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Musculoskeletal disorders usually affect the back, neck, shoulders and upper limbs, but lower limbs can also be affected. They cover any damage or disorder of the joints or other tissues. Health problems range from minor aches and pains to more serious medical conditions requiring time off or medical treatment. In more chronic cases, they can even lead to disability and the need to give up work.
The two main groups of MSDs are back pain/injuries and work-related upper limb disorders (commonly known as ‘repetitive strain injuries’).
Causes of MSDs
Most work-related MSDs develop over time. There is usually no single cause of MSDs; various factors often work in combination. Physical causes and organisational risk factors include:
- Handling loads, especially when bending and twisting
- Repetitive or forceful movements
- Awkward and static postures
- Vibration, poor lighting or cold working environments
- Fast-paced work
- Prolonged sitting or standing in the same position
There is growing evidence linking MSDs with psychosocial risk factors (especially when combined with physical risks), including:
- High demand of work or low autonomy
- Low job satisfaction
There is no single solution, and expert advice may occasionally be needed for unusual or serious problems. However, many solutions are straightforward and inexpensive, for example providing a trolley to assist with handling goods or changing the position of items on a desk.
To tackle MSDs, employers should use a combination of:
- Risk assessment: take a holistic approach, assessing and addressing the full range of causes (see above)
- Employee participation: include staff and their representatives in discussions on possible problems and solutions
Read more about preventing work-related MSDs.
Preventive actions could include changes to:
- Workplace layout: adapt the layout to improve working postures
- Equipment: make sure it is ergonomically designed and suitable for tasks
- Workers: improve risk awareness, provide training in good work methods
- Tasks: change working methods or tools
- Management: plan work to avoid repetitive work or prolonged work in poor postures. Plan rest breaks, rotate jobs or reallocate work
- Organisational factors: develop an MSD policy
Health monitoring, health promotion and rehabilitation and reintegration of workers already suffering from MSDs also need to be considered in the management approach to MSDs.
European directives, regulations of Member States and good practice guidelines already recognise the importance of preventing MSDs. Relevant directives include the general OSH ‘Framework’ directive and the directives covering the following topics: the manual handling of loads, work equipment, minimum standards for work places and work with (computer) display screens.
In 2007, the European Commission ran a consultation on possible Community actions, including new legislation. Possible plans were suspended pending a review of EU directives in 2014-15. MSDs are a a recognised priority by the EU Member States and European Social partners.
EU-OSHA monitors the incidence, causes and prevention of MSDs. EU-OSHA also supports the sharing of good practices.
In fact, in 2015, 17% of workers in the EU reported being exposed to chemical products or substances for at least a quarter of their working time, a proportion practically unchanged since 2000, and 15 % report breathing in smoke, fumes, powder or dust at work.
Some highly dangerous substances — such as asbestos or polychlorinated biphenyls (PCBs) — are now banned or under strict control. However, other potentially harmful substances are still widely used, and legislation is in place to ensure that the risks associated with them are properly managed.
The risks to health
The health problems that can be caused by working with dangerous substances range from mild eye and skin irritation to severe effects, such as birth defects and cancer. Effects can be acute or long term, and some substances can have a cumulative effect. Some of the most common dangers are:
- Skin diseases
- Reproductive problems and birth defects
- Respiratory diseases
Some dangerous substances pose safety risks, such as risk of fire, explosion or suffocation. In addition, dangerous substances normally have several of these properties.
Bacteria, viruses, fungi and parasites are found in many sectors. They are usually invisible, which means that the risks they pose may not be considered.
Workers in some sectors are in particular danger of being exposed to harmful biological agents: healthcare, agriculture, veterinary services, cleaning and maintenance, sewage and waste management, gardening and laboratory work.
Find out more:
- Factsheet 41 An introduction to biological agents
- OSHwiki article Biological agents
- EU legislation on biological agents at work and on prevention from sharp injuries and guidelines for the healthcare sector
- Work-related diseases from biological agents
- E-fact 53 — Risk assessment for biological agents
- Biological agents and pandemics: review of the literature and national policies
- Factsheet 39 — Respiratory sensitisers
- Factsheet 40 — Skin sensitisers
- Factsheet 100 — Legionella and legionnaires’ disease: European policies and good practices
New technologies, expanding sectors and changes to the way work is organised can result in greater risk of harm from biological or chemical agents. In the environmental sector, for example, innovative technologies can entail poorly understood risks. To give another example, more and more workers are exposed to dangerous substances in service professions such as home care and waste management, where the exposure is varied but awareness of the hazards involved is low. More than ever, it’s vital that employers and workers understand the potential risks and take preventive action.
