A review of work-related musuloskeletal disorder prevention interventions

Work-related musculoskeletal disorders (WMSDs) comprise a high proportion of work-related injuries in many countries, and constitute a major proportion of all compensable work-related injuries in many jurisdictions, including Victoria. This report draws on established scientific evidence to address the question ‘what interventions have been successfully used to prevent WMSDs in the workplace?’ A total of 14 reviews of WMSD interventions, and seven recent primary research studies were included in this review. The reviews included three Cochrane reviews, seven systematic reviews, and four narrative or critical reviews. The primary research studies had varied research designs. The key findings in WMSD prevention literature were: - There is evidence that multifactorial interventions can be successful in preventing or reducing WMSDs, particularly those that contain elements of: risk assessment, ergonomics, training, lifting devices, and worker participation and observation. - There is limited evidence that lifting devices in isolation are effective for preventing WMSDs. - There have been mixed results on the use of exercise training interventions to prevent WMSDs. There is some evidence that musculoskeletal health may be improved with exercise in healthcare settings, although whether this translates to WMSD prevention is unclear. - There is no evidence to support the use of training and education in isolation for preventing WMSDs, regardless of the workplace setting. - There is no evidence that back belts or lumbar supports in isolation are effective for preventing WMSDs. Limitations in the evidence base include a lack of systematic evaluations of interventions, poor quality across the research, and inadequacy of the underlying theoretical frameworks upon which interventions have been based. There is strong evidence that physical factors are related to the development of WMSDs, however more recent evidence has found that a range of psychosocial and organisational factors are also associated with increased risks of developing WMSDs. Thus, a major challenge for intervention development is developing and testing new theoretical frameworks to address the interacting underlying psychosocial and physical factors. An holistic conceptual model has been developed specifically for WMSDs, and it would be worthwhile testing interventions in the context of this model. Further, there are a number of shared underlying risk factors between job stress and WMSDs, and thus job stress interventions may provide a useful framework upon which to consider the management of psychosocial WMSD risk factors. Similarly, the emerging evidence on ISCRR Research Report# <ISCRR insert> Page 5 of 60 Psychosocial Safety Climate may provide an additional intervention site for addressing psychosocial risk factors for WMSDs.