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Workplace
Original article
Recurrent back pain during working life and exit from paid employment: a 28-year follow-up of the Whitehall II Study
  1. Tea Lallukka1,2,
  2. Minna Mänty2,3,
  3. Cyrus Cooper4,5,
  4. Maria Fleischmann6,
  5. Anne Kouvonen7,8,9,
  6. Karen E Walker-Bone10,
  7. Jenny A Head6,
  8. Jaana I Halonen1
  1. 1 Population and Work Ability Program, Finnish Institute of Occupational Health, Helsinki, Finland
  2. 2 Department of Public Health, University of Helsinki, Helsinki, Finland
  3. 3 Department of Research, Development and Innovation (RDI), Laurea University of Applied Sciences, Vantaa, Finland
  4. 4 MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
  5. 5 NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
  6. 6 Department of Epidemiology and Public Health, University College London, London, UK
  7. 7 Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
  8. 8 Division of Health Psychology, SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland
  9. 9 UKCRC Centre of Excellence for Public Health, Queen’s University Belfast, Belfast, UK
  10. 10 Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
  1. Correspondence to Tea Lallukka, Population and Work Ability Program, Finnish Institute of Occupational Health, Helsinki, Finland tea.lallukka{at}helsinki.fi

Abstract

Objectives To examine the impact of recurrent, as compared with single, reports of back pain on exit from paid employment over decades of follow-up.

Methods The study sample was from the British Whitehall II Study cohort (n=8665, 69% men, aged 35–55 at baseline), who had provided information about their reports of back pain between 1985 and 1994. Data about exit from paid employment (health-related and non-health related exit, unemployment and other exit) were collected between 1995 and 2013. Repeated measures logistic regression models were fitted to examine the associations, and adjust for covariates.

Results Recurrent pain was reported by 18% of participants, while 26% reported pain on an occasion and 56% did not report pain. Report of back pain on an occasion was not associated with health-related job exit, whereas recurrent pain was associated with such an exit (OR 1.51; 95% CI 1.15 to 1.99), when compared with those who did not report pain. These associations were somewhat stronger among middle-grade and lower-grade employees, while these associations were not seen among higher-grade employees. Differences in associations by age and psychosocial working conditions were small.

Conclusions These results highlight the need for early detection of recurrent back pain to prevent exit out of paid employment for health reasons. As the risk varies by occupational grade, this emphasises the importance of identification of high-risk groups and finding ways to address their modifiable risk factors.

  • back disorders
  • epidemiology
  • pain
  • employment transitions
  • occupational cohort

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/oemed-2018-105202

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    Footnotes

    • Contributors TL, JAH and JIH conceived and designed the study, and JIH analysed the data. TL prepared the first version of the manuscript. All authors discussed the results and commented on the manuscript, and approved the submission of the final version.

    • Funding This work was supported by the Academy of Finland. TL and JIH are supported by the Academy of Finland (Grants #287488, #294096 and #319200). AK is supported by the Medical Research Council (MRC) (Grant MR/K023241/1). MF and JAH were jointly funded by the UK Economic and Social Research Council and the UK Medical Research Council, under the Lifelong Health and Wellbeing Cross-Council Programme initiative (ES/L002892/1). MM is supported by The Finnish Work Environment Fund (Grant 115182) and the Juho Vainio Foundation. The UK Medical Research Council (MR/K013351/1; G0902037), British Heart Foundation (RG/13/2/30098), and the US National Institutes of Health (R01HL36310, R01AG013196) have supported collection of data in the Whitehall II Study.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval The Whitehall II Study was approved by the University College London ethics committee, and all participants had provided written informed consent to participate in the study.

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