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Conclusions and recommendations 80 interventions in time. An integrated care team, involving the treating health care professionals, occupational physicians and the individual themselves should work together to establish an optimal plan of intervention and return to work. • Coordinate action. Five stakeholder groups – individuals, employers, occupational physicians, clinicians and policy makers – must embrace the principles of effective management of MSDs to reduce and prevent the impact of chronic conditions on individuals’ ability to remain at work and return to employment. Better communication and coordination must be put in place to ensure that those with MSDs receive appropriate support, and that the impact of their condition on the daily activities is minimised. The report calls upon each of the stakeholder groups to take action: • Policy makers have to acknowledge both the direct and indirect costs of MSDs. We need better measures to assess the social, economic and work impact of all MSDs, to allow the Japanese government to assess and monitor both the clinical and labour market impact of MSDs in a more ‘joined-up’ way. Considering the principal role of policy makers in advising employers on effective prevention of chronic conditions, the government should urgently review the guidelines for management of MSDs for both manual and white-collar workers. • Clinicians should prioritise staying in and returning to work as both a means and an outcome of patient treatment. For some MSD patients, early access to physiotherapy or drug therapies can reduce the severity, impact or progression of the condition; a delay in diagnosis or treatment can make recovery, job retention or rehabilitation much more difficult. Clinicians should work more closely with occupational physicians to ensure that clinical treatment is complemented by appropriate workplace interventions and vocational rehabilitation. • Occupational physicians should look beyond legal compliance in maintaining the health and well-being of employees and tailor vocational rehabilitation to individual worker needs. When reviewing the safety of workplaces, they should acknowledge not only the physical, but also the psychological impact of work on health in both manual and non-manual jobs. • Employers can change the way in which the work environment is organised (including simple changes to physical layout or to working time arrangements) to help prevent MSDs from getting worse and to help people with MSD to stay in, or return to, work. They need to do this in a way which preserves job quality, avoids excessive or damaging job demands and takes heed of ergonomic good practice. Employers must recognise that work environment and working conditions can impact the health of both manual and non-manual workers. Employers should explore successful examples of Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market
Conclusions and recommendations the participatory approach and gain from employees’ first-hand experience to improve working conditions and work environments. • Individuals should play an active part in the management of their condition. There are multiple ways of learning more about chronic health conditions how to minimise their impact on work performance and psychological well-being. It is crucial to tell your doctor and occupational physicians about worsening health status, so that it can be addressed in time for appropriate intervention: early diagnosis is crucial for the prevention of longterm incapacity at work. Although the problem of MSDs and their impact on work is much higher on Japan’s official agenda than it is in Europe, there is still a paucity of clinical, epidemiological, psychological and economic evidence on the precise nature, extent and consequences of the MSDs in Japan. Nevertheless, we know enough to conclude that MSDs will affect a growing proportion of the working age population in the coming years, and while acceptance for a more holistic approach to MSD treatment is growing, the principles of biopsychosocial model are yet to be fully embraced. There is a need for more coherent, ‘joined-up’ action by government, clinicians and employers which would focus on extending the working lives of MSD patients. Fit For Work? Musculoskeletal Disorders and the Japanese Labour Market 81
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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
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Work and MSDs in Japan 24 RA affect
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Work and MSDs in Japan 26 3.3.4 Spo
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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 74 and 75: MSDs and individuals 74 Figure 7.4.
Page 76 and 77: MSDs and individuals 76 Cont. Kaize
Page 78 and 79: MSDs and individuals 78 reported wo
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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