Article Text

Download PDFPDF

Sickness absence as a predictor of mortality among male and female employees
  1. J Vahtera1,
  2. J Pentti1,
  3. M Kivimäki2
  1. 1Finnish Institute of Occupational Health, Turku, Finland
  2. 2Department of Psychology, University of Helsinki, Finland
  1. Correspondence to:
 Dr J Vahtera
 Finnish Institute of Occupational Health, Hämeenkatu 10, FIN-20500 Turku, Finland;


Objective: To determine the extent to which sickness absence is predictive of mortality.

Design: Prospective cohort study. Data on medically certified long term absences (>3 days), self certified short term absences (1–3 days), and sick days were derived from employers’ records and data on mortality from the national mortality register.

Setting: 10 towns in Finland.

Participants: 12 821 male and 28 915 female Finnish municipal employees with a job contract of five consecutive years. The mean follow up was 4.5 years.

Main results: After adjustment for age, occupational status, and type of employment contract, the overall mortality rate was 4.3 (95% confidence intervals 2.6 to 7.0) and 3.3 (2.1 to 5.3) times greater in men and women with more than one long term absences per year than in those with no absence. The corresponding hazard ratios for more than 15 annual sick days were 4.7 (2.3 to 9.6) and 3.7 (1.5 to 9.1). Both these measures of sickness absence were also predictive of deaths from cardiovascular disease, cancer, alcohol related causes, and suicide. Associations between short term sickness absences and mortality were weaker and changed to non-significant after adjustment for long term sickness absence.

Conclusions: These findings suggest that measures of sickness absence, such as long term absence spells and sick days, are strong predictors of all cause mortality and mortality due to cardiovascular disease, cancer, alcohol related causes, and suicide.

  • sickness absence
  • mortality
  • cardiovascular disease
  • cancer
  • suicide
View Full Text

Statistics from


  • Funding: this study was supported by the Academy of Finland (projects 77560 and 105195), the Finnish Work Environment Foundation (project 101190 and 103432) and the participating towns.

  • Conflicts of interest: none declared.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.