Background Reduction of personnel by businesses and other organisation
s (organisational downsizing) is common in Europe, but little is known
about its effects on the health of employees. Methods We used employe
rs' records to investigate the relation between downsizing and subsequ
ent absenteeism because of ill health in 981 local-government workers
who remained in employment in Raisio, south-western Finland, during a
period of economic decline (1991-95). Data were separated into three t
ime periods: 1991, before downsizing; 1993, major downsizing in some w
orkplaces and occupations; and 1993-95, after downsizing. We obtained
data on sick leave from records kept by the occupational health-care u
nit in Raisio. We also investigated whether the effects of downsizing
were dependent on ten other predictors of sick leave. Findings There w
as a significant association between downsizing and medically certifie
d sick leave. The rate of absenteeism was 2.3 times greater (95% CI 2.
0-2.7) after major downsizing, classified by occupation, than after mi
nor downsizing. The corresponding rate ratios for musculoskeletal diso
rders and trauma were 5.7 (4.1-8.0) and 2.7 (1.7-4.2), respectively. T
he effects of downsizing by workplace depended on the age distribution
of the staff. When the proportion of employees who were older than 50
years was high, downsizing increased the individual risk of absence b
ecause of ill health by 3.2-14.0 times, depending on diagnostic catego
ry. When the proportion of employees over 50 years was low, downsizing
had only slight effects on health. Other risk factors that increased
rates of sick leave after downsizing were age over 44 years, a large w
orkplace, poor health before downsizing, and high income. Interpretati
on Downsizing is a risk to the health of employees. But this risk vari
es according to individual factors, such as age, socioeconomic status,
and health, as well as factors related to place of work, for example,
size and age structure of the staff.