Smoking and sickness absence among public health workers

Background. As well as causing sickness and death, smoking has high socio-economic costs. The aim of this paper was to examine how closely smoking is associated with sickness absence among healthcare workers. Subjects and methods. Cases and controls were paired by age, gender and occupation among primary healthcare workers in Tenerife, Canary Islands, Spain. Cases were selected from workers that had been absent from work due to sickness for 1 or more days in an entire year, regardless of the cause. Controls were those workers who were not absent due to sickness over the same period. Tobacco consumption was verified by telephone poll. Matched pairs analysis was performed. Results. Among the 292 cases, 40% were smokers, compared with 31% of controls [odds ratio (OR) = 1.51, 95% confidence intervals (CI) = 1.06-2.14]. The association between smoking and sickness absence was stronger in those aged 30-45 years (OR=1.60, 95%CI=1.04-2.44) and among nurses (OR=2.08, 95%0=11.05-4.114). When the cause of sickness absence was a respiratory disease, no association was found with smoking. However, an association was found with back pain (OR= 5, 95%CI = 1.45-17.27). Duration of tobacco consumption was higher in cases (a) when only current smokers were considered (P=0.002), and (b) when including the smoking duration of former smokers (P=0.0004). Conclusions. Smoking is associated with a higher risk of sickness absence among healthcare workers, particularly due to back pain. This could be used as an incentive to persuade healthcare workers to stop smoking and re-inforce the non-smoking message given to their patients. (C) 2004 Published by Elsevier Ltd on behalf of The Royal Institute of Public Health.