Introduction Number of sick leave days is a risk marker for

future health outcomes, but few studies have examined its

association with major public health concerns in old age, such

as osteoporotic fractures. The aim of this prospective, nation-

wide, population-based cohort study based on Swedish regis-

ters was to investigate the association between number of sick

leave days and future risk of hip fracture.

Methods Participants included were all 983,244 individuals

who were living in Sweden on 31 December 1995, aged 50 to



64 years, employed, and with no previous hip fracture. Those

with sick leave days in 1995 were compared to those with no

sickness absence. Incidence of hip fracture was followed from

1996 to 2010.

Results According to Cox regression models adjusted for

sociodemographic factors and morbidity, being on sick

leave more than 3 months, irrespective of cause, was

associated with a 2.0-fold (hazard ratio (HR) 1.96, 95 %

confidence interval (CI) 1.74–2.20) and 1.4-fold (HR 1.40,

95 % CI 1.27–1.56) increased risk of hip fracture in men

and women, respectively. Analyses repeated among those

with previous non-hip fractures replicated the significant

associations.

Conclusion This nationwide cohort study suggests that sick-

ness absence in working-age women and men is a risk marker

of hip fracture at old ages.