What this is
What is an absence trend review?
What is an absence trend review?
It is a quarterly analysis of absence data broken down by area, shift and cause category, run jointly by HR and occupational health. It exists to catch patterns a single aggregate rate would hide, particularly concentration on one shift or role that points to a work design cause rather than an attendance one.
How does this differ from a workload review?
A workload review examines whether demand on a team or role is sustainable and is a control in its own right. An absence trend review looks backwards at what already happened and, where it finds a work-related pattern, triggers the workload review as the corrective step rather than duplicating it.
Why does one shift carrying most of the absence matter more than the headline rate?
An overall rate within the expected range can still conceal a single shift or role absorbing a disproportionate share. That concentration is the signal that something about how that shift is staffed, scheduled or supervised is making people unwell, which a flat aggregate figure will never surface.
Scope
When is an absence trend review required?
This review is the quarterly look-back across the whole workforce. It is not the place to manage one worker's case or to redesign a task in isolation from the absence data that flagged it.
Use this template when
- The quarterly review interval has arrived, or a trigger event has forced an off-cycle review
- The workspace is being set up and this register needs an entry added or retired
- You are running the Return to Work programme and this review is one of its steps
- A linked record needs this one to exist: case management or a workload review
- Return-to-work interview themes need rolling up into a workforce-level pattern rather than staying case by case
Do not use it for
- Health Screening Event Record, which records a voluntary screening event covering blood pressure, general health or similar, with uptake and anonymised outcomes, not absence data.
- Workload Review, which examines whether demand on a specific team or role is sustainable; this review triggers it rather than replacing it.
- Occupational Health Case Record, which tracks one named worker's case over time, not a workforce-wide pattern.
- MSD Trend Review, which is the ergonomics-specific equivalent for musculoskeletal injury data rather than all-cause absence.
- Anything outside KnowHealth, which belongs in the workspace that owns that process.
Compliance mapping
Which ISO 45001 cl.9.1 requirements does this satisfy?
The review sits under ISO 45001 cl.9.1 monitoring and measurement, but its value depends on cl.5.4 participation through return-to-work interviews and cl.10.2 corrective action where a work-related cause is confirmed.
| Clause | Requirement | Where it lands |
|---|---|---|
| ISO 45001 cl.9.1 | Monitoring and measurement of absence as a health and safety performance indicator, not just an HR metric | Header |
| ISO 45001 cl.6.1 | Identifying patterns that indicate a hazard or risk requiring further assessment | Pattern |
| ISO 45001 cl.9.1 | Distinguishing work-related causes from non-work-related ones within the analysis | Causes |
| ISO 45001 cl.5.4 | Return-to-work interviews as a participation mechanism that feeds the cause analysis | Causes |
| ISO 45001 cl.5.3 | Fair and consistent application of absence triggers across the workforce | Management quality |
| ISO 45001 cl.10.2 | Corrective action, including triggering a workload review, where the pattern points to work design | Outcome |
| ISO 45001 cl.9.3 | Feeding confirmed findings into the management review cycle | Outcome |
What it does not cover
- A headline rate reported as acceptable without the area and shift breakdown being checked, which lets a concentrated problem on one shift hide inside a fine-looking average.
- Concentration on one shift logged and then filed with no further action, which treats a work design signal as a curiosity rather than a trigger.
- A work-related cause identified without a workload review being raised, which leaves the review's own conclusion unactioned.
- Return-to-work interviews marked complete when most were never actually held, which means the causes section rests on assumption rather than what workers actually said.
- Absence triggers applied more strictly on one shift than another, which undermines every other finding in the review, since inconsistent management can itself inflate the very pattern being analysed.
Global
Absence Trend Review requirements by country
Absence management sits at the intersection of health and safety duties and employment protections, and the balance between the two shifts by jurisdiction.
Equality Act 2010, and HSE guidance on stress and musculoskeletal risk management
Where absence is linked to a disability, trigger-based attendance management must accommodate reasonable adjustment before any formal step, and HSE expects work-related causes identified in review data to feed back into risk assessment.
