WORK-RELATED BACK DISORDERS STATISTICS INFORMATION SHEET LAST UPDATED JANUARY 2000
INTRODUCTION
Musculoskeletal disorders are by far the most common form of work-related ill-health problem in Great Britain. They can prove costly for the individual, the business and health service providers. This information sheet cites epidemiological evidence regarding the prevalence and economic impact of musculoskeletal disorders of the back.
Much of the information for this fact sheet derives from two surveys conducted by HSE in 19902 and 19951. It is strongly recommended that those interested in the data presented below read the two publications from these surveys that will provide further information of relevance and put the data in context.
Since the publication of the results from the 1995 survey revisions have been made to the number of working days lost due to illnesses caused by work. An information sheet3 giving detailed information of the revised data can be obtained from HSE's Epidemiology and Medical Statistics Unit.
Details of other sources of statistics quoted in this fact sheet can be found in the latest edition of HSE's publication: "Health and Safety Statistics"5.
STATISTICAL INFORMATION
Prevalence
Data taken from "Self-reported Work-related Illness in 1995 - Results from a Household Survey1" (SWI95), suggested that musculoskeletal disorders were by far the most commonly reported work-related illness in this survey. The SWI95 survey estimates that over one million people in Great Britain were suffering from a musculoskeletal disorder caused by work.
Over half of the respondents, 55%, who reported a musculoskeletal disorder, caused by work, in this survey said it affected their back, an estimated prevalence of 642,000. Of these respondents 79% reported that their condition only affected their back and not any other areas of their body, an estimated 508,000 people.
Another source of statistics is the Office for National Statistics Omnibus Survey4. Questions were commissioned in 1996 to identify adults who had experienced lower back pain in the 12 months prior to the interview. A total of 40% of adults had suffered from lower back pain in that period. The most common reasons for the onset of pain were work related: around 25% considered the pain was related to the type of work they did, and 12% gave an accident or injury at work as the reason. This survey was a repeat of one carried out in 1993 which gave very similar results.
Incidence
In the SWI95 survey over half of the respondents reporting a condition affecting their back had been suffering for more than five years, and 11%, an estimated 70,000 people first became aware of their condition in the last 12 months.
Another source of incidence statistics is the OPRA and MOSS surveillance schemes5 run by Manchester University. Occupational physicians have been reporting work-related musculoskeletal disorders, along with other types of occupational disease, to OPRA since 1996 and rheumatologists have been reporting work-related musculoskeletal disorders to MOSS since October 1997. An estimated 1615 new cases of spine/back disorders (includes neck/thoracic spine and lumbar spine/trunk) were seen by participating occupational physicians in 1998 and a further 612 new cases were seen by rheumatologists in the same period.
Trends
Comparisons between the prevalence estimates reported in the 1990 survey (SWI90) and the 1995 survey (SWI95) indicates that the overall unadjusted prevalence for all work-related illnesses in England and Wales was very similar between the two surveys. However, the relative proportion of work-related musculoskeletal disorders was higher in the 1995 survey. This increase may be largely related to methodological differences between the surveys and an increased awareness of occupational musculoskeletal complaints.
The number of new cases of work-related musculoskeletal disorders affecting the back reported to OPRA by occupational physicians between 1996 and 1997 fell from 1931 to 1579, but rose to 1615 in 1998.
Age and Sex Distribution
The SWI95 survey reported that the average prevalence rate for conditions affecting the back for males was nearly 60% higher than that for females (1.9% of males and 1.2% of females who have ever worked). For both males and females prevalence rates were highest in the older working age group (age 45 to retirement), males 2.6% and females 2.1%.
The number of new cases of work-related musculoskeletal disorders affecting the back reported to OPRA and MOSS in 1998 was 1154 for females and 1073 for males. Males were reported to have more problems with the lumbar spine/trunk than females, but fewer problems with the neck/thoracic spine.
Occupational Distribution
In the SWI95 survey occupational rates were produced for individuals who ascribed their illness to their current or most recent job. Occupations with the highest rates for musculoskeletal disorders affecting the back were: 'coal mining'; 'nursing'; 'construction'; 'other processing'; 'electrical processing' and 'care workers'. Over 3% of those currently or recently working in these occupations were suffering from a musculoskeletal disorder affecting the back caused by work.
