Epidemiology of Pain in Canadian Alcohol Service Workers: Risk Factors for Chronic Pain

Epidemiology of Pain in Canadian Alcohol Service Workers: Risk Factors for Chronic Pain | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Epidemiology of Pain in Canadian Alcohol Service Workers: Risk Factors for Chronic Pain Mohammad Howard-Azzeh, Kristin Yates, Pete Driezen, Kate Bishop-Williams, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8398343/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background : Alcohol service workers face many unique work-related stressors that may increase their risk of chronic pain of chronic pain. To date, there are no comprehensive analyses that study chronic pain in this population. Therefore, the objective of this study was to examine the relationship between several personal and work-related variables on the odds of reporting chronic pain in alcohol service workers. Methods : The data for this study came from a cross-sectional survey of alcohol service workers that included the Nordic Musculoskeletal Questionnaire (NMQ) and several components of the Copenhagen Psychosocial Questionnaire (COPSOQ). A multivariable logistic regression model was fitted to investigate the associations between the odds of a chronic pain in alcohol service workers and the following variables: personal characteristics (gender identity, age, body mass index, self-rated health, burnout, and depressive symptoms), lifestyle factors (cardiovascular training, resistance training, cannabis use, high-risk drinking, and tobacco use), and work characteristics (job title, work type, emotional demands of work, work pace, and hours worked). Results : There were significantly higher odds of chronic pain with increased age, cannabis use, burnout, and emotionally demanding work. There were significantly lower odds of chronic pain among individuals who rated their health better and among individuals who frequently engaged in resistance training. Approximately half of the population reported chronic pain. Conclusion : This study highlights that good physical and mental health are likely protective against chronic pain in alcohol service workers, and individuals can likely improve their resilience to the difficult work environment by focusing on exercise, reducing substance use, and trying to reduce both work-related and personal stress. This study may increase awareness to the public, public health, and alcohol service communities of the effects of alcohol service work on chronic pain and may be used to educate those involved in this industry. chronic pain COPSOQ NMQ substance use exercise emotional job demands burnout alcohol cannabis health occupational health Figures Figure 1 Introduction Chronic pain is the cause of major occupational and public health challenges ( 1 ). Chronic pain reduces quality of life, restricts daily and occupational function, increases the risk of disability, and interferes with the ability to maintain physical and mental health ( 2 – 4 ). Chronic pain is also associated with increased risk of substance misuse ( 5 – 7 ). Globally, 20–30% of adults live with musculoskeletal conditions or chronic pain, making musculoskeletal conditions the leading cause of years lived with disability ( 8 – 10 ). In Canada, 15–19% of the adult population suffers from chronic pain ( 9 , 11 ). Chronic pain is strongly associated with occupational exposures, where an individual’s work may lead to disability, limiting their ability to continue working ( 12 – 16 ). In Canada, chronic pain likely affects 3–5 million adults and remains a leading cause of healthcare use and lost productivity ( 9 , 17 , 18 ). In the United States in 2018, the incidence of work-related musculoskeletal disease in the private sector was approximately 27 cases per 10,000 full-time workers, representing about 30% of all cases requiring days away from work ( 19 ). This highlights that work-related musculoskeletal disease and chronic pain substantially affect workforce well-being, productivity, and long-term disability risk. Alcohol services workers represent a unique occupational subgroup with distinct physical and psychosocial challenges. The unique environment that this population works in may cause these workers to be at elevated risk of chronic pain ( 20 – 22 ). Furthermore, alcohol service workers may be at a particular risk of the consequences of chronic pain, such as substance misuse ( 7 , 23 ). As alcohol is one of the leading substances for misuse and overdose death, alcohol service workers may experience compounded risk of the negative impacts of chronic pain ( 7 , 23 , 24 ). Although it is difficult to estimate the prevalence of any pain-related outcome, to our knowledge, there are no comprehensive estimates of chronic pain in alcohol service workers. More broadly, pain outcomes have been studied in other service populations such as kitchen or hotel workers, which typically show higher prevalences of pain-related outcomes than those of the general working population in the country where the study took place ( 20 , 25 – 29 ). While these studies did not focus specifically on alcohol service workers or chronic pain, they suggest that service-industry workers are subject to substantial adverse work exposures, such as work-related alcohol exposure, verbal threats, prolonged standing, repetitive motions, etc. ( 30 – 33 ) which may the increase risk of musculoskeletal pain among those working in the service/hospitality industry. Despite the known burden of chronic pain and musculoskeletal disease in Canada, alcohol service workers remain an understudied occupational subgroup. While some studies have described general wellness or identified ergonomic hazards among food and beverage staff ( 20 , 29 , 34 , 35 ), there are no epidemiologic studies assessing the prevalence of chronic pain or factors associated with chronic pain in alcohol service workers. The lack of Canadian data limits the development of targeted interventions tailored to this group. Therefore, using data recently obtained from a detailed survey of individuals working in the alcohol service industry, and as part of a compendium of studies on their health and wellbeing, we aim to fill this knowledge gap. The objective of this study was to identify personal, lifestyle, and work-related factors associated with chronic pain within the last year among individuals working in the alcohol service industry in Canada. The results of this study may be used to help establish the epidemiology of chronic pain in alcohol service workers, inform public health, support employers on minimizing the burdens imposed on this workforce, and help individuals be more risk aware. Methods Survey Data for this study were derived from a survey administered by the researchers/authors. The questionnaire included 84 items assessing general and workplace demographic characteristics, physical pain, and psychosocial well-being among workers in the alcohol service industry. Survey questions were adapted from the Nordic Musculoskeletal Questionnaire (NMQ) and the Copenhagen Psychosocial Questionnaire (COPSOQ) ( 36 , 37 ). Recruitment for survey participants occurred online. Interested workers were invited to participate voluntarily by scanning a Quick Response (QR) code, then entering an email address. A unique survey link was then generated in Qualtrics (Qualtrics LLC, Provo, UT) for each verified email address. Email addresses flagged by Qualtrics as duplicates, potential bots, or originating outside Canada (based on IP address) were excluded. Additional screening questions at the start of the survey confirmed that respondents resided in Canada and currently employed in the alcohol service industry. As an incentive, all participants who initiated the survey received a $ 30 gift card. This study was approved by the Conestoga College Research Ethics Board (REB#589), and all participants provided informed consent prior to participation. Data collection Survey recruitment primarily targeted alcohol service industry workers in southern Ontario, though a small number of participants were recruited from other regions within Canada (n = 56). Recruitment and survey administration occurred between February and July 2025, with surveys completed primarily online through Qualtrics or in person. Door-to-door recruitment was conducted at 225 alcohol serving establishments across multiple cities in southern Ontario. During each visit, a researcher briefly introduced the study to available staff. Interested individuals were provided with a one-page study overview containing a QR code linking to the survey sign-up form. Additional recruitment strategies included partnerships with industry-connected individuals, primarily based in Toronto, whose professional networks extended across Ontario and, in some cases, nationally. The study team also hosted a booth at a large professional convention, where researchers engaged directly with industry professionals, distributed study materials, and encouraged survey participation. Measures The following variables were used/generated from the survey: gender identity, age, self-rated health, body mass index (BMI), job title, cardiovascular training, resistance training, work type, cannabis use, high-risk alcohol use, tobacco use, emotional demands of work, burnout, depressive symptoms, work pace, and hours worked. Gender identity and age : Respondents reported their gender identity as “male”, “female”, “non-binary”, “transgender”, “two-spirit”, or “other”. For this study, responses were classified as “male”, “female”, or “non-binary/transgender”. Age was reported in years and grouped into four categories: 16–24, 25–35, 35–44, and 45 or older. As there were very few participants under the age of 19 (n = 17), they were grouped with those who were 19–24. Work type and job title : Work type was assessed by asking respondents which sector of the food and beverage industry they worked in, with options including “restaurant”, “bar”, “hotel/member club”, “nightclub/venue”, “casino/gaming”, “event/stadium”, “café/coffee shop”, “distillery/winery/brewery”, “retail”, and “other”. These were collapsed into five categories: “restaurant”, “bar”, “events/stadium”, “distillery/winery/brewery”, and “other”. Job title was evaluated using the question, “What is your current job title?” with options such as “owner”, “executive role”, “management”, “server/waiter/waitress”, “bartender”, “host/hostess/maître d’”, “bar help”, “sommelier”, “kitchen staff”, “cashier”, “stocker/shipping and receiving”, and “other”. These were collapsed into five categories: “bartender”, “server”, “management/executive/owner”, “kitchen staff”, and “other”. BMI and self-rated health : BMI was derived from self-reported weight and height and classified as underweight (BMI < 18.5), normal (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30) ( 38 ). Self-rated health was measured by asking respondents to rate their general health as “excellent”, “very good”, “good”, “fair”, or “poor.” These responses were classified into three categories for analysis: “poor/fair”, “good”, and “very good/excellent”. Substance use variables : High-risk drinking was measured with the question “How many alcoholic beverages do you have in a week? (1 drink = one beer, glass of wine, shot of liquor, or mixed drink)”. Responses were classified according to Canada’s Guidance on Alcohol and Health ( 39 ): “No risk (never consumes alcohol)”, “Low risk (1–2 drinks/week)”, “Moderate risk (3–6 drinks/week)”, and “Increasingly high risk (7 + drinks/week)”. Tobacco consumption was evaluated by asking respondents the question, “Do you consume tobacco? (examples include cigarettes, cigars, pipes, smokeless tobacco, and/or e-cigarettes/vapes)”. Response options were classified into three categories for analysis: “Never”, “Occasionally” (i.e., a few times per year, a few times per month, a few times per week), and “Every day”. Cannabis consumption was assessed using the question “Do you consume cannabis? (examples include cigarettes/joints, edibles, glassware, shatter, and/or e-cigarettes/vapes)”. Response options were classified into three categories for analysis: “Never”, “Less than weekly” (a few times per year, a few times per month), and “At least weekly” (A few times per week, every day). Workplace exposures : Emotional demands were assessed with two questions: “Do you have to deal with other people’s personal problems as part of your work?” and “Is your work emotionally demanding?”. Depressive symptoms were measured with two questions: “In the past 4 weeks, how often have you felt sad?” and “In the past 4 weeks, how often have you lacked interest in everyday things?”. Burnout was measured with four questions on fatigue and exhaustion (“During the last 4 weeks, how often have you felt worn out?”; “During the last 4 weeks, how often have you been physically exhausted?”; “During the last 4 weeks, how often have you been emotionally exhausted?”; “During the last 4 weeks, how often have you felt tired?”). Work pace was measured with two items: “Do you have to work very fast?” and “Do you work at a high pace throughout the day?”