National Academies Press: OpenBook
« Previous: 3 Seven Questions Posed by Congressman Robert Livingston
Suggested Citation:"4 Conclusions." National Research Council. 1998. Work-Related Musculoskeletal Disorders: A Review of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/6309.
×

4
Conclusions

The steering committee has explored the complex problem of musculoskeletal disorders in the workplace. We have supplemented our professional expertise with workshop presentations, commissioned papers and other submissions, and discussions with invited workshop participants. We find very clear signals on some topics and weaker signals on others-but little in the way of contradiction. Thus, while there are many points about which we would like to know more, there is little to shake our confidence in the thrust of our conclusions, which draw on converging results from many disciplines, using many methods:

  • There is a higher incidence of reported pain, injury, loss of work, and disability among individuals who are employed in occupations where there is a high level of exposure to physical loading than for those employed in occupations with lower levels of exposure.

  • There is a strong biological plausibility to the relationship between the incidence of musculoskeletal disorders and the causative exposure factors in high-exposure occupational settings.

  • Research clearly demonstrates that specific interventions can reduce the reported rate of musculoskeletal disorders for workers who perform high-risk tasks. No known single intervention is universally effective. Successful interventions require attention to individual, organizational, and job characteristics, tailoring the corrective actions to those characteristics.

  • Research can (1) provide a better understanding of the mechanisms that underlie the established relationships between causal factors and outcomes so that workers who are at risk can be identified and interventions undertaken before problems develop; (2) consider the influence of multiple factors (mechanical, work, social, etc.) on symptoms, injury, reporting, and disability; (3) provide more information about the relationship between incremental change in load and incremental biological response as a basis for defining the most efficient interventions; (4) improve the caliber of measurements for risk factors, outcome variables, and injury data collection and reporting systems; and (5) provide better understanding of the clinical course of these disorders.

By and large, the controversies that we observed reflect the usual disputatiousness of science, which advances when speculative challenges lead to new and clarifying results. One feature of the discourse around musculoskeletal disorders is that it sometimes involves individuals from one discipline (or sub-discipline) who reject entirely the legitimacy of research from another. The steering committee understands the claims made by these often forceful advocates of particular research ideologies. However, we respect the contributions of properly designed research conducted by the variety of disciplines needed for the topic.

The steering committee's task has been to examine the state of the evidence. As such, we have tried to assess the plausible ranges of effects for the various factors that have been studied systematically. We have, however, deliberately avoided providing recommendations for action for three reasons:

Suggested Citation:"4 Conclusions." National Research Council. 1998. Work-Related Musculoskeletal Disorders: A Review of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/6309.
×
  1. The risk of musculoskeletal disorders depends on the interaction of person and task, as does the effectiveness of options for reducing those risks. A full specification would require much more detailed treatment of person-task combinations than is possible here. We have, instead, focused on the scientific principles that should guide the prediction and prevention of problems.

  2. We have not reviewed the full range of consequences of musculoskeletal disorders and interventions related to them. For example, we have not evaluated the effects of ergonomics programs on employee productivity, turnover, and morale. Nor have we examined the effects of musculoskeletal disorders on the economic and psychological well-being of injured individuals and their families. Rational decision making must consider the full set of relevant consequences.

  3. Rational decision making also depends on the relative importance attached to the different consequences. Different people and institutions will have different values and different opportunities for action, at the governmental, employer, and individual levels.

Suggested Citation:"4 Conclusions." National Research Council. 1998. Work-Related Musculoskeletal Disorders: A Review of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/6309.
×
Page 23
Suggested Citation:"4 Conclusions." National Research Council. 1998. Work-Related Musculoskeletal Disorders: A Review of the Evidence. Washington, DC: The National Academies Press. doi: 10.17226/6309.
×
Page 24
Next: References »
Work-Related Musculoskeletal Disorders: A Review of the Evidence Get This Book
×
Buy Paperback | $47.00 Buy Ebook | $37.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

In May 1998 the National Institutes of Health asked the National Academy of Sciences/National Research Council to assemble a group of experts to examine the scientific literature relevant to work-related musculoskeletal disorders of the lower back, neck, and upper extremities. A steering committee was convened to design a workshop, to identify leading researchers on the topic to participate, and to prepare a report based on the workshop discussions and their own expertise. In addition, the steering committee was asked to address, to the extent possible, a set of seven questions posed by Congressman Robert Livingston on the topic of work-related musculoskeletal disorders. The steering committee includes experts in orthopedic surgery, occupational medicine, epidemiology, ergonomics, human factors, statistics, and risk analysis.

This document is based on the evidence presented and discussed at the two-day Workshop on Work-Related Musculoskeletal Injuries: Examining the Research Base, which was held on August 21 and 22, 1998, and on follow-up deliberations of the steering committee, reflecting its own expertise.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!