Introduction

If you ask workers about their chief health concerns at work, back pain and strain and repetitive strain injuries (RSI) are always high on the list. For example, the TUC’s biennial survey of trade union safety reps asks reps to identify the main hazards in their workplace. In the 2010 survey, back strains constituted the third most frequently mentioned hazard, with a third of safety reps saying this was a top five concern, compared with 31% in 2008. And RSI was a concern in more than a quarter of workplaces (28%).

Official figures show that injuries like back pain, RSI and other upper and lower limb disorders, collectively known as musculoskeletal disorders (MSDs), continue to account for the highest number of injuries reported to the safety watchdog, the Health and Safety Executive (HSE).

The latest estimates from the Labour Force Survey (LFS) show there has been a downward trend in the total number of work-related MSDs over the last 10 years; but that they still accounted for nearly half (508,000) of all (1,152,000) cases of work-related illness in 2010-11. And there were 158,000 new cases of MSDs in Great Britain in 2010-11.

The HSE reports that the industries with the highest rates of MSDs over the last three years were post and courier activities, specialised construction work and agriculture. Postal workers and those working in the building trades and skilled agriculture trades had higher than average rates of MSDs.

And HSE statistics show that in 2010-11, 7.6 million working days were lost as a result of work-related MSDs, with each person suffering taking an estimated 15 days off work in that 12-month period.

These official figures underestimate the scale of the problem because many injuries go unreported and undiagnosed. Across Europe, the 2010 Fit for Work Europe report by the Work Foundation business consultancy group estimated that more than 40 million workers in Europe are affected by MSDs attributable to their work and that these injuries account for a higher proportion of sickness absence from work than any other health condition.

The report estimates that this costs the UK economy some £7 billion each year, and some £219 billion across Europe. In the UK alone, it estimates that one million people suffer from MSDs that cause them to take time off work, with 9.5 million days lost each year. It says that chronic musculoskeletal pain goes undiagnosed in more than 40% of cases.

The NUT teachers’ union reports that while official statistics suggest that teachers are at a relatively low risk of developing MSDs, research carried out in 2005 found that more than 75% of primary school teachers suffer ongoing discomfort and pain due to back, shoulder and neck problems. It also found that teachers not only considered aches and pains as “part of the job”, but also that one quarter of those surveyed said that they would not report these types of problems to their employer.

And the physiotherapists’ CSP union says that its major research study on work-related MSDs affecting the physiotherapy workforce carried out in 2005 showed that 68% of its members suffered a MSD sometime during their career and that as a consequence one in 16 would likely leave the profession. But only 16% notified their line manager and only 10% completed a workplace accident form.

The British Association for Performing Arts Medicine (BAPAM) is a small national charity providing free clinical assessments for performing artists (including musicians, dancers and actors) with performance-related health problems and is funded by organisations including the musicians’ MU union and the actors’ union Equity.

Its chief executive Naomi Wade told the Labour Research Department (LRD) that around 85% of its new patients are experiencing musculoskeletal problems. But she said: “This is a huge unacknowledged issue, because most performers are very reluctant to admit to their art causing them injury or illness, as they operate in such a competitive world. In fact, there is a real ‘disposable body’ attitude towards many rank and file performers, as there are always others waiting to take their place if they drop out through injury.”

Many workers, backed by their unions, have been forced to go to court to get some compensation for their pain. While this has often been an uphill struggle, it has lead to wider recognition of the problem, and in some cases lead to improvements in the workplace. For example, a “MSD risk Assessment for Train drivers (MAT) tool” came about following a successful compensation case backed by the train drivers’ union ASLEF.

This booklet gives workers and union reps the information they need to ensure that their employer takes action to prevent MSDs including back pain and RSI, and to support workers who do develop MSDs.

It examines the extent of these injuries at work, research findings into the causes and consequences of back pain and RSI, and sets out the legal duties on employers with respect to risk assessments, prevention and rehabilitation.

The prevention of MSDs is addressed in Chapter 4, describing detailed advice from trade unions and the HSE. Advice on the rehabilitation and treatment of workers suffering from MSDs is outlined in Chapter 5, which also looks at how safety reps can help workers who develop MSDs to stay in work and ensure that they are properly compensated if they do develop injuries.

The booklet is illustrated throughout with practical advice, including examples of how unions and safety reps have successfully taken up the issues and won improvements.