Risk factors for sickness absence due to low back pain and prognostic factors for return to work in a cohort of shipyard workers

Evangelos C Alexopoulos, Eleni C Konstantinou, Giorgos Bakoyannis, Dimitra Tanagra, Alex Burdorf, Evangelos C Alexopoulos, Eleni C Konstantinou, Giorgos Bakoyannis, Dimitra Tanagra, Alex Burdorf

Abstract

The purpose of this study was to determine risk factors for the occurrence of sickness absence due to low back pain (LBP) and to evaluate prognostic factors for return to work. A longitudinal study with 1-year follow-up was conducted among 853 shipyard workers. The cohort was drawn around January 2004 among employees in the shipyard industry. Baseline information was obtained by questionnaire on physical and psychosocial work load, need for recovery, perceived general health, musculoskeletal complaints, sickness absence, and health care use during the past year. During the 1-year follow-up for each subject medical certifications were retrieved for information on the frequency and duration of spells of sickness absence and associated diagnoses. Cox regression analyses were conducted on occurrence and on duration of sickness absence with hazard ratios (HR) with 95% confidence interval (95% CI) as measure of association. During the 1-year follow-up period, 14% of the population was on sick leave at least once with LBP while recurrence reached 41%. The main risk factors for sickness absence were previous absence due to a health problem other than LBP (HR 3.07; 95%CI 1.66-5.68) or previous sickness absence due to LBP (HR 6.52; 95%CI 3.16-13.46). Care seeking for LBP and lower educational level also hold significant influences (HR 2.41; 95%CI 1.45-4.01 and HR 2.46; 95%CI 1.19-5.07, respectively). Living with others, night shift and supervising duties were associated with less absenteeism due to LBP. Workers with a history of herniated disc had a significantly decreased rate of returning to work, whereas those who suffered from hand-wrist complaints and LBP returned to work faster. Prior sick leave due to LBP partly captured the effects of work-related physical and psychosocial factors on occurrence of sick leave. Our study showed that individual and job characteristics (living alone, night shift, lower education, sick leave, or care seeking during the last 12 months) influenced the decision to take sick leave due to LBP. An increased awareness of those frequently on sick leave and additional management after return to work may have a beneficial effect on the sickness absence pattern.

