English version - Fit for Work Europe

MSDs and health care professionals
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and patients’ themselves to ensure that the work capacity of individuals with MSDs is preserved
for longer.
In the long run early detection and treatment of MSDs will reduce demand for more expensive
interventions, such as hospitalisation and advanced drug therapy. These treatment methods
already represent two of the greatest direct costs of MSDs to the health care system in Japan.
A combination of prompt medical intervention with other forms of therapy offers further savings
in the treatment costs. It is hoped that the introduction of biologics early in the treatment process
will reduce overall medical costs in the long term due to slower progression of the disease
and a reduced need for surgery, but this trend has not yet transpired (Yasui, Nishino, Kadono,
Matsui, Nakamura et al. 2010). At the same time, if work outcomes of the individuals with RA
are considered, more patients in Japan could benefit from using anti-TNF therapies earlier in the
course of their disease. While no Japanese studies have yet been published to demonstrate this
link, a UK study found that rate of turnover and absence in the workplace improved by 50 per
cent in patients using biologics, compared to those who were not (Bejarano, Quinn, Conaghan,
Reece, Keenan et al., 2008). This would produce an estimated tax increase of JPY 17 trillion
(ACCJ, 2011a).
As it becomes clear that proactive management of MSDs reduces the prevalence of chronic
conditions and disability in the long run, hinting at significant savings to the health care system,
we recommend that the health care professionals in Japan:
• Aim for early diagnosis and intervention. The evidence suggests that long periods
away from work are usually detrimental to MSD patients. The longer they are away
from work, the more difficult it is to return. Early detection of MSDs and referral to
appropriate care, preferably in partnership with the patient and their employer, will
help individuals to return to work as soon as possible and avoid work incapacity in the
long term. Occupational physicians already employed at larger organisations could be
trained to provide education and support to assist people with MSDs to continue their
role, or return to the workplace.
• Identify where job retention or early return to work is good for the patient. It is easy to
assume that work is unambiguously bad for your patients, especially if you suspect
that aspects of their job make symptoms worse. With some adjustments, staying at
work with lighter duties or adjusted hours might still be a better option than a prolonged
absence from work.
Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market