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In response to our study,1 Kivimäki et al suggested that reported sickness absence frequencies were underestimates of the total sickness absence burden in European Union (EU) member countries.2 This concern about the veracity of these estimates led Kivimäki et al to caution policy makers to not use this data to inform policy. While we agree that more research is needed to establish potential biases associated with different approaches to ascertain accurate sickness absence data, we consider the European Survey on Working Conditions (ESWC) to be useful to inform the cross-national policy debate. Country specific studies contribute knowledge to the evidence base, but cross-national studies such as ours help to provide a stronger basis on which to make cross-national inferences. Furthermore, cross-national studies become more relevant as data accumulate and the data collection quality improves. We hope that Kivimäki and colleagues are not suggesting the ESWC be discontinued.
We consider the studies …