English version - Fit for Work Europe

MSDs and individuals
indicators to measure the effectiveness of interventions (Leardini et al., 2002). Presently, two
widely used QoL measures are:
1. Disability adjusted life years (DALYs). This is a measure of the disease burden which
tallies the complete burden that a particular disease exacts. Key elements include age
at which the disease or disability occurs, how long its effects linger, and its impact on
quality of life. One DALY is equal to one year of healthy life lost.
2. Quality adjusted life years (QALYs). The QALY is also a measure of disease burden,
including both the quality and the quantity of life lived. It is used in assessing the
value for money of medical interventions and is based on the number of years of life
that would be added by these interventions. A QALY gives a measure of how many
extra months or years of life of reasonable quality a person might gain as a result of
treatment, helping in the assessment of the cost-utility of treatment options.
Both measures are the subject of debate, but have become accepted as helpful in making
comparative judgements across different countries and medical conditions. WHO (2009)
estimates that in Japan up to 10,170 DALYs were lost due to MSD per 100,000 population in
2004 (almost 8 per cent of all DALYs lost in Japan), including 583 DALYs attributed to RA.
Suka and Yoshida (2005) find that the loss of QALYs due to low back pain in the Japanese adult
population was estimated at 9.18 per 1,000 population. While low back pain has not received
the same level of attention from health professionals in Japan as cancer and cardiovascular
disease, it is suggested that low back pain substantially deprives the Japanese adult population
of their quality of life. It is predicted that with the population ageing, the losses of QALYs
associated with low back, hip, and knee pains per 1,000 population will increase from 17.2, 3.8,
and 8.9, respectively in 2005 to 18.8, 4.5, and 11.2, respectively by 2055 (Suka and Yoshida,
2009).
The most common symptom affecting quality of life among individuals with arthritis and other
MSDs is chronic or recurrent musculoskeletal pain. While the Japanese report less chronic pain
than Europeans (13 per cent compared to 19 per cent), 58 per cent of these people report being
in constant pain, compared to only 35 per cent in Europe (Hattori, 2006).
In the National Livelihood Survey of 11,507 individuals Nakamura et al. (2011) find that 15.4 per
cent of the Japanese population experience chronic pain. The majority of chronic pain is due to
MSDs (see Figure 3.4 above). For many the pain is severe and long-term (see Figure 7.1).
Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market 67