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The EU and musculoskeletal disorders

04 June 2007
by eub2 -- last modified 04 June 2007

Musculoskeletal disorders (MSDs) are the most common work-related health problem in Europe, affecting millions of workers. Across the EU27, 25 per cent of workers complain of backache and 23 per cent report muscular pains. Lighten the load, the European Agency for Safety and Health at Work's 2007 campaign to tackle MSDs in the workplace, supports an integrated management approach with three key elements. First, employers, employees and government need to work together to tackle MSDs. Secondly, any actions should address the ‘whole load on the body’, which covers all the stresses and strains being placed on the body, environmental factors such as cold working conditions, and the load being carried. Thirdly, employers need to manage the retention, rehabilitation and return to work of employees with MSDs.


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What is the problem? Why MSDs?

Musculoskeletal disorders (MSDs) are the most common work-related health problem in Europe, affecting millions of European workers across all employment sectors, with the highest rates found in the agriculture and construction sectors.

Across the EU27, 25% of workers complain of backache and 23% report muscular pains. The situation is worse in the new Member States - almost 40% of workers report these two problems.

Impact of work on health (EU27 - all workers)

The cost to individual companies, individual workers and their families, and to Europe and society at large, is high. MSDs not only result in high costs due to medical and social security expenses, and lost productivity, but also result in personal suffering for many workers.

Any worker can be affected, yet the problem can be prevented or reduced by following existing health and safety regulations, and is preventable by applying proper risk assessments, putting in place appropriate preventive measures based on guidance and good practice, and checking that these measures remain effective.

Lighten the load seeks to promote an integrated management approach to tackle MSDs embracing prevention of MSDs, and the retention, rehabilitation and reintegration of workers who already suffer from MSDs to make workplaces safer and healthier.

MSDs are the biggest cause of absence from work in practically all Member States. In some states, 40% of the costs of workers’ compensation are caused by MSDs, and up to 1.6% of the gross domestic product (GDP) of the country itself. MSDs reduce company profitability and add to the social costs of government.

Tackling MSDs is therefore a priority for the EU if we are to create more and better jobs in Europe. It is essential if European workers are to enjoy not only better quality jobs but a better quality of life and a higher standard of living.

What causes MSDs?

Lifting, carrying, pulling and pushing, making repetitive movements or working in the cold are all factors in the development of MSDs. Physical factors, though, are not the only causes. The way work is organised can also play a part. For example, workers with low levels of autonomy and job satisfaction are more likely to develop MSDs. A person’s own medical history and physical capacity is also significant.

Physical, organisational and psychosocial, and individual factors may act separately, but the risk is greater if several risk factors work together.

Physical factors include: lifting, carrying, pulling and pushing; repetitive movements, working in the cold or in excessive heat; and awkward and static postures.

  • using force - lifting, carrying, pulling, pushing
  • repetition of movements - typing, painting
  • awkward and static posture - prolonged standing and sitting, working with hands above the shoulders
  • contact pressure - local compression of tools
  • vibration - whole body and hand-arm
  • cold working environments

Organisational and psychosocial factors include: performing tasks with low levels of autonomy; low job satisfaction; and repetitive, monotonous work, at a high pace.

  • high work demand
  • lack of control over work
  • low job satisfaction
  • repetitive work
  • high pace of work
  • time pressure
  • lack of support from colleagues and managers.

Individual factors include: medical history and physical capacity.

  • prior medical history
  • physical capacity
  • age
  • smoking
  • obesity.

MSDs affect more than just the back - although, of course, backache in itself can be very serious; muscles, joints, tendons, ligaments and nerves can all be affected.

MSDs can also be acute traumas, such as fractures, that occur during an accident. These mainly affect the back, neck, shoulders and upper limbs, but also concern lower limbs.

Disorders that affect the upper body are known as work-related neck and upper limb disorders (WRULDs). Symptoms may take a long time to develop and can manifest as pain, discomfort, numbness and tingling sensations. They are also known as ‘repetitive strain injuries’; examples include carpal tunnel syndrome, tendonitis and vibration white finger.

Most work-related MSDs are cumulative disorders, resulting from repeated exposures to high or low intensity loads over a long period of time.

Who is affected?

Manual workers, whether skilled or unskilled, are most at risk from developing MSDs. As you might expect, older workers in Europe report more problems than younger employees.

Surprisingly perhaps, MSDs are not restricted to older male workers in manual jobs. It is estimated that nearly 4 million young workers in the EU under the age of 25 have backpain. Physically demanding tasks such as working in awkward positions, handling heavy loads, prolonged standing and sitting, and repetitive work appear to be common among young workers which mean that they are at considerable risk of developing MSDs.

Agriculture and construction are the most affected sectors concerning exposure to physical risks and MSDs complaints. However, all sectors are concerned, but some employment groups are more at risk.

Particularly high rates are found among:

  • agricultural, forestry and fishing workers
  • construction workers
  • carpenters
  • drivers
  • nurses
  • cleaners
  • miners
  • machine operators
  • craft workers
  • tailors
  • retail workers
  • hotel, restaurant and catering workers
  • secretaries and typists
  • loaders and unloaders.

Women are less exposed to physical risk factors, although hand or arm movements and work involving painful or tiring positions are experienced equally by both.

For certain risks - jobs involving moving people - women are significantly more exposed than men. According to recent surveys, in the healthcare sector for example, an estimated 6-7 million women lift or move people and 3-4 million report backpain. In the retail sector, about 4 to 6 million women have to carry or move heavy loads, and about 10-11 million women are exposed to prolonged periods of standing or walking. (EU data)

MSDs are not restricted to older male workers in manual jobs. Physically demanding tasks such as working in awkward positions, handling heavy loads, prolonged standing and sitting, and repetitive work appear to be common among young workers which mean that they are at considerable risk of developing MSDs. It is estimated that nearly 4 million young workers in the EU under the age of 25 have backpain. (EU data)

Upper limb disorders - commonly known as repetitive strain injuries - affect women workers more than men, largely because of the type of work they do.

Workers in precarious employment, such as those on fixed-length contracts, are also significantly more exposed to repetitive work and working in painful or tiring positions.

Statistics

Is there any statistical evidence to justify the Lighten the load campaign?

There is a substantial - and growing - body of evidence. MSDs are the most common work-related health problem in Europe. Across the EU27, 25% of workers complain of backache and 23% report muscular pains. Both conditions are more prevalent in the new Member States, at 39% and 36% respectively.

Some 62% of workers are exposed a quarter of the time or more to repetitive hand and arm movements, 46% to painful or tiring positions and 35% to carrying or moving heavy loads. Agriculture and construction are the most affected sectors for both exposure to physical risks and musculoskeletal complaints, though MSDs occur in all sectors.

MSDs are the biggest cause of absence from work in practically all Member States. In some, 40% of the costs of workers’ compensation are caused by MSDs, and up to 1.6% of the gross domestic product (GDP) of the country itself. They reduce company profitability and also add to the social costs of government. But these disorders also strongly reduce the employability and working capacity of those affected. Therefore, tackling MSDs is morally and ethically important.

Musculoskeletal disorders - a painful condition

Musculoskeletal disorders are the most common work-related health problems in the EU27: 25% of European workers complain of backache and 23% report muscular pains;

62% of workers in the EU-27 are exposed a quarter of the time or more to repetitive hand and arm movements; 46% to painful or tiring positions; 35% to carrying or moving heavy loads;

MSDs are costly conditions due to their direct – insurance, compensation, medical and administrative costs, and indirect costs of lost productivity.

Surely MSDS are only minor ailments?

The price of MSDs to workers, employers and governments is huge. For the employee, they cause personal suffering and loss of income; for the employer, they reduce business efficiency; and for government, they increase social security costs.

  • In the Czech Republic, MSDs account for one-third of all occupational diseases, and they are on the increase
  • An estimated 11.6 million working days a year are lost to work-related MSDs in the UK

Legislation

What are the legal provisions covering health and safety at work?

Council Directive 89/391 of 12 June 1989 introduced measures to encourage improvements in the safety and health of workers at work and puts general obligations on employers to assess risks, bring in protective measures, and provide information and training.

Are there specific Directives that address MSDs?

The main components of MSD prevention are recognised in European Directives, Member States’ regulations and good practice guidelines. The Directives are supplemented by a series of European standards, known as EN standards, which fill out the details or enable the Directives to be implemented.

In addition to Directive 89/391, the main European Directives relevant to preventing MSDs are:

  • 89/654: minimum requirements for the workplace
  • 89/655: suitability of work equipment
  • 89/656: suitability of personal protective equipment
  • 90/269: identification and prevention of manual handling risks
  • 90/270: minimum health and safety requirements for work with display screen equipment
  • 93/104: organisation of working time
  • 98/37: machinery
  • 2002/44: identification and prevention of risks arising from vibration.

Are there any plans to introduce new legislation?

The Commission launched the first stage of consultation of the social partners on work-related MSDs on 9th November 2004. A second-stage consultation was launched earlier this year as the Commission considers that there is a need for further Community initiatives to improve the prevention of work-related MSDs.

Musculoskeletal disorders are currently covered by various Directives, however, only a limited number of work situations, i.e. the manual handling of loads, the work with display screen equipment and the activities involving exposure to local or whole-body vibration are covered by the current individual directives.

It is clear however that, apart from the specific area of exposure to vibration, the incidence of other ergonomic risk factors such as repetition, awkward/static postures, force or contact stress is not adequately addressed in the existing EU legislation.

For instance, awkward postures are not necessarily or exclusively linked to the manual handling of loads or the work with display screen equipment; they can also occur when performing tasks or work activities that involve repeatedly raising or working with the hands above the head, kneeling or squatting or just working with the back, neck or wrists bent. The same can be said for repetition as a risk factor occurring in performing tasks where the same motion or cycle of motions is repeated within a short time frame. Moreover, other risk factors such as contact stress – e.g. using the hand or knee as a hammer or working with objects that press hard into muscles or tendons – seem to be completely ignored by the current legislation.

The Commission, therefore, considers that a legislative initiative, setting out a revised, integrated and more legible EU regulatory framework on musculoskeletal disorders, might be appropriate.

Source: European Commission