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Transitions in Self-Reported Musculoskeletal Pain and Interference with Activities Among Newspaper Workers

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Abstract

Active surveillance of symptoms and disability due to musculoskeletal disorders (MSD) in working populations can map individual transitions in symptom intensity or disability level. Using repeat surveys, this study examined if aetiological risk factors for new symptoms or disability, measured by interference with activities, were similar to prognostic risk factors for subsequent outcomes of symptoms and disability. This paper reports on 379 Toronto newspaper workers who completed questionnaires in 1996 and 1997. Questions on pain/discomfort during the last year, episode frequency and duration formed the basis for constructing three mutually exclusive symptom levels: noncases (Level 1); mild cases (Level 2); and more severe or frequent pain cases (Level 3). A similar construction of overall interference levels was based on the frequency with which musculoskeletal pain/discomfort interfered with daily, recreational, social and family activities, or ability to do one's job during the previous 12 months. The last was also examined as work interference alone. Levels of symptoms were cross-tabulated by overall and work interference at the two time points and Markov models of transitions between states were formulated. Results indicate that period prevalence of symptoms and overall interference increased between phases, though only significantly for symptoms (Levels 2 and 3, 65.7–70.7%, p = 0.04), while work interference was unchanged (17.9–17.0%). Equivalent proportions of workers improved as worsened in symptoms (21.1 and 22.4%, respectively), overall interference (16.7 and 17.8%), and work interference (7.4 and 6.6%). The only significant predictor for those without work interference at time one was job tenure, which was protective against work interference (Odds Ratio (OR) 1.06, 95% Confidence Interval (CI) 1.01–1.12). Among those who had more severe/frequent symptoms at time one, lack of improvement over time was predicted by longer job tenure (OR = 0.92 per year, CI: 0.87–0.97), greater psychological demands of work (OR = 0.65 per point, CI: 0.51–0.84) and marginally by greater upper extremity disability score. At time one, women with work interference were more likely to have persistent interference at time two (OR = 7.22, CI: 1.57–33.20). Suggestive findings included opposite effects of social support at work: reduced risk of development of new symptoms but increased risk of persistence at the highest symptom level.

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REFERENCES

  1. Ferucci L, Izmirlian G, Leveille S, Phillips CL, Corti MC, Brock DB, Guralnik JM. Smoking, physical activity and active life expectancy. Am J Epidemiol 1999; 149: 645-653.

    Google Scholar 

  2. Federal, Provincial andTerritorial Advisory Committee on Population Health. Toward a healthy future. Second Report on the Health of Canadians. Cat H39-468/1999E. Ottawa, ON: Health Canada and Minister of Public Works and Government Services, 1999.

    Google Scholar 

  3. Beckett LA, Brock DB, Lemke JH, Mendes de Leon CF, Guralnik JM, Fillenbaum GG, Branch LG, Wetle TT, Evans DA. Analysis of change in self-reported physical function among older persons in four population studies. Am J Epidemiol 1996; 143: 766-778.

    Google Scholar 

  4. Takala E-P, Viikari-Juntura E, Moneta GB, Saarenmas K, Kaivanto K. Seasonal variation in neck and shoulder symptoms. Scand J Work Environ Health 1992; 18: 257-261.

    Google Scholar 

  5. McGorry RW, Webster BS, Snook SH, Hsiang SM. The relations between pain intensity, disability and the episodic nature of chronic and recurrent low back pain. Spine 2000; 25: 834-841.

    Google Scholar 

  6. Kaergaard A, Andersen JH. Musculoskeletal disorders of the neck and shoulders in female sewing machine operators: Prevalence, incidence and prognosis. Occup Environ Med 2000; 57: 528-534.

    Google Scholar 

  7. Jonsson BG, Persson J, Kilbom A. Disorders of the cervicobrachial region among female workers in the electronics industry. A two-year follow up. Int J Ind Ergon 1988; 3: 1-12.

    Google Scholar 

  8. Estlander A-M, Takala E-P, Viikari-Juntura E. Do psychological factors predict changes in musculoskeletal pain? A prospective, two-year follow-up of a working population. J Occup Environ Med 1998; 40: 440-453.