. To establish emotional demands, depressive symptoms, burnout, and work pace scores, researchers assigned a score to each question out of 100. As each of these domains were created from multiple questions, the average score was used for their respective variable. Physical activity : Cardiovascular training was measured with “How many minutes of moderate to vigorous aerobic/cardio activities do you engage in?”. Response options were “I do not engage in moderate to vigorous aerobic/cardio activities”, “Under 60 minutes per week”, “Between 60 and 120 minutes per week”, “Between 120 and 150 minutes per week”, “Over 150 minutes per week”. This information was collapsed into three categories: “None”, “120 minutes or less per week”, or “More than 120 minutes per week”. Lastly, resistance training was measured by asking respondents, “How many times per week do you engage in muscle strengthening activities?”. Respondents could answer “Never”, “1 day per week”, “2 days per week”, “3 days per week”, or “More than 3 days per week”. Chronic pain outcome The NMQ was used to evaluate the presence of chronic pain in respondents ( 36 ). The presence of pain in eight different body regions was measured: neck, shoulders, elbows/forearms, wrists/hands/fingers, upper back, lower back, knees/legs, and feet. Respondents were asked to indicate whether, during the previous 12 months, they had any problems (i.e., soreness, pain, numbness), in these parts of their body. For each body region, there were six possible response options: “No”, “Yes, for less than 24 hours”, “Yes, for 1–7 days”, “Yes, for 8–30 days”, “Yes, for more than 30 days”, and “Yes, it’s ongoing/permanent”. Respondents reporting pain lasting more than 30 days (“More than 30 days” + “Ongoing/permanent”) in at least one body region were classified as having chronic pain (vs. no pain or pain less than 30 days in any of the eight body regions identified by the NMQ). Statistical analysis Descriptive statistics, including means, medians, interquartile ranges, standard deviations, and 95% confidence, intervals were estimated. However, all descriptive statistics were reported based on the type of data (i.e., nominal, ordinal, or continuous) used for subsequent modelling. To examine the associations between predictor variables (gender identity, age, self-rated health, BMI, job title, cardiovascular training, resistance training, work type, cannabis use, high-risk drinking, tobacco use, emotional demands of work, burnout, depressive symptoms, work pace, and hours worked) and chronic pain, the data were fitted into a multivariable logistic regression model with the following method. The correlation between independent variables was examined using correlation coefficients (i.e., Pearson, Phi, and Spearman’s rank) depending on the type of independent variables. If the correlation between two variables was greater than |0.75|, the more causally plausible variable was retained in the model moving forward. Linearity between continuous independent variables and the log odds of an individual having chronic pain was assessed graphically using locally weighted scatterplot smoothing (LOWESS) curves. If the relationship was not linear, the independent variable was categorized, or if appropriate, modelled as a quadratic relationship with the addition of a squared term. Univariable logistic regression models between the independent variables and the log odds of having chronic pain were fitted to evaluate their associations. Independent variables with significant associations (α = 0.05) were considered for inclusion in a multivariable model. The dataset (n = 593) was analyzed using Stata 19 (StataCorp, College Station, TX). Forward variable selection was applied in logistic regression modelling. Predictor variables were added to the model one at a time from most to least significant, based on results from the univariable analyses. Biologically plausible two-way interactions that were identified a priori were assessed one at a time in the main effects model. Variables with more than two categories had their overall significance tested with a Wald’s χ 2 test. Variables that did not meet the statistical criteria in the forward model building process were re-introduced to the model, and if a given variable caused a 10% change or greater in any coefficient of another significant variable on its re-introduction, it was considered an explanatory antecedent (i.e., confounder if effect reduced) or distorter variable (i.e., effect increased or direction of association changed), given it met the causal criteria (i.e., non-intervening variable) based on the causal diagram (Fig. 1 ). Predictor variables were included in the final model if they were statistically significant (α = 0.05), were part of a statistically significant interaction, or acted as an explanatory antecedent or distorter to another predictor variable. Outliers were assessed using Pearson and deviance residuals. Model fit was evaluated using Pearson χ² goodness-of-fit test. Results Descriptive statistics Of all respondents (n = 595), approximately half (n = 297) reported experiencing pain lasting more than 30 days within the past year (i.e., chronic pain) (Table 1 ). Lower back (25%), feet (25%), and shoulders (21%) were the regions that were most often associated with chronic pain (Table 1 ). Most respondents identified as female (61%), while a small proportion identified as non-binary or transgender (2%) (Table 2 ). Respondents were primarily between 16 and 44 years of age, with a relatively small proportion over 45 years (16%). Most respondents reported having good, very good, or excellent self-rated health (87%), never having performed resistance training (36%), and performed 120 minutes or less of aerobic exercise per week (51%). About half had a “normal” or “underweight” BMI (50%). The most common job title was server/waiter/waitress (31%), and most respondents worked in restaurants (45%), compared to other service locations. More than half of all participants did not consume tobacco (59%), while over one-third met the criteria for increasingly high-risk drinking (34%). The median scores for burnout, depressive symptoms, work pace, and emotional demands were 56, 37, 75, and 62, respectively (Table 3 ). Table 1 – Frequencies of regions where there was pain lasting more than 30 days/ongoing/permanent pain in the last 12 months, among alcohol service worker survey respondents in Canada (2025). Body Region Frequency % Any body region 297 49.9 Neck 96 16.1 Shoulders 122 20.5 Elbows/forearms 39 6.6 Wrists/hands/fingers 84 14.1 Upper back 106 17.8 Lower back 151 25.4 Knees/legs 115 19.3 Feet 147 24.7 Table 2 – Frequencies of categorical variables from alcohol service worker survey respondents in Canada (2025). Variable Frequency % Chronic Pain 595 No self-reported chronic pain 298 50.1 Self-reported chronic pain 297 49.9 Gender Identity 595 Male 219 36.8 Female 364 61.2 Non-binary & transgender 12 2.0 Age 593 16–24 133 22.4 25–34 199 33.6 35–44 165 27.8 45+ 96 16.2 Ethnicity 592 White 420 70.9 Non-White 172 29.1 Self-Rated Health 595 Good/very good/excellent 518 87.1 Fair/poor 77 12.9 Aerobic Exercise 594 None 107 18.0 120 Minutes or less/week 301 50.6 >120 Minutes/week 186 31.3 Resistance Training 595 Never 217 36.5 1 day/week 94 15.8 2 days/week 108 18.1 3 days/week 97 16.3 4 + days/week 79 13.3 BMI 595 Normal/underweight 296 49.8 Overweight 180 30.3 Obese 111 18.7 Unknown 8 1.3 Cannabis Use 595 Never 276 46.4 Less than weekly 212 35.6 At least weekly 107 18.0 Tobacco Use 594 Never 350 58.9 Occasionally 162 27.2 Every day 82 13.8 High Risk Drinking 572 No risk (0 drinks/week) 123 21.5 Low risk (1–2 drinks/week) 131 22.9 Moderate risk (3–6 drinks/week) 125 21.9 Increasingly high risk (7 + drinks/week) 193 33.7 Work Type 592 Restaurant 265 44.8 Bar 145 24.5 Event/stadium 52 8.8 Distillery/winery/brewery 45 7.6 Other 85 14.4 Job Title 595 Server/waiter/waitress 184 30.9 Management/executive/owner 138 23.4 Kitchen staff 40 6.7 Other 72 12.1 Unknown 160 26.9 Table 3 Descriptive statistics of continuous variables from alcohol service worker survey respondents in Canada (2025). Mean (Standard Deviation) Median (Interquartile Range) Frequency Burnout 55.8 (26.5) 56 (37.5–75.0) 595 Depressive Symptoms 42.2 (27.8) 37.5 (25.0–62.5) 595 Work Pace 71.1 (19.6) 75 (62.5–87.5) 595 Emotional Demands 56.6 (27.1) 62.5 (37.5–75.0) 595 Univariable logistic regression models Our univariable models identified the following statistically significant associations with the odds of an alcohol service worker reporting chronic pain: gender identity, age, self-rated health, cannabis use, burnout, depressive symptoms, work pace, emotional demands, ethnicity, and resistance training (Table 4 ). Table 4 Results of univariable logistic regression models examining associations between each individual variable on the odds of alcohol service workers reporting chronic pain (2025). Variable Odd Ratio Lower CI* Upper CI P-Value % with Chronic pain Gender Identity Male Referent 42.0 Female 1.66 1.17 2.34 0.003 54.7 Non-binary & transgender 1.38 0.43 4.42 0.587 50.0 Age 16–24 Referent 38.3 25–34 1.30 0.83 2.04 0.249 44.7 35–44 2.41 1.51 3.85 0.000 60.0 45+ 2.34 1.37 4.02 0.002 59.4 Ethnicity White Referent 53.8 Non-White 0.60 0.42 0.86 0.006 40.6 Self-Rated Health Good/very good/excellent Referent 46.1 Fair/poor 3.56 2.06 6.17 < 0.001 75.3 Resistance Training Never Referent 55.3 1 day/week 0.68 0.42 1.11 0.122 45.7 2 days/week 0.90 0.57 1.44 0.667 52.8 3 days/week 0.79 0.49 1.28 0.340 49.5 4 + days/week 0.47 0.28 0.80 0.005 36.7 Cannabis Use Never Referent 42.8 Less than weekly 1.44 1.01 2.07 0.045 51.9 At least weekly 2.43 1.53 3.86 < 0.001 64.5 Burnout 1.03 1.02 1.04 < 0.001 Depressive Symptoms 1.01 1.01 1.02 < 0.001 Work Pace 1.02 1.01 1.02 < 0.001 Emotional Demands 1.02 1.02 1.03 1.0 2.11 0.047 55.0 Obese 1.26 0.81 1.95 0.302 51.4 Unknown 3.58 0.71 18.01 0.122 75.0 Aerobic Exercise None Referent 48.6 120 Minutes or less/week 1.28 0.82 2.00 0.269 54.8 >120 Minutes/week 0.78 0.48 1.26 0.310 42.5 Tobacco Use Never Referent 48.0 Occasionally 1.06 0.73 1.53 0.771 49.4 Every day 1.53 0.94 2.45 0.087 58.5 High Risk Drinking No risk (0 drinks/week) Referent 44.7 Low risk (1–2 drinks/week) 0.95 0.58 1.56 0.847 43.5 Moderate risk (3–6 drinks/week) 1.43 0.87 2.35 0.162 53.6 Increasingly high risk (7 + drinks/week) 1.54 0.98 2.42 0.064 55.4 Job Title Server/waiter/waitress Referent 47.3 Management/executive/owner 1.27 0.82 1.97 0.290 53.2 Kitchen staff 1.51 0.76 3.00 0.243 57.5 Other 0.75 0.43 1.31 0.312 40.3 Unknown 1.23 0.81 1.88 0.335 52.5 Work Type Restaurant Referent 47.9 Bar 1.38 0.92 2.07 0.125 55.9 Event/stadium 0.80 0.44 1.45 0.459 42.3 Distillery/winery/brewery 0.95 0.50 1.79 0.876 46.7 Other 1.11 0.68 1.81 0.669 100.0 *Confidence Interval Multivariable logistic regression model The variables that met the criteria for inclusion in the multivariable logistic regression model were age, self-rated health, cannabis use, burnout, resistance training, emotional demands, work pace, depressive symptoms, and gender identity (Table 5 ). Table 5 Results of a multivariable logistic regression model examining associations between self-reported variables on the odds of alcohol service workers reporting chronic pain (2025). Variable Adjusted Odds Ratio Lower CI* Upper CI P-Value Age 16–24 Referent 25–34 1.04 0.63 1.73 0.871 35–44 1.81 1.07 3.07 0.027 45+ 2.77 1.51 5.06 < 0.001 Self-Rated Health Good/very good/excellent Referent Fair/Poor 1.94 1.04 3.63 0.037 Cannabis Use Never Referent Less than weekly 1.17 0.79 1.76 0.433 At least weekly 1.88 1.12 3.16 0.016 Resistance Training Never Referent 1 day/week 0.66 0.38 1.14 0.135 2 days/week 1.00 0.59 1.69 0.993 3 days/week 0.85 0.50 1.46 0.561 4 + days/week 0.50 0.27 0.91 0.024 Burnout (0-100) 1.02 1.01 1.03 1.00 1.02 0.026 Work Pace (0-100) 1.01 1.00 0.227 Gender Identity Male Referent Female 1.25 0.85 1.83 0.264 Non-binary & transgender 0.84 0.23 3.04 0.789 *Confidence Interval The model's results highlight a positive association between age and chronic pain. Alcohol service workers who were 35 to 44 years of age and those who were 45 or older had significantly higher odds of reporting chronic pain relative to workers 16–24 years of age (Table 5 ). There were also higher odds of chronic pain in those who reported having poor or fair health when compared to alcohol service workers who reported having good, very good, or excellent health. Alcohol service workers who used cannabis at least weekly had significantly higher odds of reporting chronic pain than those who did not consume cannabis (Table 5 ). However, resistance training may have had a protective effect against chronic pain in alcohol service workers. Alcohol service workers who engaged in resistance training at least 4 times a week had significantly lower odds of having chronic pain compared to those who did not. There was a positive association between self-reported burnout and chronic pain. A 25% (25 points) increase in burnout scores was associated with 1.81 times the odds of reporting chronic pain (Table 5 ). Similarly, there was a positive association between emotional demands reported from alcohol service work and chronic pain. A 25% (25 points) increase in emotional demand scores was associated with 1.27 times the odds of reporting chronic pain. Discussion This study provides the first analyses aimed at identifying risk factors associated with chronic pain in Canadian alcohol service workers. Our dataset consisted of Canadian survey respondents who worked in the alcohol service industry, drawn largely from southern Ontario. Information from this survey was used to fit a logistic regression model to identify several personal factors that were associated with higher odds of reporting chronic pain within the last year. Chronic pain was present in approximately half the sample of survey respondents (Table 1 ). This is substantially higher prevalence compared with the general working populations in Canada, which is approximately 15–19% ( 9 , 11 ). Internationally, the epidemiological picture seems to be similar, depending on the region and definition, population-based studies indicate that chronic pain affects roughly 10–30% of adults ( 40 – 42 ). Direct comparisons are difficult as studies often use stricter definitions of chronic pain than the one used in this study, and the case definition directly affects prevalence estimates. However, these data suggest that chronic pain is likely more prevalent in alcohol service workers than the general working population and chronic pain could represent an under-recognized occupational health issue in this sector. The cross-sectional design of this study needs to be considered in the interpretation of the variables identified that are associated with chronic pain in alcohol service workers. Because of this, it is difficult to establish causality and the reason for the phenomena observed. However, the directions of the odds ratios are logical and align with previous literature on pain and health as discussed below. Self-rated health was inversely associated with chronic pain. There are many interrelated mechanisms that may be contributing to this association (Table 5 ). People with good health may be more resilient to the stress of work exposures and thus less likely to experience chronic pain. This effect was observed in other studies ( 43 ). However, poor perceived health may capture underlying physical comorbidities; therefore, the presence of pain may influence participants to rate their health as poor ( 44 ). It may also reflect broader psychosocial perceptions of themselves, such as perceived control, optimism, and self-efficacy, which may influence the perception of pain and ability to cope with pain, thereby influencing individuals to report both poor health and chronic pain. Similarly, resistance training was also inversely associated with chronic pain (Table 5 ). The more frequently that alcohol service workers engaged in resistance training, the less likely they were to report chronic pain. This may be because healthier and stronger people may be more resilient to chronic pain or more likely to recover from it. It is also possible that people who frequently engaged in resistance training are more comfortable with pain and are simply less likely to report chronic pain ( 45 ). This is consistent with evidence that physical activity improves chronic pain, pain tolerance, muscle strength/endurance, joint stability, and reduces systemic inflammation ( 46 – 48 ), and through these mechanisms, physical activity may increase their ability to tolerate occupational stress. However, it is also possible that alcohol service workers who experience chronic pain are more likely to avoid exercise. Previous studies have noted the relationship between physically demanding jobs and chronic pain, and that resistance training is recommended to help mitigate and rehabilitate workers suffering from chronic pain ( 49 ). The older alcohol service workers were, the higher the probability of them reporting chronic pain (Table 5 ). Older populations may be less resilient than younger populations and have had more opportunities to develop issues that may lead to chronic pain. Population-based studies demonstrate that the prevalence of chronic pain increases with age ( 9 , 11 ). Canadian data shows chronic pain affected approximately 10% of adults aged 15–24 but 35% of those aged 75 years and older ( 9 ). Cannabis use was positively associated with chronic pain. The frequency of cannabis use was associated with greater odds of reporting chronic pain (Table 5 ). This may be because the more frequently alcohol service workers consume cannabis, the less likely they are to take care of their health, placing them at a higher risk of chronic pain. However, people often report using cannabis because of pain, therefore some people may be using cannabis as a result of chronic pain, so chronic pain may increase the probability of cannabis use ( 50 – 52 ). In either case, the association underscores the complex relationship between pain and substance use in alcohol service workers that warrants further investigation. There were positive associations between burnout, emotionally demanding work, and the probability of chronic pain. This could be because those who suffer from burnout may be at a higher risk of chronic pain ( 53 , 54 ). Similarly, emotionally demanding jobs may increase the probability of chronic pain ( 54 ). Conversely, persistent pain can exacerbate burnout and emotional exhaustion and reduce resilience to external stresses and perceived job control, perpetuating a psychophysiological cycle of stress and pain ( 55 ). This aligns with the biopsychosocial model of pain, emphasizing that occupational environment, emotional state, and individual coping jointly shape chronic pain outcomes ( 56 , 57 ). The consistency and directionality of associations across age, self-rated health, exercise, substance use, burnout, and emotionally demanding work, reinforce a broader narrative: maintaining physical health and psychosocial well-being are essential to mitigating chronic pain risk in high-stress alcohol service occupations. Alcohol service work is characterized by irregular schedules, exposure to alcohol and other substances, customer aggression and harassment, and often poor job security. Each of these stresses can erode both physical and mental health. Resulting chronic pain in this context may represent not only a biomedical outcome but also a social indicator of cumulative occupational disadvantage ( 58 ). Therefore, bringing awareness of these findings to the affected population may help individuals protect themselves. Taking care of one’s health through exercise, reduction of substance use, and stress may make individuals more resilient to working in difficult environments, such as alcohol service establishments. From an organizational perspective, the associations between emotionally demanding work, burnout, and pain suggest that ergonomic or biomedical interventions alone may be insufficient. Organization-level interventions, such as improved scheduling practices, workload management, anti-harassment training, and supportive management cultures, may help reduce chronic stress and subsequent pain manifestation among employees. These findings align with frameworks such as the Total Worker Health model ( 59 ), which emphasizes integrated approaches addressing both physical and psychosocial risk factors. Those who manage alcohol service workers can help them be aware of the risk this environment has on alcohol service workers’ physical health and try to accommodate their ability to be resilient against work-related stresses, aiming to reduce stress and promote healthy choices for their workers. Reducing the burden of chronic pain among alcohol service workers may also mitigate downstream economic impacts, including lost productivity and increased health-care costs ( 18 , 60 , 61 ). At the population level, chronic pain among service workers has broader implications for substance use and mental health. Given the accessibility and use of alcohol and cannabis among people who work in these types of occupations, chronic, ongoing pain may disproportionately increase the risk of substance use disorders in alcohol service workers, reinforcing health inequities within this workforce ( 62 – 64 ). Therefore, addressing chronic pain could have downstream benefits for mental health and substance-related harms. Alcohol service work involves a combination of irregular and extended shift schedules, physically demanding tasks, emotionally demanding work conditions, and prolonged exposure to an alcohol-centred environment. Together, these occupational conditions may increase the risk of chronic pain through sustained physical strain, psychosocial stress, and limited opportunities to recover. Addressing chronic pain in this workforce is imperative and requires comprehensive and coordinated action from employers, policymakers, and public health organizations to implement evidence-based strategies that protect worker health and promote long-term resilience. Limitations and Future Direction Potential systematic biases should be considered when interpreting the results of this study. All measures were self-reported; therefore, they are subject to the bias of the individual and vary by individual. For example, substance use measures may be under reported, however, this does not necessarily mean the associations identified are biased. People who participated in this study were given $ 30 gift cards. This incentive may contribute to selecting a more similar population. Researchers relied on a combination of venue-based and snowball sampling methods. Probabilistic sampling would have resulted in more representative and less biased estimates. However, this sampling method allowed us to increase our sample size given our resources, increasing the statistical power of this study. Chronic pain could not be exclusively attributed to occupational causes; it is plausible that non-occupational stresses also contributed to the presence of chronic pain. Questions related to chronic pain did not specify what kind of pain they should be reporting, only the body region. Some body regions were not specifically identified and therefore may be missed. Furthermore, responses related to chronic pain are most likely associated with musculoskeletal pain, however, the questions did not directly specify musculoskeletal pain, and therefore some of the pain being reported may be related to other sources of pain, such as neuropathic pain. As this is the first study to find these associations, further studies are needed to support or refute these findings. It would be meaningful to study workplace-level factors, such as management practices or work intensity, that would help identify where organizational changes could occur to reduce chronic pain in this population. As alcohol service work puts workers in unique environments in relation to substance use and harassment, it would be meaningful to use the same dataset to understand risk factors that may lead to substance use or are associated with workplace harassment. Lastly, it would be important if future studies could focus on identifying a relationship between chronic pain and the risk of substance use disorders or substance-related death in this population. Conclusion This is the first comprehensive analysis to provide evidence that chronic pain is common among alcohol service workers in Canada and that both personal health and workplace factors play an important role in its occurrence. Approximately half of surveyed workers reported chronic pain in any one or more body regions, a rate that is substantially higher than that reported among the general working population. However, further studies are needed to refine these findings. Poorer self-rated health, older age, cannabis use, burnout, and emotionally demanding work were all associated with greater odds of chronic pain, while regular resistance training may be protective against it. These findings highlight that chronic pain in this workforce is not just a physical issue but one seemingly rooted in a mixture of lifestyle and work-related stresses. Addressing this issue will likely require a combination of personal health promotion and occupational changes that reduce stress and support workers’ physical and psychological well-being. Recognizing chronic pain as an occupational health concern in the service industry could help inform future interventions, guide workplace policy, and improve the quality of life for workers who are an essential part of Canada’s hospitality and alcohol service sectors. We hope this information can help individuals in this industry be more aware of risk factors that they may have some degree of control over. Studies of this nature on this population in various regions and scales are essential to strengthen our understanding of the stresses faced by this workforce. Declarations Ethics Approval This study was approved by the Conestoga College Research Ethics Board (REB#589). All participants provided informed consent prior to participation. The research was conducted in accordance with the ethical principles of the Declaration of Helsinki and consistent with the Tri-Council Policy Statement (TCPS-2) guidelines for ethical conduct in human research in Canada. Consent to Participate All respondents provided informed consent prior to completing the survey. Funding This study was funded by the Smart Serve Foundation. The Smart Serve Foundation was not involved in any other aspect of this project. Author Contribution MHA: Conceptualization, Methodology, Analysis, Validation, Data curation, Writing original draft, Review & editing. KY: Methodology, Investigation, Data curation, Review & editing. PD: Data curation, Validation, Review & editing. KBW: Review & editing. MY: Methodology, Review & editing, Supervision, Project administration. AY: Methodology, Review & editing, Supervision, Project administration. Acknowledgement We would like to thank the Smart Serve Foundation for funding this project. Without this funding, the project would not be possible. We would also like to thank Avneet Arora for her work on the figure in this manuscript. Data Availability The data used in this study are available from the authors upon reasonable request. 