title: Classification of neck/shoulder pain in epidemiological research: a comparison of personal and occupational characteristics, disability, and prognosis among 12,195 workers from 18 countries.
abstract: To inform case definition for neck/shoulder pain in epidemiological research, we compared levels of disability, patterns of association, and prognosis for pain that was limited to the neck or shoulders (LNSP) and more generalised musculoskeletal pain that involved the neck or shoulder(s) (GPNS). Baseline data on musculoskeletal pain, disability, and potential correlates were collected by questionnaire from 12,195 workers in 47 occupational groups (mostly office workers, nurses, and manual workers) in 18 countries (response rate = 70%). Continuing pain after a mean interval of 14 months was ascertained through a follow-up questionnaire in 9150 workers from 45 occupational groups. Associations with personal and occupational factors were assessed by Poisson regression and summarised by prevalence rate ratios (PRRs). The 1-month prevalence of GPNS at baseline was much greater than that of LNSP (35.1% vs 5.6%), and it tended to be more troublesome and disabling. Unlike LNSP, the prevalence of GPNS increased with age. Moreover, it showed significantly stronger associations with somatising tendency (PRR 1.6 vs 1.3) and poor mental health (PRR 1.3 vs 1.1); greater variation between the occupational groups studied (prevalence ranging from 0% to 67.6%) that correlated poorly with the variation in LNSP; and was more persistent at follow-up (72.1% vs 61.7%). Our findings highlight important epidemiological distinctions between subcategories of neck/shoulder pain. In future epidemiological research that bases case definitions on symptoms, it would be useful to distinguish pain that is localised to the neck or shoulder from more generalised pain that happens to involve the neck/shoulder region.
authors.affiliation: Federal University of Paraná, Curitiba-PR, Brazil Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom School of Nursing, University of São Paulo, São Paulo, Brazil Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral-IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia Southwest Center for Occupational and Environmental Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA Center for Disease Control and Prevention/National Institute for Occupational Safety and Health, Atlanta, GA, USA Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry Psychology and Neuroscience, Kings College London, London, United Kingdom Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain CIBER of Epidemiology and Public Health, Barcelona, Spain IMIM (Hospital del Mar Research Institute), Barcelona, Spain Epidemiology and Preventive Medicine Research Center, University of Insubria, Varese, Italy Department of Social Medicine, Medical School, University of Crete, Heraklion, Greece Institute of Technology, Estonian University of Life Sciences, Tartu, Estonia Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon Department of Occupational Health, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan Department of Medical Education and Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka Department for Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand School of Nursing of Ribeirão Preto, University of São Paulo, São Paulo, Brazil Program Health, Work and Environment in Central America, Institute for Studies on Toxic Substances (IRET), National University of Costa Rica, Heredia, Costa Rica Occupational Health Service, Parc de Salut MAR, Barcelona, Spain Servicio de Investigación y Análisis IT/EP, Departamento de Investigación y Análisis de Prestaciones, MC Mutual, Barcelona, Spain Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Psychiatry, Medical School, University of Crete, Heraklion, Greece Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain North Estonia Medical Centre, Tallinn, Estonia Tartu University Hospital, Tartu, Estonia Klinikum Leverkusen, Leverkusen, Germany Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka Department of Joint Disease Research, 22nd Century Medical and Research Center, University of Tokyo, Tokyo, Japan Centre for Occupational and Environmental Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand AkzoNobel, Houston, TX, USA.
