Medically unexplained symptoms and the risk of loss of labor market participation--a prospective study in the Danish population.
BACKGROUND
Medically Unexplained Symptoms (MUS) are frequently encountered in general practice. However, little is known whether MUS affects labor market participation. We investigated the prospective association between MUS at baseline and risk of long-term sickness absence (LTSA), unemployment, and disability pensioning in a 5-year-follow-up study.


METHODS
In the Danish Work Environment Cohort Study 2005, 8187 randomly selected employees from the Danish general population answered a questionnaire on work and health. Responses were linked with national registers on prescribed medication and hospital treatment. Participants were classified with MUS if they: a) had reported three or more symptoms during the last month, and b) did not have a chronic condition, neither in the self-reported nor the register data. We assessed LTSA, unemployment, and disability pensioning by linking our data with National registers of social transfer payments.


RESULTS
Of the 8187 participants, 272 (3.3%) were categorized with MUS. Compared to healthy participants, participants with MUS had an increased risk of LTSA (Rate ratio (RR) = 1.76, 95% CI = 1.28-2.42), and of unemployment (RR = 1.48, 95% CI = 1.02-2.15) during follow-up. MUS participants also showed an elevated RR with regard to risk of disability pensioning, however this association was not statistically significant (RR = 2.06, 95% CI = 0.77-5.52).


CONCLUSIONS
MUS seem to have a negative effect on labor market participation defined by LTSA and unemployment, whereas it is more uncertain whether MUS affects risk of disability pensioning.
National Research Centre for the Working Environment, Lerso Parkalle 105, DK-2100, Copenhagen, Denmark. nfa.klo@gmail.com.
Katja
K
Loengaard
National Research Centre for the Working Environment, Lerso Parkalle 105, DK-2100, Copenhagen, Denmark. jbj@nrcwe.dk.|Department of Public Health, University of Copenhagen, Copenhagen, Denmark. jbj@nrcwe.dk.|QualityMetric, Lincoln, RI, USA. jbj@nrcwe.dk.
Jakob Bue
JB
Bjorner
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark. perklfi@rm.dk.
Per Klausen
PK
Fink
Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany. burr.hermann@baua.bund.de.
Hermann
H
Burr
National Research Centre for the Working Environment, Lerso Parkalle 105, DK-2100, Copenhagen, Denmark. rer@nrcwe.dk.|Department of Public Health, University of Copenhagen, Copenhagen, Denmark. rer@nrcwe.dk.|Department of Psychology, University of Copenhagen, Copenhagen, Denmark. rer@nrcwe.dk.
Reiner
R
Rugulies
D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D010415:Pensions / Q000706:statistics & numerical data; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000706:statistics & numerical data*