Joint association of physical work demands and leg pain intensity for work limitations due to pain in senior workers: cross-sectional study

Sebastian Venge Skovlund, Rúni Bláfoss, Emil Sundstrup, Kristina Thomassen, Lars L Andersen, Sebastian Venge Skovlund, Rúni Bláfoss, Emil Sundstrup, Kristina Thomassen, Lars L Andersen

Abstract

Background: Leg pain, especially of the knees and hips, is common among senior workers and may limit the ability to perform physically demanding work. In light of the aging workforce, this study determined the joint association of physical work demands and leg pain intensity for work-limiting pain in senior workers.

Methods: Currently employed senior workers (≥50 years) participated in the SeniorWorkingLife study in 2018 (n = 12,879). Associations between the combination of physical work demands and leg pain intensity (interaction) with work-limiting pain (outcome) were modeled using binary logistic regression analyses while controlling for potential covariates.

Results: We found a significant interaction (P < 0.001) between physical work demands and leg pain intensity for work-limiting pain. The combination of higher physical work demands and higher leg pain intensity had the worst outcome in terms of the odds of experiencing work-limiting pain. For example, 70% of those with the combination of high physical work demands and leg pain intensity ≥7 (scale 0-10) experienced that the pain limited them to at least some degree in their work.

Conclusions: The combination of high physical work demands and high leg pain intensity are associated with limited ability to perform work among senior workers. These findings highlight the importance of prioritizing the physical work environment in physically demanding occupations, particularly among senior workers, for prolonging working life. Thus, adjusting the work demands, e.g. through use of assistive devices, and lowering the pain, e.g. through physical rehabilitation, may be necessary to sustain work ability to a high age in this group of workers.

Trial registration: This was registered as a cohort study in ClinicalTrials.gov (Identifier: NCT03634410 ) on the 18th of August 2018 (Retrospectively registered).

Keywords: Ergonomics; Manual labour; Musculoskeletal diseases; Occupational medicine; Sustainable employment; Work ability; Workplace.

Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Weighted prevalences (%) of work-limiting pain among senior workers stratified by physical work demands and leg pain intensity

