Ai Hori1, Yosuke Inoue2, Keisuke Kuwahara2,3, Naoki Kunugita4, Shamima Akter2, Chihiro Nishiura5, Chihiro Kinugawa6, Motoki Endo7, Takayuki Ogasawara8, Satsue Nagahama9, Toshiaki Miyamoto10, Kentaro Tomita11, Makoto Yamamoto12, Tohru Nakagawa13, Toru Honda13, Shuichiro Yamamoto13, Hiroko Okazaki14, Teppei Imai15, Akiko Nishihara16, Naoko Sasaki8, Akihiko Uehara17, Taizo Murakami18, Makiko Shimizu18, Masafumi Eguchi19, Takeshi Kochi19, Maki Konishi2, Ikuko Kashino2, Miwa Yamaguchi2, Akiko Nanri2,20, Isamu Kabe21, Tetsuya Mizoue2, Seitaro Dohi14. 1. Department of Global Public Health, University of Tsukuba, Ibaraki Japan. 2. Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan. 3. Teikyo University Graduate School of Public Health, Tokyo, Japan. 4. School of Health Sciences, University of Occupational and Environmental Health, Fukuoka, Japan. 5. Department of Safety and Health, Tokyo Gas Co., Ltd., Tokyo, Japan. 6. Healc Co.,Ltd., Tokyo, Japan. 7. Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan. 8. Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan. 9. All Japan Labour Welfare Foundation, Tokyo, Japan. 10. NIPPON STEEL CORPORATION, Kimitsu Works, Chiba, Japan. 11. Healthplant Co., Ltd., Tokyo, Japan. 12. YAMAHA CORPORATION, Shizuoka, Japan. 13. Hitachi, Ltd., Ibaraki, Japan. 14. Mitsui Chemicals, Inc., Tokyo, Japan. 15. OH Support, Kanagawa, Japan. 16. Azbil Corporation, Tokyo, Japan. 17. Hidaka Tokushukai Hospital, Hokkaido, Japan. 18. Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan. 19. Furukawa Electric Co., Ltd., Tokyo, Japan. 20. Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan. 21. KUBOTA Corporation, Japan.
Abstract
BACKGROUND: Few studies have investigated the association between tobacco smoking and sick leave (SL) in Japan. METHODS: We followed 70,896 workers aged 20-59 years (60,133 males, 10,763 females) between April 2012 and March 2017. A Cox proportional hazards model was used to investigate the associations between smoking (smoking status and intensity) and long-term SL (i.e., SL lasting ≥ 30 consecutive days). Cause-specific analyses were also conducted. RESULTS: A total of 1,777 people took long-term SL during a follow-up of 307,749 person-years. Compared with never smokers, current smokers were at a higher risk of long-term SL (hazard ratio [HR] = 1.31; 95% confidence interval [CI] = 1.17-1.46). Cause-specific analyses revealed that current smoking was associated with a higher risk of SL due to all physical disorders (HR = 1.42, 95% CI = 1.21-1.67), cancer (HR = 1.49, 95% CI = 1.10-2.00), cardiovascular disease (CVD; HR = 2.09, 95% CI = 1.26-3.45), and external causes (HR = 1.84, 95% CI = 1.31-2.59). Former smokers were at a higher risk of SL due to cancer at a borderline significance level (HR = 1.37, 95% CI = 0.98-1.91). Low-intensity smoking (i.e., 1-10 cigarettes smoked per day) was associated with all-cause SL, SL due to CVD, and SL due to external causes, compared with never smokers. CONCLUSION: In a large cohort of working-age Japanese, smoking was associated with a greater risk of long-term sick leave. Greater effort is needed to mitigate disease burden associated with smoking at workplace in Japan. IMPLICATIONS: Our study contributes to the literature on the association between smoking and sick leave in several ways. First, the study was conducted among a Japanese working population. While the association has been extensively studied in Western setting, few attempts have been made elsewhere. Second, cause-specific analyses were undertaken in our study. Third, we paid attention to the effect of low-intensity smoking on sick leave given that there is growing evidence of an elevated health risk associated with low-intensity smoking.
BACKGROUND: Few studies have investigated the association between tobacco smoking and sick leave (SL) in Japan. METHODS: We followed 70,896 workers aged 20-59 years (60,133 males, 10,763 females) between April 2012 and March 2017. A Cox proportional hazards model was used to investigate the associations between smoking (smoking status and intensity) and long-term SL (i.e., SL lasting ≥ 30 consecutive days). Cause-specific analyses were also conducted. RESULTS: A total of 1,777 people took long-term SL during a follow-up of 307,749 person-years. Compared with never smokers, current smokers were at a higher risk of long-term SL (hazard ratio [HR] = 1.31; 95% confidence interval [CI] = 1.17-1.46). Cause-specific analyses revealed that current smoking was associated with a higher risk of SL due to all physical disorders (HR = 1.42, 95% CI = 1.21-1.67), cancer (HR = 1.49, 95% CI = 1.10-2.00), cardiovascular disease (CVD; HR = 2.09, 95% CI = 1.26-3.45), and external causes (HR = 1.84, 95% CI = 1.31-2.59). Former smokers were at a higher risk of SL due to cancer at a borderline significance level (HR = 1.37, 95% CI = 0.98-1.91). Low-intensity smoking (i.e., 1-10 cigarettes smoked per day) was associated with all-cause SL, SL due to CVD, and SL due to external causes, compared with never smokers. CONCLUSION: In a large cohort of working-age Japanese, smoking was associated with a greater risk of long-term sick leave. Greater effort is needed to mitigate disease burden associated with smoking at workplace in Japan. IMPLICATIONS: Our study contributes to the literature on the association between smoking and sick leave in several ways. First, the study was conducted among a Japanese working population. While the association has been extensively studied in Western setting, few attempts have been made elsewhere. Second, cause-specific analyses were undertaken in our study. Third, we paid attention to the effect of low-intensity smoking on sick leave given that there is growing evidence of an elevated health risk associated with low-intensity smoking.
Authors: Somtip Watanapongvanich; Mostafa Saidur Rahim Khan; Pongpat Putthinun; Shunsuke Ono; Yoshihiko Kadoya Journal: Front Public Health Date: 2021-01-15