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BMJ 2004;328 (6 March), doi:10.1136/bmj.328.7439.0-c
Organisational downsizing may increase sickness absence and the risk of death in employees who keep their job. Vahtera and colleagues (p 555) studied 22 430 municipal employees in Finland, who kept their jobs at a time of profound economic decline and organisational downsizing. After 7.5 years of follow up, they found that major downsizing was associated with an increase in sickness absence among permanent (but not temporary) employees. Though the number of cardiovascular deaths was small, mortality doubled, especially in the first four years after downsizing.
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Credit: HULTON GETTY
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