Musculoskeletal Disorders: a Fatality?

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Musculoskeletal Disorders a Fatality?

• Roland Gauthy, Eur.Erg.
• Research Officer _at_ ETUI-REHS

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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 workers point of view?

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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

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Impacts

• Economical impacts at several levels
• Individual (1)
• Company
• Societal
• EU (global impacts)
• Human impacts (2)
• --------------------------------------------------
  -----------
• ? (1) (2) workers costs

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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

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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

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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,
  leanprecarious
• The socio-economical context has changed
  globalized, international, extremely competitive
• The way of living is different commuting time,
  intensity, garbage producing society // garbages
  added value (re-usable, sustainable development,
  )

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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

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Examples

• Supermarkets cashiers enlarged role
• scanning (goes quicker) ? repetitive handling
  (tons/day)
• money / credit cards / coupons
• promotion / hostess
• control
• Dentists restricted role
• pure dentistry (more )
• other tasks allocated to dental assistants
• Selected sorting of valuable waste
• packing ?? unpacking ?? sorting

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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

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Facing New Challenges

• Such as
• Declining demography,
• Aging
• Longer working life,
• Globalised economy,
• Energy costs

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? Cumulated 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 ???

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or the cumulative impacts of MSDs risk factors
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Younger 50 WorkersExposures vs.
Complaints?!
Younger workers heavier jobs / less
complaints 50 lighter jobs / more
complaints Even consider the forgotten MSDs !!!
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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
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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)!

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The forgotten MSDs ?

• MSDs 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
  sensorial loads, no feelings
• Lower-limbs ? no feet-ankles, knees or hips
  disorders
• A real body with its interrelated and
  interconnected physiological functions
• ???

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The following may not exist !?
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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)

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More information

• Topics (e.g. MSD)
• http//hesa.etui-rehs.org
• Bibliography
• http//www.labourline.org
• ETUCs positions
• http//www.etuc.org