Sick leave due to back pain in a cohort of young workers

  • A. Van Nieuwenhuyse
  • A. Burdorf
  • G. Crombez
  • G. Verbeke
  • R. Masschelein
  • Ph. Mairiaux
  • G. F. Moens
  • The BelCoBack Study Group
Original Article

Abstract

Purpose

Evidence on risk factors for sick leave from prospective studies in work settings is limited. Furthermore, most available studies focused on workers with substantial low back disorders. These studies consistently report that physical work factors constitute a hindrance to work. However, it remains unclear whether the same risk factors are relevant in workers with less severe conditions or in early phases of the development of back pain. Therefore, this article aims to study risk factors for the occurrence of sick leave due to low back pain (LBP) among young workers with no or a modest history of back pain.

Methods

Participants were 716 young healthcare or distribution workers with no or minimal antecedents of LBP in the year before inclusion. We investigated the role of potential physical, psychosocial and individual risk factors at baseline on the occurrence of sick leave due to LBP 1 year later. To this purpose, we used Cox regression with a constant risk period.

Results

Six per cent (95 % CI 4.1–7.6) of the workers reported sick leave 1 year later; they accounted for 12 % of the sick-leave days independent of cause. A non-stimulating psychosocial work environment turned out to be the strongest risk factor for sick leave due to LBP (RR 6.08; 95 % CI 1.42–26.07). Physical factors were not predictive.

Conclusions

In the early phases of back pain and in less severe conditions, the main benefit of interventions lies in targeting the organisation and design of jobs to create a challenging professional environment.

Keywords

Low back pain Sick leave Psychosocial work environment Prospective Young workers 

Notes

Acknowledgments

The BelCoBack Study was supported by the Belgian Federal Office for Scientific, Technical and Cultural Affairs (OSTC), projects PS/93/25, PS/12/26, PS/01/27.

The authors thank the other co-workers from the BelCoBack Study group for their contribution to data collection and data processing: D. Pirenne, E. Persijn, A. Leys, and L. Moors.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

The study protocol was approved by the Commission for Medical Ethics appointed by the College of Physicians n°117 at the External Service for Prevention and Protection at Work IDEWE, Leuven, Belgium. A written informed consent was given by all included employees prior to their participation in the study.

