.svg)
Musculoskeletal disorders (MSDs) are the most common occupational diseases in France and developed countries. To prevent them, employers must assess the risks and implement appropriate actions.
MSDs: What's at stake in the workplace?
MSDs are caused when the body is subjected to an action that exceeds a person's physical capabilities. When physical recovery is insufficient and fatigue sets in, it is referred to as musculoskeletal imbalance. This condition can lead to an MSD.
MSDs can affect the upper and lower limbs of the body as well as their joints, but it is most often the upper limbs that are affected (hands, wrists, and fingers in 38% of cases). Among the most common MSDs are:
- tendinitis (wrist, elbow, shoulder, knee, etc.);
- carpal tunnel syndrome (wrist);
- rotator cuff syndrome (shoulder);
- lower back pain.
It is now proven that there is a link between work activity and the onset or worsening of MSDs. Consequently, many MSDs are listed in the table of occupational diseases in the Social Security Code. According to figures from the French Health Insurance, in 2015, MSDs accounted for over 87% of occupational diseases leading to sick leave or financial compensation due to lasting effects.
MSDs pose significant challenges for businesses. On the one hand, it concerns the well-being of employees in their professional activities but also in their private and daily lives. Indeed, MSDs are long-term conditions. On the other hand, MSDs can lead to disorganization within the company due to absenteeism from sick leave, or even staff turnover which directly impacts the company's productivity.
It should be noted that almost all sectors of activity are affected by the risk of MSDs in the workplace, from industrial sectors to "office" activities.
How to assess the risks of MSDs in the workplace?
The law requires employers to preserve the physical and mental health of their employees.
In the absence of a section specifically dedicated to MSDs in the Labor Code, it is necessary to refer to the general principles of risk prevention (article L.4121-2) :
- avoid risks or assess risks that cannot be avoided;
- understand and combat risks at the source by taking into account the evolution of techniques and technology;
- prioritize collective prevention measures over individual prevention measures;
- adapt work to employees and provide them with clear instructions;
- prevent risks by considering work organization, working conditions, and social, technical, and relational aspects.
Identify MSD risk positions
Initially, the employer must draw up a general assessment of their company's health to better understand the risks associated with its activity. The purpose of this action will be to precisely target risk positions MSD and prioritize actions.
This step can be carried out through:
- individual interviews with employees;
- consulting company data regarding employee health;
- consulting the Social and Economic Committee (CSE) ;
- consultation of information related to turnover, absenteeism, the social and physical characteristics of employees according to their position, etc.;
- consultation with occupational health services.
The goal is to gather as much information as possible about employee health. All potential stakeholders available to the employer can be involved during the risk assessment process, whether they are employee representatives, various company departments, the occupational physician, or external stakeholders such as the retirement and occupational health insurance fund (CARSAT).
The employer can also rely on the single document for professional risk assessment (DUERP) which lists all occupational risks to which workers are exposed. The DUERP is an essential tool for risk assessment in companies and is mandatory for all companies with at least one employee. It must be updated once a year in companies with at least 11 employees (article L4121-3-1 & R. 4121-2 C. trav.).
Analyze work positions and situations at risk of MSDs
The second step is to analyze work situations and positions in detail based on risk factors likely to cause an MSD. This analysis involves observing employees as they perform their work to precisely describeall the risk factors they are exposed to during their work and to what extent.
Biomechanical factors
The analysis of biomechanical factors will primarily focus on observing movements and posture. Any movement or posture that strains the neck, knees, shoulders, wrists, back, or other body parts must be noted and described. If movements or postures are repetitive, prolonged, or excessive, the risk they pose to employees must then be assessed.
Environmental factors:
Environmental factors relate to the workstation. Any element that forces the employee to exert additional effort to compensate for a lack of maneuverability, practice, or comfort must be noted.
Examples: temperature, noise, lighting, exposure to vibrations, etc.
Organizational factors
Work organization is an essential element for employee health, as it either allows or prevents employees from having the necessary recovery time. Prolonged work can therefore constitute a high-risk position for MSDs. It is thus necessary to consider the risks that the time allocated to an employee for a task may present.
Examples: work pace, insufficient recovery time, staggered hours, etc.
Psychosocial factors:
Psychosocial factors are directly linked to organizational factors and employee job satisfaction. Therefore, it will also be necessary to study the responsibility and psychological pressure that the position places on the employee.
Examples: monotony of tasks performed, work-related pressure, job insecurity, etc.
Individual factors:
Finally, individual factors must also be taken into account, considering all the other preceding factors.
