It is generally considered that the costs related to musculoskeletal disorders (MSDs) stem from absenteeism, medical expenses, reduced productivity, and quality of life. To estimate the costs associated with MSDs in organizations and thus determine the benefits for a company of implementing an effective and sustainable prevention program, it is necessary to consider the need to know the current and future prevalence of MSDs as well as to understand whether these data vary according to the economic sector, geographic location, and demographic aspects. It is also necessary to understand whether there are comorbidities associated with MSDs as well as the direct and indirect impacts in terms of the productive and work capacity of organizations and individuals. In the development of this study, the authors wanted to generate an analysis tool to estimate the incidence of MSDs and their economic costs, which also serves as a baseline to evaluate the possible benefits derived from prevention programs for this type of work-related disease.
TopI. Introduction
Musculoskeletal disorders (MSDs) of the upper limb and back comprise a wide range of inflammatory, degenerative diseases and disorders that cause pain and functional impairment of the hand/wrist, elbow, shoulder, neck and back, which have a significant impact on the productivity of individuals and companies, while affecting social security systems, industrial development policies and career paths of labor-active individuals.
Musculoskeletal Disorders (MSD) is the term used to refer to the set of injuries in muscles, tendons or nerves that are related to the development of physical activities at work, such as problems in the locomotor system, muscles, tendons, ligaments, and nerves (WHO, 2004; Institute for Work & Health, 2005). The literature has shown that the development of this set of injuries and symptoms is related to the ergonomic characteristics of workstations, poor posture, fast work pace, repetitive movements, and exposure to vibration. MSDs are currently the largest category of work-related diseases, constituting just over one-third of all occupational diseases reported in the United States, the Nordic countries and Japan, and representing the most common cause of work absenteeism or work disability in the United States, Canada, Finland, Sweden, and England (Punnett and Wegman, 2004).
Estimating the overall economic burden and total costs associated with MSDs in companies requires the use of a variety of data sources. The analysis of the sources of information that can contribute to identify the internal burden in the company, the costs associated with the worker, the productivity losses for the worker and for the company, should be defined in an analysis model that is flexible enough to integrate the specific variables by economic sector, by geographic location and by characteristics and complexities of the tasks involved in the generation of MSDs.
The incidence and severity of these occupational disorders have a significant impact on the productivity of workers through a reduction in their production capacity and, in more serious cases, through absence from the workplace. Musculoskeletal disorders have high direct and indirect costs, as well as long-term effects on the quality of life of the people who suffer from them. Thus, this type of accident constitutes a risk factor that affects the cost structure of firms, which is reflected in an increase in economic compensation, loss of productivity, increase in medical risk insurance rates, high worker turnover, and even adverse effects on labor relations (Punnett, 2000).
Comparative studies of the incidence of MSDs in different regions have found that there is less exposure in more economically developed countries, where the implementation of occupational safety, prevention and health practices is stronger. In contrast, in developing countries there is lower reporting of occupational diseases and a higher presence of misdiagnosis or no diagnosis (Takala et. al., 2017).
For the estimation of the economic cost, international information sources such as the World Labor Organization (ILO) and the World Health Organization (WHO), local employment figures, occupational burden, reported accidents, accidents, disability, and death due to occupational diseases reported at work and surveys on self-reported occupational diseases and injuries are considered. The costs associated with this type of occupational disease are expressed not only in the productivity capacity of workers and costs that companies face, but also constitute a public health problem that can generate a significant burden on the social security system. There is evidence that in most countries in the world, the number of deaths caused by occupational diseases is ten times higher than the number of deaths caused by occupational accidents (Takala et. al., 2017), hence the importance of making a complete assessment of this type of diseases.
In the estimation of costs associated with DME, several works have been developed, among them, those of Asay GRB, Roy K, Lang JE, Payne RL, Howard DH. Absenteeism and Employer Costs Associated with Chronic Diseases and Health Risk Factors in the US Workforce. In this work, a method was presented that includes the study variables useful for estimating individual and organizational productivity loss costs.