authors.forename: Leila M M
authors.initials: LMM
authors.lastname: Sarquis
authors.forename: David
authors.initials: D
authors.lastname: Coggon
authors.forename: Georgia
authors.initials: G
authors.lastname: Ntani
authors.forename: Karen
authors.initials: K
authors.lastname: Walker-Bone
authors.forename: Keith T
authors.initials: KT
authors.lastname: Palmer
authors.forename: Vanda E
authors.initials: VE
authors.lastname: Felli
authors.forename: Raul
authors.initials: R
authors.lastname: Harari
authors.forename: Lope H
authors.initials: LH
authors.lastname: Barrero
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Felknor
authors.forename: David
authors.initials: D
authors.lastname: Gimeno
authors.forename: Anna
authors.initials: A
authors.lastname: Cattrell
authors.forename: Sergio
authors.initials: S
authors.lastname: Vargas-Prada
authors.forename: Matteo
authors.initials: M
authors.lastname: Bonzini
authors.forename: Eleni
authors.initials: E
authors.lastname: Solidaki
authors.forename: Eda
authors.initials: E
authors.lastname: Merisalu
authors.forename: Rima R
authors.initials: RR
authors.lastname: Habib
authors.forename: Farideh
authors.initials: F
authors.lastname: Sadeghian
authors.forename: M Masood
authors.initials: MM
authors.lastname: Kadir
authors.forename: Sudath S P
authors.initials: SSP
authors.lastname: Warnakulasuriya
authors.forename: Ko
authors.initials: K
authors.lastname: Matsudaira
authors.forename: Busisiwe
authors.initials: B
authors.lastname: Nyantumbu
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Sim
authors.forename: Helen
authors.initials: H
authors.lastname: Harcombe
authors.forename: Ken
authors.initials: K
authors.lastname: Cox
authors.forename: Maria H
authors.initials: MH
authors.lastname: Marziale
authors.forename: Florencia
authors.initials: F
authors.lastname: Harari
authors.forename: Rocio
authors.initials: R
authors.lastname: Freire
authors.forename: Natalia
authors.initials: N
authors.lastname: Harari
authors.forename: Magda V
authors.initials: MV
authors.lastname: Monroy
authors.forename: Leonardo A
authors.initials: LA
authors.lastname: Quintana
authors.forename: Marianela
authors.initials: M
authors.lastname: Rojas
authors.forename: E Clare
authors.initials: EC
authors.lastname: Harris
authors.forename: Consol
authors.initials: C
authors.lastname: Serra
authors.forename: J Miguel
authors.initials: JM
authors.lastname: Martinez
authors.forename: George
authors.initials: G
authors.lastname: Delclos
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Benavides
authors.forename: Michele
authors.initials: M
authors.lastname: Carugno
authors.forename: Marco M
authors.initials: MM
authors.lastname: Ferrario
authors.forename: Angela C
authors.initials: AC
authors.lastname: Pesatori
authors.forename: Leda
authors.initials: L
authors.lastname: Chatzi
authors.forename: Panos
authors.initials: P
authors.lastname: Bitsios
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.forename: Kristel
authors.initials: K
authors.lastname: Oha
authors.forename: Tiina
authors.initials: T
authors.lastname: Freimann
authors.forename: Ali
authors.initials: A
authors.lastname: Sadeghian
authors.forename: Roshini J
authors.initials: RJ
authors.lastname: Peiris-John
authors.forename: Nalini
authors.initials: N
authors.lastname: Sathiakumar
authors.forename: A Rajitha
authors.initials: AR
authors.lastname: Wickremasinghe
authors.forename: Noriko
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Helen L
authors.initials: HL
authors.lastname: Kelsall
authors.forename: Victor C W
authors.initials: VCW
authors.lastname: Hoe
authors.forename: Donna M
authors.initials: DM
authors.lastname: Urquhart
authors.forename: Sarah
authors.initials: S
authors.lastname: Derrett
authors.forename: David
authors.initials: D
authors.lastname: McBride
authors.forename: Peter
authors.initials: P
authors.lastname: Herbison
authors.forename: Andrew
authors.initials: A
authors.lastname: Gray
authors.forename: Eduardo J
authors.initials: EJ
authors.lastname: Salazar Vega
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D006233:Persons with Disabilities; D016021:Epidemiologic Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007391:International Cooperation; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D019547:Neck Pain / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D009784:Occupational Diseases / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D020069:Shoulder Pain / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D011795:Surveys and Questionnaires; D055815:Young Adult