PROGNOSTIC FACTORS FOR MUSCULOSKELETAL SICKNESS ABSENCE AND RETURN TOWORK AMONG WELDERS AND METAL WORKERS

Objectives-To analyse factors that determine the occurrence of sicknes s absence due to musculoskeletal problems and the time it takes to ret urn to work. Methods-A longitudinal study with two year follow up was conducted among 283 male welders and metal workers. The survey started with a standardised interview on the occurrence of musculoskeletal co mplaints. 61 (22%) workers were lost to follow up. Data on sickness ab sence among 222 workers during the follow up were collected from absen ce records and self reports. Regression analysis based on proportional hazards models was applied to identify risk factors for the occurrenc e and duration of sickness absence due to various musculoskeletal comp laints. Results-During the follow up 51% of the workers attributed at least one period of sickness absence to musculoskeletal complaints whi ch accounted for 44% of all work days lost. A history of back pain was not associated with sickness absence for back pain, partly because su bjects with back pain were more Likely to be lost to follow up. Neck o r shoulder pain and pain of the upper extremities contributed signific antly to neck or shoulder absence (relative risk (RR) 3,35; 95% confid ence interval (95% CI) 1,73 to 6.47) and to upper extremities absence (RR 2.29; 95% CI 1.17 to 4.46), respectively. Company and job title we re also significant predictors for sickness absence due to these muscu loskeletal complaints. Absence with musculoskeletal complaints was not associated with age, height, body mass index, smoking, and duration o f employment. Return to work after neck or shoulder absence was worse among metal workers than welders (RR 2.12; 95% CI 1.08 to 4.17). Retur n to work after lower extremities absence was strongly influenced by v isiting a physician (RR 11,31; 95% CI 2.94 to 43.46) and by musculoske letal comorbidity (RR 2.81; 95% CI 1.18 to 6.73). Conclusions-Complain ts of the neck or shoulder and upper extremities in the 12 months befo re the study were associated with sickness absence for these complaint s during the follow up. Workers with absence due to pain from back, ne ck or shoulder, upper extremities, or lower extremities were at higher risk of subsequent sickness absence in the next year.