Effects of the Labor Inspection Authority’s regulatory tools on physician-certified sick leave and employee health in Norwegian home-care services – a cluster randomized controlled trial

Objective This study aimed to determine the effects of the Labor Inspection Authority’s regulatory tools on physician-certified sick leave and self-reported health outcomes among employees in municipal home-care services in Norway. Methods We conducted a cluster-randomized controlled trial in the home-care service sector, and 96 eligible municipalities were randomly assigned to one of three groups: (i) labor inspection visits, based on the Labor Inspection Authority’s standard inspections; (ii) guidance-through-workshops, where participants from homecare services met with labor inspectors to receive information and discuss relevant topics; and (iii) the control group. Data on employee self-reported health (N=1669) were collected at baseline and 6 and 12 months after the interventions. Additionally, registry data (N=1202) on diagnosis specific physician-certified sick leave were collected for 18 months after the interventions. Results We found no statistically significant effects of either intervention on self-reported health outcomes. There was, for both interventions, a pattern of decrease in days and periods of physician-certified sick leave due to musculoskeletal diagnoses and increase in days and periods of physician-certified sick leave due to psychological diagnoses, but these were not statistically significant. Conclusion Labor inspections and guidance-through-workshops had no statistically significant effect on selfreported health and physician-certified sick leave. The results...