Work and neck pain: A prospective study of psychological, social, and mechanical risk factors

Pain, 07/28/2010
Jan Olav Christensenab1, Stein Knardahla1

Received 19 November 2009; received in revised form 20 May 2010; accepted 1 July 2010. published online 26 July 2010.
Abstract

To determine the impact of occupational psychological/social and mechanical factors on neck pain, a prospective cohort study with a follow-up period of 2years was conducted with a sample of Norwegian employees. The following designs were tested: (i) cross-sectional analyses at baseline (n=4569) and follow-up (n=4122), (ii) prospective analyses with baseline predictors, (iii) prospective analyses with average exposure over time [(T1+T2)/2] as predictor, and (iv) prospective analyses with measures of change in exposure from T1 to T2 as predictors. A total of 2419 employees responded to both the baseline and follow-up questionnaire. Data were analyzed using ordinal logistic regression. After adjustment for age, sex, neck pain at T1, and other exposure factors that had been estimated to be confounders, the most consistent risk factors were role conflict (highest OR 2.97, 99% CI: 1.29–6.74) and working with arms raised to or above shoulder level (highest OR 1.37, 99% CI: 1.05–1.78). The most consistent protective factors were empowering leadership (lowest OR 0.53, 99% CI: 0.35–0.81) and decision control (lowest OR 0.60, 99% CI: 0.36–1.00). Hence, psychological and social factors are important precursors of neck pain, along with mechanical factors. Although traditional factors such as quantitative demands and decision control play a part in the etiology of neck pain at work, in this study several new factors emerged as more important.


a The National Institute of Occupational Health, Norway
b Department of Psychology, University of Oslo, Norway

Corresponding author. Address: The National Institute of Occupational Health, P.O. Box 8149 Dep, N-0033 Oslo, Norway. Tel.: +47 23 19 52 58; fax: +47 23 19 52 00