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Reduction in Personnel and Long-Term Sickness Absence for Psychiatric Disorders Among Employees in Swedish County Councils: An Ecological Population-Based Study

Bryngelson, Anna MSc; Mittendorfer-Rutz, Ellenor PhD; Fritzell, Johan PhD; Åsberg, Marie PhD; Nygren, Åke PhD

Journal of Occupational & Environmental Medicine: June 2011 - Volume 53 - Issue 6 - p 658–662
doi: 10.1097/JOM.0b013e31821aa706
Original Articles

Objective: The aim was to examine whether staff downsizing was related to long-term psychiatric sickness absence.

Methods: We used aggregate data on sickness absence from AFA insurance, as well as information on staff numbers from the Swedish Association of Local Authorities and Regions. Bootstrap regression analyses were used to elucidate whether there was a relationship between reduction in personnel and changes in sickness rates.

Results: A staff reduction of 1% increased the sickness rate, on average, by 9%. The associations were similar in men and women as well as in different age groups, although statistical significance was only reached in the groups of women and middle-aged employees.

Conclusions: Our findings suggest that downsizing may be related to subsequent increases in psychiatric sickness absence. The association appeared after a time-delay of several years.

From the Department of Clinical Sciences (Ms Bryngelson, and Drs Åsberg and Nygren), Department of Clinical Neuroscience, Division of Insurance Medicine (Dr Mittendorfer-Rutz), Centre for Health Equity Studies, Stockholm University (Dr Fritzell), Karolinska Institutet, Institute for Futures Studies (Dr Fritzell), Stockholm, Sweden.

Address correspondence to: Anna Bryngelson, MSc, Danderyd Hospital, Department of Clinical Sciences, Karolinska Institutet, Bldg 47, Stockholm 18288, Sweden (

©2011The American College of Occupational and Environmental Medicine