Abstract
PurposeMusculoskeletal disorders increase the risk for absenteeism and work disability. However, the threshold when musculoskeletal pain intensity significantly increases the risk of sickness absence among different occupations is unknown. This study estimates the risk for long-term sickness absence (LTSA) from different pain intensities in the low back, neck/shoulder and knees among female healthcare workers in eldercare.MethodsProspective cohort study among 8,732 Danish female healthcare workers responding to a questionnaire in 2004–2005, and subsequently followed for one year in a national register of social transfer payments (DREAM). Using Cox regression hazard ratio (HR) analysis we modeled risk estimates of pain intensities on a scale from 0–9 (reference 0, where 0 is no pain and 9 is worst imaginable pain) in the low back, neck/shoulders and knees during the last three months for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks) during one-year follow-up.ResultsDuring follow-up, the 12-month prevalence of LTSA was 6.3%. With adjustment for age, BMI, smoking and leisure physical activity, the thresholds of pain intensities significantly increasing risk of LTSA for the low back (HR 1.44 [95%CI 1.07–1.93]), neck/shoulders (HR 1.47 [95%CI 1.10–1.96]) and knees (HR 1.43 [95%CI 1.06–1.93]) were 5, 4 and 3 (scale 0–9), respectively, referencing pain intensity of 0.ConclusionThe threshold of pain intensity significantly increasing the risk for LTSA among female healthcare workers varies across body regions, with knee pain having the lowest threshold. This knowledge may be used in the prevention of LTSA among health care workers.
Highlights
Sickness absence from work is considered a global health indicator [1]
More than 100 million European citizens suffer from chronic musculoskeletal pain [4], and musculoskeletal disorders are the most common causes of work disability and consequent absence from work [5]
The aim of our study was to estimate the risk for long-term sickness absence (LTSA) from different pain intensities in the low back, neck/shoulder and knees among female healthcare workers in eldercare
Summary
Long-term sickness absence (LTSA) is especially relevant, because workers being absent for several consecutive weeks have increased risk for not returning to the labor market [2]. Low back pain and neck/shoulder pain are associated with both short-term sickness absence and LTSA in several occupations [6,7,8,9,10,11]. The consequence of pain from different body regions and severities of pain may vary between occupations with different physical demands. Whereas knee pain did not predict LTSA in the general working population [12], knee pain was a strong risk factor for LTSA among healthcare workers in eldercare [13]. The association between musculoskeletal pain and risk of sickness absence should be evaluated separately for each specific occupation, body part and thresholds of pain intensity
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