Sickness absence among municipal workers in a Brazilian municipality: a secondary data analysis

BACKGROUND: Sickness absence, work disability associated with illness or injury, is a major public health problem worldwide. Some studies have investigated determinants of sickness absence among workers with shorter job tenure, but have only focused on certain diagnostic groups. Although it is well established that job tenure has an inverse relationship with work injury rate, less is known about its association with sickness absence for other disorders. Therefore, this study aimed to investigate the risk factors for incidence and duration of sickness absence according to diagnosis over a 7-year period. A dynamic cohort consisting of all permanent civil servants hired from 2005 to 2011 by the Goiania municipality-Brazil. Data of certified sickness absences longer than 3 days were analyzed. The incidence density was calculated per 1000 person-years in each ICD-10 category. The association between sickness absence and socio-demographic and occupational characteristics was examined using negative binomial regression models. RESULTS: 18,450 workers, mean age of 32 years, accumulated 14,909 episodes of sickness absence. Overall, the incidence density was 234.6 episodes per 1000 person years. Diagnostic groups with the highest incidence density of sickness absences were injuries (49.1), musculoskeletal disorders (31.3) and mental disorders (29.2). Factors predicting any sickness absence were female gender, older age, low education, being a health professional, multiple jobs and full-time employment. Mental health disorders were more common among education professionals, musculoskeletal disorders among blue collar workers and injuries among inspection workers. Prolonged time on sick leave was associated with male gender, older age groups, low education and income, blue-collar workers, more than one job contract and full time employment. CONCLUSIONS: These findings demonstrate a substantial sickness absentee burden and they provide relevant information for targeting prevention and health promotion policies to the most vulnerable occupational groups