Predictors of sick leave owing to neck or low back pain: a 12-year longitudinal cohort study in a rural male population.
More details
Hide details
Research and Development Centre, Kronoberg County Council, Växjö, Sweden
Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Sections
Corresponding author
Sara A C Holmberg   

Research and Development Centre, Kronoberg County Council, Växjö, Sweden
Ann Agric Environ Med. 2010;17(2):251-257
Back pain is a common cause of sick leave. We analyzed how individual, work-related and lifestyle factors predicted sick leave owing to neck or low back pain over a 12-year period. In this prospective cohort study, 1,405 rural middle-aged farmers and non-farmers were surveyed in 1990-1991 (participation rate 76%) and followed up 12 years later (participation rate 68%). The 836 men who reported having experienced unspecific neck or low back pain the year prior to survey 1 were followed up for self-reported sick leave owing to neck or low back problems. Individual, occupational and lifestyle factors and data on acquired specific neck or back diagnosis were included in multiple logistic regression models. Seven percent reported neck or low back related sick leave during the 12 year period. Self-employment was associated with a lower risk of sick leave while sedentary leisure time, snuff use and a specific neck or back diagnosis was associated with a higher risk. Age, education, physical workload, marital status, sense of coherence, smoking, and alcohol consumption were not independently associated with sick leave. The low risk of sick leave among the self-employed is notable from a societal and public health perspective.
This study was financially supported by AFA Insurance, LRF Research Foundation, the Swedish Council for Working Life and Social Research and the Research and Development Centre at Kro- noberg County Council.
Alexanderson K, Norlund A: Swedish Council on Technology Assessment in Health Care (SBU). Chapter 1. Aim, background, key concepts, regulations, and current statistics. Scand J Public Health Suppl 2004, 63, 12–30.
Antonovsky A: Unraveling the mystery of health: How people manage stress and stay well. Jossey-Bass, San Fransisco, California 1987.
Bernard B: Musculoskeletal disorders (MSDs) and workplace factors. A critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back. National Institute for Occupational Safety and Health, Cincinnati 1997.
Drolet M, Maunsell E, Mondor M, Brisson C, Brisson J, Masse B, Deschenes L: Work absence after breast cancer diagnosis: a populationbased study. Cmaj 2005, 173, 765–771.
Fredriksson K, Toomingas A, Torgen M, Thorbjornsson CB, Kilbom A: Validity and reliability of self-reported retrospectively collected data on sick leave related to musculoskeletal diseases. Scand J Work Environ Health 1998, 24, 425–431.
Gundewall B, Liljeqvist M, Hansson T: Primary prevention of back symptoms and absence from work. A prospective randomized study among hospital employees. Spine 1993, 18, 587–594.
Hansson T, Jensen I: Swedish Council on Technology Assessment in Health Care (SBU). Chapter 6. Sickness absence due to back and neck disorders. Scand J Public Health Suppl 2004, 63, 109–151.
Heir T, Eide G: Injury proneness in infantry conscripts undergoing a physical training programme: smokeless tobacco use, higher age, and low levels of physical fitness are risk factors. Scand J Med Sci Sports 1997, 7, 304–311.
Hestbaek L, Leboeuf-Yde C, Manniche C: Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 2003, 12, 149–165.
Holmberg S, Stiernström EL, Thelin A, Svärdsudd K: Musculoskeletal symptoms among farmers and non-farmers: a population-based study. Int J Occup Environ Health 2002, 8, 339–345.
Holmberg S, Thelin A, Stiernström EL, Svärdsudd K: Psychosocial factors and low back pain, consultations, and sick leave among farmers and rural referents: a population-based study. J Occup Environ Med 2004, 46, 993–998.
Holmberg SA, Thelin AG: Primary care consultation, hospital admission, sick leave and disability pension owing to neck and low back pain: a 12-year prospective cohort study in a rural population. BMC Musculoskelet Disord 2006, 7, 66.
Hoogendoorn WE, Bongers PM, de Vet HC, Ariens GA, van Mechelen W, Bouter LM: 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. Occup Environ Med 2002, 59, 323–328.
