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International Archives of Occupational and Environmental Health
Published in: International Archives of Occupational and Environmental Health 4/2016

Open Access 01-05-2016 | Original Article

Measuring multimorbidity in a working population: the effect on incident sickness absence

Authors: Monica Ubalde-Lopez, George L. Delclos, Fernando G. Benavides, Eva Calvo-Bonacho, David Gimeno

Published in: International Archives of Occupational and Environmental Health | Issue 4/2016

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Abstract

Purpose

Multimorbidity research typically focuses on chronic and common diseases in patient and/or older populations. We propose a multidimensional multimorbidity score (MDMS) which incorporates chronic conditions, symptoms, and health behaviors for use in younger, presumably healthier, working populations.

Methods

Cross-sectional study of 372,370 Spanish workers who underwent a standardized medical evaluation in 2006. We computed a MDMS (range 0–100) based on the sex-specific results of a multicorrespondence analysis (MCA). We then used Cox regression models to assess the predictive validity of this MDMS on incident sickness absence (SA) episodes.

Results

Two dimensions in the MCA explained about 80 % of the variability in both sexes: (1) chronic cardiovascular conditions and health behaviors, and (2) pain symptoms, in addition to sleep disturbances in women. More men than women had at least one condition (40 vs 15 %) and two or more (i.e., multimorbidity) (12 vs 2 %). The MDMS among those with multimorbidity ranged from 16.8 (SD 2.4) to 51.7 (SD 9.9) in men and 18.5 (SD 5.8) to 43.8 (SD 7.8) in women. We found that the greater the number of health conditions, the higher the risk of SA. A higher MDMS was also a risk factor for incident SA, even after adjusting for prior SA and other covariates. In women, this trend was less evident.

Conclusions

A score incorporating chronic health conditions, behaviors, and symptoms provides a more holistic approach to multimorbidity and may be useful for defining health status in working populations and for predicting key occupational outcomes.
Appendix
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Metadata
Title
Measuring multimorbidity in a working population: the effect on incident sickness absence
Authors
Monica Ubalde-Lopez
George L. Delclos
Fernando G. Benavides
Eva Calvo-Bonacho
David Gimeno
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
International Archives of Occupational and Environmental Health / Issue 4/2016
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-015-1104-4

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