    Google Scholar 

  9. Tousignant M, Rossignol M, Goulet L, Dassa C. Occupational disability related to back pain: Application of a theoretical model of work disability using prospective cohorts of manual workers. Am J Ind Med 2000; 37: 410-422.

    Google Scholar 

  10. Bishop YMM, Fienberg SE, Holland PW. Discrete multivariate analysis: Theory and practice. Cambridge, MA: MIT press, 1975.

    Google Scholar 

  11. Luukkonen R, Martikainen R, Mutanen P, Viikari-Juntura E, Riihimäki H, Takala E-P. Analysis of longitudinal questionnaire data using three different statistical methods. In: Proceedings of the 13th Triennial Congress of the International Ergonomics Association, Vol. 4: Musculoskeletal disorders and rehabilitation, Tampere, Finland, 1997, pp. 78-80.

  12. Lusa S, Luukkonen R, Viikari-Juntura E, Punakallio A. Factors predicting musculoskeletal pain in Finnish fire-fighters: A three-year follow up study. Abstract at PREMUS, 4th International Scientific Conference on prevention of work-related musculoskeletal disorders, Amsterdam, The Netherlands, 2001, p. 223.

  13. Polanyi MFD, Cole DC, Beaton DE, Chung J, Wells R, Abdolell M, Beech-Hawley L, Ferrier SE, Mondloch MV, Shields SA, Smith JM, Shannon HS. Upper limb work-related musculoskeletal disorders among newspaper employees: Cross-sectional survey results. Am J Ind Med 1997; 32: 620-628.

    Google Scholar 

  14. Swift M, Cole DC, Beaton DE, Manno M. Health care utilization and workplace interventions for neck and upper limb problems among newspaper workers. J Occup Environ Med 2001; 43: 265-275.

    Google Scholar 

  15. Beaton DE, Cole DC, Manno M, Bombardier C, Hogg-Johnson S, Shannon H. Estimating the burden of work-related musculoskeletal disorders in newspaper workers: What difference do case definitions make? J Occup Rehabil 2000; 10: 39-53.

    Google Scholar 

  16. Hagberg M, Silverstein B, Wells R, Smith MJ, Hendrick HW, Carayon P. Perusse Health and risk factor surveillance forwork-related musculoskeletal disorders. In: Kuorinka I, Forcier L, eds. Work-related musculoskeletal disorders (WMSDs): A reference book for prevention. London: Taylor & Francis, 1995, pp. 213-243.

    Google Scholar 

  17. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jørgenson K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergo 1987; 18: 233-237.

    Google Scholar 

  18. Norman GR, Streiner DL. PDQ statistics. Toronto, ON: B.C. Decker, 1986, p. 172.

    Google Scholar 

  19. Copas JB. Regression, prediction and shrinkage (with discussion). J R Stat Soc Ser B 1983; 45: 311-354.

    Google Scholar 

  20. Bernard BP (ed.). Musculoskeletal disorders and workplace factors. A critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity and low back. DHHS (NIOSH) Publication No. 97-141. Cincinnati, OH: National Institute for Occupational Safety and Health, 1997.

    Google Scholar 

  21. Cole DC, Hudak PL. Prognosis of non-specific work-related musculoskeletal disorders of the neck and upper extremity. Am J Ind Med 1996; 29: 657-668.

    Google Scholar 

  22. Katz JN, Keller RB, Fossel AH, Punnett L, Bessette L, Simmons BP, Mooney N. Predictors of return to work following carpal tunnel release. Am J Ind Med 1997; 31: 85-91.

    Google Scholar 

  23. Katz JN, Lew RA, Bessette L, Punnett L, Fossel AH, Mooney N, Keller RB. Prevalence and predictors of long-term work disability due to carpal tunnel syndrome. Am J Ind Med 1998; 33: 543-550.

    Google Scholar 

  24. Brox JI, Staff PH, Ljunggren AE, Brevik JI. Arthroscopic surgery compared with supervised exercises in patients with rotator cuff disease (stage II impingement syndrome). Br Med J 1993; 307: 899-903.

