What are the determinants of the sex/gender difference in duration of work absence for musculoskeletal disorders? A mixed-studies systematic review

Susan Stock, Scientific Group on Work-Related Musculoskeletal Disorders, Department of Environmental and Occupational Health and Toxicology, Quebec Institute of Public Health (INSPQ); University of Montreal Hospital Research Centre (CRCHUM); Department of Social & Preventive Medicine, University of Montreal School of Public Health
Nektaria Nicolakakis, Scientific Group on Work-Related Musculoskeletal Disorders, Department of Environmental and Occupational Health and Toxicology, Quebec Institute of Public Health (INSPQ)
Kimberley Cullen, SafetyNet Centre for Occupational Health and Safety Research, School of Human Kinetics & Recreation, Memorial University of Newfoundland
Clermont E. Dionne, Laval University Hospital Research Centre (Centre de Recherche du CHU de Québec-Université Laval), Department of Social and Preventive Medicine, Faculty of Medicine, Laval University
Renée-Louise Franche, School of Population and Public Health, University of British Columbia
Valérie Lederer, Department of Industrial Relations, University of Quebec in Outaouais (UQO)
Joy C. MacDermid, School of Physical Therapy, Western University
Ellen MacEachen, School of Public Health Sciences, Faculty of Health, University of Waterloo
Karen Messing, Interdisciplinary Research Centre on Well-Being, Health, Society and Environment (CINBIOSE), Department of Biological Sciences, University of Quebec in Montreal (UQAM)
Iuliana Nastasia, Institut de recherche Robert-Sauvé en Santé et en sécurité du travail (IRSST)Follow

ORCID

Iuliana Nastasia : 0000-0002-2696-4401

Type de document

Études primaires

Année de publication

2025

Langue

Anglais

Titre de la revue

Healthcare

Résumé

Background/Objectives: Musculoskeletal disorders (MSDs) contribute to work disability arising from personal and work-related physical, organizational and psychosocial factors that often differentially affect men and women. We aimed to identify determinants of the sex/gender difference in duration of MSD work absence through a mixed-studies systematic review. Methods: We synthesized evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach adapted to prognostic studies and meta-ethnography for qualitative studies, followed by a mixed synthesis. Results: Twenty-six quantitative and four qualitative studies contributed to the evidence synthesis. Only two of the twenty-six quantitative studies addressed the sex/gender gap directly, compared to three of the four qualitative studies. Most other quantitative studies provided evidence from sex/gender-stratified analyses of determinants of MSD disability. The synthesis of qualitative studies suggested that domestic strain, less access to modified work/retraining, and gender-biased attitudes of health and insurance system gatekeepers hindered women’s return to work. Prognostic factors in women supporting this conclusion from quantitative studies included the combination “working ≥ 40 h/week and having dependents” and low supervisor support. The mixed synthesis yielded a conceptual model of hypothesized determinants of the sex/gender difference in MSD work disability that integrates factors from personal, workplace, healthcare and insurance–disability management spheres, influenced by the larger sociopolitical, cultural and macroeconomic context. Conclusions: Studies directly addressing the sex/gender gap in MSD disability are needed. These can be informed by the proposed model. Practitioners and policymakers can build upon the model to develop and implement MSD prevention and rehabilitation interventions tailored to the needs of men and women to reduce sex/gender disparities.

Mots-clés

Troubles musculosquelettiques, Musculoskeletal disease, Différence liée au sexe, Sex difference, Absentéisme maladie, Sickness absenteeism, Invalidité, Disability, Revue de littérature, Literature review

Numéro de projet IRSST

n/a

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