Fit For Work

Fit For Work?
Musculoskeletal Disorders and the Spanish Labour Market
Tatiana Quadrello Stephen Bevan Robin McGee

Contents

1. Executive summary 2. Introduction 2.1 2.2 2.3 2.4 2.5 Why is workforce health in Spain important? MSDs: The European context Objectives of the study A note on definition Structure of the report

5 9 9 12 12 14 15 16 16 18 25 28 35 37 37 39 40 42 44 48 49 49 5051 52 53 55 63 64

3. Work and MSDs in Spain 3.1 3.2 3.3 3.4 3.5 The data context The impact of MSDs on ability to work The impact of the work-place on MSDs The wider economic and social impact of MSDs Summary

4. Interventions 4.1 4.2 4.3 4.4 4.5 4.6 The case for early intervention The social security regime for the work disabled Condition-specific interventions The biopsychosocial model andwork The role of employers Summary

5. Conclusions and recommendations 5.1 5.2 5.3 5.4 5.5 References Appendix 1: Interviews and consultation with experts Appendix 2: Benchmarking grid Recommendations for employers Recommendations for employees Recommendations for clinicians Recommendations for occupational health professionals Recommendations for government

Fit For Work? MusculoskeletalDisorders and the Spanish Labour Market

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List of Boxes, Figures and Tables

Box 1: Principles of managing non-specific MSDs

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Figure 1: Most common occupational diseases by sex and disease among Spanish workers 17 Figure 2: Chronic conditions and working life by sex and employment status Figure 3: Number of employees who have not worked in the reference week Figure 4: Absence causedby MSDs by sex Figure 5: ICF model applied to work disability in RA 19 33 34 43

Table 1: Summary of intrinsic risk factors for non-specific MSDs Table 2: Direct costs associated with MSDs, RA, and low back pain

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Fit For Work? Musculoskeletal Disorders and the Spanish Labour Market

1. Executive summary

The long period of Spanish expansion has been badly affected by theglobal economic downturn. As a result, a marked increase in unemployment with all its individual, social and economic consequences has been recorded. Furthermore, the health of Spanish workers is also giving serious cause for concern. Over one million people are not healthy enough to drive the improvements in productivity which Spain needs to compete in an increasingly globalised, knowledge-basedeconomy when the up-turn comes. There is also overwhelming evidence that worklessness is, itself, bad for health and that job retention and rehabilitation back into work can positively affect physical health, psychological well-being and raise people out of poverty. Of all the causes of ill-health, chronic conditions have a strong impact on the working life of people who experience them; MSDs accountsfor 20 per cent of all sick leave days.
The ‘Fit for Work?’ project

This project, part of a wider programme of work across 24 European and other countries, has looked in some detail at the impact that MSDs have on the working lives of thousands of Spanish workers, the adequacy of the treatment and support they receive, their experiences at work, the effect of their condition on their familyand colleagues, and the human and financial costs involved. Specifically, we have looked at back pain, work-related upper limb disorders (WRULDs) – two groups of conditions which are usually characterised by non-specific and short episodes of pain and incapacity – and rheumatoid arthritis (RA) and spondyloarthropathies (SpAs), specific conditions that are often progressive and increasinglyincapacitating. We conducted a review of the recent academic and practitioner research on the relationship between these MSDs and labour market participation, and conducted interviews with acknowledged experts in this field.

The Impact of MSDs on the Spanish workforce

MSDs have a significant impact on people’s ability to work; not only on an individual but an aggregate basis. Together, they affect...