Many patients diagnosed with lymphoma are of working age. Cancer patients are known to have a higher risk of sick leave and disability pension, but this has only been delineated for certain subtypes ...of lymphoma. Therefore, this study aimed at investigating the overall risk of disability pension for all lymphoma subtypes and at quantifying return to work for patients with lymphoma in work before diagnosis.
Patients aged 18-60 years with lymphoma in complete remission (CR) diagnosed between 2000 and 2019 were included in the study. Using national registers, each patient was matched with five comparators from the general population with same sex, birth year, and level of Charlson Comorbidity Index. Risk of disability pension was calculated from 90 days after CR or end of treatment with competing events (death, retirement pension, early retirement pension, relapse for patients, or lymphoma diagnosis for comparators). Return to work for patients was calculated annually until 5 years after diagnosis for patients employed before diagnosis.
In total, 4072 patients and 20,360 comparators were included. There was a significant increased risk of disability pension for patients with all types of lymphoma compared to the general population (5-year risk difference: 5.3 (95% confidence interval (CI): 4.4;6.2)). Patients with non-Hodgkin lymphoma were more likely to get disability pension than patients with Hodgkin lymphoma (sex- and age-adjusted 10-year risk difference: 2.9 (95% CI: 0.3;5.5)). One year after diagnosis, 24.5% of the relapse-free patients were on sick leave. Return to work was highest 2 years after diagnosis (82.1%).
Patients with lymphoma across all subtypes have a significantly higher risk of disability pension. Return to work peaks at 2 years after diagnosis.
Background and aims: Medical specialists in social medicine play an important role in description of work-related health problems of the individual citizen in the Municipalities, yet knowledge of the ...consistency in their medical assessment remains poor. However, we expect good agreement between medical specialists' descriptions of health and work ability. The present paper aims to evaluate inter-rater differences between assessments issued by medical specialists in social medicine on healthrelated work ability in patients with musculoskeletal diseases and some lighter psychiatric diseases. Methods: A total of 11 medical specialists in social medicine from four departments across Denmark each described eight subjects' health and health-related disability upon request from the municipal authorities. The resultant 88 written medical expert assessments were evaluated and scored independently by two medical specialists in social medicine with respect to functional impairment/health-related work ability as intact, slightly reduced, much reduced, or extremely reduced. Kappa analysis described the inter-rater agreements. Results: The combined Kappa value for work ability was 0.33 (slight agreement). In the category "extremely reduced" work ability the Kappa value was 0.61 (good agreement), but mostly this result was due to one subject. One department had better intra-dep artmental agreement than the other departments. Agreement on the level of work ability was poorer in subjects with psychiatric diseases. Conclusions: The assessments from medical specialists in social medicine on work ability and thereby occupational possibilities show much variation. The results of the present study demonstrate that there is much room for improving agreement on these assessments.
Summary
Background : Data on the safety of azathioprine and mercaptopurine during pregnancy are very sparse.
Aim : To examine the risk of adverse birth outcomes in women who took up prescriptions for ...azathioprine or mercaptopurine during pregnancy.
Methods : This is a Danish cohort study based on data from a population‐based prescription registry, the Danish Birth Registry and the Hospital Discharge Registry. To examine the risk of congenital malformations, we included nine pregnancies exposed 30 days before conception or during the first trimester. To examine perinatal mortality, pre‐term birth and low birth weight, we included 10 pregnancies exposed during the entire pregnancy. Eleven different exposed women were included in the study. Outcomes were compared with those of 19 418 pregnancies in which no drugs were prescribed to the mothers.
Results : Fifty‐five per cent of the exposed women had inflammatory bowel disease and 45% other diseases. Adjusted odds ratios for congenital malformations, perinatal mortality, pre‐term birth and low birth weight were 6.7 (95% confidence interval, 1.4–32.4), 20.0 (2.5–161.4), 6.6 (1.7–25.9) and 3.8 (0.4–33.3), respectively.
Conclusions : Our results suggest that there is an increased risk of congenital malformations, perinatal mortality and pre‐term birth in children born to women treated with azathioprine or mercaptopurine during pregnancy. More data are needed to determine whether the associations are causal or occur through confounding.