More information related to emerging risks:
- Priorities for occupational safety and health research in Europe: 2013-2020
- Report — Green jobs and occupational safety and health: Foresight on new and emerging risks associated with new technologies by 2020 and Summary
- E-fact 72 — Tools for the management of nanomaterials in the workplace and prevention measures
- E-fact 74 — Nanomaterials in maintenance work: occupational risks and prevention
Preventive measures and management of dangerous substances
To protect workers from dangerous substances, the first step is to carry out a risk assessment. Then, actions should be taken to remove or reduce the risks as far as possible. And, finally, the situation should be regularly monitored and the effectiveness of the steps taken reviewed.
Member States as well as EU-OSHA have developed a number of models to help small and medium-sized enterprises to carry out risk assessment. The Dangerous Substances e-tool provides employers with the support and advice they need to effectively manage dangerous substances in the workplace. A database of practical tools and guidance contains practical measures for workplaces, such as guidance on risk assessments and how to substitute or eliminate the use of dangerous substances, case studies and a variety of instruments.
Read more on the OSHwiki page about risk management tools for dangerous substances.
Employers also need to take into account any vulnerable groups, such as workers who are young, pregnant or breastfeeding, for whom special protection is required by law. Other groups of workers, such as migrant workers, untrained or inexperienced staff, and contractors, such as cleaners, also need to be considered and prevention tailored to their needs.
Hierarchy of prevention
European worker protection legislation establishes a hierarchy of measures that employers need to take to control the risks to workers from dangerous substances.
- Elimination and substitution are at the top of the hierarchy of control measures. Where possible, eliminate the use of dangerous substances by changing the process or product in which the substance is used.
- If elimination is not possible, substitute a non-hazardous or less hazardous substance for the dangerous one.
- If a substance or process cannot be eliminated or substituted, the exposure can be prevented or reduced by technical and organisational solutions. These are, for example, control of the emission at the source (closed system or local exhaust ventilation), or reducing the number of workers exposed to the dangerous substance, and the duration and intensity of exposure.
- By law, using personal protective equipment (PPE) is the last resort where exposure cannot be adequately controlled by other means.
- OSH wiki section Risk management of dangerous substances
- PPT Dangerous substances and risk assessment (in 22 languages)
- Info sheet: Substitution of dangerous substances in the workplace
- E-fact 66 — Maintenance and hazardous substances
To ensure their safety, workers should be kept informed about:
- The findings of their employer’s risk assessments
- The hazards they are exposed to and how they may be affected
- What they have to do to keep themselves and others safe
- How to check and spot when things are wrong
- Who they should report any problems to
- The results of any exposure monitoring or health surveillance
- Preventive measures to be taken in case of maintenance work
- First aid and emergency procedures
Occupational exposure limits
For a number of dangerous substances, the EU and Member States have set Occupational Exposure Limits (OELs) that need to be respected.
Binding (which means that they must be met) and indicative (as an indication of what should be achieved) OEL values for dangerous substances are also laid down in European OSH directives. OELs for hazardous substances are important information for risk assessment and management. Most EU Member States establish their own national OELs, usually including more substances than the EU directives. However, OELs have been set for only a limited number of the substances currently used in the workplace.
There are specific provisions in the EU to protect workers. According to the Carcinogens Directive, employers must assess and avoid or minimise the exposure to carcinogens or mutagens. In addition to applying the hierarchy of prevention measures:
- They shall replace a carcinogen or mutagen in so far as is technically possible with a substance, mixture or process which is not or is less dangerous.
- Where this is not possible, ensure that it is, in so far as is technically possible, manufactured and used in a closed system.
- Where a closed system is not technically possible, employers shall reduce exposure to as low as is technically possible, limiting the quantities and keeping the number of workers exposed as low as possible.
They must also:
- Demarcate risk areas and use adequate warning and safety signs
- Design the work processes so as to minimise the substance release
- Evacuate carcinogens or mutagens at source, but respect the environment
- Use appropriate measurement procedures (especially for early detection of abnormal exposures from an unforeseeable event or accident)
- Use individual protection measures if collective protection measures are not enough
- Provide for hygiene measures (regular cleaning)
- Draw up emergency plans
- Use sealed and clearly and visibly labelled containers for storage, handling, transportation and waste disposal
They also have specific information requirements for workers and authorities and need to keep records of exposed workers, measurements and health surveillance results.
Everyone involved in managing dangerous substances in workplaces needs to be aware of the legislative framework covering dangerous substances in the EU.