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Tataryn N, Simas V, Catterall T, et al. Posterior-chain resistance training compared to general exercise and walking programmes for the treatment of chronic low back pain. Sports Medicine – Open. 2021;7(1):17. Syroyid IS, Cavero-Redondo I, Syroyid BS. Effects of resistance training on pain control and physical function in older adults with low back pain. Journal of Geriatric Physical Therapy. 2023;46(3):E113–E126. Sundstrup E, Seeberg KGV, Bengtsen E, Andersen LL. A systematic review of workplace interventions to rehabilitate musculoskeletal disorders among employees with physically demanding work. Journal of Occupational Rehabilitation. 2020;30(4):588–612. Wang L, Hong PJ, May C, et al. Medical cannabis or cannabinoids for chronic non-cancer and cancer-related pain: a systematic review and meta-analysis of randomised clinical trials. The BMJ. 2021;374:n1034. Godbout-Parent M, Nguena Nguefack HL, Angarita-Fonseca A, et al. Prevalence of cannabis use for pain management in Quebec. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8398343","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":582255791,"identity":"fa21b937-d243-419d-acd1-df5cdbf7ef9b","order_by":0,"name":"Mohammad Howard-Azzeh","email":"data:image/png;base64,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","orcid":"","institution":"Canadian Institute for Safety, Wellness \u0026 Performance","correspondingAuthor":true,"prefix":"","firstName":"Mohammad","middleName":"","lastName":"Howard-Azzeh","suffix":""},{"id":582255792,"identity":"cd80c648-d1db-4181-bf30-f60769216086","order_by":1,"name":"Kristin Yates","email":"","orcid":"","institution":"Canadian Institute for Safety, Wellness \u0026 Performance","correspondingAuthor":false,"prefix":"","firstName":"Kristin","middleName":"","lastName":"Yates","suffix":""},{"id":582255793,"identity":"3cfd54d0-50ab-4954-95f4-bf87367d053e","order_by":2,"name":"Pete Driezen","email":"","orcid":"","institution":"Canadian Institute for Safety, Wellness \u0026 Performance","correspondingAuthor":false,"prefix":"","firstName":"Pete","middleName":"","lastName":"Driezen","suffix":""},{"id":582255794,"identity":"d7a4d2cd-5995-4837-b7ce-13e168831da0","order_by":3,"name":"Kate Bishop-Williams","email":"","orcid":"","institution":"Canadian Institute for Safety, Wellness \u0026 Performance","correspondingAuthor":false,"prefix":"","firstName":"Kate","middleName":"","lastName":"Bishop-Williams","suffix":""},{"id":582255795,"identity":"b060c08f-2138-48a1-8029-ba716d654b4c","order_by":4,"name":"Marcus Yung","email":"","orcid":"","institution":"Canadian Institute for Safety, Wellness \u0026 Performance","correspondingAuthor":false,"prefix":"","firstName":"Marcus","middleName":"","lastName":"Yung","suffix":""},{"id":582255796,"identity":"44e01981-c346-42ce-a676-1dce343f7a76","order_by":5,"name":"Amin Yazdani","email":"","orcid":"","institution":"Canadian Institute for Safety, Wellness \u0026 Performance","correspondingAuthor":false,"prefix":"","firstName":"Amin","middleName":"","lastName":"Yazdani","suffix":""}],"badges":[],"createdAt":"2025-12-18 18:53:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8398343/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8398343/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101526313,"identity":"fceb8db5-6027-47f3-8bef-5999b253dd3a","added_by":"auto","created_at":"2026-01-30 18:28:03","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":80853,"visible":true,"origin":"","legend":"\u003cp\u003eCausal diagram representing the causal relationships between personal and work-related factors and the odds of chronic pain in alcohol service workers (2025).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8398343/v1/8c96b9a55feae20c4445a2ac.png"},{"id":101752965,"identity":"7ef0ad22-a9f6-4422-bd94-34a9d37c278d","added_by":"auto","created_at":"2026-02-03 10:38:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1574744,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8398343/v1/5beb51da-fdb3-4846-89ea-a8edae69b906.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Epidemiology of Pain in Canadian Alcohol Service Workers: Risk Factors for Chronic Pain","fulltext":[{"header":"Introduction","content":"\u003cp\u003eChronic pain is the cause of major occupational and public health challenges (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Chronic pain reduces quality of life, restricts daily and occupational function, increases the risk of disability, and interferes with the ability to maintain physical and mental health (\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Chronic pain is also associated with increased risk of substance misuse (\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Globally, 20\u0026ndash;30% of adults live with musculoskeletal conditions or chronic pain, making musculoskeletal conditions the leading cause of years lived with disability (\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). In Canada, 15\u0026ndash;19% of the adult population suffers from chronic pain (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Chronic pain is strongly associated with occupational exposures, where an individual\u0026rsquo;s work may lead to disability, limiting their ability to continue working (\u003cspan additionalcitationids=\"CR13 CR14 CR15\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). In Canada, chronic pain likely affects 3\u0026ndash;5\u0026nbsp;million adults and remains a leading cause of healthcare use and lost productivity (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). In the United States in 2018, the incidence of work-related musculoskeletal disease in the private sector was approximately 27 cases per 10,000 full-time workers, representing about 30% of all cases requiring days away from work (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). This highlights that work-related musculoskeletal disease and chronic pain substantially affect workforce well-being, productivity, and long-term disability risk.\u003c/p\u003e \u003cp\u003eAlcohol services workers represent a unique occupational subgroup with distinct physical and psychosocial challenges. The unique environment that this population works in may cause these workers to be at elevated risk of chronic pain (\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Furthermore, alcohol service workers may be at a particular risk of the consequences of chronic pain, such as substance misuse (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). As alcohol is one of the leading substances for misuse and overdose death, alcohol service workers may experience compounded risk of the negative impacts of chronic pain (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Although it is difficult to estimate the prevalence of any pain-related outcome, to our knowledge, there are no comprehensive estimates of chronic pain in alcohol service workers. More broadly, pain outcomes have been studied in other service populations such as kitchen or hotel workers, which typically show higher prevalences of pain-related outcomes than those of the general working population in the country where the study took place (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan additionalcitationids=\"CR26 CR27 CR28\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). While these studies did not focus specifically on alcohol service workers or chronic pain, they suggest that service-industry workers are subject to substantial adverse work exposures, such as work-related alcohol exposure, verbal threats, prolonged standing, repetitive motions, etc. (\u003cspan additionalcitationids=\"CR31 CR32\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) which may the increase risk of musculoskeletal pain among those working in the service/hospitality industry.\u003c/p\u003e \u003cp\u003eDespite the known burden of chronic pain and musculoskeletal disease in Canada, alcohol service workers remain an understudied occupational subgroup. While some studies have described general wellness or identified ergonomic hazards among food and beverage staff (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e), there are no epidemiologic studies assessing the prevalence of chronic pain or factors associated with chronic pain in alcohol service workers. The lack of Canadian data limits the development of targeted interventions tailored to this group. Therefore, using data recently obtained from a detailed survey of individuals working in the alcohol service industry, and as part of a compendium of studies on their health and wellbeing, we aim to fill this knowledge gap. The objective of this study was to identify personal, lifestyle, and work-related factors associated with chronic pain within the last year among individuals working in the alcohol service industry in Canada. The results of this study may be used to help establish the epidemiology of chronic pain in alcohol service workers, inform public health, support employers on minimizing the burdens imposed on this workforce, and help individuals be more risk aware.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSurvey\u003c/h2\u003e \u003cp\u003eData for this study were derived from a survey administered by the researchers/authors. The questionnaire included 84 items assessing general and workplace demographic characteristics, physical pain, and psychosocial well-being among workers in the alcohol service industry. Survey questions were adapted from the Nordic Musculoskeletal Questionnaire (NMQ) and the Copenhagen Psychosocial Questionnaire (COPSOQ) (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRecruitment for survey participants occurred online. Interested workers were invited to participate voluntarily by scanning a Quick Response (QR) code, then entering an email address. A unique survey link was then generated in Qualtrics (Qualtrics LLC, Provo, UT) for each verified email address. Email addresses flagged by Qualtrics as duplicates, potential bots, or originating outside Canada (based on IP address) were excluded. Additional screening questions at the start of the survey confirmed that respondents resided in Canada and currently employed in the alcohol service industry. As an incentive, all participants who initiated the survey received a \u003cspan\u003e$\u003c/span\u003e30 gift card. This study was approved by the Conestoga College Research Ethics Board (REB#589), and all participants provided informed consent prior to participation.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eSurvey recruitment primarily targeted alcohol service industry workers in southern Ontario, though a small number of participants were recruited from other regions within Canada (n\u0026thinsp;=\u0026thinsp;56). Recruitment and survey administration occurred between February and July 2025, with surveys completed primarily online through Qualtrics or in person.\u003c/p\u003e \u003cp\u003eDoor-to-door recruitment was conducted at 225 alcohol serving establishments across multiple cities in southern Ontario. During each visit, a researcher briefly introduced the study to available staff. Interested individuals were provided with a one-page study overview containing a QR code linking to the survey sign-up form.\u003c/p\u003e \u003cp\u003eAdditional recruitment strategies included partnerships with industry-connected individuals, primarily based in Toronto, whose professional networks extended across Ontario and, in some cases, nationally. The study team also hosted a booth at a large professional convention, where researchers engaged directly with industry professionals, distributed study materials, and encouraged survey participation.