Hoogendoorn WE, van Poppel MN, Bongers PM, Koes BW, Bouter LM: Systematic review of psychosocial factors at work and private life as risk factors for back pain. Spine 2000, 25, 2114–2125.
IJzelenberg W, Molenaar D, Burdorf A: Different risk factors for musculoskeletal complaints and musculoskeletal sickness absence. Scand J Work Environ Health 2004, 30, 56–63.
Ilmarinen J, Knauth P, Klimmer F, Rutenfranz J: The applicability of the Edholm Scale for activity studies in industry. Ergonomics 1979, 22, 369–379.
Källström HN, Ljung M: Social sustainability and collaborative learning. Ambio 2005, 34, 376–382.
Karasek R, Theorell T: Healthy work. Stress, productivity, and the reconstruction of working life. Basic Books, New York 1990.
Kivimaki M, Vahtera J, Pentti J, Virtanen M, Elovainio M, Hemingway H: Increased sickness absence in diabetic employees: what is the role of co-morbid conditions? Diabet Med 2007, 24, 1043–1048.
Kuijer W, Groothoff JW, Brouwer S, Geertzen JH, Dijkstra PU: Prediction of sickness absence in patients with chronic low back pain: a systematic review. J Occup Rehabil 2006, 16, 439–467.
Leboeuf-Yde C: Smoking and low back pain. A systematic literature review of 41 journal articles reporting 47 epidemiologic studies. Spine 1999, 24, 1463–1470.
Leboeuf-Yde C, Klougart N, Lauritzen T: How common is low back pain in the Nordic population? Data from a recent study on a middleaged general Danish population and four surveys previously conducted in the Nordic countries. Spine 1996, 21, 1518–1525; discussion 1525–1526.
Leino-Arjas P, Solovieva S, Kirjonen J, Reunanen A, Riihimaki H: Cardiovascular risk factors and low-back pain in a long-term follow-up of industrial employees. Scand J Work Environ Health 2006, 32, 12–19.
Maetzel A, Makela M, Hawker G, Bombardier C: Osteoarthritis of the hip and knee and mechanical occupational exposure – a systematic overview of the evidence. J Rheumatol 1997, 24, 1599–1607.
Nachemson A, Jonsson E: Neck and back pain. The scientific evidence of causes, diagnosis, and treatment. Lippincott Williams & Williams, Philadelphia 2000.
Nerbrand C, Aberg H, Rosén M, Tibblin G: Regional mortality variations in middle Sweden. Lakartidningen 1985, 82, 4004–4008 [in Swedish].
Stark AD, Chang HG, Fitzgerald EF, Riccardi K, Stone RR: A retrospective cohort study of mortality among New York State Farm Bureau members. Arch Environ Health 1987, 42, 204–212.
Stiernström EL, Holmberg S, Thelin A, Svärdsudd K: A prospective study of morbidity and mortality rates among farmers and rural and urban nonfarmers. J Clin Epidemiol 2001, 54, 121–126.
Stiernström EL, Holmberg S, Thelin A, Svärdsudd K: Reported health status among farmers and nonfarmers in nine rural districts. J Occup Environ Med 1998, 40, 917–924.
Thelin A, Vingard E, Holmberg S: Osteoarthritis of the hip joint and farm work. Am J Ind Med 2004, 45, 202–209.
Walker B: The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord 2000, 13, 205–217.
Wallman T, Wedel H, Johansson S, Rosengren A, Eriksson H, Welin L, Svärdsudd K: The prognosis for individuals on disability retirement. An 18-year mortality follow-up study of 6887 men and women sampled from the general population. BMC Public Health 2006, 6, 103.
Wikman A, Marklund S, Alexanderson K: Illness, disease, and sickness absence: an empirical test of differences between concepts of ill health. J Epidemiol Community Health 2005, 59, 450–454.
Yelin E, Meenan R, Nevitt M, Epstein W: Work disability in rheumatoid arthritis: effects of disease, social, and work factors. Ann Intern Med 1980, 93, 551–556.
Journals System - logo
Scroll to top