Thank you for the invitation to this session. This report is part of a larger project which was carried out o support the European Agency for Safety and Health in their next campaign "Lighten the load". What surprised me most is that there is a consistent pattern globally of MSDs not reducing in the workplace. While the link between MSDs and psychosocial risks was written about in 2002, from the European perspective we are still assessing risks separately. New developments from Australia were also identified that may prove useful in other parts of the world. I would like to ask everyone on the forum, where is New Zealand at and what might work here?

A couple of thoughts. First, why is the high rate of musculoskeletal disorders not diminishing, given all we have learned over the last 20 years about redesigning work to minimise lifting and pushing (to take one example)?

Second, have we have kept our efforts to address MSD risks and psychosocial risks in silos, largely disconnected, because 'common sense' does not suggest any link between them?

Send in your questions for Joanne now - by simply responding to this thread.

All questions and other responses go into a moderation queue to be released by me in some kind of logical sequence. I can't guarantee all responses will see the light of day, depending on repetition etc.

I'll release the first question around 9.30am as a starter for ten.

Hi Joanne
I'm interested in the direction of causality - it's easy to see how MSDs could lead to mental wellness issues, particularly if they are chronic, but less obvious how it might work in the other direction. Is there definitive causation, rather than just correlation and does it work both ways?
Also (bonus question), what impact do you imagine the double whammy of covid-19 stress and poorly designed home-based workstations may have - how should people manage that with their workers returning to the office?

Hi Craig
There appears to be an association (although still a lot of discussion) about psychosocial risk exposure and MSDs. A number of pathways have been suggested in the literature including burnout, poor social support, low level of control and other factors. One of the original pieces of research on this was done in 2002 that identified the association. My question would be if we know there is an association, should we be assessing both physical and psychosocial risks together?
In answer to your second question - I came to work today and was so glad to get back to my office chair. I suspect we will have a few issues around discomfort. I hope that everyone is sticking to the getting up and moving around regularly.

A Forum member has sent me this query which I'm posting on behalf:
"I am currently writing up the 3rd injury in less that 6 weeks for tennis elbow for workers in the cleaning team. The job involves manual scrubbing and two-thirds of their shift will involve scrubbing motions. Ageing workforce is a factor alongside developing arthritic conditions since commenced employment here. All three are fearful of losing employment and it is likely that the symptoms went unreported for some time. Any advice on preventing escalation of this type of injury?

Hi Peter

We may have regulated but is anyone checking that work has changed? My experience in Europe is that everyone does risk assessments but then the process seems to stop. Its unclear at the moment whether it is lack of knowledge of how to reduce MSD risks or concern about the possible costs of change. There seems to be a disconnect in the European context.

To answer Joanne's question, in New Zealand we have been somewhat hamstrung by ACC being the lead agency for addressing the prevention of musculoskeletal disorders (MSDs) for much of the last couple of decades. This tends to see most things somewhat two-dimensionally in terms of causation. Having said that, ACC led a very good musculoskeletal injury prevention programme between 2006-2012, that had a very systems based framework for understanding the many factors that contribute to to the risks associated with manual tasks and sedentary work - including organisational factors, psychosocial factors, and individual factors. This was the 'Discomfort, Pain and Injury Prevention and Management Programme', known as the 'DPI Programme'. Unfortunately, this was not strongly connected to regulatory action, and not well connected to health and safety actions generally - it was probably better connected to injury management. This programme was however ahead of its time in connecting the dots between psychosocial and physical issues... though it has not been supported by ACC for a number of years now..

Thanks Marion

Hi Peter

With regard to the injuries occurring, tennis elbow and golfer's elbow are most often related to twisting motions around the elbow joint (not giving medical advice here as not a physician). Firstly, are the individuals aware of the reporting process and are they happy to use it. Informing the workforce that for example, most of us will get mechanical back pain at some point in our lives. Secondly, is there a way to change the work to reduce the risk of the risks, work through the hierarchy of control and perhaps an administrative solution as in task rotation may work, as long as they are doing something with different muscle groups. Its about seeing how the work is carried out, identifying the risks and working with employees to develop workable solutions

Hi Joanne, knowing that you are a recent arrival from the UK, can you comment on how well other jurisdictions are integrating the common MSDs/psychosocial work risks in terms of the interventions and programmes they are running. Have you seen any gems that we should steal?

Hi Joanne

Do you have thoughts on how we would assess physical and psychosocial risks together?

Hi Marion
Just across the ditch, the APHIRM toolkit in Australia, we are all watching that with interest. In Europe, Germany and Sweden are taking a much more joined up approach to risk assessment including diversity such as gender and age. In the UK, the current HSE strategy aims to build evidence of what works in practice.