\u003c/p\u003e\n\u003ch3\u003eMeasures\u003c/h3\u003e\n\u003cp\u003eThe following variables were used/generated from the survey: gender identity, age, self-rated health, body mass index (BMI), job title, cardiovascular training, resistance training, work type, cannabis use, high-risk alcohol use, tobacco use, emotional demands of work, burnout, depressive symptoms, work pace, and hours worked.\u003c/p\u003e \u003cp\u003e \u003cb\u003eGender identity and age\u003c/b\u003e: Respondents reported their gender identity as \u0026ldquo;male\u0026rdquo;, \u0026ldquo;female\u0026rdquo;, \u0026ldquo;non-binary\u0026rdquo;, \u0026ldquo;transgender\u0026rdquo;, \u0026ldquo;two-spirit\u0026rdquo;, or \u0026ldquo;other\u0026rdquo;. For this study, responses were classified as \u0026ldquo;male\u0026rdquo;, \u0026ldquo;female\u0026rdquo;, or \u0026ldquo;non-binary/transgender\u0026rdquo;. Age was reported in years and grouped into four categories: 16\u0026ndash;24, 25\u0026ndash;35, 35\u0026ndash;44, and 45 or older. As there were very few participants under the age of 19 (n\u0026thinsp;=\u0026thinsp;17), they were grouped with those who were 19\u0026ndash;24.\u003c/p\u003e \u003cp\u003e \u003cb\u003eWork type and job title\u003c/b\u003e: Work type was assessed by asking respondents which sector of the food and beverage industry they worked in, with options including \u0026ldquo;restaurant\u0026rdquo;, \u0026ldquo;bar\u0026rdquo;, \u0026ldquo;hotel/member club\u0026rdquo;, \u0026ldquo;nightclub/venue\u0026rdquo;, \u0026ldquo;casino/gaming\u0026rdquo;, \u0026ldquo;event/stadium\u0026rdquo;, \u0026ldquo;caf\u0026eacute;/coffee shop\u0026rdquo;, \u0026ldquo;distillery/winery/brewery\u0026rdquo;, \u0026ldquo;retail\u0026rdquo;, and \u0026ldquo;other\u0026rdquo;. These were collapsed into five categories: \u0026ldquo;restaurant\u0026rdquo;, \u0026ldquo;bar\u0026rdquo;, \u0026ldquo;events/stadium\u0026rdquo;, \u0026ldquo;distillery/winery/brewery\u0026rdquo;, and \u0026ldquo;other\u0026rdquo;.\u003c/p\u003e \u003cp\u003eJob title was evaluated using the question, \u0026ldquo;What is your current job title?\u0026rdquo; with options such as \u0026ldquo;owner\u0026rdquo;, \u0026ldquo;executive role\u0026rdquo;, \u0026ldquo;management\u0026rdquo;, \u0026ldquo;server/waiter/waitress\u0026rdquo;, \u0026ldquo;bartender\u0026rdquo;, \u0026ldquo;host/hostess/ma\u0026icirc;tre d\u0026rsquo;\u0026rdquo;, \u0026ldquo;bar help\u0026rdquo;, \u0026ldquo;sommelier\u0026rdquo;, \u0026ldquo;kitchen staff\u0026rdquo;, \u0026ldquo;cashier\u0026rdquo;, \u0026ldquo;stocker/shipping and receiving\u0026rdquo;, and \u0026ldquo;other\u0026rdquo;. These were collapsed into five categories: \u0026ldquo;bartender\u0026rdquo;, \u0026ldquo;server\u0026rdquo;, \u0026ldquo;management/executive/owner\u0026rdquo;, \u0026ldquo;kitchen staff\u0026rdquo;, and \u0026ldquo;other\u0026rdquo;.\u003c/p\u003e \u003cp\u003e \u003cb\u003eBMI and self-rated health\u003c/b\u003e: BMI was derived from self-reported weight and height and classified as underweight (BMI\u0026thinsp;\u0026lt;\u0026thinsp;18.5), normal (18.5\u0026thinsp;\u0026le;\u0026thinsp;BMI\u0026thinsp;\u0026lt;\u0026thinsp;25), overweight (25\u0026thinsp;\u0026le;\u0026thinsp;BMI\u0026thinsp;\u0026lt;\u0026thinsp;30), and obese (BMI\u0026thinsp;\u0026ge;\u0026thinsp;30) (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Self-rated health was measured by asking respondents to rate their general health as \u0026ldquo;excellent\u0026rdquo;, \u0026ldquo;very good\u0026rdquo;, \u0026ldquo;good\u0026rdquo;, \u0026ldquo;fair\u0026rdquo;, or \u0026ldquo;poor.\u0026rdquo; These responses were classified into three categories for analysis: \u0026ldquo;poor/fair\u0026rdquo;, \u0026ldquo;good\u0026rdquo;, and \u0026ldquo;very good/excellent\u0026rdquo;.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSubstance use variables\u003c/b\u003e: High-risk drinking was measured with the question \u0026ldquo;How many alcoholic beverages do you have in a week? (1 drink\u0026thinsp;=\u0026thinsp;one beer, glass of wine, shot of liquor, or mixed drink)\u0026rdquo;. Responses were classified according to Canada\u0026rsquo;s Guidance on Alcohol and Health (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e): \u0026ldquo;No risk (never consumes alcohol)\u0026rdquo;, \u0026ldquo;Low risk (1\u0026ndash;2 drinks/week)\u0026rdquo;, \u0026ldquo;Moderate risk (3\u0026ndash;6 drinks/week)\u0026rdquo;, and \u0026ldquo;Increasingly high risk (7\u0026thinsp;+\u0026thinsp;drinks/week)\u0026rdquo;. Tobacco consumption was evaluated by asking respondents the question, \u0026ldquo;Do you consume tobacco? (examples include cigarettes, cigars, pipes, smokeless tobacco, and/or e-cigarettes/vapes)\u0026rdquo;. Response options were classified into three categories for analysis: \u0026ldquo;Never\u0026rdquo;, \u0026ldquo;Occasionally\u0026rdquo; (i.e., a few times per year, a few times per month, a few times per week), and \u0026ldquo;Every day\u0026rdquo;. Cannabis consumption was assessed using the question \u0026ldquo;Do you consume cannabis? (examples include cigarettes/joints, edibles, glassware, shatter, and/or e-cigarettes/vapes)\u0026rdquo;. Response options were classified into three categories for analysis: \u0026ldquo;Never\u0026rdquo;, \u0026ldquo;Less than weekly\u0026rdquo; (a few times per year, a few times per month), and \u0026ldquo;At least weekly\u0026rdquo; (A few times per week, every day).\u003c/p\u003e \u003cp\u003e \u003cb\u003eWorkplace exposures\u003c/b\u003e: Emotional demands were assessed with two questions: \u0026ldquo;Do you have to deal with other people\u0026rsquo;s personal problems as part of your work?\u0026rdquo; and \u0026ldquo;Is your work emotionally demanding?\u0026rdquo;. Depressive symptoms were measured with two questions: \u0026ldquo;In the past 4 weeks, how often have you felt sad?\u0026rdquo; and \u0026ldquo;In the past 4 weeks, how often have you lacked interest in everyday things?\u0026rdquo;. Burnout was measured with four questions on fatigue and exhaustion (\u0026ldquo;During the last 4 weeks, how often have you felt worn out?\u0026rdquo;; \u0026ldquo;During the last 4 weeks, how often have you been physically exhausted?\u0026rdquo;; \u0026ldquo;During the last 4 weeks, how often have you been emotionally exhausted?\u0026rdquo;; \u0026ldquo;During the last 4 weeks, how often have you felt tired?\u0026rdquo;). Work pace was measured with two items: \u0026ldquo;Do you have to work very fast?\u0026rdquo; and \u0026ldquo;Do you work at a high pace throughout the day?\u0026rdquo;.\u003c/p\u003e \u003cp\u003eTo establish emotional demands, depressive symptoms, burnout, and work pace scores, researchers assigned a score to each question out of 100. As each of these domains were created from multiple questions, the average score was used for their respective variable.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePhysical activity\u003c/b\u003e: Cardiovascular training was measured with \u0026ldquo;How many minutes of moderate to vigorous aerobic/cardio activities do you engage in?\u0026rdquo;. Response options were \u0026ldquo;I do not engage in moderate to vigorous aerobic/cardio activities\u0026rdquo;, \u0026ldquo;Under 60 minutes per week\u0026rdquo;, \u0026ldquo;Between 60 and 120 minutes per week\u0026rdquo;, \u0026ldquo;Between 120 and 150 minutes per week\u0026rdquo;, \u0026ldquo;Over 150 minutes per week\u0026rdquo;. This information was collapsed into three categories: \u0026ldquo;None\u0026rdquo;, \u0026ldquo;120 minutes or less per week\u0026rdquo;, or \u0026ldquo;More than 120 minutes per week\u0026rdquo;. Lastly, resistance training was measured by asking respondents, \u0026ldquo;How many times per week do you engage in muscle strengthening activities?\u0026rdquo;. Respondents could answer \u0026ldquo;Never\u0026rdquo;, \u0026ldquo;1 day per week\u0026rdquo;, \u0026ldquo;2 days per week\u0026rdquo;, \u0026ldquo;3 days per week\u0026rdquo;, or \u0026ldquo;More than 3 days per week\u0026rdquo;.\u003c/p\u003e\n\u003ch3\u003eChronic pain outcome\u003c/h3\u003e\n\u003cp\u003eThe NMQ was used to evaluate the presence of chronic pain in respondents (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). The presence of pain in eight different body regions was measured: neck, shoulders, elbows/forearms, wrists/hands/fingers, upper back, lower back, knees/legs, and feet. Respondents were asked to indicate whether, during the previous 12 months, they had any problems (i.e., soreness, pain, numbness), in these parts of their body. For each body region, there were six possible response options: \u0026ldquo;No\u0026rdquo;, \u0026ldquo;Yes, for less than 24 hours\u0026rdquo;, \u0026ldquo;Yes, for 1\u0026ndash;7 days\u0026rdquo;, \u0026ldquo;Yes, for 8\u0026ndash;30 days\u0026rdquo;, \u0026ldquo;Yes, for more than 30 days\u0026rdquo;, and \u0026ldquo;Yes, it\u0026rsquo;s ongoing/permanent\u0026rdquo;. Respondents reporting pain lasting more than 30 days (\u0026ldquo;More than 30 days\u0026rdquo; + \u0026ldquo;Ongoing/permanent\u0026rdquo;) in at least one body region were classified as having chronic pain (vs. no pain or pain less than 30 days in any of the eight body regions identified by the NMQ).\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eDescriptive statistics, including means, medians, interquartile ranges, standard deviations, and 95% confidence, intervals were estimated. However, all descriptive statistics were reported based on the type of data (i.e., nominal, ordinal, or continuous) used for subsequent modelling.\u003c/p\u003e \u003cp\u003eTo examine the associations between predictor variables (gender identity, age, self-rated health, BMI, job title, cardiovascular training, resistance training, work type, cannabis use, high-risk drinking, tobacco use, emotional demands of work, burnout, depressive symptoms, work pace, and hours worked) and chronic pain, the data were fitted into a multivariable logistic regression model with the following method. The correlation between independent variables was examined using correlation coefficients (i.e., Pearson, Phi, and Spearman\u0026rsquo;s rank) depending on the type of independent variables. If the correlation between two variables was greater than |0.75|, the more causally plausible variable was retained in the model moving forward. Linearity between continuous independent variables and the log odds of an individual having chronic pain was assessed graphically using locally weighted scatterplot smoothing (LOWESS) curves. If the relationship was not linear, the independent variable was categorized, or if appropriate, modelled as a quadratic relationship with the addition of a squared term. Univariable logistic regression models between the independent variables and the log odds of having chronic pain were fitted to evaluate their associations. Independent variables with significant associations (α\u0026thinsp;=\u0026thinsp;0.05) were considered for inclusion in a multivariable model. The dataset (n\u0026thinsp;=\u0026thinsp;593) was analyzed using Stata 19 (StataCorp, College Station, TX).\u003c/p\u003e \u003cp\u003eForward variable selection was applied in logistic regression modelling. Predictor variables were added to the model one at a time from most to least significant, based on results from the univariable analyses. Biologically plausible two-way interactions that were identified \u003cem\u003ea priori\u003c/em\u003e were assessed one at a time in the main effects model. Variables with more than two categories had their overall significance tested with a Wald\u0026rsquo;s χ\u003csup\u003e2\u003c/sup\u003e test. Variables that did not meet the statistical criteria in the forward model building process were re-introduced to the model, and if a given variable caused a 10% change or greater in any coefficient of another significant variable on its re-introduction, it was considered an explanatory antecedent (i.e., confounder if effect reduced) or distorter variable (i.e., effect increased or direction of association changed), given it met the causal criteria (i.e., non-intervening variable) based on the causal diagram (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Predictor variables were included in the final model if they were statistically significant (α\u0026thinsp;=\u0026thinsp;0.05), were part of a statistically significant interaction, or acted as an explanatory antecedent or distorter to another predictor variable. Outliers were assessed using Pearson and deviance residuals. Model fit was evaluated using Pearson χ\u0026sup2; goodness-of-fit test.