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Secular trends in work disability and its relationship to musculoskeletal pain and mental health: a time-trend analysis using five cross-sectional surveys (2002–2010) in the general population
  1. Gwenllian Wynne-Jones1,
  2. Ying Chen1,
  3. Peter Croft1,
  4. George Peat1,
  5. Ross Wilkie1,
  6. Kelvin Jordan1,
  7. Ingemar F Petersson2,3
  1. 1 Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
  2. 2 Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden
  3. 3 Skåne University Hospital, Lund, Sweden
  1. Correspondence to Dr Gwenllian Wynne-Jones, Research Institute for Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Keele University, Keele ST5 5BG, UK; g.wynne-jones{at}


Objectives International evidence suggests that rates of inability to work because of illness can change over time. We hypothesised that one reason for this is that the link between inability to work and common illnesses, such as musculoskeletal pain and mental illness, may also change over time. We have investigated this in a study based in one UK district.

Methods Five population surveys (spanning 2002–2010) of working-age people aged >50 years and ≤65 years were used. Work disability was defined as a single self-reported item ‘not working due to ill-health’. Presence of moderate–severe depressive symptoms was identified from the Mental Component Score of the Short Form-12, and pain from a full-body manikin. Data were analysed with multivariable logistic regression.

Results The proportion of people reporting work disability across the surveys declined, from 17.0% in 2002 to 12.1% in 2010. Those reporting work disability, one-third reported regional pain, one-half widespread pain (53%) and two-thirds moderate–severe depressive symptoms (68%). Both factors were independently associated with work disability; their co-occurrence was associated with an almost 20-fold increase in the odds of reporting work disability compared with those with neither condition.

Conclusions The association of work disability with musculoskeletal pain was stable over time; depressive symptoms became more prominent in persons reporting work disability, but overall prevalence of work disability declined. The frequency and impact of both musculoskeletal pain and depression highlight the need to move beyond symptom-directed approaches towards a more comprehensive model of health and vocational advice for people unable to work because of illness.

  • epidemiology
  • mental health
  • public health
  • musculoskeletal

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  • Contributors IFP and PC conceived the study, and IFP, PC, KJ and YC contributed to the study design. YC analysed the data. GW-J led and YC contributed to the writing of initial manuscript, and all authors contributed to the interpretation of the data. All authors approved the final version of the manuscript submitted for publication. GW-J and YC equally contributed to the paper.

  • Funding The North Staffordshire Osteoarthritis Project (NorStOP) projects were funded through the following grants: Medical Research Council Programme Grant (G9900220), Medical Research Council Project Grant G0501798), Arthritis Research UK Programme Grant (18174), North Staffordshire Primary Care research Consortium. The Clinical Assessment Study of the Foot (CASF) was funded through an Arthritis Research UK Programme Grant (18174). The Self-management Approaches for Osteoarthrosis in the Hand (SMOOTH) study was funded through an Arthritis Research UK project grant (17958) and by Support for Science Funding secured by North Staffordshire Primary Care Research Consortium for NHS service support costs. GW-J was funded by an NIHR Clinical Trials Fellowship (NIHR-CTF-2016-05-10).

  • Disclaimer This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests GW-J sits on the NICE Guideline Update Committee ‘Workplace health: long term sickness absence and capability for work’.

  • Patient consent Obtained.

  • Ethics approval North West 7 Research Ethics Committee UK (rec reference: 07/H1008/235), Coventry Research Ethics Committee (REC reference no. 10/H1210/5), North Staffordshire Local Research Ethics Committee.

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

  • Data sharing statement We are committed to sharing access to our anonymised research databases derived from our population, consultation, clinical and RCT cohorts. Researchers wanting to apply for access to individual patient data from archived studies hosted by the Keele Research Institute for Primary Care and Health Sciences should first email