Work-related Musculoskeletal Disorders (MSDs): statistics
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This presentation provides an overview of the prevalence, impact and the risk factors of work-related MSD.
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Work-related Musculoskeletal Disorders (MSDs): statistics
- 1. Safety and health at work is everyone’s concern. It’s good for you. It’s good for business. Healthy Workplaces Campaign 2020-22 LIGHTEN THE LOAD MSD-related statistics
- 2. 2 www.healthy-workplaces.eu • EU-OSHA, Work-related musculoskeletal disorders: prevalence, costs and demographics in the EU, 2019 available at: https://osha.europa.eu/es/publications/msds-facts-and-figures-overview-prevalence-costs-and- demographics-msds-europe/view • EU-OSHA, Work-related musculoskeletal disorders: Facts and Figures — Synthesis report of 10 EU Member states reports, 2020 (AT, DE, DK, ES, FI, FR, HU, IT, NL and SE) available at: https://osha.europa.eu/en/publications/work-related-musculoskeletal-disorders-facts-and-figures-synthesis- report-10-eu-member/view Overview MSDs prevalence Impact of MSDs MSD-related risk factors MSDs prevention This PPT is based on the following reports:
- 3. 3 www.healthy-workplaces.eu MSDs prevalence Around 60% of all workers with a work-related health problem, identify MSDs as their most serious issue MSD complaints slightly decreased between 2010 and 2015 MSD complaints vary considerably between Member States, sectors and occupations Women report slightly more MSDs than men MSDs prevalence is higher among older workers MSDs prevalence decreases with educational level MSD work-related accidents are among the most common accidents
- 4. 4 www.healthy-workplaces.eu MSDs - Work-related health problem number 1 Source: Eurostat, Labour Force Survey ad hoc module ‘Accidents at work and other work-related health problems’ (2013) Percentage of workers reporting a work-related health problem, by type of problem, EU-27, 2013 Musculoskeletal Disorders Stress, depression, anxiety Others 5%: other – not specified 5%: headache, eyestrain 4%: cardiovascular disorders 4%: pulmonary disorders 2%: stomach, liver, kidney or digestive problems 1%: skin problems 1%: hearing disorders 1%: infectious diseases Around 60% of all workers with a work-related health problem identify MSDs as their most serious issue
- 5. 5 www.healthy-workplaces.eu MSD complaints only slightly decreasing Source: Panteia based on the fifth (2010) and sixth (2015) waves of the European Working Conditions Survey (EWCS) Percentage of workers reporting different musculoskeletal disorders in the past 12 months, EU-28, 2010 and 2015 Muscular pains in lower limbs Muscular pains in shoulders, neck and/or upper limbs Backache One or more musculoskeletal disorders The proportion of workers reporting MSD complaints slightly decreased between 2010 and 2015
- 6. 6 www.healthy-workplaces.eu MSD complaints by Member State Percentage of workers reporting that they suffered from one or more musculoskeletal disorders in the past 12 months, by Member State, 2010 and 2015 Source: Panteia based on the fifth (2010) and sixth (2015) waves of the European Working Conditions Survey (EWCS) 2015 2010 The proportions of workers reporting MSD complaints vary considerably between MS
- 7. 7 www.healthy-workplaces.eu Backache (and MSDs in general) by sector Percentage of workers reporting backache in the past 12 months, by sector (NACE rev 2), EU-28, 2015 Source: Panteia based on the sixth (2015) wave of the European Working Conditions Survey (EWCS) Agriculture, forestry and fishing Water supply Construction Human health and social work activities Manufacturing Transportation and storage Real estate activities Other service activities Arts, entertainment and recreation Accommodation and food service activities Administrative and support service activities Electricity, gas, steam and air conditioning supply Wholesale and retail trade Mining and quarrying Information and communication Public administration and defence Professional, scientific and technical activities Education Financial and insurance activities The proportions of workers reporting backache (and MSDs in general) vary considerably between sectors