OSH legislation is aimed at protecting workers from safety and health risks in general and of dangerous substances in the workplace (e.g. the Chemical Agents Directive, the Carcinogens Directive, and the directives on limit values). It requires employers to carry out a workplace risk assessment of all safety and health risks, including the risks from dangerous substances, and to set appropriate protection and prevention measures. Find summaries of the relevant EU legislation.
The aim is to ensure that risks are tackled at the source and to make collective measures — that is, measures that protect a group of workers in a systematic way — the first priority.
The REACH legislation and the CLP Regulation require chemical manufacturers and suppliers to ensure that standardised safety labels, hazard pictograms and safety data sheets are provided. These provide information on the properties of substances and the hazards associated with them, and guidance on storage, handling and risk prevention. Other regulations and guidelines cover specific aspects, such as manufacturing, supplying, transporting and labelling dangerous substances, and these are often relevant to the workplace too.
EU regulations on safety and health at work are incorporated into national legislation, but Member States are also entitled to include additional or stricter provisions for the protection of workers. It is therefore important that enterprises check the specific legislation in each relevant country.
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If children start learning about safety and health as they learn to read and write, it becomes a natural part of how they work, play and live. They develop a good attitude to safety and health that will stay with them throughout their working lives.
Start young, stay safe: successful OSH education
OSH is best integrated into individual subjects rather than taught as a stand-alone topic. Activity-based learning and real-life examples will help bring the message home to children and young people. Key messages can be repeated in different ways for different age groups, whether in primary schools or vocational training colleges.
The whole-school approach is the ideal model. The integration of OSH into further education is more difficult and less well developed, particularly in universities. However, the same ‘whole-institute’ model applies. Networking and working in partnership with OSH authorities are key contributors to successful integration.
Integrating OSH into school life
The whole-school approach combines education and school management. Pupils and staff work together to make the school a safe and healthy place to work and learn through:
- Risk education and OSH management, e.g. involving pupils in hazard spotting
- Health education and promotion, e.g. healthy schools initiatives
- Promoting dignity and respect for all, e.g. anti-bullying campaigns
- Caring for the environment, e.g. reusing and recycling
Tips for successful integration
From case studies we know what helps to make the whole-school approach work:
- Leadership from the head teacher to motivate staff and pupils
- Involving pupils, parents and staff
- Providing practical support and tools; the ‘Napo for teachers’ resource has been helpful here
- Training for teachers
- Networking between schools
- Cooperation between OSH and education authorities
- Being practical and linking risk education to subjects being taught
- Read our report on mainstreaming OSH into the school curriculum programmes
- Network with other professionals through ENETOSH
To achieve this aim, the ERO provides an overview of safety and health at work in Europe, describes the trends and underlying factors, and anticipates changes in work and their likely impact on occupational safety and health.
As our society evolves under the influence of new technology and shifting economic and social conditions, our workplaces, work practices and processes are constantly changing. These new situations bring with them new risks and challenges for workers and employers, which in turn demand political, administrative and technical approaches that ensure high levels of safety and health at work.
Effective prevention can make an important contribution to the overall Europe 2020 objective of achieving smart, sustainable and inclusive economic growth, as well as increasing the employment rate from 69 to 75 per cent. Many people drop out of the labour market because of poor occupational safety and health, so better risk anticipation is essential if we are to improve risk prevention and achieve sustainable working lives and higher employment rates.
Successive European strategies on health and safety at work have identified the need to prepare for these new circumstances, and emphasised that:
'anticipating new and emerging risks, whether they be linked to technical innovation or caused by social change, is vital if the risks are to be brought under control.
This requires, first and foremost, ongoing observation of the risks themselves, based on the systematic collection of information and scientific opinions.' (Community Strategy on health and safety at work 2002-2006)
This strategy’s call on EU-OSHA to set up a European Risk Observatory to carry out these tasks was followed by the next Community Strategy 2007-2012, which emphasised the importance of risk anticipation, and asked the Agency’s Observatory to take on a range of initiatives.
The latest European strategy, the EU Strategic Framework on Health and Safety at Work 2014-2020, continues this theme with a call to support the findings of the European Risk Observatory.
How the European Risk Observatory works
The ERO adds value by gathering and analysing information, putting it in context (in particular in relation to the European social agenda and the Community Strategy), looking for trends in order to 'anticipate change', and communicating the key issues effectively to our target audience: policy-makers and researchers. We also aim to stimulate debate and reflection among EU-OSHA's stakeholders and to provide a platform for debate between experts and policy-makers at various levels.
The information needed to identify new and emerging risks may come from a variety of sources, such as data from official registers, the research literature, expert forecasts or survey data. To cover all these potential sources of information, we organise our activities around three basic areas: