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Musculoskeletal disorders (MSDs)

Work-related musculoskeletal disorders are impairments of bodily structures such as muscles, joints, tendons, ligaments, nerves, bones and the localised blood circulation system, that are caused or aggravated primarily by work and by the effects of the immediate environment in which work is carried out. Typically, MSDs affect the back, neck, shoulders and upper limbs; less often they affect the lower limbs.

Health problems range from discomfort, minor aches and pains, to more serious medical conditions requiring time off work and even medical treatment. In more chronic cases, treatment and recovery are often unsatisfactory — the result could be permanent disability and loss of employment.

Why are older workers especially at risk?

MSDs are the most common cause of work-related disability among older workers. They may be at greater risk of developing MSDs because the ageing process reduces their muscular strength and the range of movement of their joints.

In general, musculoskeletal problems occur if the mechanical workload is higher than the load-bearing capacity of the musculoskeletal system. This system appears to weaken as workers grow older, resulting in a decrease in load-bearing capacity. Older workers may also overload their musculoskeletal system and develop degenerative diseases; for example, handling heavy loads over long periods may cause lower back pain.

Older workers may also be affected by musculoskeletal injuries developed at an earlier point in their working lives. Finally, some age-related conditions such as arthritis or impaired visual acuity may be risk factors in developing MSDs from using computers. However, age also has its advantages: some older workers use their years of experience to minimise exposure to the heaviest loads.

Manual handling and moving heavy loads

Traditionally, moving heavy loads is a young person’s activity. But with declining numbers of young workers in the labour force, it is becoming harder to avoid such work in the modern workplace. The risk of lower back disorders increases with age and with the number of years at work.

Work-related upper limb disorders

Work-related upper limb disorders (WRULDs) are the commonest occupational diseases in Europe. They affect the neck, shoulders, arms, hands, wrists and fingers, causing pain, discomfort, numbness and tingling sensations. Other symptoms, which can be exacerbated by cold or the use of vibrating tools, include swelling in the joints, decreased mobility or grip strength, and a change in skin colour of the hands or fingers. WRULDs usually develop gradually, the cumulative effect of many, apparently moderate applications of force, repeated over an extended period. The result is muscle fatigue, which can injure the soft tissue of the neck, shoulders and upper limbs. The main risk factors include heavy loads, awkward posture, repetitive movement and too few periods of rest. If sufficient time for rest is allowed, the body will recover and may even grow stronger. A poor working environment can also increase the risk of workers developing WRULDs. For example, excessive cold can make the hands feel numb, making it hard to grip and requiring more force to be applied. Psychosocial factors also have a part to play: workers who perform monotonous jobs or who are given incentives to work faster have a higher risk of developing WRULDs.

Working hours

Poorly organised shift structures or excessive working hours can cause fatigue and lead to work-related stress. Older workers may be less able to regulate sleeping patterns as well as they could in their younger days. How long and how well a person sleeps can be disrupted by changes in work hours, and by light and noise. Older employees working shifts or at night may need a longer recovery time between shifts. Employers should consider working patterns (both the total hours and shift arrangements) as part of any risk assessment they carry out.

Psychosocial issues

Work-related stress

More than one in four workers are affected by work-related stress in the EU. Stress can develop when work demands exceed a worker’s ability to cope. And, work in Europe is changing and becoming more intense. Tighter deadlines and an increased pace of work can overwhelm workers, which can be a particular concern for older workers.

Bullying

Bullying is repeated, unreasonable behaviour directed towards a worker or group of workers that creates a risk to health and safety. Unlike violence, bullying occurs between colleagues, and can be linked to a person’s age.

Accidents and injuries

Studies indicate that although older workers have fewer accidents, their injuries are often more severe and take longer to heal. The type of injury they suffer can also be different. Younger workers tend to get more eye or hand injuries, while older workers report more back injuries. For all workers, slips, trips and falls are the largest cause of accidents across all sectors, from heavy manufacturing to office work.

The following injuries and illnesses are typical of the older worker:

• falls — due to poor balance, slower reaction times, visual problems lack of concentration and complacency
• sprain and strain injuries due to loss of strength, endurance and flexibility
• cardio-pulmonary injury due to over-exertion, loss of heat and cold tolerance, and working at heights in a respirator or in confined spaces
• health/disease-related, including diabetes, cancer, osteoporosis, coronary artery disease and hypertension
• the effect of the accumulation of injuries over the years.

Vision

A worker’s vision may change over time. Older workers may find it harder to see or adjust focus in certain distance ranges; have reduced peripheral vision; see things less clearly; find it harder to perceive depth; and be more sensitive to glare. They are also more likely to have other conditions that impair vision such as cataracts and retinal disorders.  These changes in visual capacity may increase the risk of accidents.

Noise and hearing

Older workers may have age-related hearing problems and also, after a lifetime in work, noise-induced hearing loss. In particular, they may not be able to hear higher frequencies as well as younger workers. This is often most noticeable when having to pick out a particular voice in a noisy environment. Hearing problems can also result in a failure to hear an approaching hazard, leading to an accident, or to understand a verbal instruction or alarm signal.

Extremes of temperature

Older workers are less able to maintain internal body temperatures and adjust to changes in temperature. For example, if they are performing hard manual labour, they may become overheated.