- 8. 8 www.healthy-workplaces.eu MSDs prevalence highest among blue-collar workers Source: Panteia based on the sixth (2015) wave of the European Working Conditions Survey (EWCS) Percentage of workers reporting different musculoskeletal disorders in the past 12 months, by occupation (ISCO-08), EU-28, 2015 Armed forces occupations Clerical support workers Craft and related trades workers Elementary occupations Managers Plant and machine operators and assemblers Professionals Service and sales workers Skilled agricultural, forestry and fishery workers Technicians and associate professionals Backache Muscular pains in shoulders, neck and/or upper limbs Muscular pains in lower limbs One or more MSD-related health problems
- 9. 9 www.healthy-workplaces.eu MSDs by gender Source: Panteia based on the sixth (2015) wave of the European Working Conditions Survey (EWCS) Percentage of workers reporting different musculoskeletal disorders in the past 12 months, by gender, EU-28, 2015 Muscular pains in lower limbs Women report slightly more MSDs than men Muscular pains in shoulders, neck and/or upper limbs Backache One or more musculoskeletal disorders
- 10. 10 www.healthy-workplaces.eu MSDs prevalence is higher among older workers Source: Panteia based on the sixth (2015) wave of the European Working Conditions Survey (EWCS) Percentage of workers reporting different musculoskeletal disorders in the past 12 months, by age group, EU-28, 2015 Muscular pains in lower limbs Muscular pains in shoulders, neck and/or upper limbs Backache One or more musculoskeletal disorder Under 25 25-39 40-54 55 and over
- 11. 11 www.healthy-workplaces.eu MSDs prevalence decreases with educational level Source: Panteia based on the sixth (2015) wave of the European Working Conditions Survey (EWCS) Percentage of workers reporting different musculoskeletal disorders in the past 12 months, by educational level, EU-28, 2015 Muscular pains in lower limbs Muscular pains in shoulders, neck and/or upper limbs Backache One or more MSD-related health problems Pre-primary education Primary education or first stage of basic education Lower secondary or second stage of basic education (Upper) secondary education Post-secondary non-tertiary education First stage of tertiary education Second stage of tertiary education
- 12. 12 www.healthy-workplaces.eu MSDs-related accidents The types of accidents related to MSDs-related are: dislocations, sprains and strains, bone fractures, and traumatic amputations (loss of body parts). MSD work-related accidents are among the most common work- related accidents. Source: Eurostat, European Statistics on Accidents at Work (ESAW) Distribution of fatal and non-fatal accidents at work by type of injury, EU-28, 2016 Wounds and superficial injuries Dislocations, sprains and strains Concussions and internal injuries Bone fractures Shocks Others Other not specified Burns, scalds and frostbites
- 13. 13 www.healthy-workplaces.eu MSDs have an impact on the general health of workers, for instance the proportion of workers with (very) good health is smaller for workers who suffer from MSDs Workers with MSDs tend to be absent from work more often than others Very high impact of MSDs in economic terms Lack of data on the economic impact of MSDs at EU level. Some data available at Member State level: More information available at: EU-OSHA, Work-related musculoskeletal disorders: Facts and Figures — Synthesis report of 10 EU Member states reports, 2020 (AT, DE, DK, ES, FI, FR, HU, IT, NL and SE) https://osha.europa.eu/en/publications/work- related-musculoskeletal-disorders-facts-and-figures-synthesis-report-10-eu-member/view Impact of MSDs
- 14. 14 www.healthy-workplaces.eu Workers with MSDs and Health Percentage of workers reporting that their health is very good, good, fair, bad or very bad, by different health problems in the past 12 months, EU- 28, 2010 and 2015 Source: Panteia based on the fifth (2010) and sixth (2015) waves of the European Working Conditions Survey (EWCS) 2015 2010 No health problems Only other health problems Only musculoskeletal disorders Musculoskeletal disorders and other health problems Very good Good Fair Bad Very bad Proportion of workers with (very) good health is smaller for workers who suffer from MSDs (in the upper limbs, lower limbs and / or back)
- 15. 15 www.healthy-workplaces.eu MSDs and comorbidities Percentage of workers reporting the different health problems that affect their life, by presence or absence of MSDs, EU-28, 2015 Note: Musculoskeletal disorders refer to backache and/or muscular pains in shoulders, neck, upper limbs and/or lower limbs (hips, legs, knees, feet etc.) Overall fatigue Headaches, eyestrain Waking up with feeling of exhaustion and fatigue at least several times a month Waking up repeatledly during sleep at least several times a month Difficulties falling asleep at least several times a month Anxiety Injury(ies) Skin problems Hearing problems Other (spontanoeous) Source: Panteia based on the sixth (2015) wave of the European Working Conditions Survey (EWCS) Headaches, eyestrain, overall fatigue and sleeping problems affect the lives of workers who suffer from MSDs
- 16. 16 www.healthy-workplaces.eu Main work-related illnesses and DALYs Source: Panteia based on EU-OSHA, data visualisation (2017). Available at: https://visualisation.osha.europa.eu/osh-costs#!/eu-analysis-illness Distribution of years of life lost and lived with disability (DALYs) per 100,000 workers, by main work-related illnesses, EU-28, 2017 Cancer Circulatory InjuriesMSD Others Main work-related illnesses and DALYs (Years of life lost and lived with disability). Main part is due to cancer, followed by MSD
- 17. 17 www.healthy-workplaces.eu Number of days absent in the past 12 months due to a health problem: distribution of workers, for worker with MSDs and/or other health problems and without health problems, EU-28, 2015 MSDs and Absenteeism Source: Panteia based on the sixth (2015) wave of the European Working Conditions Survey (EWCS) MSD-related and other health problems Only other health problems No health problems Total workers Never 1 to 4 days 5 to 9 days 10 to 19 days 20 to 49 days 50 days or more Workers with MSDs tend to be absent from work more often than others
- 18. 18 www.healthy-workplaces.eu High prevalence of MSDs-risk factors in EU establishments Significant relationship identified between self-reported MSDs and some physical risk factors For most physical risk factors prevalence is slightly decreasing, except for working with computers, laptops, smartphones Significant relationship identified between self-reported MSDs and organisational and psychological risk factors Work-related stress applies to more than half of workers MSD-related risk factors
- 19. 19 www.healthy-workplaces.eu Most prevalent MSDs-related risk factors present in EU establishments Note: “Prolonged sitting” and “Tiring or painful positions” are new items in ESENER 2019. Previously they were covered by a single item “Tiring or painful positions, including sitting for long periods” Source: EU-OSHA based on ESENER 2014 and ESENER 2019. (ESENER – European Survey of Enterprises on New and Emerging Risks) Percentages of employees working in establishments where different physical risk factors are in place (% establishments, EU28, 2019 and 2014) Heat, cold or draught Lifting or moving people or heavy loads Repetitive hand or arm movements Tiring or painful positions, including sitting for long periods Tiring or painful positions Prolonged sitting Heat, cold or draught Lifting or moving people or heavy loads Repetitive hand or arm movements
- 20. 20 www.healthy-workplaces.eu This table is based on the results of various binary logistic regressions that have been estimated to explain the prevalence of self-reported MSD complaints in the 6th (2015) wave of EWCS. Source: Panteia, 2019 Associations between self-reported MSDs and physical risk factors Body Area Significant relationship identified Lower limbs Upper limbs Back • Vibrations from hand tools • Working in tiring or painful positions • Carrying or moving heavy loads • Repetitive hand or arm movements • Lifting or moving people • Working with computers, laptops, etc. • Sitting • Being exposed to low temperatures • Vibrations from hand tools • Working in tiring or painful positions • Carrying or moving heavy loads • Repetitive hand or arm movements • Being exposed to low temperatures • Lifting or moving people • Working with computers, laptops, etc. • Vibrations from hand tools • Working in tiring or painful positions • Carrying or moving heavy loads • Repetitive hand or arm movements • Being exposed to low temperatures • Lifting or moving people • Working with computers, laptops, etc. • Sitting
- 21. 21 www.healthy-workplaces.eu Physical risk factors Source: Panteia based on the fourth (2005), fifth (2010) and sixth (2015) waves of the European Working Conditions Survey (EWCS) Percentage of workers reporting that they are exposed to different physical risk factors at their work at least a quarter of the time, EU-28, 2005, 2010 and 2015 Repetitive hand or arm movements Working with computers, laptops, smartphones, etc Tiring and painful positions Carrying or moving heavy loads Low temperatures whether indoors or outdoors Vibrations from hand tools, machinery, etc. 2015 2010 2005 For most physical risk factors prevalence is slightly decreasing, except for working with computers, laptops, smartphones
- 22. 22 www.healthy-workplaces.eu This table is based on the results of various binary logistic regressions that have been estimated to explain the prevalence of self- reported MSD complaints in the 6th (2015) wave of EWCS. Source: Panteia, 2019 Associations between self-reported MSDs and organisational and psychosocial risk factors Body Area Significant relationship identified Lower limbs Upper limbs Back • Anxiety • Overall fatigue • Sleeping problems • At work subjected to – verbal abuse – unwanted sexual attention – bullying /harassment • Mental well-being • Feeling energised • Knowing what is expected at work • Pace of work depends on – direct demands from customers etc. – direct control by management • Anxiety • Overall fatigue • Sleeping problems • Mental well-being • Feeling energised • At work subjected to – verbal abuse – unwanted sexual attention • Knowing what is expected at work • Able to choose or change order of tasks • Anxiety • Overall fatigue • Sleeping problems • Mental well-being • At work subjected to – verbal abuse – threats – physical violence • Employee voice • Job gives the feeling of work well done • Take a break when you wish • Fairly treated at workplace • Job requires hiding of feelings • Work-related stress • Working at very high speed
- 23. 23 www.healthy-workplaces.eu Work-related stress applies to more than half of workers Source: Panteia based on the fifth (2010) and sixth (2015) waves of the European Working Conditions Survey (EWCS) Percentage of workers reporting different organisational and psychosocial risks, EU-28, 2010 and 2015 Work-related stress Job requires hiding of feelings Overall fatigue Verbal abuse Anxiety Others
- 24. 24 www.healthy-workplaces.eu MSDs Prevention Most employees work in establishments where one or several preventive measures are in place Availability of preventive measures increases by establishment size On average 72% of enterprises have return to work measures after long-term sickness absence Preventive measures prove to be effective
- 25. 25 www.healthy-workplaces.eu Preventive measures Source: EU-OSHA based on ESENER 2019. (ESENER – European Survey of Enterprises on New and Emerging Risks) Percentage of employees working in establishments where different preventive measures are in place, by sector EU-28, 2019 Agriculture, forestry and fishing Construction, waste management water and electricity supply Manufacturing Trade, transport, food/accommodation and recreation activities IT, Finance, Real estate and other technical scientific or personal service activities Public administration Education, human health and social work activities Rotation of tasks to reduce repetitive movements or physical strain Encouraging regular breaks for people in uncomfortable or static postures including prolonged sitting Provision of ergonomic equipment Equipment to help with lifting or moving Most employees work in establishments where one or several preventive measures are in place
- 26. 26 www.healthy-workplaces.eu Preventive measures by establishment size Source: EU-OSHA based on ESENER 2019. (ESENER – European Survey of Enterprises on New and Emerging Risks) Percentage of employees working in establishments where different preventive measures are in place, by establishment size, EU-28, 2019 5-9 10-49 50-249 250+ Total Rotation of tasks to reduce repetitive movements or physical strain Encouraging regular breaks for people in uncomfortable or static postures including prolonged sitting Provision of ergonomic equipment Equipment to help with lifting moving Availability of preventive measures increases by establishment size
