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Original article
Physical work demands and psychosocial working conditions as predictors of musculoskeletal pain: a cohort study comparing self-reported and job exposure matrix measurements
  1. Ida E H Madsen1,
  2. Nidhi Gupta1,
  3. Esben Budtz-Jørgensen2,
  4. Jens Peter Bonde3,
  5. Elisabeth Framke1,
  6. Esben Meulengracht Flachs3,
  7. Sesilje Bondo Petersen3,
  8. Annemette Coop Svane-Petersen1,
  9. Andreas Holtermann1,
  10. Reiner Rugulies1,4,5
  1. 1 National Research Centre for the Working Environment, Copenhagen, Denmark
  2. 2 Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
  3. 3 Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
  4. 4 Department of Psychology, University of Copenhagen, Copenhagen, Denmark
  5. 5 Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Ida E H Madsen, National Research Centre for the Working Environment, Copenhagen DK-2100, Denmark; ihm{at}


Objectives Determining exposure to occupational factors by workers’ job titles is extensively used in epidemiological research. However, the correspondence of findings regarding associations to health between job exposure matrices (JEMs) and individual-level exposure data is largely unknown. We set out to examine the prospective associations of physical work demands and psychosocial working conditions with musculoskeletal pain, comparing JEMs with individual-level self-reported exposures.

Methods We analysed data of 8132 participants from the Work Environment and Health in Denmark cohort study. Using random intercept multilevel modelling, we constructed age-specific and sex-specific JEMs estimating predicted exposures in job groups. We analysed associations between working conditions (individual and JEM level) at baseline and musculoskeletal pain at follow-up using multilevel modelling stratified by sex, adjusting for age, education and baseline pain.

Results Any consistent associations present in the individual-level analysis were also found in the JEM-level analysis. Higher pain levels at follow-up was seen for employees with higher baseline physical work demands, women exposed to violence and men with lower decision authority, whether measured at the individual or JEM level. Higher JEM-level quantitative demands were associated with less pain, but no association was seen at the individual level.

Conclusions We found predominately comparable prospective associations between working conditions and pain, whether using JEMs or individual level exposures, with the exception of quantitative demands. The results suggest that, with few notable exceptions, findings obtained using JEMs may be comparable with those obtained when using self-reported exposures.

  • ergonomics
  • musculoskeletal
  • stress
  • longitudinal studies
  • organisation of work

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  • Contributors IEHM, NG, EB-J, JPB, EF, EMF, SBP, AH and RR contributed to the conception and design of the study, and all authors contributed to the interpretation of the data. IEHM conducted the data analysis and drafted the manuscript, and all authors critically revised it for important intellectual content and approved the final version. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding This work was funded by the Danish Work Environment Research Fund, grant numbers 43-2014-03 and 17- 2014-03, and Nordforsk grant number 75021.

  • Competing interests None declared.

  • Patient consent Not required.

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

  • Correction notice This article has been corrected since it was first published. It has been made open access.

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