Sickness absence is increasingly recognised as a measure of ill health. Studies have examined associations between absence, morbidity, and mortality,^1–3 but less is known about the status of sickness absence as a risk marker for future disability retirement,^4–6 the focus of this study.

METHODS

Participants selected from the on-going Finnish 10-town study⁴ comprised all 46 569 full time municipal employees who had a job contract lasting a minimum of three full consecutive years between 1 January 1990 and 31 December 2000, and were below 55 at the end of the follow up, the age before which medical causes exclusively determine granting of disability pension for municipal employees in Finland. We obtained sickness absence records from employers’ registers for a fixed three year period of employment (the length of exposure assessment period was the same for all participants). The start of this period varied between 1 January 1990 and 1 January 1998 depending on the date when the job contract began. For those employees who had a job contract of more than three years, absences for the first three years were included in the analysis.

We determined disability retirements from the end of the assessment period for …