Occupations with the highest annual rates (estimated cases per million employed per year) of work-related musculoskeletal disorders affecting the spine/back reported to OPRA by occupational physicians in 1997 and 1998 were 'ambulance staff' and 'assemblers/lineworkers (vehicle and other metal goods)' and those reported by rheumatologists in 1998 were 'ambulance staff' and 'assistant nurses, nursing auxiliaries' (The rates for both of these occupations are based on less than 20 cases).
Contributing Factors
Respondents to the SWI95 survey were asked their opinion of what caused (at work) the condition which affected their back, 66% of people thought that manual handling activities, mainly lifting, was the cause and 30% suggested the posture they adopt at work caused the problem.
Days off work
The revised economic impact figures3 from the SWI95 survey provide an estimate of 4.8 million working days lost in Britain in 1995 due to musculoskeletal disorders affecting the back caused by work. On average this survey estimated that each sufferer took 11 days off work in 1995 because of their complaint.
United Kingdom Vs Rest of Europe
The information taken from "Second European Survey on Working Conditions"- European Foundation for the Improvement of Living and Working Conditions6 suggested that 23 % of UK workers reported that work had affected their health resulting in backache. This compares with a figure of 44% in Greece, 37% in the former East Germany (the two countries with the highest rates), 13% in Ireland, 17% in the Netherlands (the two countries with the lowest rates) and an overall EU average of 30%.
Cost to employers
Calculations based on a recent HSE report7 have estimated that musculoskeletal disorders affecting the back caused by work cost employers between £315 million and £335 million (1995/96 prices). The costs, which have been estimated using results from SWI95, are based on a number of assumptions and are only intended to be broadly indicative.
References cited
1. Self-reported work-related illness in 1995, Jones et al. HSE Books (1998), ISBN 0071761509X.
2. Self-reported work-related illness- Results from a trailer questionnaire on the 1990 Labour Force Survey in England and Wales, Hodgson et al. HSE Books (1993), ISBN 0717606074.
3. Information sheet 2/99/EMSU Economic Impact: Revised data from the self-reported work-related illness survey in 1995 (SWI95) to obtain a copy phone 0151 951 3051.
4. The prevalence of back pain in Great Britain in 1996: A report on research for the Department of Health using the ONS omnibus survey. T. Dodd. The Stationary Office (1997), ISBN 0116209682.
5. Health and Safety Statistics 1998/99 HSE Books (1999), ISBN 0717617165.
6. Second European Survey on Working Conditions, European Foundation for the Improvement of Living and Working Conditions. (1997), ISBN 9282805522.
7. The costs to Britain of workplace accidents and work-related ill health in 1995/96. HSE Books, ISBN 0717617092.
FURTHER INFORMATION
Some other HSE publications on musculoskeletal disorders of the back.
1. Lighten the Load : Guidance for Employees on Musculoskeletal Disorders. Health and Safety Executive 1992 (IND(G) 109L(rev))
2. Manual Handling Solutions You Can Handle. Health and Safety Executive. HSE Books, 1994. ISBN 071760831X
3. Essentials of Health and Safety at Work. Health and Safety Executive. HSE Books 1994. ISBN 071760716X.
Some other information sources
Health and Safety Statistics 1996/97. HSE Books 1997. ISBN 0717614611.
Chronic Low Back Pain, Stanton-Hicks, M. Raven Press, 1982. ISBN 0890045984.
Understanding Back Pain, Porter, R.W. Churchill Livingstone, 1983. ISBN 0443027110
Back Pain and Sciatica, Frymoyer, J.W. New England Journal of Medicine, 4th Feb 1988, Vol. 318, No 5, 291 - 300.
Epidemiology review: The Epidemiology and cost of back pain. Clinical standards advisory group. HMSO publications 1994. ISBN 0113218893.
A pain in your workplace. HSE Books, ISBN 0-7176-0668-6.
Sources of Information
All HSE publications are available through HSE books, PO Box 1999, Sudbury, Suffolk, CO10 6FS. Tel: 01787 881165 or Fax: 01787 313995.
Health and Safety enquiries: HSE Infoline Tel: 0541 545500.
Details of any additional sector specific surveys may be identified by approaching the appropriate trade association and or trade union.
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