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Work Is 'Cure As Well As Cause' Of Major Workplace Illnesses, UK

08 Sept 2007

As edited by

'Musculoskeletal disorders' (MSDs) - an umbrella term that covers over 200 different ailments including arthritis, back pain and damage to joints, muscles and tendons - affect twice as many people as 'stress', account for up to a third of all GP consultations, cause 9.5 million lost working days, and cost society £7.4bn a year*.

These are the main findings of a new report from The Work Foundation into the economic and social impact of MSDs - by far the most prevalent cause of work-related illness in the UK.

The report argues that early intervention and an emphasis on keeping sufferers in work wherever possible are likely to boost national productivity and help reduce the 2.6 million people claiming Incapacity Benefit. 'There is overwhelming evidence that worklessness is, itself, bad for health,' the report says.

The government needs to urgently rethink how health agencies co-ordinate treatment of MSDs, offer greater support to small businesses, and give a higher priority to understanding the labour market impact of MSDs as part of its Work, Health and Wellbeing Strategy, the report recommends.

MSDs affect all kinds of industries and occupations - in particular health and social care, the construction and building trades, transport and machine drivers, process plant and machine operatives, and caring personal service occupations. However, people affected by an MSD are also likely to have mental health problems as well. The chances of a swift return to work after an MSD-related absence is increased if people have positive mental health and support from employers and family.

Michelle Mahdon, senior researcher at The Work Foundation, said: 'Stress hogs headlines, but in terms of people affected, MSDs are the bigger problem, affecting more than a million people a year - and, of course, their families.

'Work can be both cause and cure. It may cause or aggravate symptoms of MSDs, but evidence is amassing that with the right support arrangements work can also be part of the recovery by contributing to a person's self-esteem and sense of being productive. What urgently needs to change is the attitude of many GPs and employers that an MSD sufferer must be 100 per cent well before any return to work can be contemplated. Too many see only incapacity rather than capacity.'

The onset of an MSD may harm a person's work performance by affecting stamina, concentration, mood, mobility and agility.

However, the report urges GPs and employers to look beyond immediate physical symptoms in their management of MSDs. The 'biopsychosocial model' of health - which emphasises the interplay between biological (eg. disease, strain, joint damage), psychological (eg. disposition, anxiety) and social (eg. work demands, family support) factors - represents a 'helpful' way of assessing causes and planning treatment and rehabilitation.

Dame Professor Carol Black, the government's National Director for Health and Work, and author of the report's foreword, said: 'I hope that in time MSDs will become less relevant to work and working life. Until then, efforts to raise awareness of them must continue with ever greater urgency. I welcome this report as a valuable contribution to the debate.'

Article adapted by from original press release.

The report examined four conditions in detail. These are:

-- Back pain: a non-specific condition (meaning no specific diagnosis is given) usually involving short episodes of pain. At any one time, 33 per cent of the UK population suffers with back pain.

-- Work-related Upper Limb Disorders: Another non-specific set of conditions which affect over 375,000 people.

-- Rheumatoid Arthritis: A specific condition which affects almost 400,000 people in the UK with 12,000 new cases each year. It is estimated that almost a quarter of RA sufferers stop work within five years of diagnosis.

-- Ankylosing Spondylitis: a progressive and chronic rheumatic disorder that mainly affects the spine, but can also affect other joints, tendons and ligaments; it is most often diagnosed among men in their early twenties. Over 200,000 people visit their GP with AS every year.

The report calls for:

-- Early intervention: long periods away from work are usually bad for patients. Partnerships between patient, employer and GP can achieve a balance between an individual's need for respite and the need to work. For some MSD patients early access to physiotherapy or to drug therapies can reduce the severity, impact or progression of the condition.

-- Better job design: managers can change the ways work is organised - from adjusting working time, altering task allocation, to improving ergonomics.

-- Enhanced measurement of direct and indirect costs of MSDs: much better mechanisms to assess and monitor the social and work impact of MSDs are needed. The National Institute for Health and Clinical Excellence (NICE) should take into account labour market impacts when examining the economic effectiveness of different therapies. For example, whether a patient can be kept in work and off Incapacity Benefit may drastically affect decisions about the cost effectiveness of drug therapies.

1. 'Fit for Work: Musculoskeletal Disorders and Labour Market Participation' by Stephen Bevan, Eleanor Passmore and Michelle Mahdon is available from The Work Foundation.

2. Michelle Mahdon is available for interview.

3. The best calculation of the cost of MSDs to society comes from the Health and Safety Executive, which put the cost at £5.7 billion in 1995-6 (see Health and Safety Statistics, 2005-6, HSE). Uprated for RPI inflation using the Office for National Statistics recommended methodology results in £7.4 billion.

4. The project was supported by Abbott, the healthcare company.

5. Some individual case studies of MSD sufferers are available on request.

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