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Prevalence
Upper limb pain and
dysfunction caused by work (usually of a repetitive nature) is not a
new phenomenon and has been well documented for 300 years in jobs such
as clerical work and telegraphy. However, from the late 1970s countries
as diverse as Australia, Russia, Japan, Finland, the US and the UK
reported dramatic increases in musculoskeletal conditions; this period
of time was significant as it oversaw the widespread replacement of
typewriters with computers and a consequent increase in the automation
of work. Many workers spent long periods in a fixed position,
performing a range of tasks without moving from their workstation and
using only a limited range of movement to operate their keyboard. This
trend has continued over the last 20 years with rapid technological
advance and the rise of the service industries, with large numbers of
workers spending their entire working day inputting data onto
computers, often at a rapid pace.
Musculoskeletal disorders of the upper and lower limbs (RSIs) are a
major problem in the workplace and a significant cause of lost
production, with an estimated cost to industry in the UK of up to
£3bn/year. Major research projects conducted by the European Agency for
Safety and Health at Work, and the Agency’s Europe-wide campaign to
lift the burden of work-related musculoskeletal disorders in October
2000, are a clear indication of the serious nature of the problem and
the importance of identifying future needs and priorities. According to
a recent European survey, 45% of workers reported working in painful or
tiring positions, while 17% of workers complain of muscular pain in the
arms and legs.
There is no doubt that, while RSI has been reported for a long time,
exact prevalence is unclear for a number of reasons including
under-reporting and misdiagnosis. However, the regular Labour Force
Survey on work-related ill health, last conducted by the Health and
Safety Executive (HSE) in 1995, found that slightly more than half a
million people in Great Britain have a work-related neck or upper limb
disorder and an estimated 36,000 workers were reported to have
Vibration-induced White Finger, for example, a cumulative condition
related to hand-held power tools. Findings now suggest that this may be
a significant under-estimate.
A report from the first systematic survey of occupational exposure to
hand-transmitted vibration, conducted by Southampton University’s
Medical Research Council Environmental Epidemiology Unit for the HSE
and published in 1998, revealed that over a million people in Britain
have symptoms of tingling and numbness in their hands associated with
vibrating tools. Of those, 515,000 have disturbed sleep and 355,000
find it difficult to “do up buttons”. The new prevalence of Vibration
White Finger alone (one of the 20 or so specific RSI conditions) is
over eight times greater than the HSE’s previous estimate. In addition,
ongoing research in Sweden reveals that around half of those who work
with computers have pains in their neck, shoulders, arms or hands. A
recent study by Dr Leon Straker at Curtin University of Technology in
Australia found that 60 per cent of children suffered discomfort when
using laptop computers. In Britain, the Government’s recently professed
aim was to put a laptop on the desk of every school child. We risk
rendering thousands of children unable to work unless the problem of
RSI is taken seriously.
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