References

  1. Alexanderson K, Norlund A (2004) Swedish Council on Technology Assessment in Health Care (SBU). Chapter 12. Future need for research. Scand J Public Health Suppl 63:256–258CrossRefGoogle Scholar
  2. Alexopoulos EC, Konstantinou EC, Bakoyannis G, Tanagra D, Burdorf A (2008) Risk factors for sickness absence due to low back pain and prognostic factors for return to work in a cohort of shipyard workers. Eur Spine J 17:1185–1192. Epub 23 Jul 2008Google Scholar
  3. Bergstrom G, Bodin L, Bertilsson H, Jensen IB (2007) Risk factors for new episodes of sick leave due to neck or back pain in a working population. A prospective study with an 18-month and a three-year follow-up. Occup Environ Med 64:279–287CrossRefGoogle Scholar
  4. Dionne SD, Yammarino FJ, Atwater LE, James LR (2002) Neutralizing substitutes for leadership theory: leadership effects and common-source bias. J Appl Psychol 87:454–464CrossRefGoogle Scholar
  5. Du Bois M, Donceel P (2008) A screening questionnaire to predict no return to work within 3 months for low back pain claimants. Eur Spine J 17:380–385CrossRefGoogle Scholar
  6. Duijts SF, Kant I, Swaen GM, van den Brandt PA, Zeegers MP (2007) A meta-analysis of observational studies identifies predictors of sickness absence. J Clin Epidemiol 60:1105–1115CrossRefGoogle Scholar
  7. Ekman M, Johnell O, Lidgren L (2005) The economic cost of low back pain in Sweden in 2001. Acta Orthop 76:275–284CrossRefGoogle Scholar
  8. Elders LA, Heinrich J, Burdorf A (2003) Risk factors for sickness absence because of low back pain among scaffolders: a 3-year follow-up study. Spine 28:1340–1346Google Scholar
  9. Gheldof EL, Vinck J, Vlaeyen JW, Hidding A, Crombez G (2005) The differential role of pain, work characteristics and pain-related fear in explaining back pain and sick leave in occupational settings. Pain 113:71–81CrossRefGoogle Scholar
  10. Hemingway H, Shipley MJ, Stansfeld S, Marmot M (1997) Sickness absence from back pain, psychosocial work characteristics and employment grade among office workers. Scand J Work Environ Health 23:121–129CrossRefGoogle Scholar
  11. Hoogendoorn WE, Bongers PM, de Vet HC, Ariens GA, van Mechelen W, Bouter LM (2002) High physical work load and low job satisfaction increase the risk of sickness absence due to low back pain: results of a prospective cohort study. Occup Environ Med 59:323–328CrossRefGoogle Scholar
  12. Ijzelenberg W, Burdorf A (2005) Risk factors for musculoskeletal symptoms and ensuing health care use and sick leave. Spine 30:1550–1556CrossRefGoogle Scholar
  13. Ijzelenberg W, Molenaar D, Burdorf A (2004) Different risk factors for musculoskeletal complaints and musculoskeletal sickness absence. Scand J Work Environ Health 30:56–63CrossRefGoogle Scholar
  14. Kääriä S, Laaksonen M, Leino-Arjas P, Saastamoinen P, Lahelma E (2012) Low back pain and neck pain as predictors of sickness absence among municipal employees. Scand J Public Health 40:150–156CrossRefGoogle Scholar
  15. Karasek R, Theorell T (1990) Healthy work. Stress, productivity and the reconstruction of working life. Basic book Inc, New YorkGoogle Scholar
  16. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jorgensen K (1987) Standardised Nordic Questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 18:233–237CrossRefGoogle Scholar
  17. Maniadakis N, Gray A (2000) The economic burden of back pain in the UK. Pain 84:95–103CrossRefGoogle Scholar
  18. Mazina D, Donneau AF, Mairiaux P (2012) Determinants of sickness absence duration after an occupational back injury in the Belgian population. Am J Ind Med 55:270–280CrossRefGoogle Scholar
  19. Rothman KJ, Greenland S (1998) Modern epidemiology, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, p 295Google Scholar
  20. Royal Decree May 28th 2003 concerning the medical surveillance of employees. Belgian Law Gazette 16th June 2003. http://www.meta.fgov.be
  21. SBU (2004) SBU summary and conclusions. Scand J Public Health 32(suppl 63):6–11Google Scholar
  22. Severens JL, Mulder J, Laheij RJ, Verbeek AL (2000) Precision and accuracy in measuring absence from work as a basis for calculating productivity costs in The Netherlands. Soc Sci Med 51(2):243–249CrossRefGoogle Scholar
  23. Smedley J, Egger P, Cooper C, Coggon D (1997) Prospective cohort study of predictors of incident low back pain in nurses. BMJ 314:1225–1228CrossRefGoogle Scholar
  24. Somville PR, Mairiaux Ph (2003) Evaluation des risques biomécaniques pour la colonne lombaire au moyen d’un questionnaire. Médecine du Travail et Ergonomie XL(1):5–17Google Scholar
  25. Stapelfeldt CM, Jensen C, Andersen NT, Fleten N, Nielsen CV (2012) Validation of sick leave measures: self-reported sick leave and sickness benefit data from a Danish national register compared to multiple workplace-registered sick leave spells in a Danish municipality. BMC Public Health 12(1):661. 15 Aug 2012 [Epub ahead of print]Google Scholar
  26. Steenstra IA, Verbeek JH, Heymans MW, Bongers PM (2005) Prognostic factors for duration of sick leave in patients sick listed with acute low back pain: a systematic review of the literature. Occup Environ Med 62:851–860CrossRefGoogle Scholar
  27. Sullivan MJ, Bishop SR, Pivik J (1995) The pain catastrophising scale: development and validation. Psychol Assess 7:524–532CrossRefGoogle Scholar
  28. Thompson ML, Myers JE, Kriebel D (1998) Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done? Occup Environ Med 55:272–277CrossRefGoogle Scholar
  29. Tiedtke C, Donceel P, Knops L, Désiron H, Dierckx de Casterlé B, de Rijk A (2012) Supporting return-to-work in the face of legislation: stakeholders’ experiences with return-to-work after breast cancer in Belgium. J Occup Rehabil 22:241–251CrossRefGoogle Scholar
  30. Tubach F, Leclerc A, Landre MF, Pietri-Taleb F (2002) Risk factors for sick leave due to low back pain: a prospective study. J Occup Environ Med 44:451–458CrossRefGoogle Scholar
  31. van den Heuvel SG, Ariëns GA, Boshuizen HC, Hoogendoorn WE, Bongers PM (2004) Prognostic factors related to recurrent low-back pain and sickness absence. Scand J Work Environ Health 30:459–467CrossRefGoogle Scholar
  32. van Dixhoorn J, Duivenvoorden HJ (1985) Efficacy of Nijmegen Questionnaire in recognition of the hyperventilation syndrome. J Psychosom Res 29:199–206CrossRefGoogle Scholar
  33. Van Nieuwenhuyse A, Somville PR, Crombez G, Burdorf A, Verbeke G, Johannik K, Van den Bergh O, Masschelein R, Mairiaux P, Moens GF; BelCoBack Study Group (2006) The role of physical workload and pain-related fear in the development of low back pain in young workers: evidence from the BelCoBack Study; results after one year of follow-up. Occup Environ Med 63:45–52Google Scholar
  34. Van Nieuwenhuyse A, Fatkhutdinova L, Verbeke G, Pirenne D, Johannik K, Somville PR, Mairiaux P, Moens GF, Masschelein R (2004) Risk factors for first-ever low back pain among workers in their first employment. Occup Med (Lond.) 54:513–519CrossRefGoogle Scholar
  35. van Poppel MN, de Vet HC, Koes BW, Smid T, Bouter LM (2002) Measuring sick leave: a comparison of self-reported data on sick leave and data from company records. Occup Med (Lond.) 52:485–490CrossRefGoogle Scholar
  36. van Tulder MW, Koes BW, Bouter LM (1995) A cost-of-illness study of back pain in The Netherlands. Pain 62:233–240CrossRefGoogle Scholar
  37. Vlaeyen JW, Crombez G (1998) The modified Tampa Scale for Kinesiophobia for use in a non-pain population. Unpublished authorised Dutch/Flemish versionGoogle Scholar
  38. Von Korff M, Ormel J, Keefe FJ, Dworkin SF (1992) Grading the severity of chronic pain. Pain 50:133–149CrossRefGoogle Scholar
  39. Wasiak R, Verma S, Pransky G, Webster B (2004) Risk factors for recurrent episodes of care and work disability: case of low back pain. J Occup Environ Med 46:68–76CrossRefGoogle Scholar
  40. Watson D, Clark LA, Tellegen A (1988) Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 54:1063–1070CrossRefGoogle Scholar
  41. Wickstrom GJ, Pentti J (1998) Occupational factors affecting sick leave attributed to low-back pain. Scand J Work Environ Health 24:145–152CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • A. Van Nieuwenhuyse
    • 1
    • 2
  • A. Burdorf
    • 3
  • G. Crombez
    • 4
  • G. Verbeke
    • 5
  • R. Masschelein
    • 2
  • Ph. Mairiaux
    • 6
  • G. F. Moens
    • 2
    • 7
  • The BelCoBack Study Group
  1. 1.Department of Public Health and SurveillanceScientific Institute of Public HealthBrusselsBelgium
  2. 2.Section of Occupational, Environmental and Insurance Medicine, Department of Public HealthKatholieke Universiteit LeuvenLeuvenBelgium
  3. 3.Department of Public Health, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
  4. 4.Department of PsychologyUniversity of GhentGhentBelgium
  5. 5.Department of Public Health, Biostatistical CentreKatholieke Universiteit LeuvenLeuvenBelgium
  6. 6.Occupational Health and Health Education Unit, Department of Public HealthUniversity of LiègeLiègeBelgium
  7. 7.External Service for Prevention and Protection at Work IDEWELeuvenBelgium

Personalised recommendations