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Determinants of international variation in the prevalence of disabling wrist and hand pain

Determinants of international variation in the prevalence of disabling wrist and hand pain
Determinants of international variation in the prevalence of disabling wrist and hand pain

Background: Previous research has indicated that wide international variation in the prevalence of disabling low back pain among working populations is largely driven by factors predisposing to musculoskeletal pain more generally. This paper explores whether the same applies to disabling wrist/hand pain (WHP). Methods: Using data from the Cultural and Psychosocial Influences on Disability (CUPID) study, we focused on workers from 45 occupational groups (office workers, nurses and other workers) in 18 countries. Among 11,740 participants who completed a baseline questionnaire about musculoskeletal pain and potential risk factors, 9082 (77%) answered a further questionnaire after a mean interval of 14 months, including 1373 (15%) who reported disabling WHP in the month before follow-up. Poisson regression was used to assess associations of this outcome with baseline risk factors, including the number of anatomical sites other than wrist/hand that had been painful in the 12 months before baseline (taken as an index of general propensity to pain). Results: After allowance for other risk factors, the strongest associations were with general pain propensity (prevalence rate ratio for an index ≥6 vs. 0: 3.6, 95% confidence interval 2.9-4.4), and risk rose progressively as the index increased. The population attributable fraction for a pain propensity index > 0 was 49.4%. The prevalence of disabling WHP by occupational group ranged from 0.3 to 36.2%, and correlated strongly with mean pain propensity index (correlation coefficient 0.86). Conclusion: Strategies to prevent disability from WHP among working populations should explore ways of reducing general propensity to pain, as well as improving the ergonomics of occupational tasks.

Geographical variation, Pain propensity, Risk factors, Wrist/hand pain
1471-2474
Coggon, David
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Ntani, Georgia
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Walker-Bone, Karen
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Felli, Vanda E.
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Harari, Florencia
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Barrero, Lope H.
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Felknor, Sarah A.
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Rojas, Marianela
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Cattrell, Anna
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Serra, Consol
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Borchini, Rossana
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Solidaki, Eleni
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Merisalu, Eda
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Habib, Rima R.
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Sadeghian, Farideh
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Kadir, M. Masood
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Peiris-John, Roshini J.
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Matsudaira, Ko
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Nyantumbu-Mkhize, Busisiwe
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Kelsall, Helen L.
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Harcombe, Helen
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Coggon, David
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Ntani, Georgia
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Walker-Bone, Karen
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Felli, Vanda E.
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Harari, Florencia
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Barrero, Lope H.
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Felknor, Sarah A.
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Rojas, Marianela
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Cattrell, Anna
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Serra, Consol
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Borchini, Rossana
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Solidaki, Eleni
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Merisalu, Eda
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Habib, Rima R.
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Sadeghian, Farideh
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Kadir, M. Masood
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Peiris-John, Roshini J.
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Matsudaira, Ko
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Nyantumbu-Mkhize, Busisiwe
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Kelsall, Helen L.
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Harcombe, Helen
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Coggon, David, Ntani, Georgia, Walker-Bone, Karen, Felli, Vanda E., Harari, Florencia, Barrero, Lope H., Felknor, Sarah A., Rojas, Marianela, Cattrell, Anna, Serra, Consol, Borchini, Rossana, Solidaki, Eleni, Merisalu, Eda, Habib, Rima R., Sadeghian, Farideh, Kadir, M. Masood, Peiris-John, Roshini J., Matsudaira, Ko, Nyantumbu-Mkhize, Busisiwe, Kelsall, Helen L. and Harcombe, Helen (2019) Determinants of international variation in the prevalence of disabling wrist and hand pain. BMC Musculoskeletal Disorders, 20 (1), [436]. (doi:10.1186/s12891-019-2791-x).

Record type: Article

Abstract

Background: Previous research has indicated that wide international variation in the prevalence of disabling low back pain among working populations is largely driven by factors predisposing to musculoskeletal pain more generally. This paper explores whether the same applies to disabling wrist/hand pain (WHP). Methods: Using data from the Cultural and Psychosocial Influences on Disability (CUPID) study, we focused on workers from 45 occupational groups (office workers, nurses and other workers) in 18 countries. Among 11,740 participants who completed a baseline questionnaire about musculoskeletal pain and potential risk factors, 9082 (77%) answered a further questionnaire after a mean interval of 14 months, including 1373 (15%) who reported disabling WHP in the month before follow-up. Poisson regression was used to assess associations of this outcome with baseline risk factors, including the number of anatomical sites other than wrist/hand that had been painful in the 12 months before baseline (taken as an index of general propensity to pain). Results: After allowance for other risk factors, the strongest associations were with general pain propensity (prevalence rate ratio for an index ≥6 vs. 0: 3.6, 95% confidence interval 2.9-4.4), and risk rose progressively as the index increased. The population attributable fraction for a pain propensity index > 0 was 49.4%. The prevalence of disabling WHP by occupational group ranged from 0.3 to 36.2%, and correlated strongly with mean pain propensity index (correlation coefficient 0.86). Conclusion: Strategies to prevent disability from WHP among working populations should explore ways of reducing general propensity to pain, as well as improving the ergonomics of occupational tasks.

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Accepted/In Press date: 27 August 2019
Published date: 18 September 2019
Keywords: Geographical variation, Pain propensity, Risk factors, Wrist/hand pain

Identifiers

Local EPrints ID: 434573
URI: http://eprints.soton.ac.uk/id/eprint/434573
ISSN: 1471-2474
PURE UUID: 10e16d39-7848-421e-9382-054354fefd40
ORCID for David Coggon: ORCID iD orcid.org/0000-0003-1930-3987
ORCID for Karen Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459

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Date deposited: 02 Oct 2019 16:30
Last modified: 26 Mar 2021 02:37

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Contributors

Author: David Coggon ORCID iD
Author: Georgia Ntani
Author: Vanda E. Felli
Author: Florencia Harari
Author: Lope H. Barrero
Author: Sarah A. Felknor
Author: Marianela Rojas
Author: Anna Cattrell
Author: Consol Serra
Author: Rossana Borchini
Author: Eleni Solidaki
Author: Eda Merisalu
Author: Rima R. Habib
Author: Farideh Sadeghian
Author: M. Masood Kadir
Author: Roshini J. Peiris-John
Author: Ko Matsudaira
Author: Busisiwe Nyantumbu-Mkhize
Author: Helen L. Kelsall
Author: Helen Harcombe

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