title: A prospective cohort study on musculoskeletal risk factors for long-term sickness absence among healthcare workers in eldercare.
abstract: OBJECTIVE
  The socioeconomic burden of sickness absence from musculoskeletal disorders is considerable. However, knowledge about the risk of sickness absence from pain in different body regions among specific job groups is needed to more efficiently target preventative strategies. This study estimates the risk of long-term sickness absence (LTSA) from pain in different body regions among healthcare workers.
  
  
  METHODS
  Prospective cohort study among 8,952 Danish healthcare workers responding to a questionnaire in 2004-2005 and followed for 1 year in a national register of social transfer payments (DREAM). Using Cox regression hazard ratio (HR) analysis controlled for age, gender, BMI, smoking, seniority, leisure physical activity and psychosocial working conditions, we modeled risk estimates of sub-chronic (1-30 days last year) and chronic pain (>30 days last year) in the low back, neck/shoulder and knees for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks) during one-year follow-up.
  
  
  RESULTS
  At baseline, the prevalence of chronic pain was 23% (low back), 28% (neck/shoulder) and 12% (knees). During follow-up, the 12-month prevalence of LTSA was 6.3%. Chronic pains in the low back (HR 1.47 [95% CI 1.17-1.85]), neck/shoulder (HR 1.60 [95% CI 1.27-2.02]) and knees (HR 1.92 [95% CI 1.52-2.42]) were significant risk factors for LTSA. However, only chronic neck/shoulder (HR 1.41 [95% CI 1.09-1.82]) and knee pain (HR 1.69 [95% CI 1.32-2.16]) remained significant with mutual adjustment for all three musculoskeletal pain regions.
  
  
  CONCLUSIONS
  Musculoskeletal pain is a risk factor for LTSA among healthcare workers. Future research among healthcare workers in eldercare should include the management of neck/shoulder and knee pain in addition to the management of back pain.
authors: National Research Centre for the Working Environment, Lersø Parkalle 105, 2100, Copenhagen, Denmark. lla@nrcwe.dk
authors: Lars L
authors: LL
authors: Andersen
authors: Thomas
authors: T
authors: Clausen
authors: Ole S
authors: OS
authors: Mortensen
authors: Hermann
authors: H
authors: Burr
authors: Andreas
authors: A
authors: Holtermann
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D005851:Geriatric Nursing; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000209:etiology*; D019547:Neck Pain / Q000209:etiology; D009784:Occupational Diseases; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D018582:Sick Leave; D011795:Surveys and Questionnaires