- 27. 27 www.healthy-workplaces.eu Return to work measures Source: EU-OSHA based on ESENER 2014 and ESENER 2019 Percentage of employees working in establishments with support measures for employees in place to return to work after a long-term sickness, by country, EU-28, 2014 and 2019 2014 2010 On average 72% of enterprises have return to work measures after long-term sickness absence. However large country differences
- 28. 28 www.healthy-workplaces.eu Preventive measures prove to be effective Source: Panteia based on sixth (2015) wave of European Working Condition Survey (EWCS) and second European Survey of Enterprises on New and Emerging Risks (ESENER 2014) Percentage of workers having MSDs in back, upper limbs and lower limbs, by average number of precautionary measures in place, EU 28, 2015. MSDs in lower limbs MSDs in upper limbs Backache 1-3 3-4 4-5 5-6 Workers in countries and sectors where more preventive measures are in place are less likely to report MSD complaints
- 29. 29 www.healthy-workplaces.eu Join us and lighten the load! Find out more on the campaign website: healthy-workplaces.eu Subscribe to our campaign newsletter: https://healthy-workplaces.eu/en/healthy-workplaces-newsletter Keep up to date with activities and events through social media: #EUhealthyworkplaces
Editor's Notes
- Of all workers in the EU with a work-related health problem, 60 % identify MSDs as their most serious issue. Note: The population of workers includes everybody aged 15 to 64 who was working or had worked during the past 12 months before the survey took place. Source: Eurostat, Labour Force Survey ad hoc module ‘Accidents at work and other work-related health problems’ (2013). All EU Member States participated in this ad hoc module except for the Netherlands. The LFS questions differ from the EWCS questions in two respects: - The occurrence of MSD-related health problems (compared with other health problems) can be determined only for workers reporting work-related health problems. - The LFS identifies the most serious work-related health problem. In cases where MSD complaints coincide with other, more serious, health problems, the LFS survey will not classify a respondent as having self-reported MSD complaints.
- Workers often report more than one type of MSD.
- The prevalence of self-reported MSDs in the back, upper limbs and lower limbs shows significant differences between sectors. Most often mentioned by workers: - construction, - water supply, - agriculture, forestry and fishing, - human health and social work activities. Least often mentioned by workers: - financial and insurance activities, - professional, scientific and technical activities, - education, - and arts, entertainment and recreation.
- The prevalence of self-reported MSDs in the back, upper limbs and lower limbs shows significant differences between occupations. Most often mentioned by workers: - skilled agricultural, forestry and fishery workers, - plant and machine operators and assemblers, - craft and trade workers, - elementary occupations, - service and sales workers. Least often mentioned by workers: - clerical support workers, - professionals, - managers, - technicians and associate professors.
- Data from EWCS indicates that women are more likely than men to report MSD disorders in upper limbs, lower limbs or the back. This gender difference is also present within sectors and within occupations: additional analyses show that the likelihood of women reporting MSDs remains significantly higher than that of men, even when the analysis includes the worker’s country, sector and occupation and the extent to which workers are faced with physical, organisational and psychosocial risk factors (this applies to upper limbs, lower limbs and back problems).
- Higher age is associated with a significantly higher probability of reporting MSDs. The relationship between age and MSD prevalence is confirmed for chronic MSDs as well as for all MSDs, and for MSDs in upper limbs, lower limbs and the back. These age differences are also present within sectors and within occupations: additional analyses show that the likelihood of reporting MSDs increases significantly with age, even when the analyses include the worker’s country, sector and occupation and the extent to which workers are faced with physical, organisational and psychosocial risk factors (this applies to upper limbs, lower limbs and back problems).
