The association of pain with labor force participation, absenteeism, and presenteeism in Spain

Figures & data

Table 1.  Pain severity and frequency of pain, 2010 NHWS, weighted estimates, Spain.

Pain dimension	Distribution (%)
Pain level
Mild	24.17
Moderate	64.17
Severe	11.69
Total	100.00
Pain frequency
Daily	40.29
4–6 times a week	12.75
2–3 times a week	17.74
Weekly or less	29.22
Total	100.00
Pain level and frequency
Severe daily pain	9.45
Moderate daily pain	28.41
Pain and labor force status
Prevalence: labor force	17.36
Prevalence: not in the labor force	17.10
Prevalence: Pain severity and labor force status
Labor force: severe pain	1.43
Labor force: moderate pain	10.98
Labor force: mild pain	4.94
Not in the labor force: severe pain	2.93
Not in the labor force: moderate pain	11.20
Not in the labor force: mild pain	2.98

Source: NHWS, 2010.

Table 2.  Distribution by labor force status of persons reporting pain, 2010 NHWS, weighted estimates, Spain.

Labor force status	Persons reporting no pain (%)	Persons reporting pain (%)	Persons reporting mild pain (%)	Persons reporting moderate pain (%)	Persons reporting severe pain (%)
Employed full-time	37.65	34.57	44.94	33.31	20.16
Employed part-time	6.30	7.94	9.99	7.53	6.02
Self-employed	6.12	7.02	5.72	8.30	2.67
Unemployed	10.58	11.51	11.33	11.13	14.16
Not in labor force	39.34	38.92	28.01	39.73	57.00
Total	100.00	100.00	100.00	100.00	100.00

Source: NHWS, 2010.

Table 3.  Workplace productivity and activity impairment scale: Impact of health problems on absenteeism in the past 7 days, 2010 NHWS, weighted estimates, Spain.

Absenteeism: Percentage of worktime lost	All persons (%)	Persons reporting ‘no pain’ (%)	Persons reporting ‘pain’ (%)
0–9 (Health problems had no effect on my work)	90.36	92.65	79.20
10–19	2.56	2.02	5.19
20–29	1.69	1.32	3.45
30–49	1.45	1.33	2.01
50 and over	3.96	2.68	10.14
Total	100.00	100.00	100.00

Source: NHWS, 2010.

Table 4.  Workplace productivity and activity impairment scale: Impact of health problems on presenteeism in the past 7 days, 2010 NHWS, weighted estimates, Spain.

Presenteeism responses	All persons (%)	Persons reporting ‘no pain’ (%)	Persons reporting ‘pain’ (%)
0 (Health problems had no effect on my work)	51.79	55.09	34.54
1	12.36	12.31	12.67
2	9.82	9.07	13.77
3	5.49	5.22	6.87
4	2.66	2.07	5.78
5	5.99	5.91	6.44
6	5.66	5.09	8.66
7	3.22	2.64	6.28
8	1.86	1.53	3.56
9 and over	1.14	1.08	1.44
Total	100.00	100.00	100.00

Source: NHWS, 2010.

Table 5.  Distribution of independent variables, 2010 NHWS, weighted estimates, Spain.

Independent variables	Weighted estimates
	No pain (%)	Pain (%)
Socio-demographic variables
Age: 18–39 years	32.49	24.49
Age: 40–59 years	34.59	47.17
Age: 60 years and older	32.92	28.34
Gender: female	49.25	60.33
Gender: male	50.75	39.67
Education: University or higher	25.17	23.19
Education: High school completed	55.05	53.68
Education: Other	19.77	23.13
Income: Under €20,000	29.02	28.75
Income: €20,000–€39,999	44.45	47.02
Income: €40,000 and above	10.89	11.20
Income reporting declined	15.64	13.03
Health risk behaviors
BMI: Underweight	2.01	2.05
BMI: Normal weight	38.47	32.18
BMI: Overweight	42.13	41.90
BMI: Obese or morbidly obese	17.39	23.87
Current smoker	21.97	23.81
Alcohol user (>2 days month)	10.38	9.00
Morbidity/Comorbidity Status
Charlson Comorbidity Index (SD)	0.328 (0.820)	0.575 (1.060)

SD, standard deviation.

Source: NHWS, 2010.

Table 6.  Labor force participation regressions, 2010 NHWS, Spain.

Regression model	Logit Model I			Logit Model II
independent variables	Odds ratio	p > |z|	95% CI	Odds ratio	p > |z|	95% CI
Pain level reported in last month*
Mild	1.555	0.035	1.031–2.344
Moderate	0.852	0.198	0.667–1.087
Severe	0.356	0.000	0.217–0.585
Pain level and frequency*
Severe daily pain				0.363	0.000	0.206–0.637
Severe pain less than daily				0.322	0.017	0.127–0.814
Moderate daily pain				0.618	0.005	0.441–0.867
Moderate pain less then daily				1.093	0.599*	0.784–1.524
Mild pain				1.554	0.035	1.031–2.343
Socio-demographic variables
Age: 40–59 years^a	1.588	0.000	1.338–1.884	1.599	0.000	1.347–1.899
Age: 60 years and older^a	0.063	0.000	0.051–0.077	0.064	0.000	0.052–0.078
Gender: male^b	1.173	0.053*	0.998–1.379	1.168	0.059*	0.994–1.373
Education: high school completed^c	1.818	0.000	1.486–2.224	1.822	0.000	1.489–2.230
Education: University or higher^c	3.293	0.000	2.610–4.155	3.289	0.000	2.607–4.150
Health risk behaviors
BMI: Underweight^d	1.158	0.534*	0.729–1.839	1.168	0.512*	0.734–1.859
BMI: Overweight^d	1.165	0.096*	0.973–1.394	1.173	0.082*	0.980–1.404
BMI: Obese or morbidly obese^d	0.998	0.989*	0.801–1.245	1.009	0.939*	0.809–1.258
Current smoker^e	1.526	0.000	1.262–1.846	1.527	0.000	1.263–1.846
Alcohol user^f	0.968	0.816*	0.739–1.269	0.971	0.834*	0.741–1.274
Morbidity/comorbidity status
Charlson Comorbidity Index	0.857	0.000	0.788–0.931	0.857	0.000	0.789–0.932
n	4992			4992
Log pseudo likelihood	−3587.48			−3582.40
Pseudo R^2	0.329			0.330

All variables significant at 5% level except (*).

Reference categories: * no pain reported in last month; ^aaged 18–39 years; ^bfemales; ^cnot completed high school; ^dBMI normal weight; ^enon-smoker; ^fnon-drinker.

Table 7.  Labor force participation multinomial regression: Predicted relative probabilities for severe and moderate daily pain, 2010 NHWS, Spain.

Labor force status	Mild pain	Moderate pain	Severe pain	Moderate daily pain	Severe daily pain
Employed full-time
Pain	0.461	0.334	0.192	0.282	0.209
No pain	0.401	0.413	0.408	0.410	0.407
Employed part-time
Pain	0.108	0.078	0.058	0.058	0.061
No pain	0.069	0.069	0.070	0.071	0.070
Self-employed
Pain	0.065	0.098	0.033	0.103	0.027
No pain	0.073	0.070	0.074	0.071	0.074
Unemployed
Pain	0.114	0.104	0.104	0.093	0.093
No pain	0.110	0.111	0.110	0.111	0.110
Not in the labor force
Pain	0.253	0.387	0.615	0.465	0.611
No pain	0.347	0.337	0.338	0.337	0.339

Table 8.  Absenteeism ordered regression results, 2010 NHWS, Spain.

Regression model	Logit Model I			Logit Model II
independent variables	Odds ratio	p > |z|	95% CI	Odds ratio	p > |z|	95% CI
Pain level reported in last month*
Mild	2.146	0.005	1.255–3.671
Moderate	3.192	0.000	2.230–4.567
Severe	13.766	0.000	5.251–36.085
Pain level and frequency*
Severe daily pain				16.216	0.000	5.127–51.283
Severe pain and less than daily				7.086	0.007	1.716–29.256
Moderate daily pain				4.559	0.000	2.640–7.873
Moderate pain and less than daily				2.582	0.000	1.679–3.972
Mild pain				2.146	0.005	1.254–3.672
Socio-demographic variables
Age: 40–59 years^a	0.659	0.008	0.484–0.898	0.659	0.008	0.484–0.898
Age: 60 years and older^a	0.884	0.675*	0.496–1.576	0.875	0.656*	0.486–1.576
Gender: male^b	0.811	0.186*	0.594–1.106	0.815	0.201*	0.596–1.115
Education: high school completed^c	0.847	0.496*	0.525–1.366	0.858	0.531*	0.530–1.387
Education: University or higher^c	0.681	0.154*	0.401–1.155	0.695	0.181*	0.409–1.184
Income: €20,000–€39,999^d	0.828	0.325*	0.568–1.206	0.816	0.293*	0.558–1.193
Income: €40,000 and above^d	0.986	0.952*	0.618–1.573	0.981	0.936*	0.612–1.572
Income: Reporting declined^d	1.029	0.911*	0.629–1.681	1.028	0.911*	0.629–1.680
Health risk behaviors
BMI: Underweight^e	2.639	0.007*	1.297–5.368	2.612	0.007	1.293–5.278
BMI: Overweight^e	1.151	0.424	0.816–1.623	1.153	0.418*	0.817–1.628
BMI: Obese or morbidly obese^e	1.560	0.035	1.031–2.359	1.554	0.038	1.024–2.360
Current smoker^f	0.890	0.487*	0.640–1.236	0.894	0.506*	0.643–1.243
Alcohol user^g	1.180	0.490*	0.737–1.888	1.201	0.444*	0.751–1.921
Morbidity/comorbidity status
Charlson Comorbidity Index	1.458	0.000	1.276–1.666	1.460	0.000	1.279–1.666
n	2615			2615
Log pseudo likelihood	−1821.81			−1818.73
Pseudo R^2	0.0557			0.0573

All variables significant at the 5% level except (*).

Reference categories: * no pain reported in last month; ^aaged 18–39 years; ^bfemales; ^cnot completed high school; ^dincome under €20,000; ^eBMI normal weight; ^fnon-smoker; ^gnon-drinker.

Table 9.  Presenteeism ordered regression results, 2010 NHWS, Spain.

Regression model	Logit Model I			Logit Model II
independent variables	Odds ratio	p > |z|	95% CI	Odds ratio	p > |z|	95% CI
Pain level reported in last month*
Mild	1.684	0.001	1.228–2.308
Moderate	2.275	0.000	1.809–2.862
Severe	6.294	0.000	2.302–17.206
Pain level and frequency*
Severe daily pain				6.797	0.000	2.743–16.842
Severe pain and less than daily				3.757	0.532*	0.059–237.906
Moderate daily pain				2.271	0.000	1.480–3.483
Moderate pain and less than daily				2.278	0.000	1.763–2.943
Mild pain				1.684	0.001	1.228–2.308
Socio-demographic variables
Age: 40–59 years^a	0.663	0.000	0.563–0.780	0.663	0.000	0.563–0.780
Age: 60 years and older^a	0.543	0.000	0.396–0.745	0.542	0.000	0.395–0.744
Gender: male^b	0.873	0.101	0.742–1.027	0.872	0.100	0.742–1.026
Education: high school completed^c	1.001	0.992*	0.766–1.310	1.002	0.989*	0.766–1.310
Education: University or higher^c	0.956	0.764*	0.715–1.280	0.957	0.767*	0.715–1.281
Income: €20,000–€39,999^d	0.954	0.652*	0.776–1.172	0.955	0.662*	0.777–1.174
Income: €40,000 and above^d	0.945	0.691*	0.715–1.249	0.947	0.700*	0.716–1.251
Income: Reporting declined^d	0.925	0.583*	0.699–1.222	0.926	0.592*	0.701–1.225
Health risk behaviors
BMI: Underweight^e	0.820	0.510*	0.455–1.478	0.820	0.510*	0.455–1.478
BMI: Overweight^e	0.988	0.894*	0.830–1.176	0.989	0.898*	0.831–1.177
BMI: Obese or morbidly obese^e	1.033	0.784*	0.819–1.302	1.034	0.776*	0.820–1.304
Current smoker^f	0.782	0.007	0.654–0.933	0.782	0.007	0.655–0.934
Alcohol user^g	1.001	0.992*	0.749–1.339	1.003	0.986*	0.750–1.340
Morbidity/comorbidity status
Charlson Comorbidity Index	1.345	0.000	1.229–1.471	1.344	0.000	1.229–1.470
n	2565			2565
Log pseudo likelihood	−6235.89			−6235.72
Pseudo R^2	0.0184			0.0184

All variables significant at 5% level except (*).

Reference categories: * no pain reported in last month; ^aaged 18–39 years; ^bfemales; ^cnot completed high school; ^dincome under €20,000; ^eBMI normal weight; ^fnon-smoker; ^gnon-drinker.