Text box 1. Contributions to literature |
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• The association of pain, concurrent mental health and sickness absence among younger employees is little studied although musculoskeletal and mental disorders dominate as reasons for long-term sickness absence |
• We present findings on the associations of chronic and multisite pain and sickness absence among Finnish employees under 40 years and consider the role of concurrent mental health. We also highlight gender differences to the association between pain and sickness absence |
• We suggest further intervention studies and that the pain burden among younger employees is addressed at workplaces, in healthcare and at policy making level to prevent pain related work disability |
Background
Methods
Study population
Pain
Mental health
Sickness absence
Covariates
Statistical methods
Ethical considerations
Results
Descriptive results
Total SA days | Long-term SA days | ||
---|---|---|---|
% | mean (95% CI) | mean (95% CI) | |
Gender | |||
Women (n = 3141) | 80.3 | 12.8 (11.7–13.9) | 4.5 (3.8–5.3) |
Men (n = 770) | 19.7 | 9.3 (8.0–10.7) | 3.9 (2.5–5.2) |
All (n = 3911) | 100.0 | 12.1 (11.2–13.0) | 4.4 (3.8–5.0) |
Age | |||
< 30 years | 31.3 | 15.2 (13.0–17.4) | 5.7 (4.3–7.0) |
≥ 30 years | 68.7 | 10.7 (9.8–11.6) | 3.8 (3.1–4.5) |
Marital status | |||
Married or cohabiting | 67.2 | 11.0 (10.0–12.1) | 3.8 (3.1–4.5) |
Unmarried | 32.8 | 14.3 (12.5–16.2) | 5.6 (4.3–7.0) |
Education level | |||
High | 29.8 | 7.8 (6.5–9.1) | 2.5 (1.7–3.4) |
Intermediate | 37.8 | 12.1 (10.5–13.8) | 4.5 (3.5–5.6) |
Low | 32.4 | 16.0 (14.3–17.7) | 6.0 (4.6–7.3) |
Binge drinking | |||
Rarely | 90.0 | 13.3 (8.8–17.8) | 4.4 (3.7–5.0) |
Weekly or more | 6.4 | 11.9 (11.0–12.7) | 4.4 (1.9–6.9) |
Missing response | 3.7 | 16.7 (6.3–27.0) | 5.2 (1.3–9.0) |
Nicotine use | |||
Never or cessated | 72.8 | 11.0 (10.0–12.0) | 3.9 (3.2–4.6) |
Daily or sporadical | 27.2 | 15.1 (13.1–17.1) | 5.6 (4.2–7.1) |
Physical activity | |||
High | 61.8 | 10.7 (9.7–11.8) | 3.8 (3.0–4.5) |
Intermediate | 28.7 | 14.5 (12.3–16.8) | 5.7 (4.3–7.2) |
Low | 9.5 | 13.7 (11.5–15.9) | 4.5 (2.9–6.1) |
Body mass index (kg/m2) | |||
< 25 | 59.1 | 10.8 (9.7–12.0) | 3.4 (2.7–4.1) |
25–29.9 | 26.4 | 11.9 (10.4–13.4) | 5.2 (3.8–6.7) |
≥ 30 | 14.5 | 17.7 (14.6–20.9) | 7.1 (5.0–9.1) |
Gender | Sickness absence days | ||||
---|---|---|---|---|---|
Total | Women | Men | Total | Long-term | |
