A prospective cohort study on musculoskeletal risk factors for long-term sickness absence among healthcare workers in eldercare

  • Lars L. AndersenEmail author
  • Thomas Clausen
  • Ole S. Mortensen
  • Hermann Burr
  • Andreas Holtermann
Original Article



The socioeconomic burden of sickness absence from musculoskeletal disorders is considerable. However, knowledge about the risk of sickness absence from pain in different body regions among specific job groups is needed to more efficiently target preventative strategies. This study estimates the risk of long-term sickness absence (LTSA) from pain in different body regions among healthcare workers.


Prospective cohort study among 8,952 Danish healthcare workers responding to a questionnaire in 2004–2005 and followed for 1 year in a national register of social transfer payments (DREAM). Using Cox regression hazard ratio (HR) analysis controlled for age, gender, BMI, smoking, seniority, leisure physical activity and psychosocial working conditions, we modeled risk estimates of sub-chronic (1–30 days last year) and chronic pain (>30 days last year) in the low back, neck/shoulder and knees for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks) during one-year follow-up.


At baseline, the prevalence of chronic pain was 23% (low back), 28% (neck/shoulder) and 12% (knees). During follow-up, the 12-month prevalence of LTSA was 6.3%. Chronic pains in the low back (HR 1.47 [95% CI 1.17–1.85]), neck/shoulder (HR 1.60 [95% CI 1.27–2.02]) and knees (HR 1.92 [95% CI 1.52–2.42]) were significant risk factors for LTSA. However, only chronic neck/shoulder (HR 1.41 [95% CI 1.09–1.82]) and knee pain (HR 1.69 [95% CI 1.32–2.16]) remained significant with mutual adjustment for all three musculoskeletal pain regions.


Musculoskeletal pain is a risk factor for LTSA among healthcare workers. Future research among healthcare workers in eldercare should include the management of neck/shoulder and knee pain in addition to the management of back pain.


Chronic pain Musculoskeletal disorders Sickness absence Neck pain Back pain Knee pain 


Conflict of interest

The authors declare that they have conflict of interest.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Lars L. Andersen
    • 1
    Email author
  • Thomas Clausen
    • 1
  • Ole S. Mortensen
    • 1
    • 2
  • Hermann Burr
    • 1
    • 3
  • Andreas Holtermann
    • 1
  1. 1.National Research Centre for the Working EnvironmentCopenhagenDenmark
  2. 2.Department of Occupational and Environmental MedicineBispebjerg University HospitalCopenhagenDenmark
  3. 3.Bundesanstalt für Arbeitsschutz Und Arbeitsmedizin (BAuA)DortmundGermany

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