- There is a clear relationship between the probability of reporting MSDs and educational level: workers with pre-primary or primary education are more likely to report muscular pains in the upper limbs, lower limbs and/or back, and are also more likely to report chronic MSDs. A possible explanation is that lower educated people are segregated into jobs with higher MSD risks. Another possibility is that more educated workers have more opportunities to prevent or be protected from MSDs (for example, by adopting the good working postures, because of more autonomy at work, because of a better health in general and better access to the health system). With each higher educational level the MSD prevalence rates tend to reduce. This graphic shows the link between MSDs and the associated social health inequalities
- Among the different types of accidents that are distinguished in ESAW, the following types may be considered most likely to lead to MSD complaints: - dislocations, sprains and strains; - bone fractures; In 2016, these types of accidents accounted for 38 % of all reported fatal and non-fatal serious accidents at work. In particular, dislocation, sprains and strains are the second most common group of work-related injuries in the EU-28, after wounds and superficial injuries, accounting for 27 % of all fatal and non-fatal work-related injuries. Bone fractures are lower, at 11 % In some countries, data on accidents also address acute episodes of musculoskeletal problems. This information is important because data then show that in these countries MSDs are the most common type of work accident. National data from Spain and Sweden show the important role that MSD-related work accidents play in relation to the total of work accidents. In Spain (data from 2017), around 38 % of work accidents were caused by musculoskeletal overload. In Sweden (data from 2017), MSDs were the most common work-related source of work accidents for men (40 % of their reported work accidents relate to MSDs) and the second most common (after psychosocial diseases) for women (28%). Others: 1%: Multiple injuries <1%: Traumatic amputations (loss of body parts) <1%: Poisonings and infections <1%: Effects of temperatura extremes, light and radiation <1%: Effects of sound, vibration and pressure <1%: Drowning and asphyxiations
- The figure contains information regarding DALYs due to musculoskeletal disorders. DALYs for an illness or health condition are calculated as the sum of the years of life lost due to premature mortality in the population and the years lived with disability (YLD) for people living with the health condition or its consequences. In other words, DALYs indicate the gap between current health status and an ideal situation in which individuals live into old age without disease and disability. The measure merges the years lived with disability and the years lost due to premature mortality by using a set value for life expectancy in order to estimate the years of life lost as a consequence of premature death or disability. DALYs reflect the effect of diseases on general population in terms of quality of life and death; however, they have a greater weight on the young adult population and newborns. Even though DALYs do not indicate economic values directly, the impact on productivity could be linked to economic loss. This figure depicts the proportion of the main work-related illnesses and DALYs per 100,000 workers in the EU-28. Cancer, reaching 25 %, accounts for the main part of the cost, and musculoskeletal disorders follow at approximately 15 %.
- Note: N=32,005 (Total workers), n= 15,036 (MSD-related health problems and other health problems); n= 4,614 (Only other health problems); n= 7,680 (No health problems); This figure shows the number of days in the past 12 months (data for 2015) that workers were absent from their work because of a health issue. More than half of the workers with MSDs and other health problems were absent from work for at least 1 day, while around 23 % were absent for at least 10 days. For workers with only other health problems and workers with no health problems, these proportions are lower. This shows that workers with MSDs tend to be absent from work more often than others.
- MSD-related risk factors are among the most prevalent OSH risk factors identified in EU establisments. Some of these biomechanical / physical factors are not decreasing over the years (quite the opposite). Prolonged sitting is quite prevalent.
- Analyses on EWCS data show that prevalence of MSDs is associated with working in tiring or painful positions, carrying or moving heavy loads and repetitive hand or arm movements. This applies to all three types of MSDs that are distinguished in the EWCS (back, upper limbs and lower limbs). In addition, being exposed to vibrations from hand tools also increases the likelihood of reporting any of these three types of MSDs. Being exposed to low temperatures is associated with a higher prevalence of MSDs in upper limbs and lower limbs.
