Objectives Musculoskeletal symptoms are a common cause of disability, with major impact on workforce wellbeing, absenteeism and productivity. Several, mainly cross-sectional, studies have linked such symptoms to physical workload, and also to psychological and socio-cultural factors.
We investigated whether prolonged or increasing job strain, tendency to somatise and other individual characteristics, are associated with worsening musculoskeletal pain.
Method As part of the CUPID study, we investigated a cohort of nurses employed on medical wards at the Varese University Hospitals (Italy). Participants were asked, at baseline and after one year of follow-up, about individual and occupational risk factors, psychological characteristics (including tendency to somatise), occupational strain (by Siegrist’s Effort/Reward Imbalance Questionnaire-ERI), and musculoskeletal symptoms. Associations of worsening musculoskeletal pain with perceived job strain were assessed by multivariate log-binomial regression.
Results Occupational stress was associated with pain in the lower back (LBP) and neck/shoulder (NSP) in both cross-sectional questionnaires.
Comparing baseline and follow-up answers, workers who reported an increase in perceived stress showed more frequent worsening of both LBP (prevalence of worsening symptoms=41%, OR when compared with not stressed=1.7, 95% CI=1.1–2.7) and NSP (prevalence of worsening=51%, OR=1.2, 95% CI=0.8–1.8).
This relationship persisted after adjustment for gender, age and BMI, and exposure to physical workload, and was more evident among subjects with a tendency to somatise (OR=2.8. 95% CI=1.0–7.4 for LBP; OR=1.6, 95% CI=0.8–3.2 for NSP).
Conclusions Our observation suggests that tendency to somatise modifies individual responses to “triggering exposures”, such as psychological workload, with important implications for the health, and productivity of workers.
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