Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040

This article has now been updated. Please use the final version.

Diagnosis-specific Cumulative Incidence of Return-to-work, Resignation, and Death Among Long-term Sick-listed Employees: Findings From the Japan Epidemiology Collaboration on Occupational Health Study
Chihiro NishiuraYosuke InoueIkuko KashinoAkiko NanriMotoki EndoMasafumi EguchiTakeshi KochiNoritada KatoMakiko ShimizuTeppei ImaiAkiko NishiharaMakoto YamamotoHiroko OkazakiKentaro TomitaToshiaki MiyamotoShuichiro YamamotoTohru NakagawaToru HondaTakayuki OgasawaraNaoko SasakiAi HoriIsamu KabeTetsuya MizoueSeitaro Dohi
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JOURNAL OPEN ACCESS Advance online publication

Article ID: JE20200541

version.2: August 11, 2021
version.1: March 13, 2021

Background: While it is essential to understand how long is sufficient for return-to-work when designing paid sick-leave systems, little attempt has been done to collect cause-specific information on when and how many of sickness absentees returned to work, became unemployed, or passed away.

Methods: We studied the first sick-leave episode of ≥30 consecutive days in those ≤55 years of age during 2012–2013 among employees of 11 Japanese private companies (n = 1,209), which were followed until 2017. Overall and disease-specific cumulative incidences of return-to-work, resignations, and deaths were estimated using competing risk analysis.

Results: During the 3.5-year period (follow-up rate: 99.9%), 1,014 returned to work, 167 became unemployed, and 27 died. Overall, return-to-work occurred within 1 year in 74.9% of all absentees and in 89.3% of those who successfully returned to work. Resignation occurred within 1 year in 8.7% of all absentees and in 62.9% of all subjects who resigned. According to ICD-10 chapters, the cumulative incidence of return-to-work ranged from 82.1% for mental disorders (F00–F99) to 95.3% for circulatory diseases (I00–I99). The cumulative incidence of return-to-work due to mental disorders ranged from 66.7% in schizophrenia (F20) to 95.8% in bipolar affective disorders (F31). Death was rarely observed except for cases of neoplasms (C00–D48), of which the cumulative incidence of death reached 14.2% by 1.5 years.

Conclusions: Return-to-work and resignations occurred commonly within 1 year of sick leave among long-term sickness absentees in the Japanese private companies. Our findings may assist occupational physicians and employers in developing effective social protection schemes.

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© 2021 Chihiro Nishiura et al. This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.