Back pain, back abnormalities, and competing medical, psychological, and social factors as predictors of sick leave, early retirement, unemployment, labour turnover and mortality: a 22 year follow up of male employees in a Swedish pulp and paper company.

A total of 391 male employees in a Swedish pulp and paper company were followed up for 22 years. As a part of a health examination in 1961 back pain reported by the subjects and abnormalities of the back as judged by the physicians were investigated with respect to predictive power regarding sick leave, early retirement, unemployment, labour turnover, and mortality during the follow up period. Univariate analysis showed that abnormalities of the back were better than back pain for predicting early retirement. Neither back pain nor back abnormalities had any predictive power with respect to long term sick leave, labour turnover, or mortality. Multivariate analyses of 26 variables were performed. Both self assessment of general health and back abnormalities were predictive for early retirement with a diagnosis of back disorder on the retirement certificate but self assessed health was a stronger predictor. Age, smoking, and neuroticism were predictors regarding early retirement for all diagnoses. Education had a negative association; neuroticism did not predict early retirement with a diagnosis of back disorder.