Smoking is associated with greater pain intensity and pain-related occupational disability in Japanese workers
Pain symptom, such as that caused by musculoskeletal disorders, is a major cause of occupational disability. As nicotine intake from smoking increases pain sensitivity, smokers may experience stronger pain and be more likely to experience pain-related disability than non-smokers. The study aim was to examine whether smoking was associated with pain-related occupational disability via pain intensity.
Participants were 1189 workers with pain aged 20–74 years in Japan. Participants completed a self-report questionnaire, which included a question to measure pain-related occupational disability with ordinal-option: (1) without pain-related disability, (2) pain-related presenteeism, and (3) pain-related absenteeism. An ordinal logistic regression model was used to calculate multivariable-adjusted proportional odds ratios (OR) with 95% confidence intervals (CI) for the prevalence of pain-related occupational disability according to smoking status. A multiple mediation analysis was also conducted to assess whether pain sensitivity mediated the association between smoking and pain-related occupational disability. Adjusted variables were demographic variables, socioeconomic status, work-related psychosocial factors, general psychological factors, and pain duration.
Current smoking and pain were associated with pain-related occupational disability compared with non-smoking and pain (multivariable OR 1.78; 95% CI 1.26–2.52). Greater pain intensity partially mediated the association of current smoking and pain with pain-related occupational disability. The mediation rate (indirect/total effect) was 25%.
Smoking and pain were associated with pain-related occupational disability, partially through greater pain intensity, among Japanese workers.
KeywordsSmoking Disability studies Occupational medicine Pain Pain measurement
We are grateful to all the participants from the three companies. We thank Dr. Kyosuke Fukai, Dr. Yuichiro Kawatsu, Dr. Azusa Shima, and other staffs from the three companies for their support in conducting this survey. We thank Diane Williams, Ph.D., from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.
This research was supported by a grant for The Research Project on Elucidation of Chronic Pain from the Japan Agency for Medical Research and Development, AMED (16EK0610004H0003), Health Labour Sciences Research Grants, and Industrial Disease Clinical Research Grants (14020301-01). This research was supported in part by a fellowship to Keiko Yamada from the Astellas Foundation for Research on Metabolic Disorders and supported in part by a research assistantship of a Grant-in-Aid to Kenta Wakaizumi and the Program for Leading Graduate School for “Science for Development of Super Mature Society” from the Ministry of Education, Culture, Sport, Science, and Technology in Japan.
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest to declare.
- 1.Nastasia I, Coutu MF, Tcaciuc R. Topics and trends in research on non-clinical interventions aimed at preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs): a systematic, comprehensive literature review. Disabil Rehabil. 2014;36:1841–56.CrossRefGoogle Scholar
- 10.Weingarten TN, Moeschler SM, Ptaszynski AE, Hooten WM, Beebe TJ, Warner DO. An assessment of the association between smoking status, pain intensity, and functional interference in patients with chronic pain. Pain Physician. 2008;11:643–53.Google Scholar
- 15.Shimomitsu T, Haratani T, Nakamura K, Kawakami N, Hayashi T. The final development of the Brief Job Stress Questionnaire mainly used for assessment of the individuals. The ministry of Labour sponsored grand for the prevention of work-related illness: The 1999 report. 1990. pp. 126–64.Google Scholar
- 16.Furukawa TA, Kawakami N, Saitoh M, Ono Y, Nakane Y, Nakamura Y, Tachimori H, Iwata N, Uda H, Nakane H, Watanabe M, Naganuma Y, Hata Y, Kobayashi M, Miyake Y, Takeshima T, Kikkawa T. The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan. Int J Methods Psychiatr Res. 2008;17:152–8.CrossRefGoogle Scholar
- 18.Monzani L, Zurriaga R, López GVE. Anxiety and the severity of tension-type headache mediate the relation between headache presenteeism and workers’ productivity. PLoS One. 2018;13:1–16.Google Scholar
- 19.Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce. JAMA. 2003;290(2443):2454.Google Scholar
- 22.Shiels MS, Katki HA, Freedman ND, Purdue MP, Wentzensen N, Trabert B, Kitahara CM, Furr M, Li Y, Kemp TJ, Goedert JJ, Chang CM, Engels EA, Caporaso NE, Pinto LA, Hildesheim A, Chaturvedi AK. Cigarette smoking and variations in systemic immune and inflammation markers. J Natl Cancer Inst. 2014;106:1–8.CrossRefGoogle Scholar