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Introduction 12 2.3 International context 2.4 Objectives of the study To raise awareness of the disability caused by MSDs the United Nations declared the years 2000 to 2010 The Bone and Joint Decade. Many countries, including Japan, have since acknowledged the increasing prevalence of MSDs and the rising costs of those conditions. For example, over 107 million adults in the United States (US) reported MSDs in 2005 (United States Bone and Joint Decade, 2008). Similarly, chronic musculoskeletal pain is estimated to affect 100 million people in Europe (Veale, Woolf and Carr, 2008). Many of individuals living with MSDs are of working age. In the European Union (EU) MSDs affect more than 40 million workers and account for about half of all work-related disorders (European Trade Union Institute (ETUI), 2007), representing an estimated cost to society of between 0.5 and 2.0 per cent of gross domestic product (GDP) (Cammarota, 2005). The European Commission estimates that MSDs account for 49.9 per cent of all absences from work lasting three days or longer and for 60 per cent of permanent work incapacity (European Agency for Safety and Health at Work, 2007). Increasing awareness of the burden of MSDs on economies and societies has led to the proposal of the EU directive on MSDs, forthcoming in 2012. 1 Unlike other recent EU directives, this most recent one focuses primarily on MSD-related workplace risk, taking into account individual or psychological factors as well as the social milieu in which individuals live their lives, where work plays a large part. In particular, the directive prescribes that psychosocial factors (essentially stress) must be considered and assessed along with the ‘physical’ work-related ill health. Such recommendation signifies a welcome cultural shift towards viewing patients as workers and aiming at returning to work to become an ultimate outcome of treatment. This report looks at Japan in this wider global context and assesses where Japan is doing well and where it has challenges to confront. Appendix 3 compares Japan with other countries across a range of labour market, welfare and health care systems indicators. More specifically, this project has sought to address each of the following questions: 1. What is the impact of MSDs on employment and economic performance in Japan? How is this likely to change in the context of future demographic, workforce and lifestyle changes? 2. What is the relationship between work and MSDs? What impact do biological, psychological and social factors, including workplace factors, have on MSDs? 1 See Health and Safety Executive http://www.hse.gov.uk/aboutus/europe/euronews/dossiers/msd.htm Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market
Introduction 3. How well do employers, governmental bodies, clinicians and occupational health professionals understand and deal with MSDs as they relate to the workplace? How well equipped is the health sector to provide early intervention, rehabilitation and other support for people with these conditions? 4. What early interventions can policy-makers and employers deliver to ensure that those with MSDs a) retain their jobs b) maximise their quality of working life and their contribution to society and c) maintain access to (and routes back into) employment? In addressing the objectives outlined above, we have used the following approaches: 1. Desk research: Here we have drawn on existing published research from the medical, occupational health and health economics literature. This has enabled us to bring together the evidence on the nature, extent, impact and costs of MSDs to the Japanese economy, to employers and to individuals. We have examined a range of MSDs to assess the extent to which their impact varies and where policy and practice has been both strong and weak in preventing and intervening. 2. Secondary data analysis: We have used data from domestic and regional studies and surveys to examine the prevalence and costs of MSDs in the working age population in Japan. 3. Expert interviews: We have conducted interviews with sixteen Japanese experts across a number of disciplines (including occupational health, policy making, consulting, rheumatic disease, neck and back pain) to identify the main areas of policy and practice which need to be addressed by policy makers, health professionals and by employers. In addition to the wider picture, to focus the research, we have chosen to concentrate on four categories or groups of MSDs. These are: • Back pain; • Work-related upper-limb disorders such as regional pain and non-specific forearm pain (WRULDs); • Rheumatoid arthritis (RA); • Spondyloarthropathy (SpA). Back pain and the majority of WRULDs are categorised as non-specific and episodic conditions which may frequently be caused by, or be made worse by, work. They manifest themselves in disparate ways and may cause periods of intense discomfort and incapacity which may affect the ability of the individual worker to carry out their work. They may also abate for long periods. Many people with these conditions, such as back pain, never seek treatment and most recover Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market 13
Page 1: Fit For Work? Musculoskeletal Disor
Page 4 and 5: Contents 4 1. Executive summary 6 2
Page 6 and 7: 1. Executive summary 6 The ‘Fit f
Page 8 and 9: Executive summary 8 the data that i
Page 10 and 11: 2. Introduction 10 2.1 The global b
Page 14 and 15: Introduction 14 2.5 Structure of th
Page 16 and 17: Work and MSDs in Japan 16 Figure 3.
Page 18 and 19: Work and MSDs in Japan 18 3.2 Defin
Page 20 and 21: Work and MSDs in Japan 20 3.3 The i
Page 22 and 23: Work and MSDs in Japan 22 average t
Page 24 and 25: Work and MSDs in Japan 24 RA affect
Page 26 and 27: Work and MSDs in Japan 26 3.3.4 Spo
Page 28 and 29: Work and MSDs in Japan 28 3.4 Summa
Page 30 and 31: MSDs and government 30 4.2 MSDs: Po
Page 32 and 33: MSDs and government 32 of good heal
Page 34 and 35: MSDs and government 34 Figure 4.1.
Page 36 and 37: MSDs and government 36 deliver bett
Page 38 and 39: 5. MSDs and health care professiona
Page 40 and 41: MSDs and health care professionals
Page 50 and 51: 6. MSDs and employers 50 6.1 Costs
Page 52 and 53: MSDs and employers 52 6.2 The role
Page 54 and 55: MSDs and employers 54 Occupational
Page 56 and 57: MSDs and employers 56 The most freq
Page 58 and 59: MSDs and employers 58 levels of pai
Page 60 and 61: MSDs and employers 60 • Modified
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MSDs and employers 62 Box 2. Case s
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MSDs and employers 64 lower the mor
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7. MSDs and individuals 66 7.1 Impa
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MSDs and individuals 68 Figure 7.1.
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MSDs and individuals 70 7.2 MSDs: I
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MSDs and individuals 72 and other h
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MSDs and individuals 74 Figure 7.4.
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MSDs and individuals 76 Cont. Kaize
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MSDs and individuals 78 reported wo
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Conclusions and recommendations 80
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References 82 American Chamber of C
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References 84 Dagfinrud, H., Mengsh
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References 86 Hori, Y., Hoshino, J.
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References 88 Matsudaira, K., Hara,
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References 90 Rudwaleit, M., Gooch,
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References 92 Young, A., Dixey, J.,
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Appendix 2: Fit Note Sample 94 Sour
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Appendix 3: Benchmarking grid 96 So
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Appendix 3: Benchmarking grid 98 So
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Appendix 3: Benchmarking grid 100 O
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Appendix 3: Benchmarking grid Refer
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We provide: Research Advisory Consu
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