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Prognostic factors for long-term sickness absence among employees with neck-shoulder and low-back pain
Andreas Holtermann1, Jørgen V Hansen, Hermann Burr
1National Research Centre for the Working Environment, 2100 Copenhagen, Denmark. aho@nrcwe.dk
Objective:
The aim of this study was to identify prognostic factors for long-term sickness absence among employees with neck-shoulder or low-back pain.
Methods:
In 2000, a representative sample of Danish employees (N=5036) rated their average pain intensity in the neck-shoulder and low-back during the last three months on a 10-point scale; using a questionnaire, they also reported on physical and psychosocial work factors, health behavior, work ability and self-efficacy. Employees reporting pain intensity of >or=4 were considered to have musculoskeletal pain. As a result, we defined two populations to be included in our analyses: people with pain in the neck-shoulder (N=848) and low-back (N=676) regions. Data on long-term sickness absence of >or=3 weeks for the period 2001-2002 were attained from the Danish national register of social transfer payments.
Results:
One fifth of employees with neck-shoulder and low-back pain experienced long-term sickness absence during the two-year follow-up. Among employees with neck-shoulder and low-back pain, respectively, the main significant risk factors were (i) pain intensity [hazard ratio (HR)=1.12, 95% confidence interval (95% CI) 1.02-1.24 and HR=1.13, 95% CI 1.01-1.26] and (ii) heavy physical work (HR=1.68, 95% CI 1.21-2.33 and HR=1.41 95% CI 1.00-2.01).
Conclusion:
Preventive initiatives for long-term sickness absence should aim to reduce pain intensity and heavy physical work among employees with neck-shoulder and low-back pain.