Part-time sick leave found to speed up return to work

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Part-time sick leave, available in Finland since 2007, can offer workers a compromise where contact with the workplace is retained but work load is reduced. A study by the Finnish Institute of Occupational Health found that allowing employees suffering from musculoskeletal disorders to take early part-time sick leave (that is, reduced working hours plus modified work tasks if necessary) reduced both the time before their return to full-time work and subsequent sick leave.

Introduction

The Finnish Institute of Occupational Health (FIOH) has carried out a study (in Finnish, 3.84Mb PDF) to assess the effects of early part-time sick leave on the return to work and subsequent sick leave among patients with musculoskeletal disorders (MSDs). The study was funded by the Finnish Work Environment Fund, the Ministry of Social Affairs and Health and the Social Insurance Institution (Kela).

Sickness absence and disability in Finland

The Finnish sickness absence/disability system consists primarily of three options:

  • short-term sick leave (up to 10 working days) on full pay paid by the employer;
  • long-term sick leave, with a sickness allowance paid by Kela;
  • disability pension, paid by an earnings-related pension insurer (and/or Kela).

MSDs are the most common cause of long-term sick leave in Finland. They are also one of the two main causes of disability pensions in Finland, the other being mental disorders (Finnish Centre for Pensions, 2011). Most musculoskeletal disability pensions are due to low-back disorders.

The following statistics are reported for 2010:

  • 34% (112,500) of new sickness allowance periods were due to musculoskeletal problems (Kela, 2011);
  • 7,880 new disability pensions were granted due to MSDs (32% of all new disability pensions and 0.26% of the non-retired population aged 16–64).
  • 62,200 people received a disability pension caused by a musculoskeletal disorder (24% of all disability pensions and 1.8% of the population aged 16–64).

Part-time sick leave

In 2007, Finnish law was amended to include partial sickness allowance, although only after 60 days of sick leave. This approach, which is used in some other countries, was intended to reduce the risk of prolonged sick leave by keeping the employee active and connected with the work community. The 60-day restriction was removed in 2010, making partial sickness allowance available after two weeks of sick leave (that is, the period covered by the employer).

Part-time work is not suitable in all cases of sick leave as it may cause the underlying condition to deteriorate. However, people with MSDs often report that they can perform some of their regular duties if, for example, work is made lighter or hours are shortened.

Impact of part-time sick leave

The FIOH study involved employees in six enterprises who had sought medical advice due to musculoskeletal pain. To participate in the study, people’s symptoms and related disability had to be severe enough to justify full-time sick leave according to the prevailing practice but still allow them to work reduced hours without the risk of deterioration of their condition. A further eligibility criterion was that previous sick leave had to be two weeks or less.

A total of 120 employees were examined as potentially eligible and 63 were included in the study. The study was an individually randomised controlled trial in which participants were randomised into part-time or full-time sick leave groups. In the part-time sick leave group (intervention group), working time was reduced by about a half and the remaining work tasks were modified if necessary (for example, reduced lifting or reduced work with an arm above the head). The full-time sick leave group served as the control group.

Key results

  • The time taken to return to work was shorter in the intervention group (median: 12 days versus 20 days).
  • Total sickness absence during the 12-month follow-up was about 20% lower in the intervention than in the control group.
  • Work hours were reduced in all cases in the intervention group and work practices were modified for 30%.
  • Employees on part-time sick leave reported less disability and functional impairment, and had better self-rated health, than those on full-time sick leave.
  • Work arrangements made to suit part-time sick leave were mostly successful and the experiences of supervisors and employees were mainly positive.

Commentary

The results show that early part-time sick leave enhances the return to work in cases of musculoskeletal disorders. They also suggest better work participation outcomes after part-time sick leave compared with full-time sick leave, even in the long run. Early part-time sick leave study did not increase musculoskeletal complaints or their interference with work, suggesting it is a safe alternative to full-time sick leave.

References

Finnish Centre for Pensions (2011), Statistical yearbook of pensioners in Finland 2010, Helsinki.

Kela (2011) Kelan tialstollinen vuosikirja. FPA:s statistika årsbok. 2010 (9.78MB PDF, with English summaries) [Statistical Yearbook of the Social Insurance Institution 2010], Helsinki.

Viikari-Juntura, E., Martimo, K.-P., Kausto, J., Shiri, R., Kaila-Kangas, L., Takala, E.-P. et al (2011), Osasairausvapaa sairausloman vaihtoehtona tuki- ja liikuntaelinten sairauksissa (3.84Mb PDF) [Early part-time sick leave as an alternative to full sick leave in musculoskeletal disorders], Työympäristötutkimuksen Report 68, FIOH, Helsinki.

Viikari-Juntura, E., Kausto, J., Shiri, R., Kaila-Kangas, L., Takala, E.-P., Karppinen, J., et al (2012), ‘Return to work after early part-time sick-leave due to musculoskeletal disorders: a randomised controlled trial’, Scandinavian Journal of Work, Environment & Health, Vol. 38, No. 2, 2012, pp. 134–143.

Simo Virtanen and Eira Viikari-Juntura, Finnish Institute of Occupational Health

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