Risk factors for sickness absence due to low back pain and prognostic factors for return to work in a cohort of shipyard workers

European Spine Journal, Jul 2008

The purpose of this study was to determine risk factors for the occurrence of sickness absence due to low back pain (LBP) and to evaluate prognostic factors for return to work. A longitudinal study with 1-year follow-up was conducted among 853 shipyard workers. The cohort was drawn around January 2004 among employees in the shipyard industry. Baseline information was obtained by questionnaire on physical and psychosocial work load, need for recovery, perceived general health, musculoskeletal complaints, sickness absence, and health care use during the past year. During the 1-year follow-up for each subject medical certifications were retrieved for information on the frequency and duration of spells of sickness absence and associated diagnoses. Cox regression analyses were conducted on occurrence and on duration of sickness absence with hazard ratios (HR) with 95% confidence interval (95% CI) as measure of association. During the 1-year follow-up period, 14% of the population was on sick leave at least once with LBP while recurrence reached 41%. The main risk factors for sickness absence were previous absence due to a health problem other than LBP (HR 3.07; 95%CI 1.66–5.68) or previous sickness absence due to LBP (HR 6.52; 95%CI 3.16–13.46). Care seeking for LBP and lower educational level also hold significant influences (HR 2.41; 95%CI 1.45–4.01 and HR 2.46; 95%CI 1.19–5.07, respectively). Living with others, night shift and supervising duties were associated with less absenteeism due to LBP. Workers with a history of herniated disc had a significantly decreased rate of returning to work, whereas those who suffered from hand-wrist complaints and LBP returned to work faster. Prior sick leave due to LBP partly captured the effects of work-related physical and psychosocial factors on occurrence of sick leave. Our study showed that individual and job characteristics (living alone, night shift, lower education, sick leave, or care seeking during the last 12 months) influenced the decision to take sick leave due to LBP. An increased awareness of those frequently on sick leave and additional management after return to work may have a beneficial effect on the sickness absence pattern.

A PDF file should load here. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a PDF plug-in installed and enabled in your browser.

Alternatively, you can download the file locally and open with any standalone PDF reader:

https://link.springer.com/content/pdf/10.1007%2Fs00586-008-0711-0.pdf

Risk factors for sickness absence due to low back pain and prognostic factors for return to work in a cohort of shipyard workers

Evangelos C. Alexopoulos 0 1 2 3 Eleni C. Konstantinou 0 1 2 3 Giorgos Bakoyannis 0 1 2 3 Dimitra Tanagra 0 1 2 3 Alex Burdorf 0 1 2 3 0 G. Bakoyannis Department of Hygiene and Epidemiology, Medical School, Athens University , Athens, Greece 1 E. C. Alexopoulos E. C. Konstantinou D. Tanagra Occupational Health Department , Hellenic Shipyards SA, Athens, Greece 2 E. C. Alexopoulos (&) Department of Public Health, Medical School, University of Patras , Rio, 26500 Patras, Greece 3 A. Burdorf Department of Public Health , Erasmus MC, Rotterdam, The Netherlands The purpose of this study was to determine risk factors for the occurrence of sickness absence due to low back pain (LBP) and to evaluate prognostic factors for return to work. A longitudinal study with 1-year follow-up was conducted among 853 shipyard workers. The cohort was drawn around January 2004 among employees in the shipyard industry. Baseline information was obtained by questionnaire on physical and psychosocial work load, need for recovery, perceived general health, musculoskeletal complaints, sickness absence, and health care use during the past year. During the 1-year follow-up for each subject medical certifications were retrieved for information on the frequency and duration of spells of sickness absence and associated diagnoses. Cox regression analyses were conducted on occurrence and on duration of sickness absence with hazard ratios (HR) with 95% confidence interval (95% CI) as measure of association. During the 1year follow-up period, 14% of the population was on sick leave at least once with LBP while recurrence reached 41%. The main risk factors for sickness absence were - previous absence due to a health problem other than LBP (HR 3.07; 95%CI 1.665.68) or previous sickness absence due to LBP (HR 6.52; 95%CI 3.1613.46). Care seeking for LBP and lower educational level also hold significant influences (HR 2.41; 95%CI 1.454.01 and HR 2.46; 95%CI 1.195.07, respectively). Living with others, night shift and supervising duties were associated with less absenteeism due to LBP. Workers with a history of herniated disc had a significantly decreased rate of returning to work, whereas those who suffered from hand-wrist complaints and LBP returned to work faster. Prior sick leave due to LBP partly captured the effects of work-related physical and psychosocial factors on occurrence of sick leave. Our study showed that individual and job characteristics (living alone, night shift, lower education, sick leave, or care seeking during the last 12 months) influenced the decision to take sick leave due to LBP. An increased awareness of those frequently on sick leave and additional management after return to work may have a beneficial effect on the sickness absence pattern. A high prevalence of work-related low back pain (LBP) with substantial consequences has been reported among industrial workers. [14] In the shipyard industry metal workers, welders, carpenters, plumbers, mechanics, and various other workers hold jobs that include most of the well-established risk factors for the occurrence of LBP and other musculoskeletal disorders (MSDs) such as physical load and psychosocial stressors [2, 8, 19]. Sickness absence is an important indicator of morbidity, although it is not a simple function of ill health since it also includes psychological factors and coping behaviors. Coping strategies may depend on individual, social, organizational, and cultural factors, which negatively affect the prognosis of temporary disability and recovery. This underlines the need of ongoing research on factors affecting the workers ability to cope with his/her musculoskeletal problem at work in different settings and cultures. More knowledge about the risk factors of sickness absence will be valuable in determining strategies for reducing sick leave and this underlines why its monitoring is an essential part of occupational health care [1, 5, 10]. While there is evidence for the effectiveness of return to work (RTW) interventions [18], the results are not consistent across studies either on reducing recurrent absenteeism due to LBP [16, 17, 25] or on improving RTW [4]. Furthermore, the challenges of engaging and involving stakeholders in RTW intervention and the necessity of expanding RTW research to more diverse work settings are well acknowledged [11]. In most cases RTW after sick leave due to LBP occurs within 1 month [12, 28]. Although it is of great importance to distinguish workers with normal RTW from those with prolonged sick leave, this has shown to be difficult. Individual and complaint-related characteristics, social parameters, and pursuit of compensation have been identified as predictors for a delayed return to work among patients with LBP [30]. The aim of this longitudinal study was to describe the frequency and duration of sickness absence due to LBP, to investigate risk factors for the occurrence of sickness absence, and to determine the prognostic f (...truncated)


This is a preview of a remote PDF: https://link.springer.com/content/pdf/10.1007%2Fs00586-008-0711-0.pdf

Evangelos C. Alexopoulos, Eleni C. Konstantinou, Giorgos Bakoyannis, Dimitra Tanagra, Alex Burdorf. Risk factors for sickness absence due to low back pain and prognostic factors for return to work in a cohort of shipyard workers, European Spine Journal, 2008, pp. 1185, Volume 17, Issue 9, DOI: 10.1007/s00586-008-0711-0