title: Upper extremity musculoskeletal pain among office workers in three Spanish-speaking countries: findings from the CUPID study.
abstract: OBJECTIVE
  To estimate the prevalence and incidence of upper extremity musculoskeletal pain (UEMP) and related disability among office workers in Costa Rica, Nicaragua and Spain.
  
  
  METHODS
  Data from the multinational Cultural and Psychosocial Influences on Disability (CUPID) study on 947 (93%) participants at baseline with 90% follow-up after 12 months were employed. Logistic regression was used to estimate the associations (ORs and corresponding 95% CIs) between country and six outcomes: baseline prevalence of (1) UEMP in past 12 months, (2) UEMP in past month and (3) disabling UEMP in past month; (4) incidence of new UEMP at follow-up; (5) incidence of new disabling UEMP at follow-up and (6) persistence of UEMP at follow-up, after adjustment for sociodemographic, job-related and health-related covariates.
  
  
  RESULTS
  Baseline prevalence of UEMP in the past month was higher in Costa Rica (53.6%) (OR=1.89; 95% CI 1.36 to 2.62) and Nicaragua (51.9%) (OR=1.74; 95% CI 1.28 to 2.35) than in Spain (38.4%). Compared to Spain (33.2%), the incidence of new UEMP was 50.4% in Costa Rica (OR=2.04; 95% CI 1.34 to 3.12) and 60.2% in Nicaragua (OR=3.04; 95% CI 2.06 to 4.50). The incidence of disabling UEMP was higher in Nicaragua (OR=2.57; 95% CI 1.50 to 4.41) and Costa Rica (OR=2.16; 95% CI 1.22 to 3.84) when compared to Spain.
  
  
  CONCLUSIONS
  Prevalence of UEMP was approximately twofold higher and its incidence twofold to threefold higher in Costa Rica and Nicaragua as compared with Spain. Between-country differences were only partially explained by the covariates analysed. Research is needed to explore other aspects of work and cultural attributes that might explain the residual differences in UEMP.
authors.affiliation: The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA Instituto Tecnológico de Costa Rica, Cartago, Costa Rica.
authors.forename: Adriana
authors.identifier: http://orcid.org/0000-0002-8398-349X
authors.initials: A
authors.lastname: Campos-Fumero
authors.affiliation: The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: George L
authors.initials: GL
authors.lastname: Delclos
authors.affiliation: The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA.
authors.forename: David I
authors.initials: DI
authors.lastname: Douphrate
authors.affiliation: The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA National Institute for Occupational Safety and Health (NIOSH), Atlanta, USA.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Felknor
authors.affiliation: Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Sergio
authors.identifier: http://orcid.org/0000-0002-0713-5392
authors.initials: S
authors.lastname: Vargas-Prada
authors.affiliation: Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain Department of Occupational Health, Parc de Salut Mar, Barcelona, Spain.
authors.forename: Consol
authors.initials: C
authors.lastname: Serra
authors.affiliation: Arthritis Research-UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK Medical Research Council Lifecourse Epidemiology Unit, University of Southamptom, Southampton, UK.
authors.forename: David
authors.initials: D
authors.lastname: Coggon
authors.affiliation: The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, USA Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: David
authors.initials: D
authors.lastname: Gimeno Ruiz de Porras
mesh_terms: D000328:Adult; D003364:Costa Rica / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000523:psychology; D009527:Nicaragua / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology*; D009790:Occupations / Q000706:statistics & numerical data; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000503:physiopathology; D017132:Workplace / Q000523:psychology; D055815:Young Adult