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Sickness absence as a risk factor for job termination, unemployment, and disability pension among temporary and permanent employees
  1. M Virtanen1,
  2. M Kivimäki2,
  3. J Vahtera3,
  4. M Elovainio4,
  5. R Sund5,
  6. P Virtanen4,
  7. J E Ferrie5
  1. 1Finnish Institute of Occupational Health, Helsinki, Finland
  2. 2University of Helsinki, Department of Psychology, Helsinki, Finland
  3. 3National Research and Development Centre for Welfare and Health, Helsinki, Finland
  4. 4University Of Tampere, Faculty of Medicine and Pirkanmaa Hospital District, Tampere, Finland
  5. 5University College London, Department of Epidemiology and Public Health, London, UK
  1. Correspondence to:
 Dr M Virtanen
 Finnish Institute of Occupational Health, Department of Psychology, Topeliuksenkatu 41 a A, FIN-00250 Helsinki, Finland; marianna.virtanen{at}


Objectives: This study examined sickness absence as a risk factor for job termination, unemployment, and disability pension among temporary and permanent workers.

Methods: Prospective cohort study with data on employment contract and sickness absence in 1996, job termination by 1997, and employment status in 1997 and 2000 for 19 093 temporary and 41 530 permanent public sector employees.

Results: For women aged 40 years or less and for women over 40, a high sickness absence increased the risk of job termination among temporary employees (OR 1.52 (95% CI 1.36 to 1.71) and OR 1.70 (95% CI 1.36 to 2.13) respectively). High absence was not associated with job termination among men in temporary employment. Among permanent employees, high sickness absence predicted job termination among older, but not among younger employees. Temporary employees with high sickness absence were at the highest risk of immediate unemployment and unemployment three years later. Among older permanent employees, high sickness absence was associated with subsequent work disability pension.

Conclusions: A high rate of sickness absenteeism increases the risk of job termination and unemployment among women in temporary public sector jobs. For permanent employees, secure employment provides protection against unemployment even in the case of high sickness absence.

  • employment status
  • health selection
  • job insecurity
  • longitudinal study
  • sickness absence

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  • Funding: MK, MV, and JV were supported by the Academy of Finland (projects 104891, 105195, and 77560) and the Finnish Environment Fund. JEF was supported by the Medical Research Council (grant number G8802774) during the preparation of this paper.

  • Competing interests: none declared.