title: Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints.
abstract: OBJECTIVE
  To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints.
  
  
  METHODS
  Three hundred and forty two patients with neck or upper extremity complaints completed self-report questionnaires at baseline and after 3 months. Cox regression models were used to investigate the association between work-related risk factors and sick leave (i.e., lost days from work due to neck or upper extremity complaints in 3 months). Effect modification by sick leave at baseline, sex, worrying and musculoskeletal co-morbidity was evaluated by adding product terms to the regression models.
  
  
  RESULTS
  In the subgroup of patients who scored high on the pain copying scale "worrying" the hazard ratio of sick leave was 1.32 (95% CI 1.07-1.62) per 10% increase in heavy physical work. The subgroup of patients who were sitting for long periods of time had a reduced risk of sick leave as compared to patients who did not spend a lot of time sitting, again only in patients who scored high on the pain coping scale "worrying" (adjusted HR=0.17, 95%-CI 0.04-0.72). Other work-related risk factors were not significantly related to sick leave.
  
  
  CONCLUSIONS
  Heavy physical work increased the risk of sick leave and prolonged sitting reduced the risk of sick leave in a subgroup of patients who worried much about their pain. Additional large longitudinal studies of sufficiently large size among employees with neck or upper extremity complaints are needed to confirm our results.
authors.affiliation: Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. s.bot@vumc.nl
authors.forename: Sandra D M
authors.initials: SD
authors.lastname: Bot
authors.forename: Caroline B
authors.initials: CB
authors.lastname: Terwee
authors.forename: Daniëlle A W M
authors.initials: DA
authors.lastname: van der Windt
authors.forename: Allard J
authors.initials: AJ
authors.lastname: van der Beek
authors.forename: Lex M
authors.initials: LM
authors.lastname: Bouter
authors.forename: Joost
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000328:Adult; D001134:Arm Injuries / Q000209:etiology / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D019547:Neck Pain / Q000209:etiology / Q000523:psychology*; D009426:Netherlands / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology / Q000706:statistics & numerical data*