Are Occupational Factors Important Determinants of Socioeconomic Inequalities in Musculoskeletal Pain?

• Published in: Scandinavian Journal of Work, Environment ＆ Health Environment ＆ Health, 2008-08, Vol.34 (4), p.250-259
• Main Authors: Mehlum, Ingrid Sivesind, Kristensen, Petter, Kjuus, Helge, Wergeland, Ebba
• Format: Article
• Language: English
• Subjects: Adult; Arm; Back pain; Biological and medical sciences; Cardiovascular disease; Cross-Sectional Studies; Diseases of the osteoarticular system; Diseases of the spine; Female; Health Status Disparities; Humans; Low back pain; Male; Manual labor; Manual workers; Medical sciences; Medical screening; Men; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Musculoskeletal diseases; Musculoskeletal Diseases - epidemiology; Musculoskeletal Diseases - etiology; Musculoskeletal Diseases - prevention & control; Musculoskeletal pain; Norway - epidemiology; Occupational Diseases - epidemiology; Occupational Diseases - etiology; Occupational Diseases - prevention & control; Occupations; Pain - epidemiology; Pain - etiology; Pain - prevention & control; Prevalence; Professional Autonomy; Questionnaires; Risk Factors; Self employment; Self report; Sex Distribution; Shoulder; Skilled labor; Social Class; Socioeconomic factors; Socioeconomics; Task Performance and Analysis; Walking; Womens health; Working conditions; Working women
• ISSN: 0355-3140; 1795-990X
• DOI: 10.5271/sjweh.1269

Objectives The aim of this study was to quantify socioeconomic inequalities in low-back pain, neck-shoulder pain, and arm pain in the general working population in Oslo and to examine the impact of job characteristics on these inequalities. Methods All economically active 30-, 40-, and 45-year-old persons who attended the Oslo health study in 2000-2001 and answered questions on physical job demands, job autonomy, and musculoskeletal pain were included (N=7293). Occupational class was used as an indicator of socioeconomic status. The lower occupational classes were compared with higher grade professionals, and prevalences, prevalence ratios, prevalence differences, and population attributable fractions were calculated. Results There were marked, stepwise socioeconomic gradients for musculoskeletal pain, steeper for the men than for the women. The relative differences (prevalence ratios) were larger for low-back pain and arm pain than for neck-shoulder pain. The absolute differences (prevalence differences) were the largest for low-back pain. Physical job demands explained a substantial proportion of the absolute occupational class inequalities in lowback pain, while job autonomy was more important in explaining the inequalities in neck-shoulder pain and arm pain. The estimated population attributable fractions supported the impact of job characteristics at the working population level, especially for low-back pain. Conclusions In this cross-sectional study, physical job demands and job autonomy explained a substantial proportion of occupational class inequalities in self-reported musculoskeletal pain in the working population in Oslo. This finding indicates that the workplace may be an important arena for preventive efforts to reduce socioeconomic inequalities in musculoskeletal pain.