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Musculoskeletal disorders (MSDs) are the most widespread occupational illnesses in France and other developed countries. To prevent them, employers must assess the risks and take appropriate action.
MSD: what are the challenges for your company?
MSDs are caused when the body is called upon to perform an action that exceeds a person's physical capabilities. When physical recovery is inadequate and fatigue sets in, we speak of musculoskeletal imbalance. This condition can lead to RSI.
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). The most common MSDs include :
- tendinitis (wrist, elbow, shoulder, knee, etc.);
- carpal tunnel syndrome (wrist) ;
- rotator cuff syndrome (shoulder) ;
- lumbago (lower back pain).
It has now been proven that there is a link between work activity and the onset or aggravation of MSDs. As a result, many MSDs are listed in the occupational disease table of the French Social Security Code. According to Assurance Maladie figures, in 2015, MSDs accounted for over 87% of occupational illnesses resulting in work stoppage or financial compensation for after-effects.
MSDs raise major issues for companies. On the one hand, it concerns the well-being of employees in their professional activity , but also in their private and daily lives. MSDs are long-term illnesses. On the other hand, MSDs can lead to disorganization within the company, with absenteeism due to work stoppages and even staff turnover, which has a direct impact on the company's productivity.
It should be noted that virtually all sectors of activity are concerned by the risk of MSDs in the workplace, from the industrial sector to "office" activities.
How to assess MSD risks in the workplace?
The law requires employers to protect the physical and mental health of their employees.
In the absence of a section specifically dedicated to MSDs in the French Labor Code, it is advisable 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 source, taking into account the evolution of techniques and technology;
- favour collective prevention measures over individual prevention measures ;
- adapt work to employees and give them clear instructions;
- prevent risks by considering work organization, working conditions, social, technical and relational aspects.
Identify MSD risk workstations
As a first step, the employer needs to draw up a general assessment of his company's health, in order to gain a better understanding of the risks associated with his activity. The aim of this action is to be able to precisely target MSD-risk workstations and prioritize actions.
This step can be carried out through :
- individual interviews with employees;
- consultation of company data concerning employee health;
- consultation of the social and economic committee (CSE) ;
- consult information on staff turnover, absenteeism, the social and physical characteristics of employees according to their position, etc. ;
- occupational medicine consultation.
The aim is to gather as much information as possible on employee health. All potential players available to the employer can be called upon during the risk assessment process, including employee representatives, the company's various departments, the occupational physician, and external contributors such as the Caisse d'Assurance Retraite et de la Santé au Travail (CARSAT).
Employers can also draw on the occupational risk assessment document (DUERP) which lists all the occupational risks to which workers are exposed. The DUERP is an essential tool for assessing risks in the workplace, and is compulsory for all companies with more than 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 MSD-risk workstations and work situations
The second stage consists of a detailed analysis of work situations and workstations in terms of the risk factors likely to cause an MSD. This analysis involves observing employees as they perform their work, in order to precisely describeall the risk factors to which they are subjected during their work, and to what extent.
Biomechanical factors
The analysis of biomechanical factors will focus on the observation of movements and posture. Any movement or posture involving the neck, knees, shoulders, wrists, back or other parts of the body should be noted and described. If movements or postures are repetitive, prolonged or excessive, the risk they represent for employees must be measured.
Environmental factors :
Environmental factors concern the workplace. Any element forcing the employee to make extra efforts to compensate for a lack of maneuverability, convenience or comfort must be noted.
Examples: temperature, noisebrightness, exposure to vibration, etc.
Organizational factors
Work organization is an essential factor in employee health, in that it may or may not provide employees with the necessary recovery time. Prolonged working hours can be a risk factor for MSDs. It is therefore necessary to consider the risks that may be posed by the length of time an employee is assigned to a task.
Examples: pace of work, short recovery time, staggered working hours, etc.
Psychosocial factors :
Psychosocial factors are directly linked to organizational factors and employee job satisfaction. We therefore also need to study the responsibility and psychological pressure that the job exerts on the employee.
Examples: monotony of tasks, work pressure, job insecurity, etc.
Individual factors :
Finally, individual factors also need to be taken into account, alongside all the other factors mentioned above.
Examples: gender, age, physical condition, chronic illness, job experience, medical history, etc.
To complete the risk analysis, the dimensions of the workstation and the physical environment must be measured to ensure that the spatial organization does not promote any of the risk factors listed.
Good to know: some companies offer such analyses through ergonomic ergonomic studies of the workstation. The cost of these studies may be covered by certain organizations, such as CARSAT (the French national health and safety insurance fund) or MSA (the Mutualité Sociale Agricole) for the agricultural sector.
Finally, thanks to the data collected, the employer must also determine whether any employees are affected by the "arduous work" scheme due to their exposure to certain occupational risk factors (awkward postures, vibrations, etc.).
What actions can companies take to avoid or prevent the risk of MSDs?
Once the risk analysis has been carried out, the next step is to implement actions aimed at controlling these risks by improving working conditions and employee constraints, while ensuring that actions are prioritized according to the most at-risk positions.
The actions taken will aim to respond to the risk analysis by reducing the stresses on employees observed in the analysis. These actions can be divided into three categories: technical actions, organizational actions and medical actions.
Technical actions
Technical actions are mainly aimed at addressing biomechanical and environmental risk factors through :
- the installation of equipment to improve movements, posture, intensity of effort or joint load. Examples: personal protective equipment, less vibrating machines, knee protectors, rolling platforms and any other equipment facilitating the work in question, etc.
- workstation design to optimize work performance. Examples: improved lighting, workstations of the right size for carrying out tasks or handling machines, radiators or air-conditioning units, etc.
Organizational actions
Organizational actions can be quick and easy to implement, and effectively reduce several risk factors at once. They can also have a positive impact on employees' perception of work.
These may include :
- adjusting the pace and duration of work to limit the prolongation of risk factors over time;
- organize the workspace differently by creating access points that limit movement;
- set up a traffic system to avoid the risk of collisions;
- organize breaks;
- rotate tasks 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, actions to adapt the workstation can be proposed.
Training courses
Information and training are also among the essential elements available to employers to avoid or prevent the risk of MSDs. It should be remembered that these actions are also mandatory under article L4121-1 of the French Labour Code.
This can take several forms
- training of employees in occupational hazards by an external or internal trainer;
- training of new recruits by experienced employees ;
- information in the form of company posters on MSD risk prevention;
- a reminder of "good practices" near the various workstations(e.g. the importance of warming up before starting work).
Specific regulations
In addition, specific regulations cover the prevention of MSD for the following activities: handling loads, working at a computer screen and exposure to vibrations.
Regulations governing the handling of loads
When manual handling of loads cannot be avoided, specific regulations apply to control the risk of MSDs, mainly of a dorsolumbar nature.
Employers must provide mechanical aids or gripping accessories to make employees' work safer and less arduous.
Examples: forklift trucks, hand trucks, grippers, etc.
In addition, the employer must take into account the individual characteristics of employees, depending on the load to be handled and the physical effort required. Loads in excess of 55 kilograms may not be carried on a regular basis, unless the employee has been recognized as fit by the occupational physician. In this case, they may not exceed 105 kilograms. It is also forbidden to have women carry loads in excess of 25 kilograms, or to transport loads in excess of 40 kilograms using a wheelbarrow, including a wheelbarrow.
Finally, employers must also provide training for employees whose work involves manual handling. This training must inform the employee of the gestures and postures to adopt in manual handling.
Regulations governing screen work
These regulations apply to all activities involving the regular and prolonged use of screens.
The employer must provide suitable, functional equipment so that the employee can adapt his or her movements and posture.
Examples: adaptable office chair, quality monitor, functional, tilting keyboard.
It must also provide a good physical working environment on the company's premises (heating, lighting, sound). Finally, employees must be able to take breaks or change activity (articles R4542-1 to R4542-19 C. trav.).
Regulations governing work involving exposure to mechanical vibration
Mechanical vibrations are a risk factor for MSDs, as well as a factor in arduous work. When exposure to mechanical vibration cannot be avoided and exceeds authorized values (articles R. 4443-1 and R4443-2 C. trav.), the employer must reduce the risk by :
- limiting the duration and intensity of exposure;
- the choice of suitable work and auxiliary equipment(e.g.: cushioning seat, cushioning handle, etc.);
- employee information and training (articles R4441-1 to R4447-1 C. trav.).