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eDescriptive statistics\u003c/h2\u003e \u003cp\u003eOf all respondents (n\u0026thinsp;=\u0026thinsp;595), approximately half (n\u0026thinsp;=\u0026thinsp;297) reported experiencing pain lasting more than 30 days within the past year (i.e., chronic pain) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Lower back (25%), feet (25%), and shoulders (21%) were the regions that were most often associated with chronic pain (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Most respondents identified as female (61%), while a small proportion identified as non-binary or transgender (2%) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Respondents were primarily between 16 and 44 years of age, with a relatively small proportion over 45 years (16%). Most respondents reported having good, very good, or excellent self-rated health (87%), never having performed resistance training (36%), and performed 120 minutes or less of aerobic exercise per week (51%). About half had a \u0026ldquo;normal\u0026rdquo; or \u0026ldquo;underweight\u0026rdquo; BMI (50%). The most common job title was server/waiter/waitress (31%), and most respondents worked in restaurants (45%), compared to other service locations. More than half of all participants did not consume tobacco (59%), while over one-third met the criteria for increasingly high-risk drinking (34%).\u003c/p\u003e \u003cp\u003eThe median scores for burnout, depressive symptoms, work pace, and emotional demands were 56, 37, 75, and 62, respectively (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Frequencies of regions where there was pain lasting more than 30 days/ongoing/permanent pain in the last 12 months, among alcohol service worker survey respondents in Canada (2025).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBody Region\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAny body region\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeck\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShoulders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElbows/forearms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWrists/hands/fingers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper back\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower back\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnees/legs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFeet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Frequencies of categorical variables from alcohol service worker survey respondents in Canada (2025).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChronic Pain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo self-reported chronic pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-reported chronic pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender Identity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-binary \u0026amp; transgender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e593\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e45+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e592\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e420\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-White\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-Rated Health\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood/very good/excellent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e518\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair/poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAerobic Exercise\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e594\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e120 Minutes or less/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e301\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;120 Minutes/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResistance Training\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 day/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2 days/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3 days/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u0026thinsp;+\u0026thinsp;days/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBMI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal/underweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e296\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eObese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCannabis Use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e276\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess than weekly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt least weekly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTobacco Use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e594\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccasionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh Risk Drinking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e572\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo risk (0 drinks/week)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow risk (1\u0026ndash;2 drinks/week)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate risk (3\u0026ndash;6 drinks/week)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncreasingly high risk (7\u0026thinsp;+\u0026thinsp;drinks/week)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWork Type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e592\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRestaurant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e265\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvent/stadium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDistillery/winery/brewery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eJob Title\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eServer/waiter/waitress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eManagement/executive/owner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKitchen staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive statistics of continuous variables from alcohol service worker survey respondents in Canada (2025).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003cp\u003e(Standard Deviation)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMedian (Interquartile Range)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBurnout\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55.8 (26.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56 (37.5\u0026ndash;75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepressive Symptoms\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42.2 (27.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.5 (25.0\u0026ndash;62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWork Pace\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e71.1 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75 (62.5\u0026ndash;87.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmotional Demands\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e56.6 (27.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e62.5 (37.5\u0026ndash;75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eUnivariable logistic regression models\u003c/h3\u003e\n\u003cp\u003eOur univariable models identified the following statistically significant associations with the odds of an alcohol service worker reporting chronic pain: gender identity, age, self-rated health, cannabis use, burnout, depressive symptoms, work pace, emotional demands, ethnicity, and resistance training (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eResults of univariable logistic regression models examining associations between each individual variable on the odds of alcohol service workers reporting chronic pain (2025).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOdd Ratio\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLower CI*\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUpper CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e% with Chronic pain\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender Identity\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e42.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e54.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-binary \u0026amp; transgender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.587\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e38.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e44.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e60.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e45+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e59.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e53.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-White\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e40.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-Rated Health\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood/very good/excellent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e46.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair/poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e75.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResistance Training\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e55.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 day/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e45.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2 days/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e52.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3 days/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.340\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e49.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u0026thinsp;+\u0026thinsp;days/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e36.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCannabis Use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e42.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess than weekly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.045\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e51.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt least weekly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e64.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBurnout\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepressive Symptoms\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWork Pace\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmotional Demands\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBMI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal/underweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e45.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.047\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e55.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eObese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.302\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e51.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e75.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAerobic Exercise\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e48.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e120 Minutes or less/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e54.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;120 Minutes/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.310\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e42.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTobacco Use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e48.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccasionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.771\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e49.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvery day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e58.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigh Risk Drinking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo risk (0 drinks/week)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e44.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow risk (1\u0026ndash;2 drinks/week)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.847\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e43.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate risk (3\u0026ndash;6 drinks/week)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.162\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e53.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncreasingly high risk (7\u0026thinsp;+\u0026thinsp;drinks/week)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.064\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e55.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eJob Title\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eServer/waiter/waitress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e47.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eManagement/executive/owner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.290\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e53.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKitchen staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e57.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.312\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e40.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.335\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e52.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWork Type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRestaurant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e47.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBar\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e55.