Sickness absence from respiratory disease. 92/4

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General patterns of absence

Sickness absence and inability to work through ill-health costs the British economy £5,700 million annually in social security benefits, and perhaps four times this figure is lost in productivity.

Most employees take little or no sick leave during the course of the year; but while the majority of spells of sickness absence are of short duration, longer term spells account for a substantial proportion of working time lost.

Data from the Labour Force Survey show that 3.7% of males and 5.3% of females in employment in Great Britain were absent from work because of sickness or injury for one or more days during a reference week in spring 1991; and 1.8% of males and 2.4% of females were absent for five or more days during the reference week.

In addition to the 1.1 million people who were temporarily absent from work at some time during the reference week because of sickness or injury, 1.5 million people in Great Britain were economically inactive because of long term sickness or disability.

Sickness absence statistics

Despite the importance of sickness absence in terms of its cost to the economy and the morbidity that it represents, national statistics relating to the causes of such absence are not routinely collected. Statistics relating to claims for sickness and invalidity benefit are published but these are subject to a number of major shortcomings as a source of information on sickness absence (see footnote). The most recent reasonably comprehensive sickness benefit statistics relate to 1982/83.

Sickness absence by cause

Spells of absence

Figure 1:Spells of certified incapacity males and females

In 1982 respiratory problems were the largest single reported cause of certified absence in both males and females. Around one third of all spells commencing during the year were reported to be due to diseases of the respiratory system (figure 1).

"Influenza" and upper respiratory infections accounted for the largest proportion of spells of absence attributed to respiratory conditions. The proportion of influenza spells was high in 1982/83. Influenza more typically accounts for between 20% and 30% of all respiratory spells and 6.8% of all spells of absence.

Working time lost

Respiratory conditions assume lesser importance as a cause of lost working time and accounted for only one eighth of the total days of certified sickness/injury in 1982/83.

Figure 2: Days of certified incapacity males

In men, diseases of the circulatory system and diseases of the musculoskeletal system accounted for greater proportions of working time lost, and mental disorders were also an important cause of lost working time (figure 2).

Figure 3: Days of certified incapacity, females

In women, mental disorders and diseases of the musculoskeletal system accounted for the largest proportions of lost working time with respiratory conditions once again in third place (figure 3).

Chronic obstructive pulmonary disease (chronic bronchitis, emphysema, asthma, bronchiectasis, alveolitus and chronic airways obstruction) accounted for almost two thirds of the days lost to respiratory conditions in men and around one third of women. Chronic obstructive pulmonary disease, influenza and acute upper respiratory infections were the most common respiratory causes of lost working time in women.

Figure 4: Main respiratory causes of lost working time due to sickness absence

Chronic bronchitis, influenza and asthma were the three single most important respiratory causes of lost working time in both sexes (figure 4).

Summary

• Respiratory conditions are the single largest cause of spells of certified sickness absence.

• Respiratory conditions are less important in terms of total working time lost.

• Respiratory infections are the main respiratory cause of spells of sickness absence, but chronic obstructive pulmonary diseases have a greater impact on working time lost.

• Chronic bronchitis, influenza and asthma are the three single most important respiratory causes of lost working time.

• Currently available national statistics are biased towards longer term absence and substantially underestimate the impact of respiratory disease on sickness absence.

Figure 5: Spells of certified incapacity commencing during year

Footnote

Sickness/invalidity benefit statistics

Sickness/invalidity benefit statistics have a number of shortcomings as a source of information on sickness absence:

• Short term absences (1-3 days) are not normally covered.

• The most recent reasonably comprehensive statistics are 10 years old. Since then , coverage of the statistics has been progressively eroded as benefits and rules for eligibility have changed. Current statistics exclude absences covered by Statutory Sick Pay and are biased towards longer term spells.

• The number of spells of absence attracting sickness/invalidity benefit dropped by 80% in 1983 when Statutory Sick Pay was introduced (figure 5)

• The exclusion of absences covered by Statutory Sick Pay had a disproportionate effect on the coverage of shorter spells, as can be seen from its effect on spells attributed to influenza

• Diagnosis is coded from the "certified" reason for absence and this may not be accurate for a number of reasons - unwillingness to disclose medical information to an employer, use of imprecise lay terms, etc

• The "population at risk" is unknown: hence rates cannot be calculated.