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Smoking is associated with greater pain intensity and pain-related occupational disability in Japanese workers

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Abstract

Purpose

Pain symptom, such as that caused by musculoskeletal disorders, is a major cause of occupational disability. As nicotine intake from smoking increases pain sensitivity, smokers may experience stronger pain and be more likely to experience pain-related disability than non-smokers. The study aim was to examine whether smoking was associated with pain-related occupational disability via pain intensity.

Methods

Participants were 1189 workers with pain aged 20–74 years in Japan. Participants completed a self-report questionnaire, which included a question to measure pain-related occupational disability with ordinal-option: (1) without pain-related disability, (2) pain-related presenteeism, and (3) pain-related absenteeism. An ordinal logistic regression model was used to calculate multivariable-adjusted proportional odds ratios (OR) with 95% confidence intervals (CI) for the prevalence of pain-related occupational disability according to smoking status. A multiple mediation analysis was also conducted to assess whether pain sensitivity mediated the association between smoking and pain-related occupational disability. Adjusted variables were demographic variables, socioeconomic status, work-related psychosocial factors, general psychological factors, and pain duration.

Results

Current smoking and pain were associated with pain-related occupational disability compared with non-smoking and pain (multivariable OR 1.78; 95% CI 1.26–2.52). Greater pain intensity partially mediated the association of current smoking and pain with pain-related occupational disability. The mediation rate (indirect/total effect) was 25%.

Conclusion

Smoking and pain were associated with pain-related occupational disability, partially through greater pain intensity, among Japanese workers.

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Acknowledgements

We are grateful to all the participants from the three companies. We thank Dr. Kyosuke Fukai, Dr. Yuichiro Kawatsu, Dr. Azusa Shima, and other staffs from the three companies for their support in conducting this survey. We thank Diane Williams, Ph.D., from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

This research was supported by a grant for The Research Project on Elucidation of Chronic Pain from the Japan Agency for Medical Research and Development, AMED (16EK0610004H0003), Health Labour Sciences Research Grants, and Industrial Disease Clinical Research Grants (14020301-01). This research was supported in part by a fellowship to Keiko Yamada from the Astellas Foundation for Research on Metabolic Disorders and supported in part by a research assistantship of a Grant-in-Aid to Kenta Wakaizumi and the Program for Leading Graduate School for “Science for Development of Super Mature Society” from the Ministry of Education, Culture, Sport, Science, and Technology in Japan.

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Authors and Affiliations

  1. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Keiko Yamada

  2. Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Keiko Yamada & Ko Matsudaira

  3. Department of Psychology, McGill University, 2001 McGill College, Montreal, QC, H3A 1G1, Canada

    Keiko Yamada

  4. Shirley Ryan AbilityLab, 355 East Erie, Chicago, IL, 60611, USA

    Kenta Wakaizumi

  5. Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, 710 N Lake Shore Drive, Chicago, IL, 60611, USA

    Kenta Wakaizumi

  6. Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Joto-ku, Osaka, 536-8588, Japan

    Yasuhiko Kubota

  7. Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, 7-3-1 Bunkyo-ku, Tokyo, 113-8655, Japan

    Ko Matsudaira

  8. Department of Health Science, Naragakuen University, 15-1 Nakatomigaoka, Nara, 631-8524, Japan

    Masahiko Shibata

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  1. Keiko Yamada
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  2. Kenta Wakaizumi
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Correspondence to Keiko Yamada.

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Yamada, K., Wakaizumi, K., Kubota, Y. et al. Smoking is associated with greater pain intensity and pain-related occupational disability in Japanese workers. J Anesth 33, 523–530 (2019). https://doi.org/10.1007/s00540-019-02661-1

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  • DOI: https://doi.org/10.1007/s00540-019-02661-1

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