- The results of these analyses indicate that several psychosocial risk factors are associated with an increased likelihood of workers reporting MSDs. The following risk factors are found to be significantly related to all three types of MSDs: - anxiety; - overall fatigue; - sleeping problems; - low level of mental well-being; - being subjected to verbal abuse at work. High levels of anxiety, overall fatigue and sleeping problems may cause MSD complaints or worsen already existing MSD complaints. In this respect, they are considered potential risk factors. Anxiety, overall fatigue and sleeping problems are, however, also health problems, and workers can suffer from these health problems alongside MSD problems. The direction can also go the other way: having serious MSD complaints might increase levels of anxiety, overall fatigue and sleeping problems. The results presented merely reflect associations or relationships without making any claims about the causality of these relationships. For the following organisational and psychosocial risk factors, an association with two of the three MSD types has been found: - being subjected to unwanted sexual attention at work; - feeling energised, - knowing what is expected at work.
- Others (2010): 2%: Do not know what is expected at work 2%: Physical violence 2%: Unwanted sexual attention 1%: Bullying/harassment Other (2015): 2%: Do not know what is expected at work 2%: Physical violence 2%: Unwanted sexual attention 5%: Bullying/harassment
- As figure shows, the great majority of employees across all sectors work in establishments where equipment to help with lifting or moving is provided. Provision of ergonomic equipment and encouraging regular breaks for people in uncomfortable working positions follow, while the least promoted measure across sectors is the rotation of tasks to reduce repetitive movements.
- Employees from large establishments are more likely to have these preventive measures in their establishment than employees from small establishments. This is consistent with many prior studies that identified this size class difference.
- On average 72% of enterprises have return to work measures after long-term sickness absence. However large country differences: United Kingdom (98 %), the Netherlands (94 %) and Sweden (94 %) versus Lithuania (16 %) and Estonia (15 %).
- Notes: Data on MSDs concerns workers who work at least 12 hours per week. N= 31,143. The average number of precautionary measures is determined for each country and sector (rather than for individual workers) and varies between 1,25 and 5,86. Due to the low number of workers in countries and sectors with an average number of precautionary measures between 1 and 2 (123) this category has been combined with workers with an average number between 2 and 3. Preventive measures prove to be effective. Percentage of workers with backaches drops from 51 % (countries/sectors with on average one to three preventive measures) to 31 % (countries/sectors with on average five or six preventive measures). The prevalence of MSDs in lower limbs shows a comparable development. The main purpose for establishments implementing preventive measures is to actually prevent their employees from getting work-related health issues such as MSDs. Analysis of a combination of data from two different surveys suggests that preventive measures may indeed reduce the prevalence of MSDs. The indicators from the ESENER-2 survey have been used to construct two indicators regarding the proportion of workers in a certain country and sector who may benefit from certain preventive measures: - the percentage of employees (within each country and sector) who are working in establishments where at least one of the following preventive measures for MSDs is provided: o encouraging regular breaks for people in uncomfortable working positions, o provision of ergonomic equipment; - the average number of preventive measures provided in establishments (weighted by the number of employees involved). These indicators have been combined with the data from the sixth wave of the EWCS, after which they could be used as additional explanatory variables in a model explaining the prevalence of MSDs (whether workers report one or more MSD types). The results show that workers in countries and sectors where more preventive measures are in place are less likely to report MSD complaints. Although this analysis can identify only a relationship (and not a causality), it does suggest that preventive measures may indeed reduce the risk of acquiring MSDs. The average number of preventive measures is at least one, for all countries and sectors in the EU-28. For backache as well as MSDs in the upper limbs, the figure shows that more preventive measures are associated with lower MSD prevalence. The percentage of workers reporting backache drops from 51 % (for workers in countries and sectors where on average between one and three preventive measures are in place) to 31 % (for workers in countries and sectors where on average between five and six preventive measures are in place). The prevalence of MSDs in the lower limbs shows a comparable development, from 35 % (for workers in countries and sectors where on average between one and three preventive measures are in place) to 20 % (for workers in countries and sectors where on average between five and six preventive measures are in place). For MSDs in the upper limbs, the relationship is less strong
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