Combined musculoskeletal pain in the upper and lower body: associations with occupational mechanical and psychosocial exposures.
OBJECTIVE
Pain in more than one site is common in working populations. We aimed to characterise combined pain (pain in the upper and lower body) and to evaluate whether the prevalence of combined pain is positively related to combined occupational mechanical exposures to the upper and lower body and to high psychosocial job strain.


METHODS
This cross-sectional study was based on questionnaire data from the Musculoskeletal Research Database at the Danish Ramazzini Centre. The study included 14,081 men and 20,173 women. Occupational exposures were assessed by job exposure matrices. We analysed the prevalence of pain limited to the upper body, pain limited to the lower body, and combined pain in relation to occupational exposures using Poisson regression.


RESULTS
During the last year, 23.2 % of the men and 33.9 % of the women reported combined pain, which was characterised by somatisation, illness worrying, and low SF-36 scores. For men, the adjusted prevalence ratio for combined pain was 1.51 [95 % confidence interval (95 % CI) 1.40-1.64] in relation to exposures limited to the upper body and 2.24 (95 % CI 2.11-2.39) in relation to combined exposures. For women, the corresponding adjusted prevalence ratios were 1.56 (95 % CI 1.50-1.63) and 1.55 (95 % CI 1.50-1.61). High job strain was related to pain among men, only.


CONCLUSIONS
Combined pain may in part be explained by local effects of occupational mechanical exposures acting at more than one site.
Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark.
Tine Gjedde
TG
Sommer
Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Nørrebrogade 44, building 2C, 8000, Aarhus C, Denmark.
Poul
P
Frost
Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark. susasven@rm.dk.
Susanne Wulff
SW
Svendsen
D000328:Adult; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014937:Work / Q000523:psychology*
Lifting; Multi-site pain; Posture; Psychosocial exposure; Repetitive work