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Vargas-Prada S, Coggon D, Ntani G, Walker-Bone K, Palmer KT, Felli VE, Harari R, Barrero LH, Felknor SA, Gimeno D, Cattrell A, Bonzini M, Solidaki E, Merisalu E, Habib RR, Sadeghian F, Kadir MM, Warnakulasuriya SSP, Matsudaira K, Nyantumbu B, Sim MR, Harcombe H, Cox K, Sarquis LMM, Marziale MH, Harari F, Freire R, Harari N, Monroy MV, Quintana LA, Rojas M, Harris EC, Serra C, Martinez JM, Delclos G, Benavides FG, Carugno M, Ferrario MM, Pesatori AC, Chatzi L, Bitsios P, Kogevinas M, Oha K, Freimann T, Sadeghian A, Peiris-John RJ, Sathiakumar N, Wickremasinghe AR, Yoshimura N, Kelsall HL, Hoe VCW, Urquhart DM, Derrett S, McBride D, Herbison P, Gray A, Vega EJS. Descriptive Epidemiology of Somatising Tendency: Findings from the CUPID Study. PLoS One 2016; 11:e0153748. [PMID: 27128094 PMCID: PMC4851348 DOI: 10.1371/journal.pone.0153748] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 04/04/2016] [Indexed: 11/18/2022] Open
Abstract
Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.
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Affiliation(s)
- Sergio Vargas-Prada
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Barcelona, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - David Coggon
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
- * E-mail:
| | - Georgia Ntani
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - Karen Walker-Bone
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - Keith T. Palmer
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - Vanda E. Felli
- School of Nursing, University of São Paulo, São Paulo, Brazil
| | - Raul Harari
- Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral–IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador
| | - Lope H. Barrero
- Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Sarah A. Felknor
- Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States of America
- Center for Disease Control and Prevention/National Institute for Occupational Safety and Health, Atlanta, Georgia, United States of America
| | - David Gimeno
- Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States of America
| | - Anna Cattrell
- North East London NHS Foundation Trust, Goodmayes Hospital, Ilford, United Kingdom
| | - Matteo Bonzini
- Epidemiology and Preventive Medicine Research Center, University of Insubria, Varese, Italy
| | - Eleni Solidaki
- Department of Social Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Eda Merisalu
- Institute of Technology, Estonian University of Life Sciences, Tartu, Estonia
| | - Rima R. Habib
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Farideh Sadeghian
- Department of Occupational Health, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - M. Masood Kadir
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Sudath S. P. Warnakulasuriya
- Department of Medical Education and Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka
| | - Ko Matsudaira
- Department for Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Busisiwe Nyantumbu
- National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
- Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Malcolm R. Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Helen Harcombe
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Ken Cox
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | | | - Maria H. Marziale
- School of Nursing of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Florencia Harari
- Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral–IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador
| | - Rocio Freire
- Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral–IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador
| | - Natalia Harari
- Corporación para el Desarrollo de la Producción y el Medio Ambiente Laboral–IFA (Institute for the Development of Production and the Work Environment), Quito, Ecuador
| | - Magda V. Monroy
- Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Leonardo A. Quintana
- Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Marianela Rojas
- Program Health, Work and Environment in Central America, Institute for Studies on Toxic Substances (IRET), National University of Costa Rica, Heredia, Costa Rica
| | - E. Clare Harris
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - Consol Serra
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Barcelona, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
- Occupational Health Service, Parc de Salut MAR, Barcelona, Spain
| | - J. Miguel Martinez
- Servicio de Investigación y Análisis IT/EP, Departamento de Investigación y Análisis de Prestaciones, MC Mutual, Barcelona, Spain
| | - George Delclos
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Barcelona, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
- Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States of America
| | - Fernando G. Benavides
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Barcelona, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - Michele Carugno
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Marco M. Ferrario
- Epidemiology and Preventive Medicine Research Center, University of Insubria, Varese, Italy
| | - Angela C. Pesatori
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Fondazione Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Leda Chatzi
- Department of Social Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Panos Bitsios
- Department of Psychiatry, Medical School, University of Crete, Heraklion, Greece
| | - Manolis Kogevinas
- CIBER of Epidemiology and Public Health, Barcelona, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Kristel Oha
- North Estonia Medical Centre, Tallinn, Estonia
| | | | | | - Roshini J. Peiris-John
- Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Nalini Sathiakumar
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | | | - Noriko Yoshimura
- Department of Joint Disease Research, 22nd Century Medical and Research Center, University of Tokyo, Tokyo, Japan
| | - Helen L. Kelsall
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Victor C. W. Hoe
- Centre for Occupational and Environmental Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Donna M. Urquhart