Background
Therapeutic hypothermia for comatose survivors of out‐of‐hospital cardiac arrest (OHCA) has improved survival and neurologic outcome. This study focused on return to work 1 year after ...therapeutic hypothermia.
Methods
From June 2004 to June 2009, patients between 18 and 65 years of age with OHCA, who were treated with hypothermia from two regions, representing one third of the national population, were identified from the Danish National Patient Registry, and from hospital and ambulance records. The patients' employment status was obtained from the Danish Ministry of Employment.
Results
One hundred thirty‐three comatose patients after OHCA treated with hypothermia were identified. One hundred and four (78%) patients were employed, or able to work, at the time of cardiac arrest. This particular group of patients showed significant lower in‐hospital mortality compared to the group of patients who were not able to work before cardiac arrest; 13% vs. 48%, respectively (P < 0.001). The workable group had a lower Charlson comorbidity score (P = 0.004), a higher incidence of witnessed cardiac arrest (P = 0.004) and a higher incidence of shockable heart rhythm (P < 0.001). Eighty‐seven patients (84%), who were able to work prior to cardiac arrest, survived, and 55 (65%) of these patients were employed or able to work at 1 year follow‐up.
Conclusion
The majority of patients employed, or able to work prior to OHCA, had returned to work at one year follow‐up. Predictors of return to work in comatose patients treated with hypothermia have to be identified in a larger‐scale study.
Abstract
Background
Trends towards longer labor market participation are seen in international policies. In the EU countries, labor force participation rate for those past 60 years of age, has been ...raised extensively for the past decade. In 2035 Danish workers are expected to work till 69 years of age. The aim of the study was twofold, firstly to identify and synthesize findings from former studies of factors of importance in construction workers (age 55+) work participation and secondly to understand and explore how construction workers experience their work participation.
Methods
A systematic review and integrative thematic synthesis of qualitative and quantitative studies aiming to identify factors of importance in construction workers work participation were carried out followed by individual interview 20 Danish construction workers and thematic analysis.
Results
Four themes illustrating factors influencing construction workers work participation were identified in the review. Theme 1 Socioeconomical and cultural factors, Theme 2 Legislation and policy, Theme 3 Workplace factors and Theme 4 Individual factors. The identified themes helped structure the interview guide. Preliminary results of the individual interviews provide a deeper understanding of how both individual, social and workplace factors interacts and how it is possible for construction workers to compensate from the experienced age-related physical limitations. Elderly construction workers adjust and compensate for demanding work tasks by receiving support from co-workers and having less demanding work tasks during their workday. Both physical and psychosocial work environment and employers’ attitudes towards elderly workers seems to be significant for their ability for working late in life.
Conclusions
The interplay between individual, psychosocial, and work environmental factors are affecting elderly construction workers work participation which have an impact on their work retention late in life.
Key messages
• Elderly construction workers work participation depends on the physical and the psychosocial work environment and possibilities for adjustment and compensation for performing demanding work tasks.
• individual, social and workplace factors interacts and how it is possible for construction workers to compensate from the experienced age-related physical limitations.
Background: 5-Aminosalicylic acid (5-ASA) preparations are the firstline drugs in the treatment of inflammatory bowel disease. Data on the safety of these drugs in pregnancy are sparse. Aims: To ...examine the risk of adverse birth outcome in women who were prescribed 5-ASA drugs during pregnancy. Patients: Women were included in the study if they were prescribed 5-ASA drugs immediately before or during pregnancy. To examine the risk of malformations, we included 60 pregnancies exposed to 5-ASA drugs 30 days before pregnancy or in the first trimester. To examine stillbirths, preterm births, and low birth weight, we included 88 pregnancies exposed during the entire pregnancy. Outcomes were compared with those of 19 418 pregnancies in which no drugs were prescribed for mothers during the study period. Methods: We conducted a Danish cohort study based on data from a population based prescription registry, the Danish Birth Registry, and the Hospital Discharge Registry in North Jutland County. Results: Odds ratios for malformations, stillbirth, preterm birth, and low birth weight in women who received prescriptions for 5-ASA drugs were 1.9 (95% confidence interval 0.7–5.4), 6.4 (1.7–24.9), 1.9 (0.9–3.9), and 1.2 (0.4–3.3), respectively. The increased risk of stillbirth and preterm birth were found only in patients with ulcerative colitis. Conclusions: We found an increased risk of stillbirth and preterm birth in women who had been prescribed 5-ASA drugs during pregnancy but no substantial increased risk of malformations. It was difficult to distinguish the specific effects of disease activity and 5-ASA drugs.
Abstract
Background
In Denmark, people with permanent and significant reduced work capacity can be assigned to a flexi-job (FJ) scheme. In 2013, the social security policy for FJ was reformed in ...order to improve the chances for employment for people with reduced work capacity. In a Danish cohort study from the North Denmark Region we aimed to describe work participation in the flexi-job scheme before and after the reform. Furthermore, we described the associations between employment in the flexi-job scheme and predictors such as sociodemographic factors, healthcare use, and work participation before assignment.
Methods
The study population included individuals assigned to the FJ scheme between 2010 and 2015 in the North Denmark Region. The study population was followed until leaving the FJ scheme or end of follow up (September 2017). Baseline information included data on sex, age, place of residence, number of contacts to specialized healthcare, and number of working weeks five years before. Work participation score (WPS) was defined as number of working weeks divided with the total number of weeks in the FJ scheme. High WPS was defined as above the median. We used a logistic regression model to study associations between baseline characteristics and high WPS.
Results
A total of 4,668 people were included in the study. The overall median WPS were 73% (interquartile range (IQR) 42% - 90%). Policy changes (OR 1.40, 95% confidence interval (CI ): 1.24 - 1.59), male sex (OR 1.16, CI:1.03 - 1.31), young age (OR 1.45, CI: 1.17 - 1.80), urban living (OR 1.22, CI:1.03 - 1.46), no contact to specialized healthcare (OR 1.54, CI: 1.21 - 1.99), and a strong association to the labor market before awarded FJ (OR 4.25, CI: 3.34 - 5.41) were all predictors of a high WPS during FJ-scheme.
Conclusions
Policy changes increased work participation in the FJ-scheme. However, the strongest predictor of a high WPS for people awarded FJ was the degree of work participation before the scheme.
Key messages
Several factors had impact on work participation in a flexi-job scheme.
The flexi-job scheme might be insufficient to secure employment for people with prior weak affiliation to the labor market.
Abstract
Background
Mounting evidence suggests that mental health problems in pregnant women may negatively affect the intra- and extrauterine health and development of the child. This is especially ...of concern as the prevalence of mental health problems in pregnant women is high and believed to be increasing. We set out to quantify the effect of maternal mental health status on the risk of adverse perinatal outcomes for the infant.
Methods
We undertook a nationwide register-based cohort study including children born alive in Denmark between 2000 and 2016. The exposed cohort was children born to mothers with mental health problems in the two years prior to childbirth that had been cared for in primary care settings only (Group 1, minor problems, n = 71 759) or had required psychiatric intervention (Group 2, moderate-severe problems, n = 41 099). All non-exposed children served as comparison group (n = 908 268). We calculated risk ratios (RRs) with 95% confidence intervals (CI) for each perinatal outcome of interest.
Results
Infants in Group 1 as well as Group 2 were at higher risk of neonatal death than infants born to unaffected mothers, although for Group 2 the trend was non-significant (Group 1: adjusted RR (aRR) 1.34, 95% CI 1.17-1.52; Group 2: aRR 1.11, 95% CI 0.94-1.32). Both exposure groups were furthermore at significantly increased risk of 5-minute Apgar scores <7 (Group 1: aRR 1.27, 95% CI 1.17-1.37; Group 2: aRR 1.52, 95% CI 0.94-1.32) and <4 (Group 1: aRR 1.26, 95% CI 1.10-1.44; Group 2: aRR 1.28, 95% CI 1.08-1.52) and of hospital admission in the neonatal period (Group 1: aRR 1.22, 95% CI 1.19-1.24; Group 2: 1.29, 95% CI 1.26-1.32), paralleled by a significantly higher risk of preterm birth and several neonatal morbidities.
Conclusions
Infants born to mothers with moderate-severe as well as minor mental health problems were at increased risk of multiple adverse perinatal outcomes, thus calling for effective preventive strategies to improve outcomes in both groups.
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