Preventing work-related musculoskeletal disorders - European ...

Preventing work-related musculoskeletal disorders
JASON DEVEREUX
European Agency Topic Centre on Good Practice (MSDs), Lead Organisation Robens Centre for Health Ergonomics, University of Surrey, U.K
w ork-related stress and MSDs: is there a
link?
Work-related stress and musculoskeletal
disorders are the two leading occupational illhealth
problems in the European Union and
have also become a major medical problem.
The second European survey on working conditions produced some
indication of the magnitude of these two health problems.
Musculoskeletal complaints were the highest reported ill-health
problem followed by health affected by stress at work.
Understanding the factors that lead to the development of these
two conditions is important for prevention and rehabilitation. Both
stress and musculoskeletal disorders have been scrutinised in recent
publications of the European Agency for Safety and Health at Work.
The report on work-related stress by Professor Tom Cox et al and the
report on work-related neck and upper limb musculoskeletal
disorders by Professor Peter Buckle and Dr. Jason Devereux include
risk factors for the condition considered in each report.
Both reports make reference to physical and psychosocial workplace
risk factors. In particular, similar psychosocial factors in the
workplace were mentioned in both reports, for example perceived
work demands and job control, which appear to increase risk of
both stress and musculoskeletal disorders.
However, what is unclear at present is the role of work-related stress
reactions in the development of musculoskeletal disorders.
CAUSE OR EFFECT?
There is evidence to support a relationship between stress reactions
and musculoskeletal disorders but it is difficult to conclude whether
stress reactions are significantly involved in the development of
musculoskeletal disorders or whether those with musculoskeletal
disorders simply experience stress reactions due to the experience of
pain and functional impairment.
There are plausible mechanisms to support the relationship between
work stress and work-related musculoskeletal disorders. Being
exposed to physical and psychosocial work risk factors and their
potential interaction effects may result in certain biological reactions
that can exacerbate the effects of physical strain. These stress
reactions may limit the ability of the body’s defences and repair
systems to deal with musculoskeletal damage, therefore, it can take
longer to recover from work.
Behavioural and emotional stress reactions may increase exposure to
workplace risk factors for musculoskeletal disorders. For example, a
delivery driver may handle boxes very rapidly because of a stress
reaction to time pressure, thus, placing excessive physical strain on
the body because of the excessive speed of movement and the
excess tension brought about by the stress reaction. Finally stress
reactions may increase the psychological and physical sensitivity to
pain.
STRESS STUDY
The Robens Centre for Health Ergonomics, University of Surrey, U.K.
is currently conducting a large scale study of 7000 workers to
investigate the role of work stress reactions upon the development
of work-related musculoskeletal disorders. The three-year study
commenced on the 1 st April 2000 and is funded by the Health and
Safety Executive in the U.K.
The study will follow a cohort of workers without musculoskeletal
disorders over 14 months. It will determine whether those with
severe work stress reactions at the beginning of the 14-month
follow-up period are more at risk of developing musculoskeletal
disorder symptoms compared to those with no significant indicators
of work stress reactions at the start of the follow-up period.
Potential interaction effects between physical and psychosocial work
risk factors will also be measured as such an effect has been shown
to increase the risk of musculoskeletal disorders.
It is important in this study to make a distinction between what
researchers believe to be the cause-effect relationships of stress and
what ‘lay people’ believe regarding the role of stress. People’s beliefs
about the causes, manifestations, consequences and alleviation of
work stress may affect behaviours such as vocational choice and
reporting work stress. For example, if an individual believes that
their stress is because of their weak nerves then that person may not
seek the appropriate support from managers, colleagues etc. in
order to help overcome the stressors. Therefore, elucidating how
people react to situations that they regard as stressful or what their
expectations may be of work stress may play an important role in the
development of musculoskeletal disorders.
The research project is the first longitudinal study to investigate
beliefs of work stress in the context of musculoskeletal disorders and
also interactions between physical and psychosocial workplace risk
factors. The objective of the study is to produce results that are of
vital importance for the management of both work stress and workrelated
musculoskeletal disorders.
For further information visit
http://www.eihms.surrey.ac.uk/robens/erg/stress.htm.
European Agency for Safety and Health at Work
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