title: Are job strain and sleep disturbances prognostic factors for neck/shoulder/arm pain? A cohort study of a general population of working age in Sweden.
abstract: OBJECTIVE
  To study whether job strain, that is, psychological job demands and decision latitude, and sleep disturbances among persons with occasional neck/shoulder/arm pain (NSAP) are prognostic factors for having experienced at least one episode of troublesome NSAP, and to determine whether sleep disturbances modify the association between job strain and troublesome NSAP.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Stockholm, Sweden.
  
  
  METHODS
  A population-based cohort of individuals with occasional NSAP (n=6979) who answered surveys in 2006 and 2010.
  
  
  METHODS
  Report of at least one episode of troublesome NSAP in 2010.
  
  
  RESULTS
  The ORs for troublesome NSAP at follow-up were in individuals exposed to passive jobs 1.2 (95% CI 0.9 to 1.4); to active jobs 1.3 (95% CI 1.1 to 1.5); to high strain 1.5 (95% CI 1.0 to 2.4); to mild sleep disturbances 1.4 (95% CI 1.3 to 1.6) and to severe sleep disturbances 2.2 (95% CI 1.6 to 3.0). High strain and active jobs were associated with having experienced at least one episode of troublesome NSAP during the previous 6 months in persons with sleep disturbances, but not in individuals without sleep disturbances.
  
  
  CONCLUSIONS
  Our results indicate that high strain, active jobs and sleep disturbances are prognostic factors that should be taken into account when implementing preventive measures to minimise the risk of troublesome NSAP among people of working age. We suggest that sleep disturbances may modify the association between high strain and troublesome NSAP.
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Division of Physiotherapy, Department of Neurobiology, Caring Sciences, and Society, Karolinska Institutet, Huddinge, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Rasmussen-Barr
authors.affiliation: Division of Physiotherapy, Department of Neurobiology, Caring Sciences, and Society, Karolinska Institutet, Huddinge, Sweden.
authors.forename: W J A
authors.initials: WJ
authors.lastname: Grooten
authors.affiliation: Department of Public Health Sciences, Karolinska Universitetssjukhuset, Stockholm, Sweden Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Hallqvist
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: L W
authors.initials: LW
authors.lastname: Holm
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Skillgate
mesh_terms: D000293:Adolescent; D000328:Adult; D001132:Arm; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology / Q000209:etiology*; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology*; D009784:Occupational Diseases / Q000150:complications*; D011379:Prognosis; D020069:Shoulder Pain / Q000453:epidemiology / Q000209:etiology*; D012893:Sleep Wake Disorders / Q000150:complications*; D013315:Stress, Psychological / Q000150:complications*; D013548:Sweden; D055815:Young Adult
keywords: musculoskeletal diseases; prevention; sleep; stress; work