Frequent and long-term absence as a risk factor for work disability and job termination among employees in the private sector.

OBJECTIVES Frequent and long-term absentees were monitored over 5 years with regard to the risk of work disability and job termination. METHODS A prospective longitudinal cohort study in 53,990 employees of Dutch postal and telecommunications companies. In the first year of the study, employees who were absent four times or more (frequent absentees; n = 4126), for 6 weeks or more (long-term absentees; n = 3585), and combined frequent and long-term absentees (n = 979) were distinguished, together with a reference population consisting of 45,300 employees. The disability rate (defined as the number of employees who were absent for >1 year per 100 employee-years) and the risk of job termination were determined over a period of 4 years. RESULTS In the reference population, women had a higher disability rate (2.2 per 100 employee-years) than men (0.8 per 100 employee-years). Frequent absentees had a disability rate amounting to 2.5 per 100 employee-years in men and 4.2 per 100 employee-years in women. Long-term absentees had a disability rate of 6.7 per 100 employee-years in men and 9.1 per 100 employee-years in women. Combined frequent and long-term absentees had an even higher disability rate. The risk of employment being terminated (involuntarily) was higher in prior absentees as compared with the reference population (RR = 1.2-2.1 for job termination and RR = 1.5-2.5 for involuntary job termination). In men, absences due to neoplasms, mental disorders and respiratory disorders were associated with an increased disability risk as compared with musculoskeletal disorders. Neoplasms and mental disorders were also associated with a higher risk of job termination in men, whereas infectious and neurological diseases were associated with a higher risk of job termination in women. CONCLUSIONS Prior frequent and/or long-term absentees show high work disability in a 4-year follow-up period. Moreover, they are at higher risk of (involuntary) job termination.