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Musculoskeletal and injuries 3
  1. I. S. Mehlum1,
  2. P. Kristensen1,
  3. E. Wergeland2,
  4. H. Kjuus1
  1. 1National Institute of Occupational Health
  2. 2
    Directorate of Labour Inspection

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      208 ARE OCCUPATIONAL FACTORS IMPORTANT DETERMINANTS FOR SOCIO-ECONOMIC INEQUALITIES IN MUSCULOSKELETAL PAIN?

      Objectives:

      Socio-economic inequalities in health are well documented, and the impact of different determinants needs to be explored. The aim of this study was to quantify socio-economic inequalities in low back pain, neck/shoulder pain and arm pain in the general working population, and to examine the impact of job characteristics on these inequalities.

      Methods:

      All economically active 30-, 40-, and 45-year-old subjects who attended the Oslo Health Study 2000–2001 and answered questions on physical job demands and job autonomy and musculoskeletal pain were included (n = 7293). Occupational class was used as a measure of socio-economic position. The lower occupational classes were compared to higher grade professionals, and prevalence, prevalence ratios (PR), prevalence differences (PD) and population attributable fractions (PAF) were calculated.

      Results:

      There were marked socio-economic gradients in musculoskeletal pain, steeper in men than in women. The relative differences (PR) were larger for low back pain and arm pain than for neck/shoulder pain. The absolute differences (PD) were largest for low back pain. For non-skilled workers compared to higher grade professionals, the PD was 25 percent points (pp) in males and 15 pp in females. For neck/shoulder pain and arm pain, the corresponding differences were approximately 15 pp in men and 10 pp in women. Physical job demands explained a substantial proportion of absolute occupational class inequalities in low back pain (22% in male and 49% in female non-skilled workers), while job autonomy was more important in explaining inequalities in neck/shoulder pain (34% and 25%, respectively) and arm pain (15% and 19%). PAF estimates supported the impact of the job characteristics at the population level.

      Conclusion:

      Physical job demands and job autonomy explained a substantial proportion of occupational class inequalities in musculoskeletal pain in the working population. This suggests the workplace might be an important arena for prevention and thereby reduction of socio-economic inequalities in …

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