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Work and MSDs in Japan 22 average time to return to work or household tasks after experiencing back pain was 11.3 days; the longest time taken off was two years (Fukuhara et al., 2003). The important question is therefore why, when so many people experience back pain, does it have such an adverse effect on some and not others? There is a growing consensus that psychological factors are the differentiating factor as they are strongly associated with the progression of back pain from an acute to a chronic condition that affects two to seven per cent of people (Burton, 2005), and to disability (Burton, 2005; Bekkering et al., 2003). For example, in Japan the prevalence of episodes of various musculoskeletal pain differed by gender, age, size of city lived in, income, job status, education, body mass index, and baseline quality of life (Tokuda, Ohde, Takahashi, Shakudo, Yanai et al., 2007). 3.3.2 Work-related upper limb disorders WRULDs such as muscular pain in the neck, shoulders and upper limbs are second most common complaints relating to muscular pain in Japan. One survey found that of all the respondents experiencing chronic muscular pain, at least 55 per cent had pain in the neck, with just under 10 per cent complaining of pain in the arms or hands (Nakamura et al., 2011). At the same time, shoulder and neck were also highly ranked among sites of pain persisting for the longest periods of time (Nakamura et al., 2011). Katakori (neck and shoulder pain) is the most common complaint in Japanese females, and it is the second most common following lumbar pain in males, according to a comprehensive survey of living conditions (health and welfare) of the general population conducted in 2004. 6 On the other hand, Tada, Yoshida and Murase (2001) investigated the prevalence of industrial hygienerelated katakori, and showed that katakori was most commonly observed in office workers (63.2 per cent), followed by engineers (53.2 per cent) and skilled technicians (40.6 per cent). These results suggest that the prevalence of katakori differs according to occupation. MHLW recorded 726 cases of WRULDs in 2009, which is on decline from 986 the previous year (MHLW, 2010b). In an earlier study, reporting somewhat lower prevalence of neck and shoulder pain (at 20.3 per cent), Suka and Yoshida (2005) found that WRULDs interfere with individuals’ activities in 31 per cent of the cases for pain in neck and shoulder area, and 21.5 per cent of the cases for elbow, wrist, and hand area. 6 See MHLW http://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa04/3-1.htm Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market
The difficulty in classifying WRULDs is also reflected by a considerable debate about the definition and diagnostic criteria for WRULDs, which are also commonly referred to as ‘sprains or strains’, ‘repetitive strain injuries or disorders’, or ‘cumulative trauma disorders’. Both specific and non-specific disorders and symptoms can be covered by this category. Van Eerd, Beaton, Cole, Lucas, Hogg-Johnson et al. (2003) identified 27 different classification systems for workrelated MSDs, of which no two were found to be alike. The fact that a single disorder is often described in different ways only amplifies the problem of the systematic monitoring of WRULDs. Critically, Van Eerd et al. (2003) found that the different classification systems did not agree on which disorders should be included. This definitional problem makes it difficult to calculate the number of people with WRULDs and to develop a common understanding of the associated risk factors. Whilst no agreed classification exists there is a common consensus that symptoms of WRULDs can present in the tendons, muscles, joints, blood vessels and/or the nerves and may include pain, discomfort, numbness, and tingling sensations in the affected area. WRULDs can be specific and non-specific conditions (Aptel, Aublet-Cuvelier and Cnockaert, 2002) and attempts at classification tend to focus either on the affected body area or on the cause. Examples of WRULDs by body part include the following: • Elbow: Epicondylitis (tennis or golfer’s elbow); • Hand, wrist and forearm: Carpal tunnel syndrome; repetitive strain injury, de Quervain’s syndrome; • Shoulder: Tendinitis of the shoulder; • Neck: Neck pain. Classification by occupational causes refers to actions such as vibration of the hand and arm, which can result in Raynaud’s Syndrome, for example. The breadth of the definition of WRULD means that almost all symptoms and impacts on work associated with MSDs are associated with WRULDs. Specific symptoms and impacts of MSDs are therefore discussed in more detail below with reference to back pain, RA and SpA conditions. 3.3.3 Rheumatoid arthritis Work and MSDs in Japan RA is estimated to affect 600,000 patients in Japan, or about 0.5 per cent of the population (Tanaka, 2011). This estimated prevalence is in line with the average world prevalence rate estimated by WHO at between 0.3 per cent and 1 per cent in most industrialised countries (WHO, 2003). Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market 23
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 20 and 21: Work and MSDs in Japan 20 3.3 The i
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.
Page 70 and 71: 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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