% | % | % | mean (95% CI) | mean (95% CI) | |
Pain chronicity | |||||
No pain | 57.5 | 55.8 | 64.4 | 9.5 (8.5–10.5) | 3.2 (2.4–4.0) |
Acute | 22.7 | 23.8 | 17.9 | 13.9 (12.5–15.3) | 5.6 (4.1–7.1) |
Chronic | 19.8 | 20.4 | 17.7 | 17.7 (14.5–20.9) | 6.5 (4.9–8.1) |
Pain sites | |||||
No pain | 57.5 | 55.8 | 64.4 | 9.5 (8.5–10.5) | 3.2 (2.4–4.0) |
Single site | 14.4 | 14.5 | 13.9 | 12.4 (10–14.8) | 3.9 (2.5–5.3) |
Multisite | 28.1 | 29.6 | 21.7 | 17.3 (15.1–19.6) | 7.1 (5.6–8.6) |
Mental health | |||||
Better | 47.1 | 46.7 | 48.8 | 8.7 (7.9–9.5) | 2.3 (1.8–2.8) |
Poorer | 52.9 | 53.3 | 51.2 | 15.1 (13.6–16.7) | 6.3 (5.2–7.4) |
Pain chronicity by pain locations | |||||
No pain | 57.5 | 55.8 | 64.4 | 9.5 (8.5–10.5) | 3.2 (2.4–4.0) |
Acute single site | 8.0 | 8.0 | 7.9 | 11.0 (8.9–13.1) | 4.3 (2.3–6.3) |
Acute multisite | 14.7 | 15.8 | 10.0 | 15.4 (13.6–17.3) | 6.3 (4.3–8.4) |
Chronic single site | 6.4 | 6.5 | 6.0 | 14.1 (9.5–18.8) | 3.4 (1.5–5.3) |
Chronic multisite | 13.4 | 13.8 | 11.7 | 19.4 (15.1–23.7) | 8.0 (5.7–10.2) |
Pain chronicity by mental health | |||||
No pain, better mental health | 30.3 | 29.1 | 35.5 | 7.0 (6.3–7.7) | 1.7 (1.1–2.3) |
No pain, poorer mental health | 27.2 | 26.7 | 29.0 | 12.3 (10.4–14.2) | 4.9 (3.4–6.4) |
Acute, better mental health | 9.7 | 10.2 | 7.7 | 11.9 (10.1–13.8) | 3.8 (2.4–5.1) |
Acute, poorer mental health | 13.0 | 13.6 | 10.3 | 15.3 (13.3–17.4) | 7.0 (4.6–9.4) |
Chronic, better mental health | 7.1 | 7.4 | 5.7 | 11.7 (8.5–15.0) | 2.9 (1.2–4.6) |
Chronic, poorer mental health | 12.8 | 13.0 | 11.9 | 21.0 (16.3–25.7) | 8.5 (6.1–10.8) |
Pain sites by mental distress | |||||
No pain, better mental health | 30.3 | 29.1 | 35.5 | 7.0 (6.3–7.7) | 1.7 (1.1–2.3) |
No pain, poorer mental health | 27.2 | 26.7 | 29.0 | 12.3 (10.4–14.2) | 4.9 (3.4–6.4) |
Single site, better mental health | 6.8 | 6.9 | 6.5 | 9.2 (7.0–11.5) | 2.2 (0.6–3.7) |
Single site, poorer mental health | 7.6 | 7.6 | 7.4 | 15.2 (11.3–19.2) | 5.4 (3.2–7.7) |
Multisite, better mental health | 9.9 | 10.7 | 6.9 | 13.6 (11.2–16.1) | 4.3 (2.8–5.7) |
Multisite, poorer mental health | 18.1 | 18.9 | 14.8 | 19.4 (16.2–22.6) | 8.7 (6.5–10.9) |
Associations of pain chronicity, pain sites, and mental health with sickness absence
Total sickness absence | Long-term sickness absence | ||||
---|---|---|---|---|---|
Model 1 | Model 2 | Synergy index | Model 1 | Model 2 | |
RR (95% CI) | RR (95% CI) | RR (95% CI) | RR (95% CI) | ||
