To determine the impact of occupational psychological/social and mechanical factors on neck pain, a prospective cohort study with a follow-up period of 2 years was conducted with a sample of Norwegian employees. The following designs were tested: (i) cross-sectional analyses at baseline (n=4569) and follow-up (n=4122), (ii) prospective analyses with baseline predictors, (iii) prospective analyses with average exposure over time [(T1+T2)/2] as predictor, and (iv) prospective analyses with measures of change in exposure from T1 to T2 as predictors. A total of 2419 employees responded to both the baseline and follow-up questionnaire. Data were analyzed using ordinal logistic regression. After adjustment for age, sex, neck pain at T1, and other exposure factors that had been estimated to be confounders, the most consistent risk factors were role conflict (highest OR 2.97, 99% CI: 1.29-6.74) and working with arms raised to or above shoulder level (highest OR 1.37, 99% CI: 1.05-1.78). The most consistent protective factors were empowering leadership (lowest OR 0.53, 99% CI: 0.35-0.81) and decision control (lowest OR 0.60, 99% CI: 0.36-1.00). Hence, psychological and social factors are important precursors of neck pain, along with mechanical factors. Although traditional factors such as quantitative demands and decision control play a part in the etiology of neck pain at work, in this study several new factors emerged as more important.

Purpose: The present study aimed to clarify the prospective effects of various types and frequencies of organizational changes on aspects in the psychosocial work environment. Methods: The study had a prospective, full-panel, repeated measures design. Data were collected by self-administered, online questionnaires, with a 2-year interval between measurement occasions. Five types of organizational change were assessed – company restructuring, downsizing, layoffs, partial closure, and partial outsourcing. The effects of change on eleven, specific work factors were measured utilizing QPS Nordic. At baseline, 12652 employees participated, while 8965 responded at follow-up. Generalized estimating equations were utilized to estimate the effects of change taking place within the last 12 months or more than 24 months prior. Results: Cross-sectional analyses, i.e., changes occurring within the last 12 months, showed all 11 work factors to be statistically significantly associated with the organizational changes restructuring, downsizing, and partial closure (coefficients ranging −0.28 to 0.04). In the prospective analyses, i.e., the effects of change taking place more than 24 months prior, associations were no longer significant for a number of work factors, although all types of organizational change remained significantly associated with at least three work factors (coefficients ranging −0.14 to 0.05). Following repeated organizational changes, statistically significant associations were shown for all 11 work factors (coefficients ranging from 0.39 to −0.04). Conclusion: Following both separate and repeated organizational change, various psychological and social work factors were altered, with the most pronounced effects following repeated change. These results suggest the implementing organizational change, especially repeated change, may have an adverse effect on various parts of the psychosocial work environment. The negative effects of a company’s psychosocial working conditions may contribute to the adverse health effects often observed following such changes and help explain why many change initiatives fail to reach its intended results.

Headache is a common health complaint responsible for substantial suffering and disability. Although musculoskeletal complaints such as back and neck pain have frequently been associated with occupational psychological and social factors, headache has received less attention as a possible outcome of such exposures. The aim of the present study was to identify occupational psychological, social, and mechanical factors that predicted headache severity. Furthermore, using a full panel design, cross-lagged and synchronous structural equation models were employed to test reverse causality. Data were obtained by work environment surveys in a wide variety of organizations in Norway, with a two-year follow-up period. At baseline 6421 employees responded and 3574 employees also responded at follow-up. Ordinal logistic regression models revealed that 7 of 16 psychological/social/mechanical factors were prospectively related to headache severity. Most consistently, higher quantitative demands and role conflict, and lower decision control, control over work intensity, and job satisfaction were related to more severe headache at follow-up. Cross-lagged models indicated an impact across a 2-year period of decision control, control over work intensity, and job satisfaction on headache severity. Reverse effects from headache severity to quantitative demands were indicated. For role conflict, no cross-lagged effects were observed. However, synchronous models supported the notion of an effect of each of these factors on headache severity over a time span shorter than 2 years.

