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Influence of work ability and smoking on the prognosis of long-duration activity-limiting neck/back pain: a cohort study of a Swedish working population
Dalarna University, School of Health and Welfare, Medical Science. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0001-9507-6101
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0001-6415-8673
Stress Research Institute, Stockholm University, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
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2022 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 4, article id e054512Article in journal (Refereed) Published
Abstract [en]

Objectives Long-duration activity-limiting neck/back pain is common, but the knowledge of what work and lifestyle factors that influence the prognosis is sparse. The objective was therefore to evaluate if two factors, good self-perceived work ability and no daily smoking, are associated with a favourable prognosis of long-duration activity-limiting neck/back pain in a working population, and if these exposures have a synergistic prognostic effect.

Design A prospective cohort study based on three subsamples from the Stockholm Public Health Cohort.

Settings A working population in Stockholm County, Sweden.

Participants Individuals, 18–61 years old, reporting long-duration activity-limiting neck/back pain the previous 6 months at baseline in 2010 (n=5177).

Measures The exposures were: self-perceived work ability (categorised into good, moderate and poor) and daily smoking (no/yes). The outcome in 2014 was ‘absence of long-duration activity-limiting neck/back pain’ the previous 6 months representing a favourable prognosis of reported problems at baseline in 2010. Risk ratios (RRs) and risk differences (RDs) with 95% CI was estimated by general linear regressions, and the synergistic effect was estimated by the synergy index (SI) with 95% CI.

Results Participants with moderate or good work ability, respectively, had an adjusted RR for a favourable prognosis of 1.37 (95% CI 1.11 to 1.69), and 1.80 (1.49 to 2.17) in comparison with participants with poor work ability. The corresponding adjusted RD were 0.07 (0.02 to 0.11) and 0.17 (0.12 to 0.22). Participants not smoking on daily basis had an adjusted RR of 1.21 (1.02 to 1.42), and an adjusted RD of 0.05 (0.01 to 0.10) for a favourable outcome compared with daily smokers. The adjusted SI was 0.92 (0.60 to 1.43).

Conclusion For participants with long-duration activity-limiting neck/back pain, moderate or good self-perceived work ability and not being a daily smoker were associated with a favourable prognosis but having both exposures seemed to have no synergistic prognostic effect.

Place, publisher, year, edition, pages
2022. Vol. 12, no 4, article id e054512
Keywords [en]
Back pain; EPIDEMIOLOGY; Musculoskeletal disorders; PUBLIC HEALTH; Spine
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:du-41276DOI: 10.1136/bmjopen-2021-054512ISI: 000783232500050PubMedID: 35414549Scopus ID: 2-s2.0-85128127440OAI: oai:DiVA.org:du-41276DiVA, id: diva2:1652401
Available from: 2022-04-19 Created: 2022-04-19 Last updated: 2023-08-28Bibliographically approved

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