Impact of work,health and health beliefs on new episodes of pain-related and general absence-taking

Objectives: To evaluate the impact of physical and psychosocial workloads, and self-reported health aspects and health beliefs, on the risk of new episodes of pain-related and general sickness absence. Methods: This was a cohort study with 2 years of follow-up of 3583 employed participants, 18—64 years of age. A questionnaire was used to obtain information about workloads, physical and mental health, fear avoidance and other health beliefs. Sickness absence data were collected from company reports, supplemented by self-report of the health problem to which absence was attributed, and by linkage to a central register of state-funded income loss compensation. Results: Sickness absence of at least 14 days and pain-related absence of at least 7 days was experienced by 24.9% and 5.2%, respectively, while 14.2% received state-funded income loss compensation. Physical work demands, working in the public sector, pain intensity, care-seeking behaviour, female gender and compensated sickness absence in the year prior to follow-up were the most important predictors of new episodes of sickness absence. Pain-related absence was associated with the same variables and also with high body mass index, but effect sizes differed. Psychosocial workloads, health anxiety and fear avoidance beliefs were unrelated to any of the absence measures used. Conclusion: Risk factors for general absence and for pain-related absence in unselected working populations are similar but of different effect sizes. A potential primary prevention area could be the provision of accommodating workplaces for employees with pain problems. The mechanisms behind the influence of care-seeking behaviour warrant further research.