British Safety Council

Fact sheet: Musculoskeletal disorders

What are MSDs? :

Work-related musculoskeletal disorders are impairments of bodily structures such as muscles, joints, tendons, ligaments, nerves, bones and the localised blood circulation system, caused or aggravated primarily by work and by the effects of the immediate environment in which work is carried out.
Most work-related MSDs are cumulative, resulting from repeated exposure to high or low intensity loads over a long period of time
MSDs can also be acute traumas, such as fractures, that occur during an accident.
These disorders mainly affect the back, neck, shoulders and upper limbs, but can also affect the lower limbs.
Some MSDs, such as carpal tunnel syndrome in the wrist, are specific because of their well-defined signs and symptoms.
Others are non-specific because only pain or discomfort exists without evidence of a clear specific disorder.

Source: European Agency for Safety and Health at Work

The problem

Musculoskeletal disorders (MSDs) are the most common work related problem in Europe.
Almost 24 per cent of workers in the 25 EU states report suffering from backache and 22 per cent complain about muscular pains. Both conditions are more prevalent in the newest member states, 39 per cent and 36 per cent respectively.
MSDs affect millions of European workers across all employment sectors, with the highest rates found in the agriculture and construction sectors.
As with elsewhere in Europe, MSDs are the most common form of ill-health disorders at work in the UK.
MSDs affect 1 million people in Great Britain each year.
The most common problems include back pain, work-related neck and upper limb disorders (ULDs), including repetitive strain injuries, and lower limb disorders.

Source: European Agency for Safety and Health at Work / HSE)

What causes work related MSDs?

The EU breaks the factors contributing to MSDs down into three categories.

Physical factors
- Force application such as lifting, carrying, pulling, pushing, use of tools Repetition of movement
- Awkward and static postures
- Local compression of tools and surfaces
- Vibration
- Cold or excessive heat
- Poor lighting
- high noise levels
Organisational and psychosocial factors
- Demanding work, lack of control over tasks performed and low levels of autonomy
- Low levels of job satisfaction
- Repetitive, monotonous work at a high pace
- Lack of support from colleagues, supervisors and managers
Individual factors
- Prior medical history
- Physical Capacity
- Age
- Obesity
- Smoking

Source: European Agency for Safety and Health at Work

The overall cost

Almost half the UK adult population, 49 per cent, report low back pain lasting for at least 24 hours at some time during the year
An estimated four out of five people, 80 per cent, will experience back pain lasting more than a day at some time during their life.
The direct healthcare costs of back pain include £141m each year for GP consultations, £150.6m for NHS physiotherapy and £512m for hospital care
Back pain costs the NHS and community care services more than £1 billion each year

Source: Statistics compiled by Backcare - the charity for healthier backs)

Work related costs

The estimated total cost of back pain corresponds to between 1 per cent and 2 per cent of Gross National Product.
Musculoskeletal disorders are the most commonly reported type of work-related illness
On any one day, about 1 per cent of the working-age population are on sickness absence due to a back problem.
Nearly 5m working days were lost through bad backs in 2003/04. On average each sufferer took about 20 days off in that period.
Back pain is the nation's leading cause of disability, with 1.1 million people disabled by it.
Back pain is the second commonest cause of long term sickness absence for much of the UK and the commonest for people in manual occupations.
At any one time 430,000 people in the UK are receiving Social Security payments primarily for back pain.
One in eight (13 per cent of unemployed people say that back pain is the reason they are not working.

Source: Statistics compiled by Backcare - the charity for healthier backs)

Regional Statistics

Estimated rate of self-reported MSDs caused or made worse by work, by region. Figures are a percentage of the population that has ever been employed. Compiled by the HSE for 2004/05.

	Percent	Number
North East	3.1%	51,234
North West	2.3%	101,271
Yorkshire and the Humber	2.6%	84,703
East Midlands	2.7%	75,087
West Midlands	2.6%	89,089
East	1.8%	63,585
London	1.8%	93,276
South East	2.2%	115,071
South West	2.4%	76,480
Wales	3.0%	56,118
Scotland	2.3%	76,654
TOTAL		882,568

Source: HSE

RIDDOR Statistics on pushing and pulling

The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR) requires employers to report specified workplace incidents. RIDDOR statistic compiled by the HSE show workplace tasks which involve pushing and pulling are a major cause of MSDs:

11 per cent of manual handling-related RIDDOR accidents investigated by HSE involved pushing and pulling.
The most frequently reported site of injury was the back (44 per cent).
Followed by the upper limbs (shoulder, arms, wrist and hand) accounted for 28.6 per cent.
12 per cent more accidents involved pulling than pushing (where the activity could be identified within the reports).
61 per cent of accidents involved pushing and pulling objects that were not supported on wheels (e.g. bales, desks etc.)
35 per cent of pushing and pulling accidents involved wheeled objects

Source: HSE

Back pain

Back pain can arise in many work situations. The exact cause is often unclear, but back pain is more common in tasks that involve:

heavy manual labour, and handling tasks in heavy industry;
manual handling in awkward places, like delivery work;
repetitive tasks, such as manual packing of goods;
sitting at a workstation for a long period of time if the workstation is not correctly arranged or adjusted to fit the person, eg working with computers;
driving long distances or driving over rough ground, particularly if the seat is not, or cannot be, properly adjusted or adequately sprung. Operating heavy equipment, such as an excavator, can lead to excessive jolting and jarring.

Source: HSE

Employers' responsibilities

Employers have a legal obligation to protect their health and safety and that of their workforce. Regulation 3, of the Management of Health and Safety at Work Regulations 1999, requires that all employers assess the risks to the health and safety of their employees while they are at work.

As well as the general risk assessment requirements set out in the Management Regulations, there is a requirement in the Manual Handling Operations Regulations 1992 (as amended) to carry out a risk assessment on manual handling tasks.

The Display Screen Equipment Regulations 1992 (as amended) require employers to undertake an analysis of the workstation to assess and reduce risks.

Source: HSE

Undertaking a risk assessment

The main areas to focus on are the task, load, working environment and individual capability.

Risk assessment is a five stage process and involves:

looking for the hazards;
deciding who might be harmed and how;
evaluating the risks and deciding whether the existing precautions are adequate or whether more should be done;
recording your findings and telling your employees about them; and
reviewing your assessment and revising it if necessary, for example:
- if the work changes significantly;
- if there is an accident; or
- when someone returns to work after sickness or injury, or suffers a change in their health, that could affect or be affected by their work.

Source: HSE