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Work and MSDs in Japan 20 3.3 The impact of MSDs on ability to work the data on work-related compensations is gathered according to the list of occupational diseases above. Such approach to epidemiological surveys may lead to misleading in-country and international comparisons. This is a troubling picture for a number of reasons: • Low awareness of the wider economic and societal costs of MSDs, their impact on productivity, workers and their families delay action necessary to be taken by Japanese employers and policy makers. For example, the guidelines on low back pain, issued in 1994, are highly relevant for prevention of industrial accidents associated with manual work, yet are not applicable to prevent back pain among office workers. • If, as is likely, the prevalence of MSDs increases with the ageing of the Japanese workforce, the absence of good baseline data will complicate forecasting of the future impact of MSDs. • The benefits of clinical, labour market or workplace interventions are made all the more difficult to quantify (or justify) if there are no reliable or comprehensive data on the extent or impact of MSDs in the Japanese workforce. While the number of compensation claims for MSDs has been decreasing gradually in Japan (MHLW, 2010c), hinting at a decline in the incidence, this trend may in fact reflect the gaps in the system of classification of work-related diseases, which restricts the definition of MSDs to the occupational injuries caused by work. Exclusion of chronic diseases of the musculoskeletal system, with less obvious links to the work-related causes, may be misleading the reporting of the prevalence of MSDs. At the same time, Japanese National Livelihood survey on chronic pain (Nakamura et al., 2011) revealed that MSDs are the most common reason for individuals to be experiencing chronic pain in Japan (see Figure 3.3). This section reviews existing data on the prevalence of four MSDs common in Japan. 3.3.1 Back pain Back pain, back problems and disc disorders are very common complaints in Japan. One large-scale study reports that of all the respondents experiencing chronic muscular pain, at least 65 per cent had pain in their low back (Nakamura et al., 2011). Another study reports that 57.1 per cent of males and 51.1 per cent females experienced low back pain severe enough to seek treatment (Fukuhara, Suzukamo, Morita, Takahashi, Konno et al., 2003). At the same time, official data is much different from the self-reported prevalence. As the patient survey data collected by MHLW is based on absence data of four days and longer, the rates of back pain appear to be much lower: in 2009 only 81 cases of work-related low back pain were recorded, Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market
Figure 3.3. Site of chronic pain and site of most persistent pain Proportion of respondents 70% 60% 50% 40% 30% 20% 10% 0% Neck Shoulder Elbow & surrounding areas Hand Overall arm Work and MSDs in Japan which is almost twice as many as the 45 cases in 2005 (MHLW, 2008a). In the vast majority of patients with back pain no specific diagnosis is given. Back pain is common, episodic, often recurrent and generally self-limiting. It is defined as recurrent if several episodes occur in one year for a duration of less than six months, acute if an episode lasts for less than six weeks, sub-acute (7-12 weeks) and chronic if it endures for over 12 weeks. Back pain is a recurrent problem for many people, although this does not necessitate that symptoms will worsen. For the majority of people pain will disappear of its own accord within four to six weeks. In a European study of people visiting their family doctors because of back pain, 65 per cent were free of symptoms within 12 weeks (van der Hoogen et al., 1998 in Bekkering, Henriks, Koes, Oostendorp, Ostelo et al., 2003). In Japan 61.4 per cent of individuals reporting back pain are in employment (Fukuhara et al., 2003). Recorded absence is greatest amongst the minority of individuals whose condition is chronic or recurrent. Most people who are affected by back pain either remain in work or return to work promptly. About 85 per cent of people with back pain take fewer than seven days off, yet this accounts for only half of the number of working days lost. The rest is accounted for by the 15 per cent who are absent for more than one month (Bekkering et al., 2003). In Japan, the Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market 21 Back Low back Hip & surrounding area Knee & surrounding area Site of chronic pain Site of most persistent pain Foot Overall leg Source: Nakamura et al. (2011)
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 12 and 13: Introduction 12 2.3 International c
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 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
Page 62 and 63: MSDs and employers 62 Box 2. Case s
Page 64 and 65: MSDs and employers 64 lower the mor
Page 66 and 67: 7. MSDs and individuals 66 7.1 Impa
Page 68 and 69: 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.
Page 76 and 77:
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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