title: Is smoking and alcohol consumption associated with long-term sick leave due to unspecific back or neck pain among employees in the public sector? Results of a three-year follow-up cohort study.
abstract: OBJECTIVE
  To investigate the associations between smoking and alcohol consumption, and long-term sick leave due to unspecific back or neck pain among employees in the public sector.
  
  
  METHODS
  A 3-year prospective cohort study.
  
  
  METHODS
  Approximately 9000 persons in the public sector in Sweden were invited to participate. Of these, 7533 answered a questionnaire and 6532 were included in the study, classified as having "good health for working".
  
  
  METHODS
  New periods of sick leave >or= 28 days were consecutively reported from the employers or the occupational health service during a period of 3 years. Rate ratios were estimated by means of Cox proportional hazard regression model.
  
  
  RESULTS
  Smoking was associated with an increased risk of long-term sick leave due to unspecific back or neck pain. Compared with people who have never smoked, "ever smokers" had a higher risk (rate ratio = 1.8, 95% confidence interval: 1.3-2.4). Alcohol consumption tended to be associated with a decreased risk, but the results were not statistically significant.
  
  
  CONCLUSIONS
  Our results suggest that smoking is a risk factor for long-term sick leave due to unspecific back or neck pain. Moderate alcohol consumption tends to have a protective effect, at least among women in the public sector.
authors: Institute of Environmental Medicine, Karolinska Institutet, Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden.
authors: Eva
authors: E
authors: Skillgate
authors: Eva
authors: E
authors: Vingård
authors: Malin
authors: M
authors: Josephson
authors: Lena W
authors: LW
authors: Holm
authors: Lars
authors: L
authors: Alfredsson
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D001416:Back Pain / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis*; D016272:Occupational Health; D011446:Prospective Studies; D017150:Public Sector; D012307:Risk Factors; D018582:Sick Leave; D012907:Smoking / Q000009:adverse effects*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors