Background Despite a growing body of research on sick leave policies, there remains a significant gap in research concerning job protections during illness leaves, which is critical in Canada since several provinces are considering or passing job-protected leave expansions. We examined three major job-protected leave expansions, Quebec (2003), Manitoba (2016), and Alberta (2018).

Methods We used the Canadian Labour Force Survey data spanning from 1998 to 2022. Using a difference-in-difference approach, we examined 5-year changes in leave behaviour before and after expansions in job-protected leave in the three provinces compared to changes in provinces with less than 2 weeks of job-protected leave. We analyzed the prevalence, duration, and distribution of illness/disability absences using ordinary least squares and linear probability models.

Results We found that expanding job-protected leave in Quebec was associated with decreases in the overall length of leave by 2.2 (95% CI: -3.2 to -1.5; P<0.001) weeks or 14.0% relative reduction. Similarly, expansions in Alberta and Manitoba were associated with decreases in the overall length of leave by 1.2 (95% CI: -2.1 to -0.3; P=0.016) weeks or 7.4% relative reduction. Results for absence prevalence were mixed (small increase (Quebec) (p<0.05), no significant change (Alberta-Manitoba) (p>0.05). Both expansions were associated with significant increases in absence duration consistent with the policy (i.e., 3-17-week leaves) (p<0.05).

Conclusions Our results suggest that job-protected leave expansion may influence leave behaviour even in the presence of protections provided by human rights laws and without imposing large additional costs for employers or governments.

Conflict of interest: Michael Lebenbaum and Jennifer Gillis are and Ioana Nicolau was employed by the Canadian Cancer Society, who employs other individuals actively advocating for extensions of job-protective leave in Canada.

This study did not receive external funding.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study used ONLY openly available human data that were accessed via email to Statistics Canada and originally located at: https://www150.statcan.gc.ca/n1/en/catalogue/71M0001X

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes