Musculoskeletal Disorders: a Fatality?

Roland Gauthy, Eur.Erg.

Research Officer @ ETUI-REHS

Agenda

• An “old” problem,– with huge consequences (costs / impacts)– caused by classical & newer risk factors

• Confrontation with new challenges:demography, global economy, technological

changes

• What to do from a worker’s point of view?

An old problem

• Paleopathologists show that MSDs already existed since antique times

• MSDs remain a problem although efforts have been made to better understand & control them– Clear link between different activities, working

conditions & MSDs… 1000 of publications– Legislative instruments: directive, standards– Measure of impacts & costs

Impacts

• Economical impacts at several levels – Individual (1)– Company– Societal– EU (global impacts)

• Human impacts (2)

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(1) + (2) ~ ‘worker’s costs’

Workers’ costs (not only €) • Loss of wages• Out- and inpatient costs, orthopaedic equipment

and rehabilitation costs, home care costs• Time spent in health care and rehabilitation

facilities (lost opportunities to do… )• Transportation• Altered way of life (autonomy)• Lost of opportunities: living projects, working

projects, leisure, pension...• Deteriorated quality of life with impacts on the

family and the social network

Classical vs newer risk factors

• We have the classical combination of physical factors triggering MSDs

Force / Posture / Repetition / Vibration

but

• Other factors and contexts shall be considered even in ‘lighter jobs’ are MSDs observed:

Newer contexts & risk factors

• The work content has changed: lighter (less physical), more intense, enlarged (combo of several tasks) but (paradox) with restricted room to manoeuvre

• The working conditions are different: more flexible, high tech, just-on-time, lean…precarious

• The socio-economical context has changed = globalized, international, extremely competitive

• The way of living is different: commuting time, intensity, garbage producing society // garbage’s added value (re-usable, sustainable development, …)

Combination of risk factors & of loads • Stressors, emotional loads, sensorial ones, etc.:

working with people, violence, specialization• Use of ICT: ‘ping pong’ ~ extremely reduced

response time is the rule, proactivity is required, emotional intelligence is must…

• Quasi absence of variations in posture + sedentary way of life (use of cars / transportation)

• Suppression of ‘non added value’ time ~ suppression of recovery periods

Examples

• Supermarket’s cashiers enlarged role– scanning (goes quicker) repetitive handling

(tons/day)– money / credit cards / coupons– promotion / hostess– control

• Dentist’s restricted role– pure dentistry (more €)– other tasks allocated to dental assistants

• Selected sorting of valuable wastepacking unpacking sorting

Stressors in the workplace

(often combined with mechanical factors) could explain the development of MSD although actions have been taken to combat physical/mechanical factors:

• work organisation, • psychosocial burdens,• degree of latitude – room to manoeuvre• social support …

Facing New Challenges…

Such as:

• Declining demography,

• Aging

• Longer working life,

• Globalised economy,

• Energy costs

Cumulated Health Impacts Health Impacts

• Unless speaking of an accident, the isolated impact of a MSD is totally uninteresting! “Unfortunately” MSDs do not kill but are slowly “gnawing”

• It is in the long run, through repetitions that the (bio) mechanical part of the body erodes… like your intervertebral disks while seating constantly…

• It is in the duration, from our birth, and all along our career (inclusive the excursions out of the tracks) that health is either constructed or destructed destructed

or the cumulative impacts of MSD’s risk factors

Younger & “50+” Workers’Exposures vs. Complaints…?!

Younger workers = heavier jobs / less complaints

50+ = lighter jobs / more complaints

Even consider the “forgotten MSDs” !!!Even consider the “forgotten MSDs” !!!

Demographic challenge ! working up to 67 years ?

What about the preventive approach at work for everybody & everywhere?Here should Ethics & Intelligence (prevention) work together... At least for those willing to look ahead

Precariousness & prevention

• The weakest way to prevent is to provide training… because training does not– Address potential causes– Tend to influence the weakest link (that is why training

is so essentially weak!)• Although it is the most popular preventive tool in

companies… (lack of vision or cupidity ?)• Access to training is usually limited: few

precarious workers are incorporated in OSH training programs… one could imagine to which level they are involved in participatory design and hazard inventory (stocktaking)!…

The “forgotten” MSDs ?• MSD’s history started with tile setters’ hygroma• Its continues with “salami” chopped workers =

– a lumbar area– a neck– upper-limbs

• Where are the other body parts ? It seems that they do not have– Brain & CNS no cognitive, emotional or no cognitive, emotional or

sensorial loads, no feelingssensorial loads, no feelings– Lower-limbs no “feet-ankles, knees or hips” no “feet-ankles, knees or hips”

disordersdisorders– A real body with its interrelated and A real body with its interrelated and

interconnected physiological functionsinterconnected physiological functions

The following may not exist !?

What do workers need?

– Adequate legislation (directive) “asap”– Useful and “in-use” legislation: principle = “pedagogic-

control-sanction”– Participatory hazard reduction from design to

implementation of tools & work systems– Increased knowledge and awareness at all levels (workers

and representatives, preventionists, labour inspection & employers)

– Job retention / return to work (rehabilitation)– Systematic compensation for the victims– Updated list of occupational diseases (even to allow better

EU comparisons)

More information

Topics (e.g. MSD)http://hesa.etui-rehs.org

Bibliography

http://www.labourline.org

ETUC’s positions

http://www.etuc.org