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Table 1 Summaries of each of the 17 included studies, regarding included data on sickness absence, presented by type of study (cohort, intervention, cross sectional), in chronological order, by first author

From: Hearing difficulties, ear-related diagnoses and sickness absence or disability pension - a systematic literature review

First author Aim of the study Study population. Hearing diagnoses/ symptom Type of data Measures used of: Results, regarding sickness absence Results regarding disability pension
Year   Study participants (% of men (♂)).   Years of follow-up. - Sick leave   
Country      - Disability pension   
   Mean age (age range).   Years of data collection.    
Prospective cohort studies
Carlsson [16] Investigate relation between sudden senorineural hearing loss and quality of life, psychosocial consequences and audiological rehabilitation. 588 (response rate 63%). Sudden sensorineural hearing loss Questionnaire data. -Proportion of patients on sick leave and grade of sick leave. 10% upheld sick-leave benefits before the sudden sensorineural hearing loss, 29% directly after and 27% after ≥7 years, most of them for full time  
2011     7 years.    
Sweden   369 patients (56% ♂). 277 with information about sick leave.      
   Mean age 59 (13–91).      
Gustafsson [17] Assess risk of being granted a disability pension among people with sick leave due to otoaudiological diagnoses compared to other sickness absentees. 231 499. Otoaudiological diagnose as the reason for sick leave. Data from sickness certificates and from registers. - No. of individuals with a sick-leave spells (>7 days) due to otoaudiological diagnoses in 1985. 162 men with a new sick-leave spells due to otoaudiological diagnoses and 18 151 men with sick-leave spells due to other diagnoses. RR for disability pension 1.42 (95% CI 1.23-1.64) among people on sick-leave with otoaudiological diagnoses compared to all other on sick leave, adjusted for age and sex.
2011   40 786 (45% ♂).      
Sweden   Age range 16–64.      
     11 years.    
      - No. and rate of people granted disability pension with different diagnoses. 353 women with a new sick-leave spell due to otoaudiological diagnoses and 22 120 with sick-leave spells due to other diagnoses.  
Skøien [18] Assess incidence of vertigo in long-term sickness absence and to identify sociodemographic diagnostic predictors for transition into disability pension 1 939 355. Vertigo (ICD10: H82) or dizziness (ICD10: N17) diagnoses. Register data. -No. of people on long-term sick leave (≥8 weeks) due to vertigo or dizziness diagnoses 282 women were on long-term sick leave due to vertigo, among 920 139 women eligible for sickness absence benefits and 134 men among 1 1019 216 eligible. 24% of men and 23% of women obtained a disability pension, Those with diagnose ICD10:H82 had a RR 1.5 (95% CI 1.1-1.9) for disability pension compared to those with diagnose ICD10:N17.
2008   1020 long-term sickness absentees, due to vertigo or dizziness (32% ♂).   5 years    
Norway     1997–2002.    
   Age range 16–62.      
      - No. granted disability pension   
Bjerlemo [19] Follow the recovery process and explore the disease impact on sick-leave in patients with acute unilateral vestibular loss All 44 patients from three hospitals, 27 responded (48% ♂). Unilateral vestibular loss Questionnaire data. -Being on sick leave At onset, 95% were on sick leave, after one month 26%; and after 6 months 22%.  
2006     6 months.    
Sweden     ?    
   19 patients with information about sick leave.      
   Mean age 52 (16–70).      
Andersson [27] Examine occupational status after 5 years, related to working hours, sick leave, pension, unemployment among patient with tinnitus. 189 tinnitus patients (77% response rate =146) (47% ♂). Tinnitus Medical files and questionnaire data. -Being sickness absent at admission and at follow up (self reported). No. of sickness absentees had decreased (13 vs. 6 subjects) at follow up.  
Sweden   142.      
   Mean age 56.4, age range 22–83.      
     Average 4.9 years (3–10 years).    
Holgers [26] Investigate risk factors for severe tinnitus measured as absence from work related to tinnitus of more than one month during the 18 month period 172 tinnitus patients, 127 (74%) completed questionnaire. Tinnitus Questionnaire and register data. -Absent from work >1 month due to tinnitus. 18 patients had been absent from work >1 month during the study period.  
Sweden     18 months.    
   79 patients not on old age pensioned (?).   ?    
   Mean age ♀ 75, ♂ 52.      
Starzynski [32] Occupational diseases and consequences such as disability pension 86 871 cases of occupational diseases, 10 278 also with consequences. Noise-induced hearing loss Register data. -No. granted disability pension among individuals with different occupational diseases   Among individuals with the occupational disease: noise induced hearing loss, 1990 (62%) had been granted disability pension.
1993     ?    
Poland     1990–1992.    
   3228 noise induced hearing loss (?)      
Retrospective cohort studies
Hagberg [21] To determine the incidence of tinnitus, hearing impairment and musculoskeletal disorders among musicians, and the relation to practicing hours and instrument type. 655 musicians (dropout due to: death 2%, emigration 6%, or non response 29%). Tinnitus, hearing impairment Questionnaire data. -No. having been on sick-leave due to hearing problems (tinnitus and/or impaired hearing) 13 individuals had been on sick leave due to hearing problems.  
2005     Questions regarding present, previous year, 5, 10, and 15 years ago.    
Sweden   407 participants (54% ♂)      
   Men: mean age 35 (23–49)   2000    
   Women: mean age 34 (24–57).      
Sewell [30] Examine the prevalence of hearing loss among Union Army veterans in the US by year, birth cohort and occupation and to compare civil war pension and contemporary disability programs by examining monthly dollar award. Random sample of US Army veterans n = 35 747 (100% ♂). Hearing loss from physical examination records Medical records. -Proportions of all pensions compensating for hearing loss.   Total 5891 or 33% of the individuals receiving a pension received compensation for hearing loss. Prevalence increased with time, age and later birth cohort.
2004     ?    
USA     1862–1907.    
   17 722 receiving a pension.      
Rudin [28] Long-term effects of otitis media on the general health, measured hearing loss and the wellbeing of the subjects. A population-based sample of 945 men born in 1913 (81% response rate), 292 men born 1923 (75% response rate). History of otitis media (self-reported). Data from interviews and registers. -No. of days and periods of sickness benefit. Non-significant (p = 0.20) difference in number of days or periods of sickness benefits between history of otitis media compared to no history.  
     Register data for 1955–1973    
   927 (100% ♂).   1973.    
   Age 60 and 50 years-old.      
Intervention studies
Gates [22] Evaluate a portable low-intensity alternating pressure generator in controlling symptoms of Ménière’s disease. 62 Ménière’ patients, 30 in treatment group (33% ♂) and 32 in control group (31% ♂). Ménière’s disease “Diary”-data. -No. of sick days (self-reported) during follow-up. Median proportion of sick days all 4 months: treatment = 0.00, control = 0.02 (p = 0.02).  
2004.     4 months.    
USA.     2002–2003.    
     2002–2003.   Baseline mean proportion of sick days in the treatment = 0.05, and in the control = 0.07. At 4 months, 0.01 in both groups.  
  A randomized, double-blinded, placebo controlled clinical trial. 52 (84%) patients participated all 4 months.      
   Age range 33–71.      
Bjorne [24] A cost-benefit analysis of reduction in treatment costs, sick leave and disability pension among working individuals with Ménière’s disease receiving treatment of tempemanibular and cervical spine disorders. Ménière’s patients: 24 treated, 24 matched population-based controls. 4 (17%) dropped out. Ménière’s disease Register data. -No. of sick-leave days due to Ménière’s or related symptoms 3 years before and 3 years after treatment. Sick leave reduced from 1536 to 270 days, before and after treatment, compared to from 8 to 6 days for the control group.  
   19 patients and 19 controls (not on disability pension or old age pension) (47% ♂).      
   Mean age 52, age range 29–74.   3 years    
Joore [25] To assess benefits in terms of gain in health-related quality of life and possible savings in terms of increased productivity and decreased use of medical services after hearing aid fitting in a population of moderately hearing impaired first-time hearing aid applicants. 80 hearing impaired patients. Hearing loss. Interview data. -Absence from work due to health or due to hearing impairment No reported absence from work due to hearing impairment or other health problems at baseline or at follow-up among those employed.  
2003     25 weeks    
Netherlands   10 with paid employment (100% ♂).   ?    
Cross-sectional studies
Neuhauser [10] Assess burden of dizziness and quantify contribution of vestibular vertigo and non-vestibular dizziness 8318 random digit sample (response rate 52%) screened for history of dizziness; 1157 fulfilled criteria (had dizziness). Vestibular vertigo. Interview data. -Reported sick leave among working individuals Among individuals with vestibular vertigo, 40.6% reported sick leave compared to 14.7% among those with non-vestibular dizziness p < 0.001.  
Germany     NA   Higher rates among women.  
   1003 (87%) (?).   2003.    
   Age range 18–79.      
Ide [29] Define level of hearing loss associated with ill-health retirement. 35 737 fire fighters. Hearing loss in decibels Questionnaire and medical data provided by work sites. -No. and rate granted ill-health retirement due to hearing loss.   4% (n = 135 among 3366) of the ill health retirements were due to hearing loss.
2007   3366 whole time firefighters granted ill-health retirement (100% ♂).      
   Mean age among firefighters granted ill health retirement due to hearing loss: 49 years, range 29–59.   1997–2002 (60 months).    
Kramer [20] Compare the occupational performance of employees with hearing impairment and normal hearing. Unknown Post lingual hearing loss Questionnaire data. -No. of sick-leave days in the last 12 months and reason for sick leave. Hearing impaired had increased risk of sick leave due to distress/strain OR 4.6 (1.3-16.5) compared to normal hearing, adjusted for age, sex, education, job demands/control/support, career satisfaction and type of contract.  
2006   150 hearing impaired employed (47% ♂), 60 normal hearing from the same workplaces (48% ♂).      
Netherlands     NA    
   Mean age normal hearing 42.7, impaired hearing 45.3 (21–65).      
Chau [23] Assess relationships of job, age and life conditions with causes and severity of occupational injuries. 880 construction workers (employed since at least 5 years) with non-fatal accident and sick-leave occasion and been seen by the physician. Hearing impairment Questionnaire data (filled in by the company physician). -Sick leave >60 days, reported by occupational physician. Hearing impaired individuals had a higher risk of sick leave (OR = 1.52). Analysis adjusted for age, BMI, sleep disorders, smoking, sporting activities, and occupation.  
   880 (100% ♂).      
Ide [31] Count the causes of death and ill-health retirement, determine the emergence of any trends and examine the relationships between length of service and cause of ill health retirement or death among fire-fighters 505 ill-health retired fire fighters Ear and mastoid diagnoses (ICD9:380–389) as primary diagnose. Data from annual reports, management information system and medical records. -No. with ill-health retirement   16 (3%) of the ill-health retirements were due to ear and mastoid diagnoses.
1998 UK        
   488 (=96.6% with clinical notes) (100% ♂).   1985-1994    
   Mean age 43.75      
  1. Abbreviation: NA Not Applicable.