Figures

Fig. 1
Fig. 1
Time to a first period of sickness absence due to low back pain

References

    1. Alexopoulos EC, Burdorf A. Prognostic factors for respiratory sickness absence and return to work among blue collar workers and office personnel. Occup Environ Med. 2001;58(4):246–252. doi: 10.1136/oem.58.4.246.
    1. Alexopoulos EC, Tanagra D, Konstantinou E, Burdorf A. Musculoskeletal disorders in shipyard industry: prevalence, health care use, and absenteeism. BMC Musculoskelet Disord. 2006;7:88. doi: 10.1186/1471-2474-7-88.
    1. Bonato L, Lusinyan L (2004) Work absence in Europe. IMF Working Paper 04/193, Washington
    1. Bonde JP, Rasmussen MS, Hjollund H, Svendsen SW, Kolstad HA, Jensen LD, Wieclaw J. Occupational disorders and return to work: A randomized controlled study. J Rehabil Med. 2005;37:230–235. doi: 10.1080/16501970410025487.
    1. Boot CR, Vercoulen JH, van der Gulden JW, van den Borne BH, Orbon KH, van Weel C, Folgering HT. Sick leave in workers with asthma and COPD: the role of attitudes, perceived social norms and self efficacy. Patient Educ Couns. 2005;58:192–198. doi: 10.1016/j.pec.2004.08.010.
    1. Borg G (1990) Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health 16 Suppl. 1:55–58
    1. Borg K, Hensing G, Alexanderson K. Prediction of future low levels of sickness absence among young persons sick listed with back, neck, or shoulder diagnoses. Work. 2004;23:159–167.
    1. Charizani F, Moysiadou I, Siarkos E, Alexopoulos EC. Subjective risk assessment of industry employees. Rev Clin Pharmacol Pharmacokinet. 2005;19:87–92.
    1. De Croon EM, Sluiter JK, Frings-Dresen MH. Need for recovery after work predicts sickness absence: a 2-year prospective cohort study in truck drivers. J Psychosom Res. 2003;55:331–339. doi: 10.1016/S0022-3999(02)00630-X.
    1. Eriksen W, Bruusgaard D, Knardahl S. Work factors as predictors of sickness absence attributed to airway infections; a three month prospective study of nurses’ aides. Occup Environ Med. 2004;61:45–51. doi: 10.1136/oem.2003.008482.
    1. Franche RL, Baril R, Shaw W, Nicholas M, Loisel P. Workplace- based return-to-work interventions: optimizing the role of stakeholders in implementation and research. J Occup Rehabil. 2005;15:525–542. doi: 10.1007/s10926-005-8032-1.
    1. Frank JW, Brooker AS, DeMaio SE, Kerr MS, Maetzel A, Shannon HS, Sullivan TJ, Norman RW, Wells RP. Disability resulting from occupational low back pain.Part I: what do we know about secondary prevention? A review of the scientific evidence on prevention after disability begins. Spine. 1996;21:2918–2929. doi: 10.1097/00007632-199612150-00025.
    1. Gheldof EL, Vinck J, Vlaeyen JW, Hidding A, Crombez G. The differential role of pain, work characteristics and pain-related fear in explaining back pain and sick leave in occupational settings. Pain. 2005;113:71–81. doi: 10.1016/j.pain.2004.09.040.
    1. Guo HR, Tanaka S, Halperin WE, Cameron LL. Back pain prevalence in US industry and estimates of lost workdays. Am J Public Health. 1999;89:1029–1035. doi: 10.2105/AJPH.89.7.1029.
    1. Hagen KB, Tambs K, Bjerkedal T. What mediates the inverse association between education and occupational disability from back pain?–A prospective cohort study from the Nord-Trondelag health study in Norway. Soc Sci Med. 2006;63(5):1267–1275. doi: 10.1016/j.socscimed.2006.03.041.
    1. Head J, Kivimaki M, Martikainen P, Vahtera J, Ferrie JE, Marmot MG. Influence of change in psychosocial work characteristics on sickness absence: The Whitehall II Study. J Epidemiol Community Health. 2006;60:55–61. doi: 10.1136/jech.2005.038752.
    1. Hiebert R, Skovron ML, Nordin M, Crane M. Work restrictions and outcome of nonspecific low back pain. Spine. 2003;28:722–728. doi: 10.1097/00007632-200304010-00019.
    1. Hlobil H, Staal JB, Spoelstra M, Ariens GA, Smid T, van Mechelen W. Effectiveness of a return-to-work intervention for subacute low-back pain. Scand J Work Environ Health. 2005;31:249–257.
    1. Hoogendoorn WE, Bongers PM, de Vet HC, Ariens GA, van Mechelen W, Bouter LM. High physical work load and low job satisfaction increase the risk of sickness absence due to low back pain: results of a prospective cohort study. Occup Environ Med. 2002;59:323–328. doi: 10.1136/oem.59.5.323.
    1. Infante-Rivard C, Lortie M. Prognostic factors for return to work after a first compensated episode of back pain. Occup Environ Med. 1996;53:488–494.
    1. Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B. The job content questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol. 1998;3:322–355. doi: 10.1037/1076-8998.3.4.322.
    1. Kleiven M, Boggild H, Jeppesen HJ. Shift work and sick leave. Scand J Work Environ Health. 1998;24(Suppl. 3):128–133.
    1. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jorgensen K. Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergonom. 1987;18:233–237. doi: 10.1016/0003-6870(87)90010-X.
    1. Lotters F, Hogg-Johnson S, Burdorf A. Health status, its perceptions, and effect on return to work and recurrent sick leave. Spine. 2005;30:1086–1092. doi: 10.1097/01.brs.0000161484.89398.48.
    1. Luijsterburg PAJ, Bongers PM, de Vroome EMM. A new bricklayers’ method for use in the construction industry. Scand J Work Environ Health. 2005;31:394–400.
    1. Mercado AC, Carroll LJ, Cassidy JD, Cote P. Passive coping is a risk factor for disabling neck or low back pain. Pain. 2005;117:51–57. doi: 10.1016/j.pain.2005.05.014.
    1. Nyman T, Grooten WJ, Wiktorin C, Liwing J, Norrman L. Sickness absence and concurrent low back and neck-shoulder pain: results from the MUSIC-Norrtalje study. Eur Spine J. 2007;16(5):631–638. doi: 10.1007/s00586-006-0152-6.
    1. Pengel LH, Herbert RD, Maher CG, Refshauge KM. Acute low back pain: systematic review of its prognosis. BMJ. 2003;327:323–325. doi: 10.1136/bmj.327.7410.323.
    1. Seferlis T, Nemeth G, Carlsson AM. Prediction of functional disability, recurrences, and chronicity after 1 year in 180 patients who required sick leave for acute low-back pain. J Spinal Disord. 2000;13:470–477. doi: 10.1097/00002517-200012000-00002.
    1. Steenstra IA, Verbeek JH, Heymans MW, Bongers PM. Prognostic factors for duration of sick leave in patients sick listed with acute low back pain: a systematic review of the literature. Occup Environ Med. 2005;62:851–860. doi: 10.1136/oem.2004.015842.
    1. Tubach F, Leclerc A, Landre MF, Pietri-Taleb F. Risk factors for sick leave due to low back pain: a prospective study. J Occup Environ Med. 2002;44:451–458. doi: 10.1097/00043764-200205000-00013.
    1. van den Heuvel SG, Ariens GA, Boshuizen HC, Hoogendoorn WE, Bongers PM. Prognostic factors related to recurrent low-back pain and sickness absence. Scand J Work Environ Health. 2004;30:459–467.
    1. Vingard E, Mortimer M, Wiktorin C, Pernold RPTG, Fredriksson K, Nemeth G, Alfredsson L. Musculoskeletal Intervention Center-Norrtalje Study Group. Seeking care for low back pain in the general population: a two-year follow-up study: results from the MUSIC-Norrtalje Study. Spine. 2002;27:2159–2165. doi: 10.1097/00007632-200210010-00016.
    1. Wahlgren DR, Atkinson JH, Epping-Jordan JE, Williams RA, Prutt SD, Klapow JC, Patterson TL, Grant I, Webster JS, Slater MA. One-year follow-up of first onset low back pain. Pain. 1997;73:213–221. doi: 10.1016/S0304-3959(97)00106-1.
    1. Wasiak R, Kim J, Pransky G. Work disability and costs caused by recurrence of low back pain: longer and more costly than in first episodes. Spine. 2006;31:219–225. doi: 10.1097/01.brs.0000194774.85971.df.

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