English version - Fit for Work Europe

It is noted that large organisations are more likely to monitor health and safety of their workers
consistently by performing workstation assessments and giving guidance on manual handling,
for example (Tanaka et al., 1998). However, they are still likely to neglect the wider range
of work-associated factors, including psychosocial aspects of the workplace, that can also
contribute to MSDs. These aspects are often missed in the literature and advice dealing with
health and safety. Even where ‘stress’ is mentioned, the connection between psychosocial
factors and physical conditions is omitted, reinforcing the primary focus on safety.
Lack of financial and human resources means that small and medium-sized enterprises (SMEs),
especially those with fewer than 50 employees, are at risk of low compliance with occupational
health and safety legislation. Small enterprises are not required to contract an occupational
physician and may not see improving health and safety of the work environment as a benefit
to performance and productivity. 25 Examining the organisations with clear occupational risks,
Furuki, Hirata and Kage (2006) found that 51.9 per cent of enterprises with 1-4 employees,
about 42 per cent of enterprises with 5-9 employees and 20 per cent of organisations with 10-49
employees did not conduct special health examinations. At least 40.6 per cent of SMEs with 1-4
employees, 26.8 per cent of SMEs with 5-9 employees, and 14.1 per cent of SMEs with 10-49
employees failed to conduct regular periodic health examinations (Furuki, Hirata and Kage,
2006).
At the same time, the costs of ill health may be particularly significant for SMEs, as both
presenteeism and absenteeism may have more severe effects on customer satisfaction,
productivity and business performance. For example, occupational health specialists may at
times be overly enthusiastic to return individuals to work immediately to ensure performance
targets are met. 26 In some cases, 24 to 48 hours rest is advisable for people with certain MSDs.
The importance of balancing support to return employees to work and the value of giving an
employee the chance for respite is yet to be acknowledged by some Japanese employers.
Generally there is an increased risk of injury when any of the physical risk factors mentioned
above are combined, or when adverse psychosocial, personal or occupational factors
are present (Devereux, Rydstedt, Kelly, Weston and Buckle, 2004). Psychological and
organisational factors can also combine with physical factors to influence the probability of an
individual leaving work prematurely. Research on low back pain shows that an employee’s
belief that work itself produces pain precedes sickness behaviour, and is a risk factor for chronic
work disability (Werner, Lærum, Wormgoor, Lindh and Indhal, 2007). Sokka and Pincus (2001)
reviewed 15 studies and showed that physically demanding work, lack of autonomy, higher
25 Reiterated in expert interviews
26 Expert interview
MSDs and employers
Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market 57