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sarah Derrett
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - David McBride
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Peter Herbison
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Andrew Gray
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Eduardo J. Salazar Vega
- Health Safety and Environment Department, AkzoNobel, Houston, Texas, United States of America
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Coggon D, Ntani G, Palmer KT, Felli VE, Harari R, Barrero LH, Felknor SA, Gimeno D, Cattrell A, Serra C, Bonzini M, Solidaki E, Merisalu E, Habib RR, Sadeghian F, Masood Kadir M, Warnakulasuriya SSP, Matsudaira K, Nyantumbu B, Sim MR, Harcombe H, Cox K, Marziale MH, Sarquis LM, Harari F, Freire R, Harari N, Monroy MV, Quintana LA, Rojas M, Salazar Vega EJ, Harris EC, Vargas-Prada S, Martinez JM, Delclos G, Benavides FG, Carugno M, Ferrario MM, Pesatori AC, Chatzi L, Bitsios P, Kogevinas M, Oha K, Sirk T, Sadeghian A, Peiris-John RJ, Sathiakumar N, Wickremasinghe AR, Yoshimura N, Kelsall HL, Hoe VCW, Urquhart DM, Derrett S, McBride D, Herbison P, Gray A. Disabling musculoskeletal pain in working populations: is it the job, the person, or the culture? Pain 2014; 154:856-63. [PMID: 23688828 PMCID: PMC3675684 DOI: 10.1016/j.pain.2013.02.008] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 02/11/2013] [Accepted: 02/19/2013] [Indexed: 11/05/2022]
Abstract
To compare the prevalence of disabling low back pain (DLBP) and disabling wrist/hand pain (DWHP) among groups of workers carrying out similar physical activities in different cultural environments, and to explore explanations for observed differences, we conducted a cross-sectional survey in 18 countries. Standardised questionnaires were used to ascertain pain that interfered with everyday activities and exposure to possible risk factors in 12,426 participants from 47 occupational groups (mostly nurses and office workers). Associations with risk factors were assessed by Poisson regression. The 1-month prevalence of DLBP in nurses varied from 9.6% to 42.6%, and that of DWHP in office workers from 2.2% to 31.6%. Rates of disabling pain at the 2 anatomical sites covaried (r = 0.76), but DLBP tended to be relatively more common in nurses and DWHP in office workers. Established risk factors such as occupational physical activities, psychosocial aspects of work, and tendency to somatise were confirmed, and associations were found also with adverse health beliefs and group awareness of people outside work with musculoskeletal pain. However, after allowance for these risk factors, an up-to 8-fold difference in prevalence remained. Systems of compensation for work-related illness and financial support for health-related incapacity for work appeared to have little influence on the occurrence of symptoms. Our findings indicate large international variation in the prevalence of disabling forearm and back pain among occupational groups carrying out similar tasks, which is only partially explained by the personal and socioeconomic risk factors that were analysed.
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Affiliation(s)
- David Coggon
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UK.
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Coggon D, Ntani G, Palmer KT, Felli VE, Harari R, Barrero LH, Felknor SA, Gimeno D, Cattrell A, Serra C, Bonzini M, Solidaki E, Merisalu E, Habib RR, Sadeghian F, Kadir M, Warnakulasuriya SSP, Matsudaira K, Nyantumbu B, Sim MR, Harcombe H, Cox K, Marziale MH, Sarquis LM, Harari F, Freire R, Harari N, Monroy MV, Quintana LA, Rojas M, Salazar Vega EJ, Harris EC, Vargas-Prada S, Martinez JM, Delclos G, Benavides FG, Carugno M, Ferrario MM, Pesatori AC, Chatzi L, Bitsios P, Kogevinas M, Oha K, Sirk T, Sadeghian A, Peiris-John RJ, Sathiakumar N, Wickremasinghe AR, Yoshimura N, Kielkowski D, Kelsall HL, Hoe VCW, Urquhart DM, Derrett S, McBride D, Gray A. The CUPID (Cultural and Psychosocial Influences on Disability) study: methods of data collection and characteristics of study sample. PLoS One 2012; 7:e39820. [PMID: 22792189 PMCID: PMC3391206 DOI: 10.1371/journal.pone.0039820] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/28/2012] [Indexed: 11/20/2022] Open
Abstract
Background The CUPID (Cultural and Psychosocial Influences on Disability) study was established to explore the hypothesis that common musculoskeletal disorders (MSDs) and associated disability are importantly influenced by culturally determined health beliefs and expectations. This paper describes the methods of data collection and various characteristics of the study sample. Methods/Principal Findings A standardised questionnaire covering musculoskeletal symptoms, disability and potential risk factors, was used to collect information from 47 samples of nurses, office workers, and other (mostly manual) workers in 18 countries from six continents. In addition, local investigators provided data on economic aspects of employment for each occupational group. Participation exceeded 80% in 33 of the 47 occupational groups, and after pre-specified exclusions, analysis was based on 12,426 subjects (92 to 1018 per occupational group). As expected, there was high usage of computer keyboards by office workers, while nurses had the highest prevalence of heavy manual lifting in all but one country. There was substantial heterogeneity between occupational groups in economic and psychosocial aspects of work; three- to five-fold variation in awareness of someone outside work with musculoskeletal pain; and more than ten-fold variation in the prevalence of adverse health beliefs about back and arm pain, and in awareness of terms such as “repetitive strain injury” (RSI). Conclusions/Significance The large differences in psychosocial risk factors (including knowledge and beliefs about MSDs) between occupational groups should allow the study hypothesis to be addressed effectively.
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Affiliation(s)
- David Coggon
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
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