Abstract
BackgroundMusculoskeletal pain is a risk factor for leaving the labour market temporarily and permanently. While the presence of multi-site pain increases the risk of disability pension, we lack detailed knowledge about pain intensity as a risk factor. This study investigated the association between musculoskeletal pain intensity in different body regions and risk of future disability pension among eldercare workers.MethodsEight thousand seven hundred thirty-one female eldercare workers replied to a questionnaire on work and health in 2005 and were followed for 11 years in the Danish Register for Evaluation of Marginalization. Time-to-event analyses estimated hazard ratios (HR) for disability pension from pain intensities (0–9 numeric rating scale (NRS)) in the low-back, neck/shoulders, and knees during the previous 3 months. Analyses were mutually adjusted for pain regions, age, education, lifestyle, psychosocial work factors, and physical exertion at work.ResultsDuring 11-year follow-up, 1035 (11.9%) of the eldercare workers received disability pension. For all body regions among all eldercare workers, dose-response associations were observed between higher pain intensity and risk of disability pension (p < 0.001). The risk for disability pension was increased when reporting “very high” pain levels (≥7 points on the 0–9 NRS) in the low-back (HR 2.19, 95% CI 1.70–2.82), neck/shoulders (HR 2.34, 95% CI 1.88–2.92), and knees (HR 1.89, 95% CI 1.44–2.47). Population attributable risks (PAR) were 15.5, 23.2, and 9.6% for pain > 2 on NRS in the low-back, neck/shoulders, and knees, respectively, indicating that 15.5, 23.2, and 9.6% fewer eldercare workers would likely receive disability pension if the pain intensity was reduced to 2 or less. For workers ≤45 years and > 45 years, PAR was highest for neck/shoulder pain (27.6%) and low-back pain (18.8%), respectively.ConclusionsThe present study found positive dose-response associations between pain intensity in the low-back, neck/shoulders, and knees, and risk of disability pension during 11-year follow-up. Moderate to very high levels of musculoskeletal pain in eldercare workers should, therefore, be considered an early warning sign of involuntary premature exit from the labour market. These findings underscore the importance of preventing, managing, and reducing musculoskeletal pain to ensure a long and healthy working life.
Highlights
Musculoskeletal pain is a risk factor for leaving the labour market temporarily and permanently
Musculoskeletal pain located in different body regions, such as low-back, neck/shoulders, and knees has been associated with reduced work ability in a dose-response fashion [7, 8] and elevated risk of sickness absence [9, 10], both of which being associated with an increased risk of disability pension [11,12,13,14]
The prevalence of sickness absence among nurses’ aides gradually increased during the 104 weeks before start of disability pension in a 15-year register follow-up cohort study [23]. These findings indicate that healthcare work is costly for the society and workplaces due to an increased risk of disability pension, and due to a gradually increasing prevalence of sickness absence for at least 2 years before ending on disability pension [23]
Summary
Musculoskeletal pain is a risk factor for leaving the labour market temporarily and permanently. Workers with physically demanding occupations are at a high risk of both musculoskeletal pain [2, 3], long-term sickness absence, and disability pension compared to workers within more sedentary occupations [4,5,6]. Musculoskeletal pain located in different body regions, such as low-back, neck/shoulders, and knees has been associated with reduced work ability in a dose-response fashion [7, 8] and elevated risk of sickness absence [9, 10], both of which being associated with an increased risk of disability pension [11,12,13,14]. Workplaces should be aware of workers in pain and aim to prevent and reduce the incidence of musculoskeletal pain among the workers
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