Jun 16

A Study of Sickness Absence and Transition to Disability Pension in Norway

A Norwegian study has found that age, diagnoses, and socioeconomic variables were important predictors of an adverse outcome among workers with a sickness absence of 8 or more weeks.

The aim of the population-based, 5-year study was to assess the incidence of musculoskeletal disorders (MSDs) in sickness absence longer than 8 weeks in Norway, and to identify diagnostic and socioeconomic predictors of the transition to disability pension.

For the study, 37,942 females and 26,307 males with an episode of sickness absence of greater than 8 weeks in 1997, who were diagnosed with a certified with a musculoskeletal disorder were followed up for 5 years.

Diagnostic and sociodemographic data were obtained from a national database. The cases were divided into 9 diagnostic subgroups, based on the International Classification of Primary Health Care, including:

  1. fractures & injuries;
  2. upper limb problems;
  3. back problems;
  4. osteoarthrosis;
  5. myalgia/fibromyalgia;
  6. rheumatoid arthritis.

Overall, 20% of cases obtained disability pension during the follow-up.

Among those aged 50 to 62, and among those with only basic education, 46% obtained the disability pension.

The proportion of cases in each diagnostic subgroup obtaining disability pension was highest for osteoarthrosis (47%), rheumatoid arthritis (46%), and myalgia/fibromyalgia (38%). Fractures/injuries had the lowest rate.

Controlled for age, education and income, the relative risk of getting disability pension was:

  • 1.0 for fractures & injuries;
  • 1.5 for upper limb problems;
  • 2.0 for back problems;
  • 2.8 for osteoarthrosis;
  • 3.3 for myalgia/fibromyalgia;
  • 4.2 for rheumatoid arthritis.

In conclusion:

"Age, diagnoses, and socioeconomic variables were important predictors of an adverse outcome among workers with a sickness absence of 8 or more weeks."

Further research is needed to determine whether differentiated follow-up strategies might prevent permanent disability.

References:

  1. Gjesdal S, Bratberg E, Mæland JG. Musculoskeletal Impairments in the Norwegian Working Population: The Prognostic Role of Diagnoses and Socioeconomic Status: A Prospective Study of Sickness Absence and Transition to Disability Pension. Spine. 2009 Jun 15;34(14):1519-1525.