Keiko Yamada1,2,3, Kenta Wakaizumi4,5, Yasuhiko Kubota6, Ko Matsudaira7,8, Masahiko Shibata9. 1. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. keiko-yamada@umin.org. 2. Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. keiko-yamada@umin.org. 3. Department of Psychology, McGill University, 2001 McGill College, Montreal, QC, H3A 1G1, Canada. keiko-yamada@umin.org. 4. Shirley Ryan AbilityLab, 355 East Erie, Chicago, IL, 60611, USA. 5. Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, 710 N Lake Shore Drive, Chicago, IL, 60611, USA. 6. Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Joto-ku, Osaka, 536-8588, Japan. 7. Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. 8. Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, 7-3-1 Bunkyo-ku, Tokyo, 113-8655, Japan. 9. Department of Health Science, Naragakuen University, 15-1 Nakatomigaoka, Nara, 631-8524, Japan.
Abstract
PURPOSE: Pain symptom, such as that caused by musculoskeletal disorders, is a major cause of occupational disability. As nicotine intake from smoking increases pain sensitivity, smokers may experience stronger pain and be more likely to experience pain-related disability than non-smokers. The study aim was to examine whether smoking was associated with pain-related occupational disability via pain intensity. METHODS: Participants were 1189 workers with pain aged 20-74 years in Japan. Participants completed a self-report questionnaire, which included a question to measure pain-related occupational disability with ordinal-option: (1) without pain-related disability, (2) pain-related presenteeism, and (3) pain-related absenteeism. An ordinal logistic regression model was used to calculate multivariable-adjusted proportional odds ratios (OR) with 95% confidence intervals (CI) for the prevalence of pain-related occupational disability according to smoking status. A multiple mediation analysis was also conducted to assess whether pain sensitivity mediated the association between smoking and pain-related occupational disability. Adjusted variables were demographic variables, socioeconomic status, work-related psychosocial factors, general psychological factors, and pain duration. RESULTS: Current smoking and pain were associated with pain-related occupational disability compared with non-smoking and pain (multivariable OR 1.78; 95% CI 1.26-2.52). Greater pain intensity partially mediated the association of current smoking and pain with pain-related occupational disability. The mediation rate (indirect/total effect) was 25%. CONCLUSION: Smoking and pain were associated with pain-related occupational disability, partially through greater pain intensity, among Japanese workers.
PURPOSE:Pain symptom, such as that caused by musculoskeletal disorders, is a major cause of occupational disability. As nicotine intake from smoking increases pain sensitivity, smokers may experience stronger pain and be more likely to experience pain-related disability than non-smokers. The study aim was to examine whether smoking was associated with pain-related occupational disability via pain intensity. METHODS:Participants were 1189 workers with pain aged 20-74 years in Japan. Participants completed a self-report questionnaire, which included a question to measure pain-related occupational disability with ordinal-option: (1) without pain-related disability, (2) pain-related presenteeism, and (3) pain-related absenteeism. An ordinal logistic regression model was used to calculate multivariable-adjusted proportional odds ratios (OR) with 95% confidence intervals (CI) for the prevalence of pain-related occupational disability according to smoking status. A multiple mediation analysis was also conducted to assess whether pain sensitivity mediated the association between smoking and pain-related occupational disability. Adjusted variables were demographic variables, socioeconomic status, work-related psychosocial factors, general psychological factors, and pain duration. RESULTS: Current smoking and pain were associated with pain-related occupational disability compared with non-smoking and pain (multivariable OR 1.78; 95% CI 1.26-2.52). Greater pain intensity partially mediated the association of current smoking and pain with pain-related occupational disability. The mediation rate (indirect/total effect) was 25%. CONCLUSION: Smoking and pain were associated with pain-related occupational disability, partially through greater pain intensity, among Japanese workers.
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