Predictors of sick leave owing to neck or low back pain: a 12-year longitudinal cohort study in a rural male population.

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.