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The effect of pain on sickness absence among middle-aged municipal employees
  1. P Saastamoinen1,
  2. M Laaksonen1,
  3. E Lahelma1,
  4. P Leino-Arjas2
  1. 1
    Department of Public Health, University of Helsinki, Helsinki, Finland
  2. 2
    Finnish Institute of Occupational Health, Helsinki, Finland
  1. Peppiina Saastamoinen, University of Helsinki, Department of Public Health, PO Box 41, 00014 University of Helsinki, Helsinki, Finland; peppiina.saastamoinen{at}


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 City of Helsinki personnel register data on sickness absence and a cross-sectional questionnaire survey which was carried out among employees of the City of Helsinki who reached the age of 40, 45, 50, 55 or 60 years during the years 2000–2002 (n = 8960, response rate 67%). Data sets were combined for those who gave permission for such linkage (78%). The 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 of work load factors and socio-economic position showed that pain was a relatively independent determinant of subsequent sickness absence, but in particular physical work load and socio-economic position explained a small proportion of the association. Overall, pain accounted for 13% of self-certified absence among women and 8% among men. Corresponding figures were 23% and 25% for medically certified 4–14-day sickness absence and 37% and 30% for absence of over 2 weeks.

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

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  • Funding: The Helsinki Health Study is supported by the Academy of Finland (nos. 205588 and 1121748), PS is supported by Doctoral Programs of Public Health and The Finnish Work Environment Fund (no. 107187).

  • Competing interests: None.

  • Ethics approval: The protocol of the Helsinki Health Study has been approved by the Ethical Committees of the Health Authorities of the City of Helsinki and the Department of Public Health, University of Helsinki.