References

    1. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789–1858. doi: 10.1016/S0140-6736(18)32279-7.
    1. Institute for Health Metrics and Evaluation (IHME). GBD Compare Data Visualization, (accessed 28 July 2020).
    1. Sundstrup E, Seeberg KGV, Bengtsen E, et al. A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work. J Occup Rehabil. Epub ahead of print 26 March 2020. DOI: 10.1007/s10926-020-09879-x.
    1. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019;393:1745–1759. doi: 10.1016/S0140-6736(19)30417-9.
    1. Greenspan JD, Craft RM, LeResche L, et al. Studying sex and gender differences in pain and analgesia: a consensus report. Pain. 2007;132:S26–S45. doi: 10.1016/j.pain.2007.10.014.
    1. Pereira D, Peleteiro B, Araújo J, et al. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthr Cartil. 2011;19:1270–1285. doi: 10.1016/j.joca.2011.08.009.
    1. Miranda H, Kaila-Kangas L, Heliövaara M, et al. Musculoskeletal pain at multiple sites and its effects on work ability in a general working population. Occup Environ Med. 2010;67:449–455. doi: 10.1136/oem.2009.048249.
    1. Bayattork M, Jakobsen MD, Sundstrup E, et al. Musculoskeletal pain in multiple body sites and work ability in the general working population: cross-sectional study among 10,000 wage earners. Scand J Pain. 2019;19:131–137. doi: 10.1515/sjpain-2018-0304.
    1. Hallman DM, Holtermann A, Dencker-Larsen S, et al. Are trajectories of neck-shoulder pain associated with sick leave and work ability in workers? A 1-year prospective study. BMJ Open. 2019;9:e022006. doi: 10.1136/bmjopen-2018-022006.
    1. Neupane S, Virtanen P, Leino-Arjas P, et al. Multi-site pain and working conditions as predictors of work ability in a 4-year follow-up among food industry employees. Eur J Pain. 2013;17:444–451. doi: 10.1002/j.1532-2149.2012.00198.x.
    1. McDonald M, da Costa DBM, Ullman S. Musculoskeletal pain in the workforce: the effects of Back, arthritis, and fibromyalgia pain on quality of life and work productivity. J Occup Environ Med. 2011;53:765–770. doi: 10.1097/JOM.0b013e318222af81.
    1. Andersen LL, Mortensen OS, Hansen JV, et al. A prospective cohort study on severe pain as a risk factor for long-term sickness absence in blue- and white-collar workers. Occup Environ Med. 2011;68:590–592. doi: 10.1136/oem.2010.056259.
    1. Andersen LL, Clausen T, Mortensen OS, et al. A prospective cohort study on musculoskeletal risk factors for long-term sickness absence among healthcare workers in eldercare. Int Arch Occup Environ Health. 2012;85:615–622. doi: 10.1007/s00420-011-0709-5.
    1. Andersen LL, Clausen T, Burr H, et al. Threshold of musculoskeletal pain intensity for increased risk of long-term sickness absence among female healthcare Workers in Eldercare. PLoS One. 2012;7:e41287. doi: 10.1371/journal.pone.0041287.
    1. Morken T, Riise T, Moen B, et al. Low back pain and widespread pain predict sickness absence among industrial workers. BMC Musculoskelet Disord. 2003;4:21. doi: 10.1186/1471-2474-4-21.
    1. Andersen LL, Thorsen SV, Flyvholm M-A, et al. Long-term sickness absence from combined factors related to physical work demands: prospective cohort study. Eur J Pub Health. 2018;28:824–829. doi: 10.1093/eurpub/cky073.
    1. Natvig B, Eriksen W, Bruusgaard D. Low back pain as a predictor of long-term work disability. Scand J Public Health. 2002;30:288–292. doi: 10.1080/14034940210133951.
    1. Øverland S, Harvey SB, Knudsen AK, et al. Widespread pain and medically certified disability pension in the Hordaland health study. Eur J Pain. 2012;16:611–620. doi: 10.1016/j.ejpain.2011.08.005.
    1. Haukka E, Kaila-Kangas L, Ojajärvi A, et al. Multisite musculoskeletal pain predicts medically certified disability retirement among Finns. Eur J Pain. 2015;19:1119–1128. doi: 10.1002/ejp.635.
    1. Sundstrup E, Meng A, Poulsen OM, et al. Seniorers Arbejdsmiljø og Helbred - Analyse til Seniortænketanken for et længere & godt seniorarbejdsliv. p. 1–139.
    1. National Research Centre for the Working Environment . Arbejdsmiljø og Helbred i Danmark 2012–2018. 2020.
    1. Det Nationale Forskningscenter for Arbejdsmiljø . Fakta om Arbejdsmiljø og Helbred 2018. Det Nationale Forskningscenter for Arbejdsmiljø. 2019.
    1. Moseley GL. Reconceptualising pain according to modern pain science. Phys Ther Rev. 2007;12:169–178. doi: 10.1179/108331907X223010.
