Work-related neck and Upper limb disorders – a pain in the neck
October 1st 2007

Work-related neck and upper limb disorders (WRULDs) are responsible for almost half of all occupational diseases in Europe. Almost two thirds of EU workers report being exposed to repetitive hand and arm movements, and a quarter to vibrations from tools, both of which are significant risk factors for WRULDs reports the EU-OSHA

As their name suggests, WRULDs affect the neck, shoulders, arms, hands, wrists and fingers, causing pain, discomfort, numbness and tingling sensations. Other symptoms include swelling in the joints, decreased mobility or grip strength, and a change in skin colour of the hands or fingers. Some of these disorders, such as tendonitis and carpal tunnel syndrome, have well-defined symptoms and a familiar medical name.

Symptoms may take weeks, months or in some cases years to develop. So, once workers report them, action has to be taken without delay. A far better option is to stop the symptoms from developing in the first place.

Risk assessment followed by appropriate workplace action would reduce the chance of workers at higher risk from developing WRULDs. And employee involvement is essential when tackling any workplace hazards – after all, the workforce and their representatives know the workplace as well, if not better, than anyone.

Helping car workers in Hungary A recent study of car seat upholsterers in Hungary shows how easily WRULDs – in this case, severe wrist pain – can develop, and how effective preventative action can be.

Three public and occupational health experts analysed the upholstery work process at a car factory after noting that injuries were occurring at an 'almost accident-like rate'.

They suggested a series of measures that involved changes in technology, tools and work organisation to reduce the physical strain put on the upholsterers. Since these recommendations were implemented, there have been no new reported cases of WRULDs.

In the view of the experts, the most important lesson from the study was that injuries caused by "excessive physical strain can be properly diagnosed through an extensive analysis of the working process. By using sensible measures to reduce the excessive strain, adapting the work to the worker and optimising the use of the worker, such injuries can be prevented." They made one other interesting discovery: previous hand or arm injuries "may predispose a person to disorders caused by overuse."

Helping keyboard users in the UK Several copy-takers doing prolonged repetitive keyboard work in the advertising department of a UK newspaper developed upper limb disorders. This led to high sickness absence and staff turnover.

The company employed an ergonomist to assess the work environment and suggest changes. As a result, managers were made responsible for ensuring that workers took breaks and a rest room was provided. The company also adjusted work schedules to reduce pressure on staff, and provided chairs and desks that could be adjusted for height.

These changes cost over 65,000 euro but the savings in reduced staff absence and turnover were worth more than 30,000 euro a year. In fact, there were no reported cases linked to musculoskeletal disorders (MSDs) in the three years following the company's intervention. The result was that the company recouped its money in a little over two years.

'Lighten the load' Many problems can be prevented, or at least greatly reduced, through concerted action in the workplace. This is the message of 'Lighten the load', the European Agency for Safety and Health at Work's 2007 campaign to tackle WRULDS and other MSDs. The Bilbao-based Agency was set up by the EU a decade ago to improve people's working lives.

Not only do WRULDs cause personal suffering and loss of income, but they also cost businesses and national economies. The cost of WRULDs has been estimated at between 0.5% and 2% of gross national product.

'Lighten the load' supports an integrated management approach to tackling WRULDs and other MSDs. First, employers, employees and government need to work together. Secondly, any actions should address the 'whole load on the body', which covers all the stresses and strains being placed on the body, environmental factors such as cold working conditions, and the actual load being carried. Thirdly, employers need to retain, rehabilitate and help employees with MSDs return to work.

Some people only experience minor discomfort, but WRULDs and other MSDs can develop into serious medical conditions that require time off work and medical treatment. In the most chronic cases, treatment and recovery are often unsatisfactory. The result can be permanent disability and even loss of employment.

MSDs, including WRULDs, are a widespread problem – at some point in their life as many as 90% of people will suffer from them – and both employers and workers need to tackle them without delay. The agency's campaign, 'Lighten the load', is a good way to start.

What causes WRULDs?

Work-related neck and upper limb disorders (WRULDs) tend to develop gradually, the cumulative effect of many, apparently moderate applications of force, repeated over a long period.

These loads do not appear to cause immediate injury but the result is muscle fatigue, which can injure the soft tissue of the neck, shoulders and upper limbs.

If sufficient time for rest is allowed, the body will recover and may grow stronger; if not, WRULDs can develop.

The following factors may contribute to the development of WRULDs:

heavy loads awkward and static postures repetitive movement too little rest excessive cold monotonous tasks high pace of work

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