English version - Fit for Work Europe

• Indirect costs including lost work output attributable to a reduced capacity for activity,
such as lost productivity, lost earnings, lost opportunities for family members, lost
earnings of family members and lost tax revenue;
• Intangible costs including psychosocial burden resulting in reduced quality of life, such
as job stress, economic stress, family stress and suffering (WHO, 2003).
These costs vary considerably depending on the condition, on the severity of the symptoms,
and whether these cause short or long-term absence or disability. Moreover, they vary
depending on the particular methods used to calculate the costs. Some factors which affect the
calculations include the following:
• Severity of patient’s conditions;
• Mix of patient demographics in a study;
• Calculation method for productivity;
• Definitions of work disability;
• The treatment costs or outcomes due to treatments;
• Change in health care financing systems;
• Incidence or prevalence based estimates of costs.
Introduction
The biopsychosocial model (Waddell and Burton, 2006b) advocates taking into consideration
the interplay between the biological (eg disease, joint damage), the psychological (eg
disposition, anxiety) and the social (eg work demands, family support) factors, when assessing
the overall impact of chronic health conditions. The psychological status and behaviour of
a patient can be equally affected by a ‘physical’ injury (such as back pain), and should be
addressed during treatment and rehabilitation. It is evident that the interaction of the biological,
psychological and social dimensions defines the long-term impact of a musculoskeletal
condition.
While it is hardly possibly to quantify the exact burden of MSDs on individuals, employers and
the wider society, it is clear that reduced workability contributes to the indirect and intangible
costs of MSDs, which are eventually greater than the direct costs of treatment (Lundkvist,
Kastäng and Kobelt, 2008). A number of stakeholders including policy makers, health care
professionals, employers and individuals have to work together to anticipate the negative
impact of MSDs in time for the most efficient prevention and management of the effects of those
conditions.
Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market 11