Physical demand at work and sick leave due to low back pain: a cross-sectional study

Jonathan Petersen, Lilli Kirkeskov, Bjarke Brandt Hansen, Luise Moelenberg Begtrup, Esben Meulengracht Flachs, Mikael Boesen, Philip Hansen, Henning Bliddal, Ann Isabel Kryger, Jonathan Petersen, Lilli Kirkeskov, Bjarke Brandt Hansen, Luise Moelenberg Begtrup, Esben Meulengracht Flachs, Mikael Boesen, Philip Hansen, Henning Bliddal, Ann Isabel Kryger

Abstract

Objectives: To investigate if self-reported high physical demand at work, objective physical workload using a job exposure matrix (JEM) and fear-avoidance beliefs are associated with reported sick leave in the previous year in persons with low back pain (LBP). Second, to investigate if the effects of fear-avoidance and self-reported high physical demand at work on sick leave are modified by the objective physical workloads.

Settings: Participants were recruited from general practice and by advertisement in a local newspaper.

Participants: 305participants with a current period of 2-4 weeks LBP and self-reported difficulty in maintaining physically demanding jobs due to LBP were interviewed, clinically examined and had an MRI at baseline.

Main outcome measures: Independent variables were high fear-avoidance, self-reported high physical demand at work and objective measures of physical workloads (JEM). Outcome was self-reported sick leave due to LBP in the previous year. Logistic regression and tests for interaction were used to identify risk factors and modifiers for the association with self-reported sick leave.

Results: Self-reported physically demanding work and high fear-avoidance were significantly associated with prior sick leave due to LBP in the previous year with OR 1.75 95% CI (1.10 to 2.75) and 2.75 95% CI (1.61to 4.84), respectively. No objective physical workloads had significant associations. There was no modifying effect of objective physical workloads on the association between self-reported physical demand at work/high fear-avoidance and sick leave.

Conclusions: Occupational interventions to reduce sick leave due to LBP may have to focus more on those with high self-reported physical demands and high fear-avoidance, and less on individuals with the objectively highest physical workload.

Trial registration number: NCT02015572; Post-results.

Keywords: preventive medicine; rehabilitation medicine; rheumatology.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Flow chart for the actual study in the GoBack trial.

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