Objective: To study the associations of sociodemographic factors, working conditions, lifestyle and previous pain in the spine with new onset chronic neck pain (NP). Methods: The participants were municipal employees free of chronic NP at baseline, aged 40, 45, 50, 55 or 60 years (n = 5277, 80% women). Self-reported data on occupational class, working conditions, body mass index, smoking, exercise, mental well-being, sleep problems, NP and low back pain (LBP) were obtained from baseline questionnaire surveys in 2000-2002. The question on chronic NP was repeated in a follow-up in 2007. Logistic regression analysis was used. Results: The incidence of chronic NP was 15% in women and 9% in men. In multivariable analysis among women, acute NP [odds ratio (OR) 3.8, 95% confidence interval (CI) 2.9-5.1], chronic LBP (1.6, 1.2-2.2), reporting current workplace bullying (OR 1.6, 95% CI 1.1-2.4), earlier bullying at the present workplace (1.6, 1.2-2.0), and earlier bullying in another workplace (1.8, 1.3-2.4), frequent sleep problems (1.5, 1.2-2.0), overweight (1.2, 1.0-1.5), and obesity (1.4, 1.1-1.8) predicted chronic NP at follow-up. Men with acute NP (2.3, 1.4-3.8), chronic LBP (2.3, 1.2-4.3), manual occupational class (1.8, 1.1-3.1) and high work-related emotional exhaustion (1.9, 1.1-3.3) at baseline had an increased risk of new onset chronic NP. Conclusions: We found potentially modifiable predictors of chronic NP among employees: workplace bullying, sleep problems, and high body mass index in women, and work-related emotional exhaustion in men. In both genders, previous acute NP and chronic LBP were predictive of chronic NP.

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This study examined the association of pain with subsequent disability retirement due to all causes as well as musculoskeletal diseases, mental disorders, and a heterogeneous group of other diseases and to study whether pain has an effect of its own after taking into account long-standing illness, physician-diagnosed diseases, working conditions, and occupational class, which are the key factors affecting disability retirement. The data consisted of the Helsinki Health Study baseline survey linked to national pension register data (n=6258). Mean follow-up time was 8.1 years. The data included 594 disability retirement events. Pain (acute or chronic) was stratified by long-standing illness (yes/no). Cox regression analysis was performed. Chronic pain without and with co-occurring long-standing illness was strongly associated with all types of disability retirement outcomes, but the associations were particularly strong for disability retirement due to musculoskeletal diseases. The associations remained even when further adjusted for physician diagnosed chronic conditions and diseases, psychosocial and physical working conditions, and occupational class. Associations for acute pain were also found, but they were clearly weaker than those of chronic pain. Chronic pain contributes to disability retirement. Prevention and effective treatment of chronic pain may help prevent early retirement due to disability.

213Original article Scand J Work Environ Health. 2011;37(3):213-218. doi:10.5271/sjweh.3131 Different domains of health functioning as predictors of sickness absencea prospective cohort study by Mikko Laaksonen, PhD,1 PhD, MD, PhD, 2 Eero Lahelma, PhD 1 Laaksonen M, Kääriä S-M, Leino-Arjas P, Lahelma E. Different domains of health functioning as predictors of sickness absence -a prospective cohort study. Scand J Work Environ Health. 2011;37(3):213-218. doi:10.5271/sjweh.3131 Objectives The aim of this study was to examine different domains of health functioning as predictors of sickness absence.Methods The Short Form 36 (SF-36) is one of the best known instruments measuring various domains of physical and mental health functioning. A questionnaire including the SF-36 was mailed to 40-60-year-old employees of the City of Helsinki in 2000-2002. For the subsequent three years, sickness absence episodes >2 weeks were derived from the employer's register. The predictive ability of the eight subscales and two component summaries of the SF-36 were compared using regression methods and receiver operating characteristic (ROC) curve analysis.Results All eight SF-36 subscales and the two component summaries predicted the occurrence of sickness absence over the follow-up period. Among women, bodily pain was the strongest predictor, with 1 standard deviation increase in bodily pain increasing the occurrence of sickness absence by 77% [95% confidence interval (95% CI) 68-86%]. Role limitations due to emotional problems were the weakest predictor of sickness absence (29%, 95% CI 23-36%). Among men, the results were similar to those of women. In both genders, the area under the ROC curve was largest for bodily pain, general health, and physical functioning and lowest for mental health and role limitation due to emotional problems. ConclusionsThe subscales measuring physical domains of functioning were more strongly associated with sickness absence than the mental subscales. In particular, ability to perform daily activities, pain, and general health were important predictors of sickness absence >2 weeks. Sickness absence has been increasingly used as an outcome in research on work and health. However, there is some debate about the nature and validity of sickness absence as a health measure. It has been argued that motivational factors and employee satisfaction play a decisive role in sickness absence behavior (1, 2), which is also affected by contextual factors at work (3, 4) and outside of work (5, 6). Previous studies examining associations between sickness absence and other health measures have shown that medically confirmed sickness absence predicts future disability retirement (7, 8) and mortality (9-11). In a UK study, medically confirmed sickness absence predicted mortality even better than well-established indicators of general health such as poor self-rated health or having a longstanding illness (12). The association with mortality has been observed for various causes of death (11, 13), and diagnostic inf...

The aim of the study was to examine the stability of voluntary and household physical activity (PA) and to compare it with that of the use of the most common stimulants. The prospective cohort study comprised of follow-ups at 5, 10, and 28 years at baseline in 1973 in four plants of an industrial corporation in Finland. A systematic, non-proportional sample (n=902, age range 18-64 years) stratified for age, gender, and occupational status was drawn from the employees. Scores of PA were based on a questionnaire and interviews. Logistic regression models with proportional odds assumptions were counted. The 5-year stability (Spearman's rho) of PA time was 0.44 (PA intensity 0.44), the respective 10-year coefficient was 0.26 (0.32), and that in the 28-year follow-up was 0.18 (0.20). The stability of PA decreased rapidly from 1973 to 1983 and more slowly thereafter. Changes along the follow-up reflect a polarization of the distributions of PA within the sample. Age and an initially low level of activity were the strongest predictors of inactivity. The stability coefficient of smoking and alcohol consumption was twice as high as that of PA. Stimulant use was a greater factor in the individual's lifestyle than PA.