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvent/stadium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.459\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e42.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDistillery/winery/brewery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.876\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e46.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.669\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e*Confidence Interval\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eMultivariable logistic regression model\u003c/h2\u003e \u003cp\u003eThe variables that met the criteria for inclusion in the multivariable logistic regression model were age, self-rated health, cannabis use, burnout, resistance training, emotional demands, work pace, depressive symptoms, and gender identity (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eResults of a multivariable logistic regression model examining associations between self-reported variables on the odds of alcohol service workers reporting chronic pain (2025).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdjusted Odds Ratio\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLower CI*\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUpper CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.871\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.027\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e45+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-Rated Health\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood/very good/excellent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair/Poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.037\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCannabis Use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess than weekly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.433\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt least weekly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.016\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResistance Training\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 day/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.135\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2 days/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.993\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3 days/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.561\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u0026thinsp;+\u0026thinsp;days/week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.024\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBurnout (0-100)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmotional Demands (0-100)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.026\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWork Pace (0-100)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.194\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepressive Symptoms (0-100)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.227\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender Identity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReferent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.264\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-binary \u0026amp; transgender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.789\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e*Confidence Interval\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe model's results highlight a positive association between age and chronic pain. Alcohol service workers who were 35 to 44 years of age and those who were 45 or older had significantly higher odds of reporting chronic pain relative to workers 16\u0026ndash;24 years of age (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). There were also higher odds of chronic pain in those who reported having poor or fair health when compared to alcohol service workers who reported having good, very good, or excellent health.\u003c/p\u003e \u003cp\u003eAlcohol service workers who used cannabis at least weekly had significantly higher odds of reporting chronic pain than those who did not consume cannabis (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). However, resistance training may have had a protective effect against chronic pain in alcohol service workers. Alcohol service workers who engaged in resistance training at least 4 times a week had significantly lower odds of having chronic pain compared to those who did not.\u003c/p\u003e \u003cp\u003eThere was a positive association between self-reported burnout and chronic pain. A 25% (25 points) increase in burnout scores was associated with 1.81 times the odds of reporting chronic pain (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Similarly, there was a positive association between emotional demands reported from alcohol service work and chronic pain. A 25% (25 points) increase in emotional demand scores was associated with 1.27 times the odds of reporting chronic pain.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study provides the first analyses aimed at identifying risk factors associated with chronic pain in Canadian alcohol service workers. Our dataset consisted of Canadian survey respondents who worked in the alcohol service industry, drawn largely from southern Ontario. Information from this survey was used to fit a logistic regression model to identify several personal factors that were associated with higher odds of reporting chronic pain within the last year.\u003c/p\u003e \u003cp\u003eChronic pain was present in approximately half the sample of survey respondents (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). This is substantially higher prevalence compared with the general working populations in Canada, which is approximately 15\u0026ndash;19% (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Internationally, the epidemiological picture seems to be similar, depending on the region and definition, population-based studies indicate that chronic pain affects roughly 10\u0026ndash;30% of adults (\u003cspan additionalcitationids=\"CR41\" citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). Direct comparisons are difficult as studies often use stricter definitions of chronic pain than the one used in this study, and the case definition directly affects prevalence estimates. However, these data suggest that chronic pain is likely more prevalent in alcohol service workers than the general working population and chronic pain could represent an under-recognized occupational health issue in this sector.\u003c/p\u003e \u003cp\u003eThe cross-sectional design of this study needs to be considered in the interpretation of the variables identified that are associated with chronic pain in alcohol service workers. Because of this, it is difficult to establish causality and the reason for the phenomena observed. However, the directions of the odds ratios are logical and align with previous literature on pain and health as discussed below.\u003c/p\u003e \u003cp\u003eSelf-rated health was inversely associated with chronic pain. There are many interrelated mechanisms that may be contributing to this association (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). People with good health may be more resilient to the stress of work exposures and thus less likely to experience chronic pain. This effect was observed in other studies (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). However, poor perceived health may capture underlying physical comorbidities; therefore, the presence of pain may influence participants to rate their health as poor (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). It may also reflect broader psychosocial perceptions of themselves, such as perceived control, optimism, and self-efficacy, which may influence the perception of pain and ability to cope with pain, thereby influencing individuals to report both poor health and chronic pain.\u003c/p\u003e \u003cp\u003eSimilarly, resistance training was also inversely associated with chronic pain (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). The more frequently that alcohol service workers engaged in resistance training, the less likely they were to report chronic pain. This may be because healthier and stronger people may be more resilient to chronic pain or more likely to recover from it. It is also possible that people who frequently engaged in resistance training are more comfortable with pain and are simply less likely to report chronic pain (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). This is consistent with evidence that physical activity improves chronic pain, pain tolerance, muscle strength/endurance, joint stability, and reduces systemic inflammation (\u003cspan additionalcitationids=\"CR47\" citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e), and through these mechanisms, physical activity may increase their ability to tolerate occupational stress. However, it is also possible that alcohol service workers who experience chronic pain are more likely to avoid exercise. Previous studies have noted the relationship between physically demanding jobs and chronic pain, and that resistance training is recommended to help mitigate and rehabilitate workers suffering from chronic pain (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe older alcohol service workers were, the higher the probability of them reporting chronic pain (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Older populations may be less resilient than younger populations and have had more opportunities to develop issues that may lead to chronic pain. Population-based studies demonstrate that the prevalence of chronic pain increases with age (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Canadian data shows chronic pain affected approximately 10% of adults aged 15\u0026ndash;24 but 35% of those aged 75 years and older (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCannabis use was positively associated with chronic pain. The frequency of cannabis use was associated with greater odds of reporting chronic pain (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). This may be because the more frequently alcohol service workers consume cannabis, the less likely they are to take care of their health, placing them at a higher risk of chronic pain. However, people often report using cannabis because of pain, therefore some people may be using cannabis as a result of chronic pain, so chronic pain may increase the probability of cannabis use (\u003cspan additionalcitationids=\"CR51\" citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e). In either case, the association underscores the complex relationship between pain and substance use in alcohol service workers that warrants further investigation.\u003c/p\u003e \u003cp\u003eThere were positive associations between burnout, emotionally demanding work, and the probability of chronic pain. This could be because those who suffer from burnout may be at a higher risk of chronic pain (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e). Similarly, emotionally demanding jobs may increase the probability of chronic pain (\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e). Conversely, persistent pain can exacerbate burnout and emotional exhaustion and reduce resilience to external stresses and perceived job control, perpetuating a psychophysiological cycle of stress and pain (\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e). This aligns with the biopsychosocial model of pain, emphasizing that occupational environment, emotional state, and individual coping jointly shape chronic pain outcomes (\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe consistency and directionality of associations across age, self-rated health, exercise, substance use, burnout, and emotionally demanding work, reinforce a broader narrative: maintaining physical health and psychosocial well-being are essential to mitigating chronic pain risk in high-stress alcohol service occupations. Alcohol service work is characterized by irregular schedules, exposure to alcohol and other substances, customer aggression and harassment, and often poor job security. Each of these stresses can erode both physical and mental health. Resulting chronic pain in this context may represent not only a biomedical outcome but also a social indicator of cumulative occupational disadvantage (\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e). Therefore, bringing awareness of these findings to the affected population may help individuals protect themselves. Taking care of one\u0026rsquo;s health through exercise, reduction of substance use, and stress may make individuals more resilient to working in difficult environments, such as alcohol service establishments.