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MSDs and individuals 74 Figure 7.4. ICF model applied to work disability in RA (Impaired) body functions and structures Environmental factors Rheumatoid arthritis Activity (limitations) Personal factors Participation (restrictions); work (dis)ability Source: de Croon et al., (2004) Some critics of the biopsychosocial model have focused on this last point, highlighting concerns that this approach may encourage or ‘permit’ helplessness in some patients or that, in other circumstances, it may alienate patients who feel they are being told that their condition is ‘all in the mind’. Clearly, clinicians and others must take care in how they mitigate these risks, but the balance of the literature – and of the expert opinion offered during the course of our interviews – strongly supports the biopsychosocial model and its role in informing the management of MSDs in both clinical and occupational settings. An example of reducing sickness absence by using successful intervention based on the biopsychosocial model is provided by Ektor-Andersen, Ingvarsson, Kullendorff and Ørbæk (2008). In their study, Ektor-Andersen et al. (2008) developed a tool based on the CBT method of functional behaviour analysis, according to which risk factors for long-term sick leave due to musculoskeletal symptoms were identified in four different domains: the community, the workplace, the family/spare time and the health care system. Care-seekers were examined by each member of the interdisciplinary team and risk factors were identified and classified as stable or dynamic. Dynamic factors were the ones which the care-seekers and the team agreed to intervene on. Some of these interventions involved CBT or physiotherapy sessions, Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market
MSDs and individuals which were administered for a year. Results from the study show that this type of intervention is effective in reducing sick leave and social security expenditure four months after the intervention began. Although the cost-benefit analysis presented by Ektor-Andersen et al. (2008) underestimates the total savings by taking into account social security costs alone, the costs of this type of intervention are balanced out by reduced costs in sickness allowance during the first year. Box 3. Case study: Participatory approaches to workplace adjustment in Japan Participatory approaches to improvement of the workplace have evolved since the mid- 1980s. They have developed in the form of ‘action-oriented training of local people who plan and implement immediate improvements in their own workplaces’ (Kogi, 2006, p.548). People thus develop the capacity to control a significant amount of their activities at work and power to influence both processes and outcomes in order to achieve desirable goals (Kogi, 2006). Studies suggest that a participatory approach carries benefits for both employer and employee. By facilitating workers’ initiative, it could create good communication among workers and a healthy climate within the workplace. It could also lead to the rise of work engagement and to the improvement of work performance. Nagami, Tsutsumi, Tsuchiya and Marimoto (2010) have surveyed 777 full-time employees at a manufacturing company in Japan to show that job control was positively related to job performance. The example of the WIND training programme presented below creates preconditions for a healthier, safer and better informed workforce (Ikeda et al., 2012). WIND also demonstrates features of the kaizen method of workplace improvement. ‘Kaizen is the Japanese word for improvement, carrying the connotation in industry of all the uncontracted and partially contracted activities which take place in the Japanese workplace to enhance the operations and the environment. Kaizen epitomises the mobilisation of the workforce, providing the main channel for employees to contribute to their company’s development. In isolation, the concept seems simple: with every pair of hands, you get a free brain’ (Brunet and New, 2003, p. 1427) The principle of kaizen is characterised by generality and simplicity. The importance of kaizen in Japanese management has been widely recognised. It is often described as one of the underlying principles of lean production and total quality management (TQM). In the management literature it has often been credited as the key element in Japanese manufacturing success. Cont. Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market 75
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Fit For Work? Musculoskeletal Disor
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Contents 4 1. Executive summary 6 2
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1. Executive summary 6 The ‘Fit f
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Executive summary 8 the data that i
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2. Introduction 10 2.1 The global b
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Introduction 12 2.3 International c
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Introduction 14 2.5 Structure of th
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Work and MSDs in Japan 16 Figure 3.
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Work and MSDs in Japan 18 3.2 Defin
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Work and MSDs in Japan 20 3.3 The i
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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.
Page 70 and 71: MSDs and individuals 70 7.2 MSDs: I
Page 72 and 73: MSDs and individuals 72 and other h
Page 76 and 77: MSDs and individuals 76 Cont. Kaize
Page 78 and 79: MSDs and individuals 78 reported wo
Page 80 and 81: Conclusions and recommendations 80
Page 82 and 83: References 82 American Chamber of C
Page 84 and 85: References 84 Dagfinrud, H., Mengsh
Page 86 and 87: References 86 Hori, Y., Hoshino, J.
Page 88 and 89: References 88 Matsudaira, K., Hara,
Page 90 and 91: References 90 Rudwaleit, M., Gooch,
Page 92 and 93: References 92 Young, A., Dixey, J.,
Page 94 and 95: Appendix 2: Fit Note Sample 94 Sour
Page 96 and 97: Appendix 3: Benchmarking grid 96 So
Page 98 and 99: Appendix 3: Benchmarking grid 98 So
Page 100 and 101: Appendix 3: Benchmarking grid 100 O
Page 102 and 103: Appendix 3: Benchmarking grid Refer
Page 104: We provide: Research Advisory Consu
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