Physical demand at work and sick leave due to low back pain: a cross-sectional study

Jonathan Petersen; Lilli Kirkeskov; Bjarke Brandt Hansen; Luise Moelenberg Begtrup; Esben Meulengracht Flachs; Mikael Boesen; Philip Hansen; Henning Bliddal; Ann Isabel Kryger

doi:10.1136/bmjopen-2018-026917

Physical demand at work and sick leave due to low back pain: a cross-sectional study

BMJ Open. 2019 May 22;9(5):e026917. doi: 10.1136/bmjopen-2018-026917.

Authors

Jonathan Petersen¹, Lilli Kirkeskov², Bjarke Brandt Hansen³, Luise Moelenberg Begtrup¹, Esben Meulengracht Flachs¹, Mikael Boesen⁴, Philip Hansen⁴, Henning Bliddal³, Ann Isabel Kryger¹

Affiliations

¹ Department of Occupational and Environmental Medicine, Copenhagen University Hospital at Bispebjerg and Frederiksberg, Copenhagen, Denmark.
² Department of Occupational and Environmental Medicine, Unit of Social Medicine, Copenhagen University Hospital at Bispebjerg and Frederiksberg, Copenhagen, Denmark.
³ Department of Rheumatology, The Parker Institute, Copenhagen University Hospital at Bispebjerg and Frederiksberg, Copenhagen, Denmark.
⁴ Department of Radiology, Copenhagen University Hospital at Bispebjerg and Frederiksberg, Copenhagen, Denmark.

Abstract

Objectives: To investigate if self-reported high physical demand at work, objective physical workload using a job exposure matrix (JEM) and fear-avoidance beliefs are associated with reported sick leave in the previous year in persons with low back pain (LBP). Second, to investigate if the effects of fear-avoidance and self-reported high physical demand at work on sick leave are modified by the objective physical workloads.

Settings: Participants were recruited from general practice and by advertisement in a local newspaper.

Participants: 305participants with a current period of 2-4 weeks LBP and self-reported difficulty in maintaining physically demanding jobs due to LBP were interviewed, clinically examined and had an MRI at baseline.

Main outcome measures: Independent variables were high fear-avoidance, self-reported high physical demand at work and objective measures of physical workloads (JEM). Outcome was self-reported sick leave due to LBP in the previous year. Logistic regression and tests for interaction were used to identify risk factors and modifiers for the association with self-reported sick leave.

Results: Self-reported physically demanding work and high fear-avoidance were significantly associated with prior sick leave due to LBP in the previous year with OR 1.75 95% CI (1.10 to 2.75) and 2.75 95% CI (1.61to 4.84), respectively. No objective physical workloads had significant associations. There was no modifying effect of objective physical workloads on the association between self-reported physical demand at work/high fear-avoidance and sick leave.

Conclusions: Occupational interventions to reduce sick leave due to LBP may have to focus more on those with high self-reported physical demands and high fear-avoidance, and less on individuals with the objectively highest physical workload.

Trial registration number: NCT02015572; Post-results.

Keywords: preventive medicine; rehabilitation medicine; rheumatology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Avoidance Learning
Cross-Sectional Studies
Fear
Female
General Practice
Humans
Lifting
Logistic Models
Low Back Pain*
Magnetic Resonance Imaging
Male
Middle Aged
Occupational Health*
Odds Ratio
Risk Factors
Self Report
Sick Leave / statistics & numerical data*
Standing Position
Walking
Workload*

Associated data

ClinicalTrials.gov/NCT02015572