Open Access Highly Accessed Commentary

Prevention of musculoskeletal disorders in workers: classification and health surveillance – statements of the Scientific Committee on Musculoskeletal Disorders of the International Commission on Occupational Health

Mats Hagberg1*, Francesco Saverio Violante2, Roberta Bonfiglioli2, Alexis Descatha3, Judith Gold4, Brad Evanoff5 and Judith K Sluiter6

Author affiliations

1 Department of Public Health and Community Medicine, University of Gothenburg (UGOT), Box 414, SE 405 30, Gothenburg, Sweden

2 Occupational Health Unit, University of Bologna Sant’Orsola Malpighi Hospital via Palagi, 9, 40138, Bologna, Italy

3 Occupational Health Department/INSERM U1018-UVSQ Poincaré Teaching Hospital AP-HP, Garches, France

4 Department of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Ritter Annex, Philadelphia, PA 19122, USA

5 Division of General Medical Sciences, Washington University School of Medicine, Campus, Box 8005, 660 S, Euclid Ave., St. Louis, MO 63130, USA

6 Academic Medical Centre, Department: Coronel Institute of Occupational Health, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

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Citation and License

BMC Musculoskeletal Disorders 2012, 13:109  doi:10.1186/1471-2474-13-109

Published: 21 June 2012


The underlying purpose of this commentary and position paper is to achieve evidence-based recommendations on prevention of work-related musculoskeletal disorders (MSDs). Such prevention can take different forms (primary, secondary and tertiary), occur at different levels (i.e. in a clinical setting, at the workplace, at national level) and involve several types of activities. Members of the Scientific Committee (SC) on MSDs of the International Commission on Occupational Health (ICOH) and other interested scientists and members of the public recently discussed the scientific and clinical future of prevention of (work-related) MSDs during five round-table sessions at two ICOH conferences (in Cape Town, South Africa, in 2009, and in Angers, France, in 2010). Approximately 50 researchers participated in each of the sessions. More specifically, the sessions aimed to discuss new developments since 1996 in measures and classification systems used both in research and in practice, and agree on future needs in the field.

The discussion focused on three questions: At what degree of severity does musculoskeletal ill health, and do health problems related to MSDs, in an individual worker or in a group of workers justify preventive action in occupational health? What reliable and valid instruments do we have in research to distinguish ‘normal musculoskeletal symptoms’ from ‘serious musculoskeletal symptoms’ in workers? What measures or classification system of musculoskeletal health will we need in the near future to address musculoskeletal health and related work ability?

Four new, agreed-upon statements were extrapolated from the discussions: 1. Musculoskeletal discomfort that is at risk of worsening with work activities, and that affects work ability or quality of life, needs to be identified. 2. We need to know our options of actions before identifying workers at risk (providing evidence-based medicine and applying the principle of best practice). 3. Classification systems and measures must include aspects such as the severity, frequency, and intensity of pain, as well as measures of impairment of functioning, which can help in prevention, treatment and prognosis. 4. We need to be aware of economic and/or socio-cultural consequences of classification systems and measures.

Occupation; Epidemiology; Prevention; Aetiology; Expert opinion; Occupational health; Public health; Rheumatology; Rehabilitation; Orthopaedics