Examples: gender, age, physical condition, chronic illness, job experience, medical history, etc.
To complete the risk analysis, it is advisable to measure the dimensions of the workstation and the physical environment to ensure that the spatial organization does not promote any of the stated risk factors.
Good to know: some companies offer such analyses through ergonomic workstation studies. The cost of these studies may be covered by certain organizations such as CARSAT or the Mutualité Sociale Agricole (MSA) for the agricultural sector.
Finally, thanks to the data collected, The employer must also determine if employees are affected by the arduousness at work scheme due to their exposure to certain occupational risk factors (strenuous postures, vibrations, etc.).
What actions can be implemented in the workplace to avoid or prevent MSD risks?
Once the risk analysis is established, it will be a matter of implementing actions aimed at controlling these risks by improving working conditions and reducing employee constraints, while ensuring to prioritize actions based on the highest-risk positions.
The actions undertaken will aim to address the risk analysis by reducing the strenuous demands on employees observed therein. These actions can be divided into three categories: technical actions, organizational actions, and medical actions.
Technical actions
Technical measures primarily aim to address biomechanical and environmental risk factors through:
- the provision of equipment designed to improve movement, posture, effort intensity, or joint strain. Examples: personal protective equipment, lower-vibration machines, knee pads, wheeled platforms, and any equipment facilitating the work in question, etc.
- workstation layout aimed at optimizing work execution. Examples: improved lighting, workstations with adequate dimensions for task execution or machine operation, heaters or air conditioners, etc.
Organizational measures
Organizational measures can be easy and quick to implement and effectively reduce several risk factors simultaneously. They also enable to positively impact employees' perception of work.
These may include:
- adjusting work pace and duration to limit the prolonged exposure to risk factors;
- reorganizing the workspace by creating access points that limit movement;
- implementing a circulation plan to avoid collision risks;
- organizing breaks;
- implementing job rotation to avoid repetitive movements or awkward postures.
Medical actions
The occupational physician must be involved in the medical monitoring of the employees concerned in order to detect the first symptoms of MSDs as early as possible. If necessary, workstation adjustments can be proposed.
Training
Information and training are also essential elements available to the employer to avoid or prevent the risks of MSDs. It should be noted that these actions are also mandatory under Article L4121-1 of the Labor Code.
This can take several forms
- training employees on occupational risks by an external or internal trainer;
- training new hires by experienced employees;
- information in the form of posters within the company on MSD risk prevention;
- reminding of "best practices" near different workstations (for example: importance of warm-ups before starting work).
Specific Regulations
Additionally, specific regulations aim to prevent MSDs for the following activities: manual handling of loads, screen work, and exposure to vibrations.
Regulations on Manual Handling of Loads
When manual handling of loads cannot be avoided, very specific regulations apply to control the risks of MSDs, which are primarily back-related.
The employer must therefore provide mechanical aids or gripping accessories to make employees' tasks safer and less strenuous.
Examples: forklift, hand trucks, gripping tongs, etc.
Furthermore, the employer must take into account the individual characteristics of employees based on the load to be handled and the physical effort required. Loads exceeding 55 kilograms cannot be routinely carried unless the employee has been deemed fit by the occupational physician. In this case, they cannot exceed 105 kilograms. It is also forbidden for women to carry loads exceeding 25 kilograms or to transport loads exceeding 40 kilograms using a wheelbarrow, including the wheelbarrow.
Finally, the employer must also provide training to employees whose work involves manual handling. It must inform employees about the correct movements and postures to adopt for manual handling tasks.
Regulations for Display Screen Equipment Work
These regulations apply to any activity involving the habitual and prolonged use of screens.
The employer must ensure the provision of suitable and functional equipment so that the employee can adapt their movements and posture.
Examples: adjustable office chair, quality screen, functional and adjustable keyboard.
They must also provide a good physical working environment in the company's premises (thermal environment, lighting, noise levels). Finally, employees must be able to benefit from breaks or changes in activity (articles R4542-1 to R4542-19 of the Labour Code).
Regulations for Work Involving Exposure to Mechanical Vibrations
Mechanical vibrations are a risk factor for MSDs and contribute to occupational hardship. When exposure to mechanical vibrations cannot be avoided and exceeds permitted limits (Art. R. 4443-1 and R4443-2 C. trav.), the employer must reduce the risk by:
- limiting the duration and intensity of exposure;
- selecting appropriate work equipment and auxiliary equipment (examples: vibration-dampening seat, vibration-dampening handle, etc.);
- informing and training employees (Arts. R4441-1 to R4447-1 C. trav.).