Hi Hillary
The APHIRM toolkit does this. It comes from La Trobe University and what makes it different is that it covers physical risks, psychosocial risks, participation by the employee and prioritization of findings. It helps the organisation to prioritise what needs dealing with first, should there be more than one problem identified.

With more and more work forces having driving as part of their risk profile, I have been interested to see there is limited information on what 'good' looks like for driving ergonomics. Do you have any information or where we can find such information? I remember in a past life being told sit up straight, and set your rear view mirror, this way you will know you are slouching when driving as you wont see out your mirror correctly if you are slouching.

I have had initial conversations with the La Trobe team regarding APHIRM, and am interested in NZ human factors/ergonomics professionals getting a good look at this, in liaison with the WorkSafe team who are beginning their work on addressing these now fully recognised health risks.

re: tennis/golfers elbow - yes they are aware of reporting procedures they are happy to use it but really reluctant to do so if they have an underlying health problem. Unfortunately much of the cleaning is scrubbing lots of small and finicky parts attached to large manufacturing machines so yes a lot of twisting motions of the wrist/elbow, task rotation occurs but as much of the cleaning job is scrubbing the only variation from the rotation is scrubbing large pieces of equipment versus small parts

Hi Mark

There are a number of advice sources for driving ergonomics as again there are associations between MSDs and driving. Would recommend http://drivingergonomics.lboro.ac.uk/ but I have not searched for more local information and there may be some available. Some important facts are about getting the seat positioned correctly to give support to the back; the headrest is not a headrest but a whiplash prevention measure and certainly in the UK we were advised not to drive for more than 2.5 hours at a time.

HI Craig, I've just read a 2018 report by Yves Roquelaure (Belgium) 'Musculoskeletal disorders and psychosocial factors at work' (Report 142). It had some good discussion of the way that the physical and psychosocial elements work and how, for risk causation. You might enjoy the read.

Hi Joanne,

Can you provide a sense of what a 'joined up ' approach is or point us to references that we can explore?

Hi Marion
I am sure the La Trobe team would be willing to talk and hopefully visit if we get a trans-Tasman bubble.

Hi Robyn
is job enlargement a possibility for these workers? Alternatively is there different cleaning equipment that could be sourced to take some of the pressure of the joints?

Hi Robyn, It sounds like a good call for a more robust assessment that includes broader job design aspects, and the design of the equipment itself, as well as considering your work force issues and needs. This is work that an ergonomist can assist you with. You can track down certified ergonomists (also called human factors professionals) via the HASANZ Register, and by looking at the 'Find a Professional' page for the Human Factors and Ergonomics Society of NZ.

Hi Hillary
https://www.aphirm.org.au/
The recently published report https://osha.europa.eu/en/publications/work-related-musculoskeletal-disorders-why-are-they-still-so-prevalent-evidence/view
The European Agency for Safety and Health are starting a new campaign in October on MSDs called "Lighten the load". This campaign will release a number of different research reports that were carried out in the past 3 years.

Good Morning Joanne.
Are you aware of any MSD Assessment model where domestic and social activities are included?

Only assessing and mitigating what occurs in an 8hr window seems a pretty dated (and compliance driven) approach, especially when we consider the phycho-social issues that arise from such injuries.

Posture, break practices, work (and other) stressors, fitness and stretching, nutrition ad hydration, the consideration of exposure to whole body vibration, hours of work, cognitive load, etc etc etc.... The 'ergonomics' of driving are about considerably more than simple physical set-up and fit!

Many thanks.

Hi Joanne
Do you think this lack of trending down for MSD is due to comorbidity factors - sedentariness, obesity, and chronic conditions, pain related mental fatigue - that is impacting on these figures ?

Hi Chris
A good point and again its a gap between work and home. However, there is evidence to show that individuals with poor lifestyle behaviours are more at risk of MSDs (smoking, overweight and low levels of physical activity). We need to link up health promotion too. However, certain hobbies do put stress on your joints (decorating, gaming etc) perhaps we should be getting the message out about risk in the public health and home environment too.

I think that working to change how the work is designed and done is the crucial element. In NZ because good musculoskeletal risk assessment and intervention is reasonably rarely done, I suspect that many times a basic 'assessment' (of varying skill level) reduces the issues to "it's common sense" and restricts the intervention to 'training'. Thus, the risk remains.

Hi Wendy
No, not just those factors listed. When you look at data to the workplace risk factors that people are exposed to for MSDs, in Europe and New Zealand, such as adopting poor posture, manual handling, repetitive work and sedentary work, exposures are not reducing. Although there has been sectoral change in employment, the risk factors are not reduced in most sectors in Europe.