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A prospective cohort study on severe pain as a risk factor for long-term sickness absence in blue- and white-collar workers
  1. Lars Louis Andersen1,
  2. Ole Steen Mortensen1,2,
  3. Jørgen Vinsløv Hansen1,
  4. Hermann Burr1
  1. 1National Research Centre for the Working Environment, Copenhagen, Denmark
  2. 2Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, DK 2400 Copenhagen, NV
  1. Correspondence to Dr Lars Louis Andersen, National Research Centre for the Working Environment, Lersø Parkalle 105, Copenhagen 2100, Denmark; lla{at}


Objective To estimate the impact of pain in different body regions on future long-term sickness absence (LTSA) among blue- and white-collar workers.

Method Prospective cohort study in a representative sample of 5603 employees (the Danish Work Environment Cohort Study) interviewed in 2000, and followed in 2001–2002 in a national sickness absence register. Cox regression analysis was performed to assess the risk estimates of mutually adjusted severe pain in the neck/shoulder, low back, hand/wrist and knees for onset of LTSA, defined as receiving sickness absence compensation for at least 3 consecutive weeks. Age, gender, body mass index, smoking and diagnosed disease were controlled for.

Results In 2000 the prevalence among blue- and white-collar workers, respectively, of severe pain was 33% and 29% (neck/shoulder), 33% and 25% (low back), 16% and 11% (hand/wrists), and 16% and 12% (knees). During 2001–2002, the prevalence of LTSA among blue- and white-collar workers was 18% and 12%, respectively. Hand/wrist pain (HR 1.49, 95% CI 1.23 to 1.81) and low back pain (HR 1.30, 95% CI 1.11 to 1.53) were significant risk factors among the total cohort. Neck/shoulder pain was a significant risk factor among white-collar workers only (HR 1.35, 95% CI 1.21 to 1.85). Knee pain was not a significant risk factor.

Conclusion While hand/wrist pain and low back pain are general risk factors for LTSA, neck/shoulder pain is a specific risk factor among white-collar workers. This study suggests the potential for preventing future LTSA through interventions to manage or reduce musculoskeletal pain.

  • Epidemiology
  • musculoskeletal
  • sickness absence

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  • Competing interests None.

  • Ethics approval The study has been notified to and registered by Datatilsynet (the Danish Data Protection Agency). According to Danish law, questionnaire and register based studies do not need approval by ethics and scientific committees, nor informed consent.

  • Provenance and peer review Not commissioned; externally peer reviewed.