\u003c/p\u003e \u003cp\u003eFrom an organizational perspective, the associations between emotionally demanding work, burnout, and pain suggest that ergonomic or biomedical interventions alone may be insufficient. Organization-level interventions, such as improved scheduling practices, workload management, anti-harassment training, and supportive management cultures, may help reduce chronic stress and subsequent pain manifestation among employees. These findings align with frameworks such as the Total Worker Health model (\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e), which emphasizes integrated approaches addressing both physical and psychosocial risk factors. Those who manage alcohol service workers can help them be aware of the risk this environment has on alcohol service workers\u0026rsquo; physical health and try to accommodate their ability to be resilient against work-related stresses, aiming to reduce stress and promote healthy choices for their workers. Reducing the burden of chronic pain among alcohol service workers may also mitigate downstream economic impacts, including lost productivity and increased health-care costs (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e, \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAt the population level, chronic pain among service workers has broader implications for substance use and mental health. Given the accessibility and use of alcohol and cannabis among people who work in these types of occupations, chronic, ongoing pain may disproportionately increase the risk of substance use disorders in alcohol service workers, reinforcing health inequities within this workforce (\u003cspan additionalcitationids=\"CR63\" citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e). Therefore, addressing chronic pain could have downstream benefits for mental health and substance-related harms.\u003c/p\u003e \u003cp\u003eAlcohol service work involves a combination of irregular and extended shift schedules, physically demanding tasks, emotionally demanding work conditions, and prolonged exposure to an alcohol-centred environment. Together, these occupational conditions may increase the risk of chronic pain through sustained physical strain, psychosocial stress, and limited opportunities to recover. Addressing chronic pain in this workforce is imperative and requires comprehensive and coordinated action from employers, policymakers, and public health organizations to implement evidence-based strategies that protect worker health and promote long-term resilience.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eLimitations and Future Direction\u003c/h2\u003e \u003cp\u003ePotential systematic biases should be considered when interpreting the results of this study. All measures were self-reported; therefore, they are subject to the bias of the individual and vary by individual. For example, substance use measures may be under reported, however, this does not necessarily mean the associations identified are biased. People who participated in this study were given \u003cspan\u003e$\u003c/span\u003e30 gift cards. This incentive may contribute to selecting a more similar population. Researchers relied on a combination of venue-based and snowball sampling methods. Probabilistic sampling would have resulted in more representative and less biased estimates. However, this sampling method allowed us to increase our sample size given our resources, increasing the statistical power of this study. Chronic pain could not be exclusively attributed to occupational causes; it is plausible that non-occupational stresses also contributed to the presence of chronic pain. Questions related to chronic pain did not specify what kind of pain they should be reporting, only the body region. Some body regions were not specifically identified and therefore may be missed. Furthermore, responses related to chronic pain are most likely associated with musculoskeletal pain, however, the questions did not directly specify musculoskeletal pain, and therefore some of the pain being reported may be related to other sources of pain, such as neuropathic pain. As this is the first study to find these associations, further studies are needed to support or refute these findings.\u003c/p\u003e \u003cp\u003eIt would be meaningful to study workplace-level factors, such as management practices or work intensity, that would help identify where organizational changes could occur to reduce chronic pain in this population. As alcohol service work puts workers in unique environments in relation to substance use and harassment, it would be meaningful to use the same dataset to understand risk factors that may lead to substance use or are associated with workplace harassment. Lastly, it would be important if future studies could focus on identifying a relationship between chronic pain and the risk of substance use disorders or substance-related death in this population.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis is the first comprehensive analysis to provide evidence that chronic pain is common among alcohol service workers in Canada and that both personal health and workplace factors play an important role in its occurrence. Approximately half of surveyed workers reported chronic pain in any one or more body regions, a rate that is substantially higher than that reported among the general working population. However, further studies are needed to refine these findings. Poorer self-rated health, older age, cannabis use, burnout, and emotionally demanding work were all associated with greater odds of chronic pain, while regular resistance training may be protective against it.\u003c/p\u003e \u003cp\u003eThese findings highlight that chronic pain in this workforce is not just a physical issue but one seemingly rooted in a mixture of lifestyle and work-related stresses. Addressing this issue will likely require a combination of personal health promotion and occupational changes that reduce stress and support workers\u0026rsquo; physical and psychological well-being. Recognizing chronic pain as an occupational health concern in the service industry could help inform future interventions, guide workplace policy, and improve the quality of life for workers who are an essential part of Canada\u0026rsquo;s hospitality and alcohol service sectors. We hope this information can help individuals in this industry be more aware of risk factors that they may have some degree of control over. Studies of this nature on this population in various regions and scales are essential to strengthen our understanding of the stresses faced by this workforce.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthics Approval\u003c/h2\u003e\n\u003cp\u003eThis study was approved by the Conestoga College Research Ethics Board (REB#589). All participants provided informed consent prior to participation. The research was conducted in accordance with the ethical principles of the Declaration of Helsinki and consistent with the Tri-Council Policy Statement (TCPS-2) guidelines for ethical conduct in human research in Canada.\u003c/p\u003e\n\u003ch2\u003eConsent to Participate\u003c/h2\u003e\n\u003cp\u003eAll respondents provided informed consent prior to completing the survey.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThis study was funded by the Smart Serve Foundation. The Smart Serve Foundation was not involved in any other aspect of this project.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eMHA: Conceptualization, Methodology, Analysis, Validation, Data curation, Writing original draft, Review \u0026amp; editing. KY: Methodology, Investigation, Data curation, Review \u0026amp; editing. PD: Data curation, Validation, Review \u0026amp; editing. KBW: Review \u0026amp; editing. MY: Methodology, Review \u0026amp; editing, Supervision, Project administration. AY: Methodology, Review \u0026amp; editing, Supervision, Project administration.\u003c/p\u003e\n\u003ch2\u003eAcknowledgement\u003c/h2\u003e\n\u003cp\u003eWe would like to thank the Smart Serve Foundation for funding this project. Without this funding, the project would not be possible. We would also like to thank Avneet Arora for her work on the figure in this manuscript.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe data used in this study are available from the authors upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGoldberg DS, McGee SJ. Pain as a global public health priority. BMC Public Health. 2011;11:770.\u003c/li\u003e\n\u003cli\u003eDue\u0026ntilde;as M, Ojeda B, Salazar A, Mic\u0026oacute; JA, Failde I. A review of chronic pain impact on patients, their social environment and the health care system. 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Pain as a risk factor for substance use: a qualitative study of people who use drugs in British Columbia, Canada. Harm Reduction Journal. 2018;15(1):35.\u003c/li\u003e\n\u003cli\u003eSchaffer J, Fogelman N, Seo D, Sinha R. Chronic pain, chronic stress and substance use: overlapping mechanisms and implications. Frontiers in Pain Research. 2023;4:1145934.\u003c/li\u003e\n\u003cli\u003eMcIlwaine S, et al. Workplaces and Substance Use: Safety-Sensitive Positions. Ottawa; 2025.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"chronic pain, COPSOQ, NMQ, substance use, exercise, emotional job demands, burnout, alcohol, cannabis, health, occupational health","lastPublishedDoi":"10.21203/rs.3.rs-8398343/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8398343/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Alcohol service workers face many unique work-related stressors that may increase their risk of chronic pain of chronic pain. To date, there are no comprehensive analyses that study chronic pain in this population. Therefore, the objective of this study was to examine the relationship between several personal and work-related variables on the odds of reporting chronic pain in alcohol service workers. \u003cbr\u003e\n\u003cstrong\u003eMethods\u003c/strong\u003e: The data for this study came from a cross-sectional survey of alcohol service workers that included the Nordic Musculoskeletal Questionnaire (NMQ) and several components of the Copenhagen Psychosocial Questionnaire (COPSOQ). A multivariable logistic regression model was fitted to investigate the associations between the odds of a chronic pain in alcohol service workers and the following variables: personal characteristics (gender identity, age, body mass index, self-rated health, burnout, and depressive symptoms), lifestyle factors (cardiovascular training, resistance training, cannabis use, high-risk drinking, and tobacco use), and work characteristics (job title, work type, emotional demands of work, work pace, and hours worked). \u003cbr\u003e\n\u003cstrong\u003eResults\u003c/strong\u003e: There were significantly higher odds of chronic pain with increased age, cannabis use, burnout, and emotionally demanding work. There were significantly lower odds of chronic pain among individuals who rated their health better and among individuals who frequently engaged in resistance training. Approximately half of the population reported chronic pain.\u003cbr\u003e\n\u003cstrong\u003eConclusion\u003c/strong\u003e: This study highlights that good physical and mental health are likely protective against chronic pain in alcohol service workers, and individuals can likely improve their resilience to the difficult work environment by focusing on exercise, reducing substance use, and trying to reduce both work-related and personal stress. This study may increase awareness to the public, public health, and alcohol service communities of the effects of alcohol service work on chronic pain and may be used to educate those involved in this industry.\u003c/p\u003e","manuscriptTitle":"Epidemiology of Pain in Canadian Alcohol Service Workers: Risk Factors for Chronic Pain","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-30 18:27:59","doi":"10.21203/rs.3.rs-8398343/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-28T03:51:14+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-17T23:04:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-14T09:53:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"306684629547004307501313132558576646453","date":"2026-04-09T20:44:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"283435519404338815840087832456063802995","date":"2026-04-07T07:37:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"244346535614127648756316213246235433346","date":"2026-04-07T06:58:20+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-28T10:45:57+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-31T08:13:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-30T01:15:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-30T01:14:58+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-12-18T18:50:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0e9211f9-540d-4a86-aee7-07f19a67e060","owner":[],"postedDate":"January 30th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-30T18:27:59+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-30 18:27:59","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8398343","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8398343","identity":"rs-8398343","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}