0168 Somatising tendency, occupational strain and musculoskeletal symptoms: results from a longitudinal study among Italian nurses

OBJECTIVES: Musculoskeletal symptoms are a common cause of disability, with major
impact on workforce wellbeing, absenteeism and productivity. Several, mainly
cross-sectional, studies have linked such symptoms to physical workload, and also
to psychological and socio-cultural factors. We investigated whether prolonged or
increasing job strain, tendency to somatise and other individual characteristics,
are associated with worsening musculoskeletal pain.
METHOD: As part of the CUPID study, we investigated a cohort of nurses employed
on medical wards at the Varese University Hospitals (Italy). Participants were
asked, at baseline and after one year of follow-up, about individual and
occupational risk factors, psychological characteristics (including tendency to
somatise), occupational strain (by Siegrist's Effort/Reward Imbalance
Questionnaire-ERI), and musculoskeletal symptoms. Associations of worsening
musculoskeletal pain with perceived job strain were assessed by multivariate
log-binomial regression.
RESULTS: Occupational stress was associated with pain in the lower back (LBP) and
neck/shoulder (NSP) in both cross-sectional questionnaires. Comparing baseline
and follow-up answers, workers who reported an increase in perceived stress
showed more frequent worsening of both LBP (prevalence of worsening symptoms=41%,
OR when compared with not stressed=1.7, 95% CI=1.1-2.7) and NSP (prevalence of
worsening=51%, OR=1.2, 95% CI=0.8-1.8). This relationship persisted after
adjustment for gender, age and BMI, and exposure to physical workload, and was
more evident among subjects with a tendency to somatise (OR=2.8. 95% CI=1.0-7.4
for LBP; OR=1.6, 95% CI=0.8-3.2 for NSP).
CONCLUSIONS: Our observation suggests that tendency to somatise modifies
individual responses to "triggering exposures", such as psychological workload,
with important implications for the health, and productivity of workers.