In the regression analysis, we controlled for age, gender and expected absenteeism, as these are the factors that are known to have an impact on the absence of disease (4). Good cooperation with work centres has been associated with a high rate of illness, most likely because work centres pay more attention to companies with high absenteeism. High fluctuation has also been associated with a high rate of absenteeism, as other studies have shown (5,6). Staff involvement and reinforcement were linked to a low rate of illness, as reported by Allebeck and Mastekaasa (4). Good collaboration with the occupational health service has also been associated with a low rate of disease. The same association has been demonstrated by some studies (7-9), while others have not found it or have criticized such collaboration (10,11). We also found that good collaboration with the occupational health department was strongly correlated with a high score in the IWL activity. This may indicate that both the use of the occupational health service and the implementation of many IWL activities can be beneficial in reducing absenteeism. However, the possibility of a Bias report cannot be ruled out due to the design of cross-sectional studies. In an editorial on reducing absenteeism in the workplace, Martimo (12) gives an overview of evidence-based interventions very similar to those of the IWL agreement.
Mr Martimo (12) proposed that the occupational health service should play a key role as a return-to-work coordinator in a company. In order to facilitate the implementation of the IWL Agreement, a bank of good practices was set up in 2000, with the support of social security and the social partners. At first, it focused only on disease-free, but when the IWL campaign began, it was transformed into a bank of best practice models for IWL. The Bank filled three people who, together with the social partners and the IWL centres, were tasked with identifying successful IWL companies and presenting them to the public through newsletters and web presentations to inspire other companies. To be identified as a success, the company had to have fulfilled certain criteria that met the objectives of the IWL campaign (reduction of sick leave, promotion of early return to work, prevention of early retirement and promotion of employment of people with disabilities). Another explanation for a higher-than-expected absenteeism rate in the companies studied may be that a company was considered more successful when it experienced a sharp reduction in sickness absence than if its absenteeism remained low but unchanged over time. A third explanation could be that the initiatives of the Norwegian IWL Agreement, although they are considered good practices (1) by the European Foundation, simply do not work. In a 2002 report, Spurgeon (3) found that interventions such as `management training` accurately recorded and monitored absences; previous management contacts with absent persons; Return to work interviews; trigger points for action and verification; Verification of isolated cases” are not evidence-based to reduce absenteeism.
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