Fagerlund Pi, Shiri Rahman, Walker-Bone Karen, Rahkonen Ossi, Lallukka Tea
Department of Public Health, University of Helsinki, Helsinki, Finland
Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.
BMJ Open. 2024 Dec 20;14(12):e085011. doi: 10.1136/bmjopen-2024-085011.
This study aimed to identify distinct trajectories of long-term sickness absence (LTSA, >10 consecutive working days) among young and early midlife Finnish employees who experienced pain at baseline. It also aimed to determine the pain characteristics and occupational and lifestyle factors associated with these LTSA patterns.
Longitudinal occupational cohort study with register linkage.
The largest municipal employer in Finland.
The study population comprised 19-39-year-old Finnish municipal employees (n=1685) who reported pain in 2017.
Prospective register data on all-cause LTSA through March 2020 were obtained from the Social Insurance Institution of Finland. Group-based trajectory modelling was used to identify distinct all-cause LTSA trajectories. Multinomial logistic regression was used to examine associations of pain characteristics and work- and lifestyle-related factors with trajectory group membership.
Three distinct LTSA-trajectory groups were identified: no LTSA (74%), decreasing (18%) and increasing (8%). The decreasing trajectory group had a higher prevalence of chronic or multisite pain, smoking (average marginal effects (AME) 6% points, 95% CI 2 to 11), obesity (AME 8% points, 95% CI 2 to 13), manual or routine non-manual occupation (AME 9% points, 95% CI 4 to 13) and high physical workload, after adjusting for age and gender. No predictor was identified for the increasing trajectory.
A majority of young and early midlife employees with pain had no LTSA during follow-up; however, chronic and multisite pain, smoking, overweight or obesity, lower occupational class and higher physical workload were associated with the decreasing LTSA trajectory. Interventions at workplaces and in occupational healthcare to prevent LTSA should aim at supporting employees who work with pain and have these risk factors.
本研究旨在确定在基线时经历疼痛的芬兰年轻和中年早期员工中，长期病假（LTSA，连续超过10个工作日）的不同轨迹。它还旨在确定与这些LTSA模式相关的疼痛特征、职业和生活方式因素。
采用登记链接的纵向职业队列研究。
芬兰最大的市政雇主。
研究人群包括19至39岁的芬兰市政雇员（n = 1685），他们在2017年报告有疼痛症状。
从芬兰社会保险机构获得截至2020年3月的全因LTSA的前瞻性登记数据。基于组的轨迹模型用于识别不同的全因LTSA轨迹。多项逻辑回归用于检验疼痛特征以及与工作和生活方式相关的因素与轨迹组成员身份之间的关联。
确定了三个不同的LTSA轨迹组：无LTSA（74%）、下降（18%）和上升（8%）。在调整年龄和性别后，下降轨迹组中慢性或多部位疼痛、吸烟（平均边际效应（AME）6个百分点，95%CI 2至11）、肥胖（AME 8个百分点，95%CI 2至13）、体力或常规非体力职业（AME 9个百分点，95%CI 4至13）以及高体力工作量的患病率更高。未发现与上升轨迹相关的预测因素。
大多数有疼痛症状的年轻和中年早期员工在随访期间没有LTSA；然而，慢性和多部位疼痛、吸烟、超重或肥胖、较低的职业阶层以及较高的体力工作量与LTSA下降轨迹相关。工作场所和职业医疗保健中预防LTSA的干预措施应旨在支持有疼痛症状且有这些风险因素的员工。
