{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:02:22Z","timestamp":1771459342691,"version":"3.50.1"},"reference-count":35,"publisher":"BMJ","issue":"11","funder":[{"name":"The Finnish Work Environment Fund"},{"DOI":"10.13039\/501100000265","name":"the Medical Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000265","name":"The UK Medical Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Juho Vainio Foundation"},{"name":"UK Economic and Social Research Council and the UK Medical Research Council, under the Lifelong Health and Wellbeing Cross-Council Programme initiative"},{"DOI":"10.13039\/100000002","name":"US National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002341","name":"the Academy of Finland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine the impact of recurrent, as compared with single, reports of back pain on exit from paid employment over decades of follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study sample was from the British Whitehall II Study cohort (n=8665, 69% men, aged 35\u201355 at baseline), who had provided information about their reports of back pain between 1985 and 1994. Data about exit from paid employment (health-related and non-health related exit, unemployment and other exit) were collected between 1995 and 2013. Repeated measures logistic regression models were fitted to examine the associations, and adjust for covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Recurrent pain was reported by 18% of participants, while 26% reported pain on an occasion and 56% did not report pain. Report of back pain on an occasion was not associated with health-related job exit, whereas recurrent pain was associated with such an exit (OR 1.51; 95%\u2009CI 1.15 to 1.99), when compared with those who did not report pain. These associations were somewhat stronger among middle-grade and lower-grade employees, while these associations were not seen among higher-grade employees. Differences in associations by age and psychosocial working conditions were small.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results highlight the need for early detection of recurrent back pain to prevent exit out of paid employment for health reasons. As the risk varies by occupational grade, this emphasises the importance of identification of high-risk groups and finding ways to address their modifiable risk factors.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oemed-2018-105202","type":"journal-article","created":{"date-parts":[[2018,10,4]],"date-time":"2018-10-04T16:14:52Z","timestamp":1538669692000},"page":"786-791","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Recurrent back pain during working life and exit from paid employment: a 28-year follow-up of the Whitehall II Study"],"prefix":"10.1136","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3841-3129","authenticated-orcid":false,"given":"Tea","family":"Lallukka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minna","family":"M\u00e4nty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyrus","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Fleischmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6997-8312","authenticated-orcid":false,"given":"Anne","family":"Kouvonen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen E","family":"Walker-Bone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny A","family":"Head","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1142-0388","authenticated-orcid":false,"given":"Jaana I","family":"Halonen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,10,4]]},"reference":[{"key":"2023020904450689000_75.11.786.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2011.07.006"},{"key":"2023020904450689000_75.11.786.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.11.005"},{"key":"2023020904450689000_75.11.786.3","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.635"},{"key":"2023020904450689000_75.11.786.4","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2015-205719"},{"key":"2023020904450689000_75.11.786.5","doi-asserted-by":"publisher","DOI":"10.1136\/jech.55.7.455"},{"key":"2023020904450689000_75.11.786.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.12.033"},{"key":"2023020904450689000_75.11.786.7","doi-asserted-by":"publisher","DOI":"10.1002\/j.1532-2149.2013.00351.x"},{"key":"2023020904450689000_75.11.786.8","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-11-23"},{"key":"2023020904450689000_75.11.786.9","doi-asserted-by":"crossref","unstructured":"Macfarlane GJ . 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