    Google Scholar 

  25. Feuerstein M, Huang GD, Haufler AJ, Miller JK. Development of a screen for predicting clinical outcomes in patients with work-related upper extremity disorders. J Occup Environ Med 2000; 42: 749-761.

    Google Scholar 

  26. Karlqvist L, Hagberg M, Wenemark M, Ånell R, Köster M. Musculoskeletal symptoms among computerassisted design (CAD) operators and evaluation of a self-assessment questionnaire. Int J Occup Environ Health 1996; 2: 185-194.

    Google Scholar 

  27. Wilkins K, Beaudet MP. Work stress and health. Health Rep 1998; 10: 47-62.

    Google Scholar 

  28. Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B. The Job Content Questionnaire (JCQ): An instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol 1998; 3: 322-355.

    Google Scholar 

  29. Von Korff M, Dworkin SF, Le Resche L. Graded chronic pain status: An epidemiologic evaluation. Pain 1990; 40: 279-291.

    Google Scholar 

  30. Von Korff M, Ormel J, Keefe FJ, Dworkin SF. Grading the severity of chronic pain. Pain 1992; 50: 133-149.

    Google Scholar 

  31. Smith JM, Cole DC, Beaton DE, Manno M, and the Worksite Upper Extremity Research Group. Comparing severity indices for upper extremity work-related musculoskeletal disorders across multiple indicators. Institute for Work and Health Working Paper #110. Toronto, ON: Institute for Work and Health, 2001.

    Google Scholar 

  32. Hudak PE, Amadio PC, Bombardier C, and the Upper Extremity Collaborative Group. Development of an upper extremity outcome measure: The DASH (Disabilities of the Arm, Shoulder and Hand). Am J Ind Med 1996; 29: 602-608.

    Google Scholar 

  33. McConnell S, Beaton DE, Bombardier C. The DASH outcome measure: A user's manual, 1st edn., Toronto, ON: Institute for Work and Health, 1999.

    Google Scholar 

  34. SAS Institute Inc. SAS/STAT users' guide, Version 6, Vol. 12, 4th edn. Cary, NC: SAS Institute Inc., 1989.

    Google Scholar 

  35. National Institute for Occupational Safety and Health (NIOSH). NIOSH health hazard evaluation report. NIOSH Report No. HETA89-250-2046. Newsday, Inc., Melville, NewYork. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health.

  36. Josephson M, Lagerström M, Hagberg M, Hjelm EW. Musculoskeletal symptoms and job strain among nursing personnel: A study over a three year period. Occup Environ Med 1997; 54: 681-685.

    Google Scholar 

  37. Hoogendoorn WE, van Poppel MNM, Bongers PM, Koes BW, Bouter LM. Systematic reviewof psychosocial factors at work and private life as risk factors for back pain. Spine 2000; 25: 2114-2125.

    Google Scholar 

  38. Cole DC, Ibrahim SA, Shannon HS, Scott F, Eyles J. Work correlates of back problems and activity restriction due to musculoskeletal disorders in the Canadian National Population Health Survey (NPHS) 1994/95 Data. Occup Environ Med 2001; 58: 728-734.

    Google Scholar 

  39. Clarke J, Chung J, Cole DC, Hogg-Johnson S, Haidar and the ECC Prognosis Working Group. Gender and benefit duration in lost time work-related soft tissue disorders: Relationships with work and social factors. Institute for Work and Health Working Paper #85. Toronto, ON: Institute for Work and Health, 1999.

    Google Scholar 

  40. Hagberg M, Christiani D, Courtney TK, Halperin W, Leamon TB, Smith TJ. Conceptual and definitional issues in occupational injury epidemiology. Am J Ind Med 1999; 32: 106-115.

    Google Scholar 

  41. Brandt EJ, Pope AM (eds.). Enabling America: Assessing the role of rehabilitation science and engineering. Division of Health Sciences Policy, Institute of Medicine. Washington, DC: National Academy Press, 1997.

    Google Scholar 

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Correspondence to Donald C. Cole.

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Cole, D.C., Manno, M., Beaton, D. et al. Transitions in Self-Reported Musculoskeletal Pain and Interference with Activities Among Newspaper Workers. J Occup Rehabil 12, 163–174 (2002). https://doi.org/10.1023/A:1016842611591

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