The Cultural and Psychosocial Influences on Disability (CUPID) Cohort

Overview: The international CUPID cohort was incepted in the last quinquennium, coordinated at the MRC LEU. It includes 12,410 workers aged 20-59 years from 47 occupational groups in 18 countries across 5 continents.

Objective: To test the hypothesis that common musculoskeletal disorders and associated disability are importantly influenced by culturally determined health beliefs and expectations.

Methods: All participants completed a baseline questionnaire (where necessary translated, back-translated and amended) about occupational activities, psychosocial risk factors, musculoskeletal symptoms (including knowledge and beliefs about work-related musculoskeletal disorders) and disability. Participants who agreed were also sent a one-year follow-up questionnaire, asking about new or continuing symptoms. These questionnaire data have been supplemented by information from local collaborators about socio-economic circumstances (e.g. unemployment rates, availability of sick pay).

Key findings in the last quinquennium:

• There is wide variation in the prevalence of different musculoskeletal symptoms among workers from different occupations and cultures, with differences between people doing similar work that cannot be explained by differences in exposure to established risk factors, and more than 30-fold differences in rates of sickness absence (> 5 days) for musculoskeletal conditions⁶⁹⁴