Subjects with doctor-diagnosed knee OA have an almost twofold increased risk of sick leave and about 40-50% increased risk of disability pension compared with the general population. About 2% of all sick days in society are attributable to knee OA.
BackgroundSickness absence has represented a growing public health problem in many Western countries over the last decade. In Sweden disorders of the musculoskeletal system cause approximately one third of all sick leave. The Social Insurance Agency (SIA) and the health care system are important actors in handling the sickness absence process. The objective was to study how patients with personal experience of sickness absence due to musculoskeletal disorders perceived their contact with these actors and what they considered as obstructing or facilitating factors for recovery and return to work in this situation.MethodsIn-depth interviews using open-ended questions were conducted with fifteen informants (aged 33-63, 11 women), all with experience of sickness absence due to musculoskeletal disorders and purposefully recruited to represent various backgrounds as regards diagnosis, length of sick leave and return to work. The interviews were audio-recorded, transcribed verbatim and analysed using content analysis.ResultsThe informants' perceived the interaction with the SIA and health care as ranging from coherent to fragmented. Being on sick leave was described as going through a process of adjustment in both private and working life. This process of adjustment was interactive and included not only the possibilities to adjust work demands and living conditions but also personal and emotional adjustment. The informants' experiences of fragmented interaction reflected a sense that their entire situation was not being taken into account. Coherent interaction was described as facilitating recovery and return to work, while fragmented interaction was described as obstructing this. The complex division of responsibilities within the Swedish rehabilitation system may hamper sickness absentees' possibilities of taking responsibility for their own rehabilitation.ConclusionsThis study shows that people on sick leave considered the interaction with the SIA and health care as an important part of the rehabilitation process. The contact with these actors was perceived as affecting recovery and return to work. Working for a more coherent process of rehabilitation and offering professional guidance to patients on sick leave might have an empowering effect.
Objective: To investigate the association between occupation and risk for sick leave or disability pension due to knee or hip osteoarthritis (OA) from a gender perspective.Methods: Population-based study including residents aged 40-70 years in the Skåne region, Sweden (2007) and working in the included job sectors (n=165 179). We retrieved data on causespecific sick leave and disability pension (2007)(2008)(2009)(2010)(2011)(2012) and linked to individual information on occupation and education (2007). Occupations were classified into job sectors. We calculated gender-specific, age-adjusted odds ratio (OR) of sick leave and disability pension due to OA in traditionally female-dominated job sectors (health care, child care, cleaning) and traditionally male-dominated job sectors (construction, farming, metal work or transportation) compared to business and administration.Results: Of all eligible subjects, 2445 had sick leave or disability pension due to knee or hip OA.Adjusted for age, the risk of sick leave due to knee OA was increased for women working in health care OR 3.3 (95% CI 2.6-4.2), child care OR 2.9 (2.2-3.8) and cleaning OR 3.0 (2.2-4.1), as was the risk for disability pension. The risk was increased also for persons working in occupations with higher educational requirements. The risk was similarly increased in maledominated sectors. In female-dominated job sectors the risk of sick leave and disability pension due to knee OA, but not hip OA, was higher than that for other musculoskeletal diseases. Conclusion:Traditionally female-dominated occupational sectors are associated with an increased risk of sick leave and disability pension due to knee OA.• Women working in health care, child care and cleaning have an increased risk of sick leave and disability pension due to knee OA compared to women in business and administration. The risk was increased also in occupations with higher educational requirements, e.g., nursing, midwifery, and pre-school teaching professionals.• For women in health care and child care the risk for sick leave and disability pension due to knee OA remained increased also when comparing with the risk of sick leave for other musculoskeletal diseases.• We found no statistically significant association between work in health care, child care and cleaning and sick leave due to hip OA, but we did find an association with disability pension.• There is a need to gain further knowledge on occupational exposures in femaledominated job sectors and its relation with OA pathogenesis.
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