Negative impact of musculoskeletal disorders on Irish labour market

Recent research as part of the wider European ‘Fit for work’ study examined the negative impact of musculoskeletal disorders (MSDs) on the working lives of Irish workers and the Irish labour market. MSDs are the most commonly reported cause of work-related ill health in Ireland and the annual direct cost of MSDs at work is estimated to be at least €750 million. More than twice as many working days are lost through MSDs in Ireland than are lost to stress.

According to a recent research report (673Kb PDF), musculoskeletal diseases (MSDs) such as back pain, arm or neck strains, or diseases of the joints are the number one cause of work absence in Ireland by some margin, costing the economy an estimated €750 million each year. Although the number of working days lost to stress in Ireland is high, more than twice as many are lost through MSDs.

The research by Arthritis Ireland and London-based The Work Foundation was part of a bigger pan-European study entitled [Fit for work (1.86Mb PDF)](http://www.fitforworkeurope.eu/Website-Documents/Fit for Work pan-European report.pdf). In terms of the European average across 24 countries, MSDs account for nearly half (49%) of all absences from work. Ireland ranks just above the average at 50%. Ireland also spends more per capita (40.9%) on sickness and healthcare benefits than all of the other 24 countries in the pan-European study.

MSDs reduce productivity considerably

The Irish report looks in detail at:

• the impact that MSDs have on the working lives of thousands of Irish workers;

• the adequacy of the treatment and support that workers receive;

• their experiences at work;

• the effect of their condition on their family and colleagues;

• the human and financial costs involved.

The researchers reviewed recent academic and practitioner research on the relationship between MSDs and labour market participation, and conducted interviews with experts in the field.

They found that MSDs have a significant negative impact on people’s ability to work and affect the productivity and labour market participation of many Irish workers. Their evidence suggests that:

• over half of Irish workers experience back pain each year;

• over a quarter of non-fatal injuries in Irish workplaces are attributable to back pain;

• just under 60% of Irish workers experience muscular pain in their neck, shoulders and upper limbs;

• 714,000 people in Ireland have arthritis, with 25% of all visits to doctor’s surgeries each year being attributable to arthritis and other musculoskeletal conditions.

Biopsychosocial model of health

According to the researchers, the biopsychosocial model of health emphasises the interplay between the biological (such as disease, strain and joint damage), the psychological (such as disposition and anxiety) and the social (such as work demands and family support). The model represents a helpful way of assessing the causes of some MSDs, of planning treatment and management, and of approaching rehabilitation into the workplace. However, it is not being adopted as widely as it should because many doctors and employers find it difficult to look beyond the immediate physical symptoms.

Five principles for improving working lives

The report argues that doctors, employers, employees and the government should focus on the following five main principles in order to improve the working lives of those with MSDs.

Early intervention is essential

Early action – preferably in a partnership between the patient, their doctor and their employer – can help those with MSDs to keep their jobs and to achieve a balance between an individual’s need for respite and their need to work.

Focus on capacity not incapacity

Employers and employees can ‘catastrophise’ MSDs, imagining their effects to be far more serious or insurmountable than is the case. Most workers with MSDs can continue to make a significant contribution at work if they are allowed to. For example, if doctors were asked to issue a ‘fit note’ rather than a ‘sick note’, it would be clearer what the worker was still able to do at work.

Imaginative job design is key to rehabilitation

Managers can change the ways in which work is organised (including simple but effective changes to physical layout or to working time arrangements) to help prevent MSDs getting worse and to help people suffering from MSDs to stay in, or return to, work.

Think beyond physical symptoms

Clinicians should apply their understanding of the biopsychosocial model rather than focusing solely on immediate physical symptoms in their diagnosis and treatment of the patient and, most importantly, their assessment of the role that a job might play in helping someone to stay active and avoid isolation.

Assess the direct and indirect costs of MSDs

Better measures are required to assess the social, economic and work impact of MSDs to allow government departments such as the Department of Health and Children to assess and monitor both the clinical and labour market impact of MSDs in a more ‘joined up’ way.

Reference

Bevan, S., McGee, R. and Quadrello, T., Fit for work? Musculoskeletal disorders and the Irish labour market, London and Dublin, The Work Foundation and Arthritis Ireland, 2009, available online at http://www.fitforworkeurope.eu/Website-Documents/ffw_Ireland311009.pdf.

Tony Dobbins, NUI Galway