# Cardiovascular disease and absenteeism in Dutch occupational health: a retrospective study in a regular working population

## TL;DR

This study shows that cardiovascular disease is a major cause of long-term absenteeism and high costs for employers in the Netherlands.

## Contribution

The study provides new empirical data on the impact of CVD on absenteeism and costs in a working population.

## Key findings

- CVD is the primary cause of absenteeism in 3.2% of all cases.
- The median absenteeism duration due to CVD is 119 working days.
- The estimated cost to employers is €37,000 per employee affected by CVD.

## Abstract

There is very limited data available on the impact of cardiovascular disease (CVD) on absenteeism occurrence, absenteeism duration, and the associated rough cost-estimate for employers.

We extracted routinely collected absenteeism data for the years 2019–2022 from a database maintained by two large, nationally operating occupational health services (n = 443,740). All diagnoses and included sickness cases were recorded > 6 weeks of absenteeism.

Descriptive statistics, including median values (IQR) and percentages, were calculated and compared using the Mann-Whitney U test and Pearson chi-square test. Subgroup comparisons were performed using the Kruskal-Wallis test. To analyse return-to-work over time, a Kaplan-Meier curve was constructed, and differences in return-to-work were assessed using the Log Rank (Mantel-Cox) test.

CVD is the primary cause of absenteeism in 3.2% of all absenteeism cases. The median duration of absenteeism following CVD was 119 working days (IQR 156; Q1–Q3 62.9–218.6) with a minimum rough cost-estimate to employers of € 37,000 per employee. The most frequently occurring CVD diagnoses were: acute myocardial infarction, cerebrovascular disease, cardiac arrhythmia, unspecified cardiovascular complaints and angina.

CVD occurs frequently, results in prolonged absenteeism, and incurs high costs for employers. We strongly believe that CVD-related absenteeism should receive greater attention. Specifically, both in-hospital and outpatient treatments should place a stronger emphasis on work-related issues, including strategies for returning to work with or without tailored assignments in the workplace. This focus will help ensure that employees can sustainably return to work and continue to contribute to society.

The online version of this article (10.1007/s12471-025-01989-6) contains supplementary material, which is available to authorized users.