Onset of Work Restriction in Employed Adults with Lower Limb Joint Pain: Individual Factors and Area-Level Socioeconomic Conditions

Abstract

Purpose To examine individual and area-level socioeconomic factors that predict the onset of work restriction in employed persons with lower limb joint pain. Methods Population-based prospective cohort study. Adults were aged 50–59, reported hip, knee, foot pain or a combination and maintained employment through 3 year follow-up (n = 716). Work restriction was measured as inability to participate in work as desired. Multi-level logistic regression was used to assess the associations of work restriction onset with baseline factors: health (severity of knee pain/functional limitation, comorbidity, anxiety, depression, cognitive impairment, abnormal weight), demographic socio-economic, environment and area-level employment deprivation. Results 108 (15.1 %) reported the onset of work restriction over 3 years. Severe lower limb joint pain and functional limitation, number of affected body sites and area employment deprivation were independently associated with onset. Significant interactions indicated a greater effect of area employment deprivation on older and more depressed workers. Conclusions Results suggest that effectively preventing work disability in those with OA will require both condition-specific interventions to decrease pain and maintain function, and providing alternative employment opportunities for those with progressive functional limitations. Results in older workers are particularly concerning, as retirement ages are expected to increase in the general population.

Joint association of physical work demands and leg pain intensity for work limitations due to pain in senior workers: cross-sectional study

“…For the entire study sample of senior workers, we found a significant dose-response association ( p < 0.0001) between leg pain intensity and work-limiting pain. Our results thus elaborate on previous findings demonstrating the importance of not just the presence of pain but also the severity of pain and functional limitation for long-term sickness absence and the ability to work [ 8 , 9 , 14 , 40 ]. For instance, we have previously demonstrated strong dose-response associations of increasing pain intensities in the low-back, neck-shoulders, and knees with increased risk of long-term sickness absence in healthcare workers [ 14 ].…”

“…≥3 on a scale from 0 to 9) compared to low-back and neck−/shoulder pain (5 and 4, respectively) [ 14 ], potentially indicating a relatively larger impact of knee pain on working functional capacity compared to low-back and neck−/shoulder MSDs. This study and others [ 8 , 9 , 40 ] underline the importance of pain intensity on the degree of functional limitation, with higher pain intensities being associated with higher risks of work disability and sickness absence.…”

“…Several studies have reported compromised work ability and productivity (presenteeism) among workers with MSD having manual jobs characterized by higher physical work demands as compared to workers with MSD in more sedentary jobs [ 10 , 29 , 37 – 40 ]. A Dutch study reported that high physical workload (including high exposures of heavy lifting, awkward and static postures) compared to low physical workload was associated with low work ability among workers with physician-diagnosed MSD [ 37 ], whereas Pensola and coworkers demonstrated that having jobs with predominantly ‘strenuous’ work tasks was associated with lower work ability compared to jobs with ‘moderately heavy’ or ‘light’ work tasks among workers with multi-site pain (including lower extremity pain) [ 29 ].…”

“…Importantly, many workers have MSD without reporting lower work ability and increased sickness absence [ 29 , 33 ], which may be explained by – amongst others – factors as musculoskeletal pain intensity and location, physical work demands, age, and sex [ 8 – 10 , 14 , 29 , 34 – 40 ]. For example, it is possible that a senior employee with MSD may be capable of going to work and take full care of his/her work duties if it is a sedentary office job, whereas another senior employee with MSD may not be able to perform his or her job tasks if it is a job that is physically demanding.…”

Anticipated significant work limitation in primary care consulters with osteoarthritis: a prospective cohort study

“…In addition, overall pain levels, illness perceptions and health beliefs have not been included, which may have considerable impact on predicted work outcomes 35. We chose to measure the extent of pain rather than the pain level, as we have previously found extent of pain to be associated with poor work outcomes, and this may be more reflective of total arthritis impact on physical function than pain intensity 36. However, clinical measures may not be as important in predicting work disability, compared with measure of function, psychosocial and workplace factors 34.…”