This study aims to identify risk factors and their prevalence in long-term sickness absence. The study is designed as a case-referent study which comprises 481 participants who have experienced a sickness absence lasting >10 weeks and a reference group of 1326 individuals in active employment. Multivariate analysis identified the following significant risk factors for men: (i) age >50 years [odds ratio (OR) = 2.4]; (ii) short period of education (OR = 2.3); (iii) unemployment within the last 3 years (OR = 1.7); (iv) heavy-duty work (OR = 2.1); (v) monotonous, repetitive work (OR = 1.7); (vi) lack of job satisfaction (OR = 2.1); and (vii) much back pain during the last 3 years (OR = 2.1). The following risk factors were identified for women: (i) leaving school without graduation (OR = 2.6); (ii) unemployment within the last 3 years (OR = 1.5); (iii) heavy-duty work (OR = 2.8); (iv) lack of influence on own job situation (OR = 2.1); and (v) much back pain within the last 3 years (OR = 1.8). It is concluded that the identification of working environment risk factors constitutes a case for improvement of the working environment which may be instrumental in reducing long-term sickness absence.

This study aims to explore the effect of vocational intervention in a rheumatological outpatient clinic. The study is designed as a randomized study with intervention in 108 patients and with 93 patients serving as controls. The study population comprises patients referred for non-inflammatory diseases of the locomotor system who are all active members of the workforce and whose vocational status is threatened by their disease. Intervention consisted of sociomedical examination, multidisciplinary assessment and individual sociomedical rehabilitation plans. The study shows that intervention was an important instrument in the process of clarifying patients' future maintenance situation as assessed 1 year after intervention (relative risk (RR) = 1.2 (CI 1.0-1.5)). The effect was particularly prominent among well-educated women. A non-significant effect was established for vocational status in general (RR = 1.1 (CI 0.8-1.4)). This effect was significant and positive for well-educated patients with a short-term sick leave (maximum 6 months). The verified effect of early sociomedical intervention in the secondary healthcare sector warrants the permanency of routine intervention.