Portugal: Musculoskeletal disorders identified as main risk factor in companies

Musculoskeletal disorders were cited as the most prevalent risk factor in the company segment of the 2015 National Survey on Working Conditions Survey in Continental Portugal. Psychological and emotional factors is the next most common risk factor. The Authority for Working Conditions (ACT) has stressed the importance of using the results to inform public policies in this domain.


The 2015 National Survey on Working Conditions in Continental Portugal was essentially two surveys: one of companies and the other of workers. This article focuses on the results for occupational safety and health (OSH) in the company survey. An earlier article discusses the results from the workers’ survey.

The survey was conducted by the Centre for Studies for Social Intervention (CESIS), at the request of the Portuguese labour inspectorate, the Authority for Working Conditions (ACT).

The survey addressed:

  • occupational risks;
  • occupational risk-prevention and control;
  • accidents at work and occupational diseases;
  • health;
  • work–life balance.


This survey covered a representative sample of 1,004 employers in mainland Portugal. An initial sample, stratified by quotas of 804 employers, was defined which was considered representative of employers in mainland Portugal. Additionally, a complementary sample of 200 employers was defined, also representative, but only of employers with 10 or more workers. The face-to-face interviews according to a paper-based questionnaire were conducted with the person or department responsible for OSH in each company.

Some 76.5% of the employers were micro companies (fewer than 10 workers), 20.4% were small companies (10–49 workers), 2.7% were medium companies (50–249 workers) and 0.4% were large companies (250 or more workers).

In total, the employers surveyed employed 18,805 workers: 8,401 women and 10,404 men.

The sample was stratified by the Nomenclature of Territorial Units for Statistics (NUTS II) and the Statistical Classification of Economic Activities in the European Community (NACE) Rev. 2 main sections, according to the last data published (17 June 2011) by Statistics Portugal (INE), in relation to all activities, with the exception of Section O – Public administration and defence; compulsory social security. Since the information on this section does not exist in INE, it was obtained through the Bank of Portugal.

The fieldwork took place between 10 October and 15 December 2015.

The sampling process followed was the method of quotas by region and by activity crossed with the size of the company.

Several quality control procedures were implemented. These included:

  • permanent monitoring of the interviews in order to ensure the proportionality of the strata;
  • all the interviews were revised answer by answer, and in case of non-conformity, omissions or incoherencies the interview was repeated;
  • a second quality check was carried out on a random sample of 20% of the interviews conducted by each interviewer and phone contact with the interviewee.

The design of the survey was based on the questionnaire used for the Second European Survey of Enterprises on New and Emerging Risks (PDF) (ESENER-2) conducted by the European Agency for Safety and Health at Work (EU OSHA).

Occupational risks

When questioned about the existence of risk factors associated with the performance of their activity, 42.1% of respondents identified at least one risk factor. ‘Agriculture’ and ‘livestock, hunting, forestry and fishing’ were the two sectors where risk factors were mentioned the most (61.9% and 60%, respectively).

Among the list of different risk factors, musculoskeletal disorders related to posture, effort and movement, were the most prevalent risk factor identified by respondents (36.4%), followed by psychological and emotional factors (20.7%).

Of the companies which cited musculoskeletal disorders, 40% performed some type of evaluation of the underlying factors, with 80% of those companies then implementing measures (non-specified) to minimise musculoskeletal disorders among their workers.

‘Construction activities’ (11.4%), followed by ‘work at a height’ (10.7%), ‘excavation and earth-moving works’ (6.8%), ‘work in confined spaces or with reduced dimensions’ (6.4%) and ‘works involving exposure to silica’ (6.2%) were the high-risk activities or works (as defined by Law 102/2009 of 10 September (PDF) identified more often by the respondents as being performed in their companies.

Prevention and control of occupational risks 

Health and safety at work services were not organised in almost one-fifth of the companies (19.9% in case of safety at work and 16% in case of health at work).

The contracting of external services was the most common form of managing OSH: 67.9% companies did this for safety services and 68.3% for health.

Some 86.7% of the companies with up to nine employees said there was no one tasked with OSH in their company. The existence of a designated worker responsible for OSH, or the employer assuming this role, is a legal requirement for micro companies.

Furthermore, fewer than 9% (8.8%) of the employers said the company had a workers’ representative for OSH. Manufacturing had the highest share of workers’ representatives for OSH (17.2%). Of the employers who did have such representatives, 39.1% also had a health and safety commission at work. Of those who said they had a health and safety commission, 23.5% belonged to the ‘wholesale and retail trade, repair of motor vehicles and motorcycles’.

