Background

There is limited knowledge on the influence of physical behaviors at work such as sitting, standing, low- (LIPA) and moderate-to-vigorous physical activity (MVPA) on sick leave due to pain. Studies addressing this relationship using valid objective measures of physical behaviors are scarce. The aim was to determine the prospective association between time-use compositions of physical behavior at work with sick leave trajectories due to musculoskeletal pain.

Methods

Data on 981 workers were analyzed in the DPHACTO cohort (2012-2014). Physical behaviors at work were assessed objectively at baseline using accelerometers, and the resulting time-line of exposure at work was classified as sitting, standing, low- (LIPA) and moderate-to-vigorous physical activity (MVPA). The number of days on sick leave due to musculoskeletal pain was reported using text messages at 4-week intervals across 1 year (14 waves in total). Latent class growth analysis was used to distinguish sub-groups with different trajectories of sick leave. Associations between time-use in physical behaviors and sick leave trajectories were determined using multinomial regression analysis with adjustment for age and gender. Compositional data analysis was used to account for the co-dependency of different behaviors.

Results

We identified four distinct trajectories of sick leave due to pain over one year as follows: no days (prevalence 76%), few days-increasing (19%), some days-decreasing (3%), and some days-increasing (2%). Spending more time in sitting relative to the other behaviors was associated with a reduced likelihood of few days-increasing sick leave (class 2 p<0.001), while time in LIPA was associated with an increased likelihood of some days-increasing sick leave (class 4 p=0.001).

Conclusion

We found that the time-use composition of physical behaviors at work was associated with sick leave trajectories due to pain over 1 year. Reducing time in occupational physical activities in favor of sitting may be useful for preventing sick leave due to musculoskeletal pain.