title: Pain in multiple sites and sickness absence trajectories: a prospective study among Finns.
abstract: We studied the number of musculoskeletal pain sites as a predictor of sickness absence during a 7-year follow-up among a nationally representative sample (the Health 2000 survey) of occupationally active Finns 30 to 55years of age (3420 subjects who did not retire or die during the follow-up). Baseline data (questionnaire, interview, clinical examination by a physician) were gathered in 2000 to 2001 and linked with information from national registers on annual compensated sickness absence periods (⩾10workdays) covering the years 2002 to 2008. Pain during the preceding month in 18 body locations was inquired and combined into 4 sites (neck, upper limbs, low back, lower limbs). Demographic factors, BMI, smoking, leisure-time physical activity, sleep disorders, physical and psychosocial workload, and chronic diseases were assessed. Four distinct sickness absence trajectories emerged, labeled as Low (59% of the subjects), Ascending (21%), Mixed (11%), and High (9%). In multinomial logistic regression, the odds ratios (ORs) for belonging to the High vs. the Low trajectory increased with the number of pain sites, being 2.1 for single-site pain, 2.6 for 2 pain sites, 2.9 for 3 pain sites, and 4.1 for 4 pain sites, after adjustment for chronic diseases, demographic and lifestyle factors, and workload. The confidence intervals of the ORs did not include unity. The adjusted ORs for belonging to the Ascending trajectory were 1.1, 1.3, 1.7, and 1.7, respectively. As the number of pain sites was a strong independent predictor of work absenteeism, early screening of workers with multisite pain and interventions to support work ability seem warranted.
authors.affiliation: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland Disability Prevention Centre, Finnish Institute of Occupational Health, Helsinki, Finland Creating Solutions, Statistics and Health Economics Team, Finnish Institute of Occupational Health, Helsinki, Finland Occupational Health Services, OP-Pohjola Group, Helsinki, Finland Department of Health Sciences, University of Tampere, Tampere, Finland Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Eija
authors.initials: E
authors.lastname: Haukka
authors.forename: Leena
authors.initials: L
authors.lastname: Kaila-Kangas
authors.forename: Anneli
authors.initials: A
authors.lastname: Ojajärvi
authors.forename: Helena
authors.initials: H
authors.lastname: Miranda
authors.forename: Jaro
authors.initials: J
authors.lastname: Karppinen
authors.forename: Eira
authors.initials: E
authors.lastname: Viikari-Juntura
authors.forename: Markku
authors.initials: M
authors.lastname: Heliövaara
authors.forename: Päivi
authors.initials: P
authors.lastname: Leino-Arjas
mesh_terms: D000328:Adult; D005260:Female; D005387:Finland; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000523:psychology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D011446:Prospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires