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

Abstract

Objective: To determine whether physical and psychosocial load at work influence sickness absence due to low back pain. Methods: The research was a part of the study on musculoskeletal disorders, absenteeism, stress, and health (SMASH), a 3 year prospective cohort study on risk factors for musculoskeletal disorders. Workers from 21 companies located throughout The Netherlands participated in the part of this study on sickness absence due to low back pain. The study population consisted of 732 workers with no sickness absences of 3 days or longer due to low back pain in the 3 months before the baseline survey and complete data on the reasons for absences during the follow up period. The mean (range) period of follow up in this group was 37 (7-44) months. Physical load at work was assessed by analyses of video recordings. Baseline information on psychosocial work characteristics was obtained by a questionnaire. Data on sickness absence were collected from company records. The main outcome measure was the rate of sickness absences of 3 days or longer due to low back pain during the follow up period. Results: After adjustment of the work related physical and psychosocial factors for each other and for other potential determinants, significant rate ratios ranging from 2.0 to 3.2 were found for trunk flexion, trunk rotation, lifting, and low job satisfaction. A dose-response relation was found for trunk flexion, but not for trunk rotation or lifting. Non-significant rate ratios of about 1.4 were found for low supervisor support and low coworker support. Quantitative job demands, conflicting demands, decision authority, and skill discretion showed no relation with sickness absence due to low back pain. Conclusions: Flexion and rotation of the trunk, lifting, and low job satisfaction are risk factors for sickness absence due to low back pain. Some indications of a relation between low social support, either from supervisors or coworkers, and sickness absence due to low back pain are also present.

Physical activity and low back pain: a systematic review of recent literature

“…The percentage loss to follow-up varied between 11 [53] and 43% [31] in studies with a follow-up of B1 year [25,28,29,31,37,38,42,46,52,53,55,56], between 10 [54] and 60% [31] in studies with a follow-up [1 and B3 years [22,23,25,28,31,34,35,39,41,49,54,55] and between 12 [45] and 28% [30,44] in studies with a follow-up of more than 3 years. In studies with a follow-up of more than 15 years [24,33,43,47] percentages loss to follow-up varied between 38 [47] and 84% [24].…”

“…The occurrence of new episodes of LBP was measured by the use of questionnaires [22, 24, 25, 27, 28, 31-34, 36, 38, 39, 42, 49, 53-56], interviews [24,41,49] or reports by care providers [50][51][52]57]. Sick leave was derived from questionnaires [25,26,28,29,33,37,38,43,45,47], company registers [23,26,35,40] and social insurance administrations [30,40,48].…”

“…standing, awkward positions such as flexed-twisted-rotated), magnitudes of work and non-work-related physical loadings (light, moderate, heavy), sports and physical exercise. The measurement of the outcome (dependent) variable varied between the occurrence of new episodes of LBP [22-24, 27, 31, 32, 34, 36, 39, 41, 44, 46, 50, 52, 54, 57], sick leave due to LBP [23,26,29,30,35,40,43,48] or a combination of both [25, 28, 33, 36, 38, 42, 44-46, 49, 51, 53, 55]. Twentyeight studies applied (self-administered) questionnaires in the screening of exposures [22-24, 26-33, 36, 37, 39, 40, 42-45, 47-49, 52-57].…”

“…In 28% of the studies, authors gave information on the validation and/or reproducibility of the questionnaires [22,28,31,32,46,47,49,53,57]. Four studies used an interview [24,41,50,51] and four studies [25,34,35,38] used an observational method.…”

“…Eight studies specifically focused on a working population [22,23,26,28,34,35,42] and three studies were population-based [24,54,57]. Lifting and carrying were explored in 10 studies [22-24, 27, 28, 34, 35, 42, 54, 56] whilst one study [26] focused on the association between strenuous arm movements in scaffolding and back pain.…”