Employment sustainability after return to work among Japanese stroke survivors

Abstract

PurposeFew studies have investigated the work continuance rate among stroke survivors who return to work (RTW). The objective of this study was to investigate work sustainability after RTW and the causes of recurrent sickness absence (RSA) among Japanese stroke survivors.MethodsData on stroke survivors were collected from an occupational health register. The inclusion criteria were as follows: employees who were aged 15–60 years old and returned to work after an episode of sick leave due to a clinically certified stroke that was diagnosed during the period from 1 January 2000 through 31 December 2011.Results284 employees returned to work after their first episode of stroke-induced sick leave. The work continuance rate for all subjects was 78.8 and 59.0% at one and 5 years after the subjects’ RTW, respectively. After returning to work, the subjects worked for a mean of 7.0 years. Of 284 employees who returned to work, 86 (30.3%) experienced RSA. The RSA were caused by recurrent strokes in 57.0% (49/86) of cases, mental disorders in 20.9% (18/86) of cases, and fractures (often due to accidents involving steps at train stations or the subject’s home) in 10.5% (9/86) of cases. 21 employees resigned after returning to work. The resignation rates at 1 and 5 years were 4.9 and 7.6%, respectively. According to the multivariate analysis including all variables, the subjects in the ≥ 50 year group were at greater risk of work discontinuation than the ≤ 49 year (reference) age group (HR: 2.26, 95% CI 1.39–3.68).ConclusionsOccupational health professionals need to provide better RTW support to stroke survivors and should pay particularly close attention to preventing recurrent strokes, mental disorders, and fractures.

Recurrent sick leave and resignation rates among female cancer survivors after return to work: the Japan sickness absence and return to work (J-SAR) study

“…We guess that cancer survivors who work at small and medium-sized enterprises have no choice but to quit because of their companies’ economic circumstances, among other factors. On the other hand, this Japanese company group has more improved sickness absence system and RTW system than other companies, as described in our previous studies [15, 23–28].…”

“…The J-SAR study analyzed data regarding sick leave that were registered in the health data system of a private occupational health center. This occupational health center had signed occupational health service with the following companies: regional, international telecommunication, big data and mobile services (installing and maintaining telephones, faxes, telegrams, internet systems, cell phones), logistics, energy, and construction etc., as described elsewhere [15, 23–28]. In 2000, about 68,000 employees were working for these companies on a full-time basis.…”

“…The J-SAR study analyzed data regarding sick leave that were registered in the health data system of a private occupational health center, which belongs to a large-scale Japanese company group. J-SAR study data analyzed during this study are included in these published articles [15, 23–28].…”

Return to Work Among Stroke Survivors

“…Future studies are needed to identify reasons for these RTW disparities. Some individuals are able to RTW but may still face absences from work due to a recurrent stroke or mental disorder, such as PSD (Endo et al, 2018). Difficulties comparing diverse stroke populations, national strategies in rehabilitation, employment of disabled persons, and income supplements could contribute to variations in the proportion of patients who RTW after stroke (Chang et al, 2016; Glader et al, 2017).…”

“…Post-stroke depression (PSD) was associated with lower RTW rates at longer periods post-stroke (Arwert et al, 2017; Van der Kemp et al, 2017). Endo et al (2018) found 21% of stroke survivors had recurrent sickness absences due to mental disorders. Cognitive functioning was significantly associated with RTW 1-year post-stroke (Fride et al, 2015; Van der Kemp et al, 2017).…”