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The effect of pain on sickness absence among middle-aged municipal employees
  1. Peppiina Saastamoinen (peppiina.saastamoinen{at}
  1. University of Helsinki, Department of Public Health, Finland
    1. Mikko Laaksonen (mikko.t.laaksonen{at}
    1. University of Helsinki, Department of Public Health, Finland
      1. Päivi Leino-Arjas (paivi.leino-arjas{at}
      1. Finnish Institute of Occupational Health, Finland
        1. Eero Lahelma (eero.lahelma{at}
        1. University of Helsinki, Department of Public Health, Finland



          Objectives: To study the effects of pain on sickness absence, taking into account physical and psychosocial work load and socio-economic position.

          Methods: Data consisted of the City of Helsinki personnel register data on sickness absence and a cross sectional questionnaire survey, which was carried out among the employees of the city of Helsinki who reached the age of 40, 45, 50, 55 and 60 year during years 2000-2002 (n=8960, response rate 67%). Data sets were combined for those who gave permission for such linkage (78%). Main statistical method was negative binomial regression analysis.

          Results: The burden of pain on sickness absence was dependent on the duration of absence: the longer the duration, the higher the burden. Self-certified absence was equally predicted by acute and chronic pain, but medically certified absence was more clearly predicted by chronic pain. Adjustments for a range work-load factors and socio-economic position showed that pain was a relatively independent determinant of subsequent sickness absence, but especially physical work load and socio-economic position explained a small part of the association. Overall, pain accounted for 13% of self-certified absence among women and 8% among men. Corresponding figures for medically certified 4-14 day sickness absence were 23% and 25% and for over two week absence 37% and 30%.

          Conclusions: The burden of pain to medically certified sickness absence is considerable. Prevention of pain problems is vital for reducing sickness absence rates.

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