    1. Andersen JH, Haahr JP, Frost P. Risk factors for more severe regional musculoskeletal symptoms: a two-year prospective study of a general working population. Arthritis Rheum. 2007;56:1355–1364. doi: 10.1002/art.22513.
    1. da Costa BR, Vieira ER. Risk factors for work-related musculoskeletal disorders: a systematic review of recent longitudinal studies. Am J Ind Med. 2010;53:285–323.
    1. Kenny GP, Groeller H, McGinn R, et al. Age, human performance, and physical employment standards. Appl Physiol Nutr Metab. 2016;41:S92–S107. doi: 10.1139/apnm-2015-0483.
    1. Det Nationale Forskningscenter for Arbejdsmiljø . Aalborg Universitet, TeamArbejdsliv. SeniorArbejdsLiv. 2020.
    1. El Fassi M, Bocquet V, Majery N, et al. Work ability assessment in a worker population: comparison and determinants of work ability index and work ability score. BMC Public Health. 2013;13:305. doi: 10.1186/1471-2458-13-305.
    1. Pensola T, Haukka E, Kaila-Kangas L, et al. Good work ability despite multisite musculoskeletal pain? A study among occupationally active Finns. Scand J Public Health. 2016;44:300–310. doi: 10.1177/1403494815617087.
    1. Berg TIJ van den, Elders L a. M, Zwart BCH de et al. The effects of work-related and individual factors on the work ability index: a systematic review. Occup Environ Med. 2009;66:211–220.
    1. Ilmarinen J. The ageing workforce--challenges for occupational health. Occup Med (Lond) 2006;56:362–364. doi: 10.1093/occmed/kql046.
    1. Oakman J, Neupane S, Proper KI, et al. Workplace interventions to improve work ability: a systematic review and meta-analysis of their effectiveness. Scand J Work Environ Health. 2018;44:134–146.
    1. Haukka E, Ojajärvi A, Kaila-Kangas L, et al. Protective determinants of sickness absence among employees with multisite pain-a 7-year follow-up. Pain. 2017;158:220–229. doi: 10.1097/j.pain.0000000000000741.
    1. Holtermann A, Hansen JV, Burr H, et al. Prognostic factors for long-term sickness absence among employees with neck-shoulder and low-back pain. Scand J Work Environ Health. 2010;36:34–41. doi: 10.5271/sjweh.2883.
    1. Hubertsson J, Turkiewicz A, Petersson IF, et al. Understanding occupation, sick leave, and disability pension due to knee and hip osteoarthritis from a sex perspective. Arthritis Care Res (Hoboken) 2017;69:226–233. doi: 10.1002/acr.22909.
    1. Pekkala J, Rahkonen O, Pietiläinen O, et al. Sickness absence due to different musculoskeletal diagnoses by occupational class: a register-based study among 1.2 million Finnish employees. Occup Environ Med. 2018;75:296–302. doi: 10.1136/oemed-2017-104571.
    1. van den Berg S, Burdorf A, Robroek SJW. Associations between common diseases and work ability and sick leave among health care workers. Int Arch Occup Environ Health. 2017;90:685–693. doi: 10.1007/s00420-017-1231-1.
    1. Skovlund SV, Bláfoss R, Sundstrup E, et al. Association between physical work demands and work ability in workers with musculoskeletal pain: cross-sectional study. BMC Musculoskelet Disord. 2020;21:166. doi: 10.1186/s12891-020-03191-8.
    1. Agaliotis M, Fransen M, Bridgett L, et al. Risk factors associated with reduced work productivity among people with chronic knee pain. Osteoarthr Cartil. 2013;21:1160–1169. doi: 10.1016/j.joca.2013.07.005.
    1. Wilkie R, Blagojevic-Bucknall M, Jordan KP, et al. Onset of work restriction in employed adults with lower limb joint pain: individual factors and area-level socioeconomic conditions. J Occup Rehabil. 2013;23:180–188. doi: 10.1007/s10926-013-9443-z.
    1. Miller AE, MacDougall JD, Tarnopolsky MA, et al. Gender differences in strength and muscle fiber characteristics. Eur J Appl Physiol Occup Physiol. 1993;66:254–262. doi: 10.1007/BF00235103.
    1. Andersen LL, Sundstrup E. Study protocol for SeniorWorkingLife - push and stay mechanisms for labour market participation among older workers. BMC Public Health. 2019;19:133. doi: 10.1186/s12889-019-6461-6.
    1. von Elm E, Altman DG, Egger M, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344–349. doi: 10.1016/j.jclinepi.2007.11.008.
    1. Nygaard PP, Skovlund SV, Sundstrup E, et al. Is low-back pain a limiting factor for senior workers with high physical work demands? A cross-sectional study. BMC Musculoskeletal Disord. 2020;21:622. doi: 10.1186/s12891-020-03643-1.