The current study estimated the impact of psychological and social work factors over time on neck pain. A sample of Norwegian employees (n=1250) was surveyed on 3 occasions spanning 4 years. Five exposures were studied: quantitative demands, decision control, social climate, empowering leadership, and role conflict. Group-based trajectory models suggested factors changed little over time-employees could be classified by mean levels of exposure into groups exhibiting stable "high", "middle", and "low" levels. The exception was decision control, for which a 4-level classification was derived: "high", "high-middle", "low-middle", and "low". Pain prevalence at the end of the study period was compared across groups. Risk and prognosis were also assessed separately by dividing the sample according to pain status at baseline. For all factors, distinct differences in risk were observed between exposure groups, controlled for pain at baseline, skill level, sex, and age. Statistically significant effects ranged from 0.38 (CI 0.20-0.73, P<0.01) for high social climate to 3.00 (CI 1.63-5.50, P<0.01) for high role conflict. The risk of new-onset pain was predicted by all factors. ORs ranged from 0.32 (CI 0.16-0.67, P<0.01) for high empowering leadership to 2.61 (CI 1.09-6.21, P<0.05) for high role conflict. Pain persistence was predicted by high role conflict (OR 3.26, CI 1.30-8.18, P<0.05), high quantitative demands (odds ratio [OR] 3.66, CI 1.58-8.49, P<0.01), and high-middle decision control (OR 0.45, CI 0.21-0.99, P<0.05). Future studies should collect information at multiple time points to clarify the impact of prolonged and changing exposure on musculoskeletal pain.

Objective Despite the multifactoriality of work and health, studies of psychosocial work factors with pain are typically limited to a few factors. This study examined a wide range of factors to determine (i) typical combinations of work factor levels ("work situations") and (ii) whether "work situations" predicted pain complaints of six anatomic regions. Methods Questionnaires were distributed to 6175 employees twice over a two-year period. Latent profile analysis was conducted to group employees into profiles of work factor levels. Twelve work factors were measured, reflecting six themes: demands, control, role expectations, leadership, predictability, and organizational climate. Logistic and Poisson regressions compared the groups’ risk of pain of the neck, head, back, shoulders, legs and arms, as well as multi-site pain (>1 pain site). Results Four latent profiles emerged based on relative levels of work factors. Profile 1 reflected relatively "desirable" levels of all factors, demonstrating the lowest risk of pain. Profile 2 exhibited the highest, and profile 3 the lowest levels of both demands and control with similar risks of pain, suggesting high levels of control were insufficient to buffer the impact of the combination of the other factors. Profile 4 exhibited "undesirable" levels of all factors and the highest risk, most notably for multi-site pain [odds ratio (OR) 2.32, 95% confidence intervals (CI) 1.80–2.85 compared with profile 1]. Conclusions Different compositions of psychosocial exposures were differentially related to pain. Future studies should take the complexity of work into account by studying comprehensive arrays of co-occurring work factors with health.

Objectives: We investigated prospective associations of shift work with chronic pain and C‐reactive protein (CRP), an indicator of inflammation. Furthermore, we elucidated CRP as a possible mediator and/or moderator of effects of shift work on pain. Methods: Data from a 7 years follow‐up study were analyzed (N = 2323). Shift work and chronic pain of “neck/shoulder”, “arm/hand”, “upper back”, “low back”, “hip/leg/feet”, and “other regions” were measured by questionnaires. “Chronic widespread pain”, “number of chronic pain sites”, and “any chronic pain” were computed. CRP was measured in serum samples. Logistic and Poisson regressions were conducted. Mediation was assessed by casual mediation analyses and moderation by the Relative Excess Risk due to Interaction (RERI). Results: Shift work was not associated with any chronic pain variable and no mediation was detected. CRP was associated with low back pain, hip/leg pain, and “number of pain sites”, and also with the combination of shift work and CRP of 1–2.99 mg/L (compared to: no shiftwork and CRP < 1). Additionally, shiftwork and CRP 1–2.99 mg/L was associated with risk of “any chronic pain” (OR: 1.76, 95% CI: 1.12, 2.85), which was not associated with CRP alone. Moderation analyses suggested the risks for “any chronic pain” and “number of pain regions” increased when individuals with elevated CRP worked shifts—beyond what the separate effects of CRP and shift would suggest. Conclusions: We found no evidence of shift work in general affecting CRP or chronic pain. However, shift work and elevated CRP combined may influence chronic pain.