Pain chronicity | |||||
No pain | 1.00 | 1.00 | 1.00 | 1.00 | |
Acute | 1.45 (1.28–1.63) | 1.36 (1.21–1.53) | 1.71 (0.93–3.16) | 1.70 (0.92–3.15) | |
Chronic | 1.87 (1.64–2.12) | 1.66 (1.47–1.89) | 2.19 (1.13–4.21) | 1.96 (1.01–3.79) | |
Pain sites | |||||
No pain | 1.00 | 1.00 | 1.00 | 1.00 | |
Single site | 1.32 (1.14–1.52) | 1.28 (1.11–1.47) | 1.19 (0.57–2.46) | 1.14 (0.54–2.40) | |
Multisite | 1.81 (1.62–2.02) | 1.62 (1.44–1.81) | 2.34 (1.31–4.16) | 2.19 (1.22–3.90) | |
Mental health | |||||
Better | 1.00 | 1.00 | 1.00 | 1.00 | |
Poorer | 1.70 (1.54–1.87) | 1.63 (1.48–1.8) | 2.81 (1.71–4.60) | 2.73 (1.65–4.54) | |
Pain chronicity by pain sites | |||||
No pain | 1.00 | 1.00 | 1.00 | 1.00 | |
Acute single site | 1.17 (0.97–1.40) | 1.16 (0.97–1.39) | 1.26 (0.50–3.21) | 1.33 (0.51–3.43) | |
Acute multisite | 1.60 (1.39–1.84) | 1.47 (1.28–1.69) | 1.97 (0.95–4.05) | 1.90 (0.92–3.93) | |
Chronic single site | 1.51 (1.23–1.84) | 1.43 (1.17–1.75) | 1.09 (0.39–3.04) | 0.91 (0.32–2.59) | |
Chronic multisite | 2.05 (1.77–2.37) | 1.78 (1.54–2.06) | 0.95 (0.63–1.42) | 2.76 (1.29–5.93) | 2.51 (1.17–5.42) |
Pain chronicity by mental health | |||||
No pain, better mental health | 1.00 | 1.00 | 1.00 | 1.00 | |
No pain, poorer mental health | 1.69 (1.49–1.92) | 1.66 (1.47–1.89) | 2.95 (1.55–5.63) | 2.73 (1.39–5.37) | |
Acute, better mental health | 1.62 (1.36–1.93) | 1.55 (1.31–1.85) | 2.17 (0.88–5.35) | 2.12 (0.86–5.24) | |
Acute, poorer mental health | 2.14 (1.82–2.5) | 1.94 (1.66–2.27) | 4.07 (1.81–9.14) | 3.65 (1.59–8.35) | |
Chronic, better mental health | 1.69 (1.38–2.07) | 1.50 (1.23–1.83) | 1.83 (0.65–5.13) | 1.20 (0.40–3.59) | |
Chronic, poorer mental health | 2.90 (2.47–3.41) | 2.58 (2.20–3.02) | 1.38 (0.99–1.91) | 5.53 (2.42–12.63) | 5.04 (2.14–11.87) |
Pain sites by mental health | |||||
No pain, better mental health | 1.00 | 1.00 | 1.00 | 1.00 | |
No pain, poorer mental health | 1.69 (1.49–1.92) | 1.66 (1.46–1.88) | 2.94 (1.54–5.60) | 2.72 (1.38–5.34) | |
Single site, better mental health | 1.27 (1.04–1.56) | 1.22 (1.00–1.49) | 1.20 (0.43–3.39) | 1.04 (0.36–2.97) | |
Single site, poorer mental health | 2.17 (1.78–2.63) | 2.11 (1.74–2.56) | 3.27 (1.21–8.87) | 3.17 (1.11–9.03) | |
Multisite, better mental health | 1.91 (1.61–2.28) | 1.75 (1.47–2.08) | 2.61 (1.07–6.36) | 2.26 (0.91–5.61) | |
Multisite, poorer mental health | 2.66 (2.31–3.07) | 2.31 (2.00–2.66) | 1.03 (0.78–1.36) | 5.48 (2.64–11.37) | 4.88 (2.3–10.33) |