Risk assessments and protective equipment

About one-third of the employers had carried out a risk assessment in the previous two years and, following this, about 80% of them reported having taken action. More than 10% of the employers said that they had not taken any measures, but were considering doing so.

Regarding collective protective equipment (such as covering machines or local ventilation), the results were as follows:

  • 36% of employers did not have any collective protective equipment;
  • 16% reported having some equipment;
  • only 29% had complete collective protective equipment;
  • 19% stated that this kind of equipment was not required.

Respondents were also asked about the provision and maintenance of protective equipment as a risk and accidents prevention activity. Some 33.8% reported having developed or being in the process of developing activities related to the provision and maintenance of collective protective equipment; and 40.2% reported having developed or in the process of developing activities related to the provision and maintenance of individual protective equipment.

Lack of collective protective equipment was most evident in occupations linked to ‘artistic, entertainment, sports and recreational activities’ (61.9%) and ‘information and communication activities’ (57.1%).

Employers who claimed to have all the compulsory collective protective equipment stood out in ‘public administration’ (75%) and ‘construction’ (68.6%). Specific OSH regulations for the construction sector, commonly identified as one of the sectors with a higher incidence of accidents at work, may have contributed to this result, while in public administration, rules must be implemented.

For almost half of respondents, the main reason for the absence of collective protective equipment was that it was not necessary; for 40% of the respondents, collective protective equipment was not a priority and approximately 4% claimed it was too expensive.


About half of the employers (51%) reported they had provided training on health and safety at work over the previous two years.

First aid (39.1%), fire safety (39%) and safety signs (37.4%) were the areas more often covered. The manufacturing sector was foremost in the promotion of training in these three areas. Topics that were covered less were:

  • biological risks (4.3%);
  • use of chemicals (5.7%);
  • jobs with risks (6.9%).

Over 6 out of 10 employers (61.1%) developed or were developing at least one activity related to the prevention of risks and accidents at work. The installation and maintenance of safety signs, the preparation of an internal emergency plan, and the availability and maintenance of personal protective equipment were mentioned by employers in 53.3%, 42.6% and 40.2% of cases, respectively.

However, 88.3% of the companies said they had never run any programme/activities on health promotion and 81.5% admitted never monitoring the working conditions of workers in more vulnerable situations.

Manufacturing and public administration were the main sectors where activities had been developed to prevent risks and accidents at work. Manufacturing is the sector with a higher prevalence of accidents at work and is covered by specific OSH regulations.

Accidents at work and occupational diseases

Approximately 11% of employers had registered an occupational accident in the previous two years. A total of 2,139 accidents were reported in the survey, affecting more men than women (1,364 and 633, respectively). Some 85.6% of the registered accidents involved sick leave and hospitalisation; one fatal accident was registered. Distractions, carelessness, lack of attention (55.5%), followed by incorrect postures, efforts and/or extreme movements during the task (26.4%) and high speed of work (18.2%) were identified as the main causes of accidents at work.

Assessment of recent legislation on promotion of OSH at work

Current legislation on the promotion of OSH was considered by about half of employers to be easy to apply and adequate. However, the other half (particularly micro companies) considered it complex and economically disadvantageous, oriented to the industrial sector or large entities.

Compliance with legislation was the main motivation for employers to develop measures to promote the improvement of OSH (47.6%). The second reason was to avoid fines and other sanctions (22.5%). The need to promote a safe and healthy working environment appeared only third as a reason (17.3%) for employers to carry out these sorts of measures.


The companies’ segment of the 2015 National Working Conditions Survey in Continental Portugal produced an array of important results for OSH. These outcomes may not only inform public policy and company-level action but also contribute to fostering social dialogue and collective bargaining in this domain.

The Confederation of Portuguese Industry (CIP) and the Portuguese Trade and Services Confederation (CCP) plus the General Workers’ Union (UGT) agreed that:

  • it was very important to have regular and updated survey results on working conditions in Portugal;
  • further action is required to build a prevention culture.

Specific concerns are expressed by UGT regarding, for example:

  • musculoskeletal disorders as the main risk factor;
  • the prioritisation of collective protection over that individual protection;
  • the very small number of employers who have workers’ representatives for OSH;
  • the violation of the risk assessment obligation;
  • the complexity of OSH legislation.

Also important is the fact that the OSH National Strategy 2015–2020 (PDF) foresees the development of toolkits to support new employers in meeting their OSH and labour obligations. ACT stressed the importance of taking into account the outcomes of the survey in monitoring the measures set out in the national OSH strategy. ACT added that a potential revision of the strategy could benefit from using these conclusions to inform public policies in this domain.

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