A review that finds a work-related cause but does not link it back to the site risk assessment is missing a duty, not just an opportunity.
Family and Medical Leave Act, and ADA reasonable accommodation requirements
Protected leave and accommodation-related absence must be excluded from trigger counts and from any pattern read as a performance or attendance issue.
The review's cause categories need to separate protected absence cleanly, or the whole trend analysis risks conflating lawful leave with a genuine work design problem.
Framework Directive 89/391/EEC on employer duties to assess and reduce risk to health
Aggregated absence data indicating a work-related health pattern falls within the employer's general duty to assess and act on risks to worker health, not solely an HR administration matter.
A confirmed work-related pattern in this review is evidence relevant to the site's risk assessment obligations, independent of any individual employment law process running in parallel.
How to complete it
How to complete an absence trend review, step by step
The fields themselves are a data pull. Four judgement calls decide whether the review actually explains the pattern or just restates the rate.
A rate inside the expected range can still conceal concentration on one area, shift or role. The review has to check the breakdown before signing off the headline figure as fine.
Musculoskeletal, mental health or respiratory causes being prominent is a pattern, not proof. The judgement call is whether return-to-work interview evidence and occupational health input actually support a work-related conclusion, or whether the categories are being inferred from absence codes alone.
If one manager escalates every absence and another lets things slide, the resulting pattern reflects management style as much as worker health. The review needs to weigh this before drawing conclusions from the raw numbers.
Not every elevated cause category justifies raising a workload review immediately. The call is whether the concentration, the trend direction, and the work-related element together clear the bar for triggering that heavier piece of work.
What auditors find
Most common absence trend review findings
Six patterns turn up repeatedly when this review is checked against the underlying absence data.
| Finding | Clause | What fixes it |
|---|---|---|
| Aggregate rate reported as within range while one shift carried more than double the average | ISO 45001 cl.9.1 | Require the shift and area breakdown to be reviewed before the aggregate rate is signed off, not alongside it. |
| Musculoskeletal causes flagged as prominent with no link made to any ergonomic assessment | ISO 45001 cl.9.1 | Cross-reference the causes section against open MSD trend review findings for the same area before closing. |
| Return-to-work interviews marked complete but the interview records could not be located | ISO 45001 cl.5.4 | Require the interview record reference to be entered against the completion tick, not just the tick itself. |
| Work-related element identified as partly present with no workload review raised | ISO 45001 cl.10.2 | Make raising the linked workload review mandatory whenever the work-related element is anything but 'No'. |
| Trigger application found inconsistent between two supervisors on the same site | ISO 45001 cl.5.3 | Standardise the trigger policy and audit a sample of cases per supervisor each quarter. |
| Seasonal pattern noted but never compared against the same quarter in the prior year | ISO 45001 cl.9.1 | Add a year-over-year comparison step so a genuine seasonal effect is not repeatedly re-discovered as a new finding. |
Case in point
Case in point: the shift the aggregate hid
A site's quarterly absence rate came back at 4.2 percent, comfortably inside the expected range, and the review was on track to close with no action. A late check of the shift breakdown, added only because occupational health asked for it, showed the night shift running at 9 percent while the other two shifts sat below 3 percent.
The night shift had lost its dedicated supervisor two quarters earlier and had been covered by rotating day-shift managers unfamiliar with its workload. Once staffing was restored, the shift's absence rate fell back in line within two review cycles, confirming what the aggregate had almost let pass as fine.
The template
The template, field by field
The form exactly as it installs. Every field, option, score and conditional rule is editable, and the links to other templates come with it.
5 sections
- Reference
- HLT-049
- Archetype
- Review
- Record ID
- ATR-2026-000
- Scoring
- Absence rate
- Direction
- Low is good
- Singleton
- Yes
- Basis
- ISO 45001 cl.9.1
- Links
- Links Case management, Workload review
- Tags
- Health promotion, Absence
- Sections
- 5
- Fields
- 42
- Follow up fields
- 3
- Repeating sections
- 0
- Links out
- 3
Header
10 fieldsReview ID*
Auto sequence. Format ATR-2026-000.
