TY - JOUR AU - Ørstavik, Ragnhild E. AU - Knudsen, Gun Peggy AU - Tambs, Kristian AU - Gjerde, Line C. AU - Torvik, Fartein Ask AU - Nielsen, Christopher AU - Røysamb, Espen AU - Reichborn-Kjennerud, Ted PY - 2016/07/20 Y2 - 2024/03/29 TI - Musculoskeletal pain and work absence – a 10 year follow-up study of Norwegian young adult twins JF - Norsk Epidemiologi JA - Nor J Epidemiol VL - 26 IS - 1-2 SE - DO - 10.5324/nje.v26i1-2.2018 UR - https://www.ntnu.no/ojs/index.php/norepid/article/view/2018 SP - AB - <em>Background and aims:</em> Sickness absence (SA) and disability pension (DP) are increasingly recognized as<br />major public problems. Musculoskeletal disorders are among the most common diagnoses set by physicians<br />granting SA and DP. Results from recent twin studies have established that SA and DP are influenced<br />not only by environmental and social factors, but also moderately to substantially by genes. The aim of the<br />current study was to examine to what degree musculoskeletal complaints in young adults predict SA and<br />DP, including SA granted for other diagnoses. As the participants were twins, we were able to perform<br />within pair analyses, to see if the associations between musculoskeletal pain and later DP or SA were confounded<br />by unmeasured genetic and shared environmental factors.<br /><em>Materials and methods:</em> The Norwegian twin registry includes a questionnaire conducted in 1998. From<br />this, we included three measures of recurrent pain (lower back, neck/shoulders and muscular) as well as<br />symptoms of anxiety and depression (measured by the Symptom Checklist-5 (SCL-5)). The questionnaire<br />has been linked to highly reliable official registries on SA and DP, as well as a range of sociodemographic<br />variables, for a ten-year follow up period. We applied logistic (DP as dependent variable) and binomial<br />regression (SA as dependent variable) analyses to explore the relationship between musculoskeletal pain<br />and DP and SA. In the final models, we adjusted for sociodemographic factors and symptoms of anxiety<br />and depression. Differences between twins in a pair were explored by applying fixed effect models. All<br />analyses were conducted using STATA version 13.1.<br /><em>Results:</em> The final sample of 7,626 twins included 3,055 complete pairs (488 monozygotic (MZ) male, 349<br />dizygotic (DZ) male, 747 MZ female, 589 DZ female, and 882 opposite sex twin pairs) and 1,516 singletons.<br />By the end of follow up, 181 subjects (44 men and 137 women) received DP, and 63.7% of the sample<br />(47.4% of males and 76.0% of females) had at least one period of SA extending 16 days. Pain at any site<br />was significantly associated with DP in both sexes. Any increase in the number of pain sites reported was<br />associated with about a 60% increased risk for receiving DP (OR 1.6, 95% CI 1.4-1.9), and the strength of<br />the association was only marginally reduced when adjusted for symptoms of mental disorders (1.4, 1.2-<br />1.7). In the within pair analyses the effect was no longer significant, indicating possible confounding from<br />genetic and shared environmental effects. As for all cause SA, musculoskeletal pain predicted SA independently<br />of all measured confounders, and the results remained significant in the within pair analyses (Incidence<br />Rate Ratio (IRR) 1.12, 95% CI 1.03-1.23).<br /><em>Conclusion:</em> In young adults, musculoskeletal pain strongly predicted SA and DP for a 10 year follow-up<br />period. Musculoskeletal pain was associated with higher levels of all cause SA, even within discordant MZ<br />twin pairs. Our results indicate that interventions to prevent musculoskeletal pain in young adults can<br />reduce levels of SA and DP. ER -