• Subas Neupane, Helena Miranda, Pekka Virtanen, Anna Siukola, and Clas-Håkan Nygård.
• School of Health Sciences, 33014 University of Tampere, Tampere, Finland. subas.neupane@uta.fi
• Int Arch Occup Environ Health. 2013 Jul 1;86(5):581-9.

PurposeMusculoskeletal pain at multiple sites is common among working-age people and greatly increases work disability risk. Little is known of the work-related physical and psychosocial factors contributing to multi-site pain.MethodsSurvey responses from 734 employees (518 blue- and 216 white-collar; 65 % female) of a food processing company were collected twice, in 2005 and 2009. Information on musculoskeletal pain during the preceding week, and on environmental, biomechanical and psychosocial work exposures were obtained through a structured questionnaire. The association of multi-site pain with work exposures was estimated with logistic regression by gender and age group.ResultsAt baseline, 54 % of informants reported pain in more than one area, and 50 % at 4-year follow-up. Forty percent of all employees had multi-site pain both at baseline and at follow-up. Among those with multi-site pain at baseline, 69 % had multi-site pain at follow-up. Both repetitive work and awkward work postures at baseline were associated with multi-site pain at follow-up. Psychosocial factors (low job satisfaction, low team spirit, and little opportunity to exert influence at work) also strongly predicted multi-site pain at follow-up, especially among younger workers and men.ConclusionThis prospective study provides new evidence of the high occurrence and persistence of musculoskeletal pain at multiple body sites in an industrial population with a strong association between biomechanical and psychosocial exposures at work and multi-site pain. Prevention of multi-site pain with many-sided modification of work exposures is likely to reduce work disability.

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