The record's own ID. Other templates point at this value.
Status*
Drives who this goes to next.
- Planned2 pts
- In progress2 pts
- Complete3 pts
- Deferred0 pts
- Open0 pts
- Closed3 pts
- Overdue0 pts
Date and Time*
Completed By*
Site*
Site ID*
Format SITE-000.
Links to FDN-001 Site ID
Period Covered*
Reviewed By*
Workers In Scope*
Absence Concentrated On One Shift Is Work Design
If one area or one shift carries most of the absence, the cause is usually in how the work is organised rather than in the people doing it.
Pattern
6 fieldsAbsence Rate Within Expected Range*
- Yes3 pts
- Partly1 pt
- No0 pts
Concentrated In One Area*
- Yes3 pts
- Partly1 pt
- No0 pts
Concentrated On One Shift*
- No3 pts
- Yes0 pts
Concentrated In One Role*
- Yes3 pts
- Partly1 pt
- No0 pts
Seasonal Pattern Present*
- Yes3 pts
- Partly1 pt
- No0 pts
Short Term Absence Dominant*
- Yes3 pts
- Partly1 pt
- No0 pts
Causes
6 fieldsMusculoskeletal Causes Prominent*
- Yes3 pts
- Partly1 pt
- No0 pts
Mental Health Causes Prominent*
- Yes3 pts
- Partly1 pt
- No0 pts
Respiratory Or Skin Causes Prominent*
- Yes3 pts
- Partly1 pt
- No0 pts
Work Related Causes Identified*
- Yes3 pts
- Partly1 pt
- No0 pts
Return To Work Interviews Completed*
- Yes2 pts
- No0 pts
- N/Aexcluded from denominator
Occupational Health Involved Where Needed*
- Yes2 pts
- No0 pts
- N/Aexcluded from denominator
Management quality
6 fieldsAbsence Recorded Consistently*
- Yes3 pts
- Partly1 pt
- No0 pts
Managers Trained On The Process*
- Yes2 pts
- No0 pts
- N/Aexcluded from denominator
Triggers Applied Fairly*
- Yes3 pts
- Partly1 pt
- No0 pts
Adjustments Offered Where Appropriate*
- Yes3 pts
- Partly1 pt
- No0 pts
Long Term Cases Actively Managed*
- Yes3 pts
- Partly1 pt
- No0 pts
Presenteeism Considered*
- Yes3 pts
- Partly1 pt
- No0 pts
Outcome
14 fieldsAbsence Rate Percent*
Trend Versus Last Period*
- Improving3 pts
- Stable2 pts
- Worsening0 pts
Work Related Element*
- Yes3 pts
- Partly1 pt
- No0 pts
Workload Review Triggered*
- Not needed3 pts
- Yes1 pt
Review ID
Links to HLT-024 Review ID
Feeds Management Review*
- Yes3 pts
- Partly1 pt
- No0 pts
Action Required*
Raise the action record, then enter its reference here.
- No2 pts
- Yes0 pts
Priority
- High0 pts
- Medium1 pt
- Low3 pts
CAPA ID
Format CAPA-2026-00000.
Links to FDN-014 CAPA ID
Action Owner
HR*
Signature*
Occupational Health*
Second Signature*
HLT-049 · record IDs look like ATR-2026-000 · Links Case management, Workload review
Open in KnowellaRun it with agents
From a document you fill in to a programme that runs itself
Pulling the absence numbers is straightforward. Catching the concentration an aggregate hides and making sure a confirmed work-related pattern actually triggers the next step is where this needs a system behind it.
Holds the absence trend register, cross-references cause categories against open case and MSD trend records, and raises the linked workload review automatically when the work-related element is confirmed.
Surfaces shift and area staffing context alongside the absence breakdown, so a concentration finding can be checked against known cover gaps before it is written up.
