Onset of neck pain after a motor vehicle accident: a case-control study

OBJECTIVE: To assess the relative contribution of constitutional (individual) factors, pre-accident health, psychological and workplace psychosocial factors, and accident related (mechanical) factors in the development of neck pain (whiplash) following a motor vehicle accident. METHODS: We conducted...

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Bibliographic Details
Published in:Journal of rheumatology 2005-08, Vol.32 (8), p.1576-1583
Main Authors: WILES, Nicola J, JONES, Gareth T, SILMAN, Alan J, MACFARLANE, Gary J
Format: Article
Language:English
Subjects:
Accidents, Traffic - statistics & numerical data
Adolescent
Adult
Aged
Biological and medical sciences
Case-Control Studies
Diseases of the osteoarticular system
Diseases of the spine
Female
Humans
Male
Medical sciences
Middle Aged
Neck Pain - epidemiology
Neck Pain - etiology
Postal Service
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Factors
Surveys and Questionnaires
Whiplash Injuries - epidemiology
Whiplash Injuries - etiology
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Summary:OBJECTIVE: To assess the relative contribution of constitutional (individual) factors, pre-accident health, psychological and workplace psychosocial factors, and accident related (mechanical) factors in the development of neck pain (whiplash) following a motor vehicle accident. METHODS: We conducted a case-control study of drivers (ages 17-70 yrs) who reported a motor vehicle accident to their insurance company. A self-report mailed questionnaire retrospectively collected information on the driver's pre- and post-accident health, details of the accident, and other exposure data. Case/control status (post-accident neck pain) was ascertained using a preshaded manikin. RESULTS: In total, 26% of drivers reported post-accident neck pain. Women, younger individuals, and those with a history of neck pain were more likely to report neck pain following their accident (OR 1.50, 95% CI 0.98, 2.28; OR 1.62, 95% CI 0.96, 2.74; OR 1.75, 95% CI 1.09, 2.81, respectively). In addition, a number of accident related and psychosocial factors were independently associated with reporting post-accident neck pain: collision from behind (OR 2.55, 95% CI 1.41, 4.62); vehicle stationary at impact (OR 1.93, 95% CI 1.12, 3.33); collision severity (upper vs lowest tertile: OR 16.1, 95% CI 8.64, 30.1); not being at fault (OR 2.61, 95% CI 1.49, 4.59); and monotonous work (OR 2.19, 95% CI 1.19, 4.04). Based on these 8 factors, the likelihood of having neck pain increased from 7% with < or = 2 risk factors to 62% with > or = 5. CONCLUSION: Development of neck pain after a motor vehicle accident is a complex phenomenon resulting from the combined effects of constitutional, mechanical, and psychosocial factors. Using 8 such variables it is possible to identify those at high risk of developing neck pain.
ISSN:0315-162X
1499-2752