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The Association of Chronic Neck Pain, Low Back Pain, and Migraine With Absenteeism Due to Health Problems in Spanish Workers

Mesas, Arthur Eumann PhD*; González, Alberto Durán PhD*; Mesas, Cézar Eumann MD, PhD; de Andrade, Selma Maffei PhD*; Magro, Isabel Sánchez MD, PhD; del Llano, Juan MD, PhD§

doi: 10.1097/BRS.0000000000000387
Occupational Health/Ergonomics

Study Design. Cross-sectional.

Objective. To examine whether 3 types of chronic pain are associated with absenteeism and with the number of days absent from work in the general population of Spain.

Summary of Background Data. Chronic pain has been associated with absenteeism, but most of the evidence is based on unadjusted analyses and on specific professional categories.

Methods. A cross-sectional analysis was performed on the basis of data of 8283 Spanish workers. Chronic pain was ascertained from self-reported information on frequent symptoms of pain in the low back and neck and/or migraine in the last 12 months. Absenteeism was defined as missing at least 1 day from work because of health problems. Multivariate regression models were adjusted for the main confounders.

Results. Health-related absenteeism was reported by 27.8% of subjects. The prevalence of chronic pain was reported to be 12.3% in the neck, 14.1% in the low back, and 10.3% migraine. In adjusted analyses, absenteeism was associated with chronic neck pain (odds ratio: 1.20; 95% confidence interval [CI], 1.02–1.40), low back pain (odds ratio: 1.22; 95% CI, 1.06–1.42), and migraine (odds ratio: 1.22; 95% CI, 1.04–1.44). These associations were strongest in younger (18–34 yr) rather than in older workers. Furthermore, those who reported frequent pain in the neck and low back were 44% more likely to be absent for more than 30 days in the past year than those who did not report these symptoms.

Conclusion. Spanish workers with chronic pain were more likely to be absent from work and to stay absent from work for longer. These associations are independent of sociodemographic characteristics, occupation, lifestyle, health status, and analgesics use.

Level of Evidence: N/A

A cross-sectional analysis with 8283 Spanish workers shows that absenteeism was independently associated with chronic neck pain, low back pain, and migraine. The associations were strongest in younger rather than in older workers.

*Department of Public Health, Health Sciences Center, Universidade Estadual de Londrina, Paraná, Brazil

Hemodinamics Sector, University Hospital, Universidade Estadual de Londrina, Paraná, Brazil

Medical Department, Grünenthal Pharma, Madrid, Spain; and

§Gaspar Casal Foundation, Madrid, Spain.

Address correspondence and reprint requests to Arthur Eumann Mesas, PhD, Department of Public Health, Health Sciences Center, Universidade Estadual de Londrina, Paraná, Brazil; E-mail:

Acknowledgment date: August 2, 2013. First revision date: November 6, 2013. Second revision date: February 20, 2014. Acceptance date: March 18, 2014.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Grünhental Foundation, Spain, funds were received, in part, to support this work.

Relevant financial activities outside the submitted work: employment, grants/grants pending and travel/accommodations/meeting expenses.

© 2014 by Lippincott Williams & Wilkins