    1. Committee System on Biomedical Research Ethics . Guidelines about Notification etc. of a Biomedical Research Project to the Committee System on Biomedical Research Ethics. 2011.
    1. Bláfoss R, Micheletti JK, Sundstrup E, et al. Is fatigue after work a barrier for leisure-time physical activity? Cross-sectional study among 10,000 adults from the general working population. Scand J Public Health. 2019;47:383–391. doi: 10.1177/1403494818765894.
    1. Andersen LL, Jensen PH, Sundstrup E. Barriers and opportunities for prolonging working life across different occupational groups: the SeniorWorkingLife study. Eur J Public Health. Epub ahead of print 29 August 2019. DOI: 10.1093/eurpub/ckz146.
    1. Kuorinka I, Jonsson B, Kilbom A, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18:233–237. doi: 10.1016/0003-6870(87)90010-X.
    1. Calatayud J, Jakobsen MD, Sundstrup E, et al. Dose-response association between leisure time physical activity and work ability: cross-sectional study among 3000 workers. Scand J Public Health. 2015;43:819–824. doi: 10.1177/1403494815600312.
    1. Pejtersen JH, Kristensen TS, Borg V, et al. The second version of the Copenhagen psychosocial questionnaire. Scand J Public Health. 2010;38:8–24. doi: 10.1177/1403494809349858.
    1. Andersen LL, Izquierdo M, Sundstrup E. Overweight and obesity are progressively associated with lower work ability in the general working population: cross-sectional study among 10,000 adults. Int Arch Occup Environ Health. 2017;90:779–787. doi: 10.1007/s00420-017-1240-0.
    1. Van Eerd D, Munhall C, Irvin E, et al. Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence. Occup Environ Med. 2016;73:62–70. doi: 10.1136/oemed-2015-102992.
    1. Sundstrup E, Andersen LL. Hard physical work intensifies the occupational consequence of physician-diagnosed Back disorder: prospective cohort study with register follow-up among 10,000 workers. Int J Rheumatol. 2017;2017:1037051. doi: 10.1155/2017/1037051.
    1. Hubertsson J, Englund M, Hallgårde U, et al. Sick leave patterns in common musculoskeletal disorders – a study of doctor prescribed sick leave. BMC Musculoskelet Disord. 2014;15:176. doi: 10.1186/1471-2474-15-176.
    1. THEIS KA, MURPHY L, HOOTMAN JM, et al. Prevalence and correlates of arthritis-attributable work limitation in the US population among persons ages 18–64: 2002 National Health Interview Survey Data. Arthritis Rheum. 2007;57:355–363. doi: 10.1002/art.22622.
    1. Hubertsson J, Petersson IF, Thorstensson CA, et al. Risk of sick leave and disability pension in working-age women and men with knee osteoarthritis. Ann Rheum Dis. 2013;72:401–405. doi: 10.1136/annrheumdis-2012-201472.
    1. Andersen LL, Thorsen SV, Larsen M, et al. Work factors facilitating working beyond state pension age: prospective cohort study with register follow-up. Scan J Work Environ Health. Epub ahead of print. 2020. 10.5271/sjweh.3904.
    1. Oakman J, Clays E, Jørgensen MB, et al. Are occupational physical activities tailored to the age of cleaners and manufacturing workers? Int Arch Occup Environ Health. 2019;92:185–193. doi: 10.1007/s00420-018-1364-x.
    1. Merkus SL, Lunde L-K, Koch M, et al. Physical capacity, occupational physical demands, and relative physical strain of older employees in construction and healthcare. Int Arch Occup Environ Health. 2019;92:295–307. doi: 10.1007/s00420-018-1377-5.
    1. Andersen LL, Jensen PH, Meng A, et al. Strong Labour Market Inequality of Opportunities at the Workplace for Supporting a Long and Healthy Work-Life: The SeniorWorkingLife Study. Int J Environ Res Public Health; 16. Epub ahead of print 05 2019. DOI: 10.3390/ijerph16183264.
    1. Labriola M, Lund T, Burr H. Prospective study of physical and psychosocial risk factors for sickness absence. Occup Med (Lond) 2006;56:469–474. doi: 10.1093/occmed/kql058.
    1. Lagersted-Olsen J, Korshøj M, Skotte J, et al. Comparison of objectively measured and self-reported time spent sitting. Int J Sports Med. 2014;35:534–540.
    1. Podsakoff PM, MacKenzie SB, Lee J-Y, et al. Common method biases in behavioral research: a critical review of the literature and recommended remedies. J Appl Psychol. 2003;88:879–903. doi: 10.1037/0021-9010.88.5.879.

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