1. Smoking and Long-Term Sick Leave in a Japanese Working Population: Findings of the Japan Epidemiology Collaboration on Occupational Health Study.
- Author
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Hori, Ai, Inoue, Yosuke, Kuwahara, Keisuke, Kunugita, Naoki, Akter, Shamima, Nishiura, Chihiro, Kinugawa, Chihiro, Endo, Motoki, Ogasawara, Takayuki, Nagahama, Satsue, Miyamoto, Toshiaki, Tomita, Kentaro, Yamamoto, Makoto, Nakagawa, Tohru, Honda, Toru, Yamamoto, Shuichiro, Okazaki, Hiroko, Imai, Teppei, Nishihara, Akiko, and Sasaki, Naoko
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SICK leave , *INDUSTRIAL hygiene , *PROPORTIONAL hazards models , *CIGARETTE smoke - 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 (ie, SL lasting ≥30 consecutive days). Cause-specific analyses were also conducted.Results: A total of 1777 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] = 1.32; 95% confidence interval [CI] = 1.19 to 1.48). Cause-specific analyses revealed that current smoking was associated with a higher risk of SL due to all physical disorders (HR = 1.44, 95% CI = 1.22 to 1.69), cancer (HR = 1.49, 95% CI = 1.10 to 2.01), cardiovascular disease (CVD; HR = 2.16, 95% CI = 1.31 to 3.55), and injuries/external causes (HR = 1.83, 95% CI = 1.31 to 2.58). Former smokers were at a higher risk of SL due to cancer at a borderline significance level (HR = 1.38, 95% CI = 0.99 to 1.92). Low-intensity smoking (ie, 1-10 cigarettes smoked per day) was associated with all-cause SL, SL due to CVD, and SL due to injuries/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 SL. 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 SL 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 SL given that there is growing evidence of an elevated health risk associated with low-intensity smoking. [ABSTRACT FROM AUTHOR]- Published
- 2021
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