Objective: To study the effect of a preventive vocationally oriented intervention on the rates of sickness absence and disability pension in employees who are considered to be at risk of future work disability.
Design: An observational register based study of public sector employees.
Subjects: A total of 2,236 participants of the intervention programme and 8,944 matched controls were followed up for 8 years.
Methods: Multidisciplinary intervention was carried out at rehabilitation institutions. Data on demographics and sickness absences were obtained from the employers' records. Information about health at baseline, participation in the intervention, and subsequent disability pension was collected from national registers.
Results: Prior to the intervention the participants showed a17 % higher number of annual sick leave days and 23 % higher rate of absence spells lasting >21 days than the controls. In the year of intervention and the 3 subsequent years, the sickness absence rate among the participants reduced to the level observed among the controls, but thereafter the rate increased to the pre-intervention level (p for curvilinear trend <0.0001 for absence days and 0.03 for absence spells). The association between the intervention and future disability pension was non-proportional among the participants. Compared to the controls, the risk among the participants was lower in the first 4 years of the follow-up, but thereafter it returned to the same higher level as before the intervention. In terms of absolute figures per 1,000 employees, the temporary decline in sickness absence attributable to the intervention totalled 6,673 absence days and the cumulative reduction in disability was 56.4 years. These direct health benefits may not fully cover the costs of the intervention.
Conclusion: The results suggest that the risk of work disability can, at least temporarily, be diminished in employees at risk by means of a vocationally oriented multidisciplinary intervention programme.
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