Risk factors for musculoskeletal symptoms and ensuing health care use and sick leave

W IJzelenberg, A Burdorf
Spine 2005 July 1, 30 (13): 1550-6

STUDY DESIGN: Longitudinal study with a 6-month follow-up.

OBJECTIVE: To investigate whether demographic, work-related physical and psychosocial risk factors involved in the occurrence of musculoskeletal symptoms also determine subsequent health care use and sick leave.

SUMMARY OF BACKGROUND DATA: Preventing the socioeconomic consequences of disability from musculoskeletal symptoms may be a goal separate from that of eliminating the symptoms themselves; thus, other factors may need to be addressed in intervention.

METHODS: A questionnaire provided data on demographics and work-related factors, musculoskeletal symptoms, and ensuing health care use and sick leave among 407 industrial workers.

RESULTS: The 12-month prevalence of low back pain (LBP) and neck/upper extremity symptoms was 52% and 56%, respectively. Of those individuals with symptoms at baseline, 68% had a recurrence of LBP, and 62% a recurrence of neck/upper extremity symptoms during a 6-month follow-up. The recurrence of sick leave for a particular musculoskeletal complaint was approximately 30%, while recurrence of health care use was more than 40%. Recurrence of symptoms, health care use, and sick leave were strongly associated with a history of severe symptoms. Physical load, high job strain, and low social support at work determined the occurrence of LBP, related health care use, and sick leave. Older age and living alone were also important risk factors, especially for sick leave. High job strain determined the occurrence of neck/upper extremity symptoms, related health care use, and sick leave. Being female and living alone increased the probability of the occurrence of all 3 endpoints, especially the occurrence of sick leave.

CONCLUSIONS: Work-related factors that were associated with the occurrence of musculoskeletal symptoms were quite similar to those associated with health care use and sick leave. However, for LBP, older age and living alone, and, for neck/upper extremity symptoms, living alone and being female more strongly determined whether subjects with these complaints took sick leave. These results imply that prevention strategies aimed at minimizing the risks of the occurrence of work-related musculoskeletal symptoms and prevention programs aimed at reducing sick leave may need to emphasize different sets of risk factors.

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