Flags trigger application that looks inconsistent across supervisors or sites, and keeps protected leave categories separated from the pattern being analysed.
Coordinates the crew, rolls this quarter's pattern against the last one into a single view, and holds every write for your approval before it touches a record.
This template lives in KnowHealth — employee wellbeing. Exposure monitoring, health surveillance, case management and return to work.
Meet KnowHealth→Glossary
Absence Trend Review definitions and key terms
- Absence rate
- The proportion of scheduled working time lost to absence over the review period, used here as the scored outcome, where a lower rate is better.
- Trigger
- A predefined threshold of absence occurrences or days that prompts a formal management step, such as a return-to-work interview or a case review.
- Work-related element
- The portion of an absence pattern attributable to how work is organised, staffed or scheduled, as distinct from causes unconnected to the job.
- Return to work interview
- A structured conversation held with a worker on their return from absence, used both to support the individual and to surface cause information for trend analysis.
- Presenteeism
- Attending work while unwell, which can mask an absence pattern and, over time, produce worse outcomes than the absence it appears to avoid.
FAQ
Frequently asked questions about absence trend review
What is the absence trend review template based on?+
It is built against ISO 45001 cl.9.1 for monitoring and measurement, drawing on cl.5.4 participation through return-to-work interviews and cl.10.2 corrective action where a work-related cause is confirmed.
How often does this review run?+
Quarterly, plus an off-cycle review after any trigger event significant enough to warrant looking at the pattern before the next scheduled interval.
How many of these records should we have?+
This is a singleton per workspace: one review record set up and maintained, with each quarterly analysis logged against it rather than a new template each time.
Which programme does this belong to?+
It sits across Return to Work, Ergonomics and MSD Prevention, and Wellbeing and Mental Health, since absence causes routinely span all three and the review is the point where they get reconciled.
How is it scored?+
Scoring is absence rate, where low is good, but the rate on its own is a headline figure; the pattern breakdown by area, shift and cause is what the review is actually for.
Can the template be changed?+
Yes. Every field, option, score and conditional rule is editable, including the links to case management and the workload review. Most teams install it as-is, run a quarter, then adjust the cause categories to match what their own data actually surfaces.
Keep going
Related templates and programmes
Industries this is written for
Programmes this belongs to
Return to Work
Shorter absences, sustained returns, and work related cases fed back into risk control.
Ergonomics and MSD Prevention
Assessed tasks with before and after scores, and a business case that gets equipment approved.
Wellbeing and Mental Health
Psychosocial risk assessed the way physical risk is, with workload treated as a control.
Used together in Return to Work
Occupational Health Case Record
Records and tracks a health case from first report through to closure
Work Restriction Record
Records what a worker can and cannot do while recovering, and for how long
Modified Duty Plan
Sets out the temporary duties a recovering worker will perform
Case Progress Review
Reviews how a health case is progressing against its expected timeline
Case Closure Record
Closes a health case, recording the outcome and any lasting restrictions
Claim Support Record
Records the information provided to support a workers compensation claim
Written and reviewed by
Siddarth Singh
Founder & Chief Executive Officer, Knowella
Certified Safety Professional and industrial and systems engineer with more than a decade inside food supply chain, freight and manufacturing operations. This page was written against the current text of the standards it cites, not against secondary summaries of them.
- Certified Safety Professional (CSP), Board of Certified Safety Professionals
- MBA, University of Chicago Booth School of Business
- MS and BS, The Ohio State University, Industrial and Systems Engineering
- Six Sigma Black Belt
Sources and last review. Reviewed 16 August 2026 against:
- ISO 45001:2018 cl.9.1 — Monitoring, measurement, analysis and performance evaluation
- ISO 45001:2018 cl.5.4 — Consultation and participation of workers
- ISO 45001:2018 cl.10.2 — Incident, nonconformity and corrective action
- Equality Act 2010 — Reasonable adjustment duties
- Family and Medical Leave Act — Protected leave provisions
This page is general guidance, not legal advice. Confirm requirements with your jurisdiction’s regulator.