifting, as well as conditions influencing the woman's control with her time.

Get full access to this article

View all access options for this article.

References

Hauge Lundby I , Tellnes G , Stray-Pedersen B. Pregnancy and sick-leave . Tidsskr Nor Lægeforen 1988; 108 (27): 2291–4.

Grünfeld B , Qvigstad E. Disease during pregnancy. Sick-listing among pregnant women in Oslo . Tidsskr Nor Lægeforen 1991; 111 (10): 1269–72.

Strand K , Wergeland E , Endresen EH , Bjerkedal T. Factors associated with workstatus of pregnant employees in Norway 1989. In: Wijma K and von Schoultz B , editors. Reproductive Life: Advances in research in psychosomatic obstetrics and gynaeocology. Canforth: The Parthenon Publishing Group,; 1992. p. 617–23.

Sydsjo A , Sydsjo G , Wijma B.

High sickness absence during pregnancy in spite of well developed parental leave insurance, (in Swedish)

Läkartidningen 1989; vol 86, no 47: 4141–4.

Alexanderson K , Hensing G , Leijon M., et al. Pregnancy-related sickness absence in a Swedish county, 1985–87 . J Epidemiol Community Health 1994; 48: 464–70.

Kierkegaard O , Kristiansen JL. Sick-leave during pregnancy-focusing on textile workers . Ugeskr Laeger 1992; 154 (34): 2306–8.

Voigt S. Sick-listing in pregnancy: Extent, diagnostic pattern and the issuing authority . Ugeskr Laeger 1993; 155 (2): 86–9.

Conne-Perréard E , Bousquet A. Prescription of temporary sick leave to pregnant women in the absence of legal provisions . Revue D'Epidemiologie Et De Sante Publique 1992; 40 (2): 113–20.

Saurel-Cubizolles MJ , Kaminski M. Pregnant women's working conditions and their changes during pregnancy: A national study in France . Br J Ind Med 1987; 44: 236–43.

10.

Saurel-Cubizolles MJ , Subtil D , Kaminski M.

Is preterm delivery still related to physical working conditions in pregnancy?

J Epidemiol Community Health 1991; 45: 29–34.

11.

Tellnes G. Days lost by Sickness Certification . Scand J Prim Health Care 1989; 7: 245–51.

12.

Spyckerelle Y , Trudel M , Deschamps JP. Pregnancy and work: apropos of sick leave . Revue Francaise de Gynecologie et d'Obstetrique 1989; 84 (11): 743–6.

13.

Soutoul J, et al. The social protection of pregnant women and young mothers in Europe . J Gynecol Obstet Biol Reprod, 1991; 20 (6): 757–65.

14.

Saurel-Cobizolles MJ , Romito P , Garcia J. Description of maternity rights for working women in France, Italy and in the United Kingdom . European Journal of Public Health 1993; 3: 48–53.

15.

Social Security in the Nordic Countries . Scope, expenditure and financing 1990. Statistical Reports of the Nordic Countries 59; NOSOSO 1993.

16.

The Norwegian Social Insurance Scheme-A survey January 1995. Oslo: The Norwegian Ministry of Health and Social Affairs.

17.

Forplantningsskader og arbeidsmiljo. Forskrift til arbeidsmiljoloven. Best nr. 535 (in Norwegian). Oslo: Arbeidstilsynet. 1995.

18.

Wergeland E , Strand K , Endresen EH. “Pregnant in Norway at the entrance of the nineties”, a national survey Norway 1989. Rapport nr. 1. (in Norwegian) Oslo: Department of Preventive Medicine, University of Oslo,; 1991.

19.

Strand K , Wergeland E , Bjerkedal T. Pregnancy and work, a national survey Norway 1989. Representativity of study sample and responders. Working paper. Oslo: Department of Preventive Medicine, University of Oslo,; 1995.

20.

Rosner Bernard . Fundamentals of Biostatistics. PWS Publishers ,; 1982 (86).

21.

Brennan P , Silman A. Statistical methods for assessing observer variability in clinical measures . BMJ 1992; 304: 1491–4.

22.

Hosmer D , Lemenshow S. Applied Logistic Regression. New York: John Wiley & Sons Inc; 1989.

23.

SPSS/PC+4.0. The statistical package for IBM PC. Chicago 1990. SPSSinc.

24.

Reidy A. Questioning the status quo: Sickness absence research so far claims more than it should . Soc Sci Med 1990; vol 31 (4): 421–32.

25.

Kristensen T. Sickness absence and work strain among Danish slaughterhouse workers: An analysis of absence from work regarded as coping behaviour . Soc Sci Med 1991; Vol 32(1): 15–27.

26.

North F , Syme SL , Feeney A , Head J , Shipley MJ , Marmot MG. Explaining sosioeconomic differences in sickness absence: the Whitehall II study . BMJ 1993; 306: 361–6.

27.

Hauge Lundby I , Stray-Pedersen B , Tellnes G. Diagnoses among pregnant women certified sick . Tidsskr Nor Lægeforen 1991; 111: 2833–6.

28.

Hatch M , Stein ZA. Work and exercise during pregnancy: Epidemiological studies. In: Mittelmark RA , Wiswell RA , Drinkwater B : (eds) Exercise in pregnancy. Baltimore: Williams and Wilins; 1991.

29.

Schaumburg I. Ergonomi og reproduktionsskader (in Danish) AT-rapport nr 1–1994. Kobenhavn: Arbejdstilsynet; 1994.

30.

Ahlborg G. Physical workload and pregnancy outcome . JOEM 1995; 37: 941–4.

31.

Østgaard HC , Andersson GB , Karlsson K. Prevalence of back pain in pregnancy . Spine 1991; 16 (5): 549–52.

32.

Endresen E. Pelvic Pain and Low Back Pain in Pregnant Women-an Epidemiological Study . Scand J Rheumatol 1995; 24: 135–41.

33.

Wergeland E , Strand K. Working conditions and prevalence of pre-eclampsia . Int J Gynecology Obstetrics (in press).

34.

Brandt LPA , Nielsen CV.

Job stress and Adverse Outcome of Pregnancy: A Causal Link or Recall Bias?

Am J Epidemiol 1992; 135: 302–11.

35.

Wiktorin C , Selin K , Ekenvall L , Alfredsson L and the Music-Norrtälje Study Group . An Interview Technique for Recording Work Postures in Epidemiological Studies . International Journal of Epidemiology 1996; 25: 171–80.

36.

Romito P. Women's paid and unpaid work and pregnancy outcome: a dicussion of some open questions . Health Promotion 1989; 4 (1): 31–41.