Musculoskeletal disorders impact economy

Back and joint pain cause over half of long-term worker absences.

By JUDY SIEGEL-ITZKOVICH
doctor 311 (photo credit: Avi Hayoun)
doctor 311
(photo credit: Avi Hayoun)
Most people know of colleagues at work – or themselves – who have taken sick days due to acute back pain. But chronic back and joint pains have now been shown to cause half of all work absences over three days or more, according to an international study conducted in 25 countries and last year also in Israel. Musculoskeletal disorders (MSDs) – a general name for a wide variety of orthopedic and rheumatological conditions such as back pain, strained hands or neck and joint diseases – affect 700,000 Israelis (1 in 10) and annually cost the economy some NIS 26 billion or 4 percent of the gross national product.
According to the World Health Organization, these disorders are classified as fourth among the 10 most common diseases affecting women and ninth among those affecting men. They are accompanied by pains and many disabilities that may further affect functional aspects of individuals in both their work and personal life. The study estimates that the number of individuals suffering from MSDs is expected to rise considerably and damage the Israeli workforce production and industrial capacity, while intensifying the burden on both health care and welfare systems.
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Prof. Joseph Ribak, chairman of the Health Ministry’s national council for workers health, said that 80% of adults will be affected by MSDs at some point in their lives. “The new study demonstrates how serious the problem is and that it requires systemic treatment. Resources must be allocated for early diagnosis and treatment.
Changing the current perception from a rehabilitative model to a preventative model would allow for the preservation of thousands of working places while saving substantial public funds,” he said.
The “Fit For Work?” project was conducted by England’s The Work Foundation as part of a unique research program comprising 25 European and other countries. The project was conducted here in collaboration with the government and other local bodies, examining in detail how MSDs impact the life and employment potential of thousands of Israeli workers. The results were revealed during a recent Health Economy Forum convened specially to discuss the ramifications on the labor market, the health care system and the economy.
Prof. Moshe Tishler, chairman of Israel Rheumatology Society, said that many patients suffering from MSDs are oblivious to the future implications of their disease or are referred to a specialist too late. “This has direct impact on the severity of their disorder and chances for recovery. These circumstances necessitate systemic emergency treatment,” adds Tishler.
Data provided by the National Insurance Institute shows that 32,612 Israelis, mostly at working age, are receiving government disability pensions due to MSDs. Rehabilitation efforts invested in such people are considerably more expensive than those aimed at other disorders, yet only 35% of rehabilitated persons return to the workforce. Moreover, MSDs are the most common cause for early retirement due to health reasons and affect not only those suffering from them, but also heavily burden the economy.
One research conclusion was that the number of MSD patients in the Israeli workforce is expected to rise in upcoming decades, and its impact on the economy will continue to escalate. The Work Foundation’s general manager, Steven Bevan, added that “evidence presented by the report shows that many Israelis at workingage are directly affected by MSDs or will be affected by them in the next few years. This will have substantial economic and social ramifications, reducing Israeli workforce production capacity in general as well as industrial capacity, while intensifying the burden on both health care and pension systems.”
Can people with MSDs return to the labor market, or better yet, not be released from it to begin with? Not only can they do it – but they must, said Bevan. “The prevalent approach in Israel presumes that one has to achieve 100% fitness to return to work. The study refutes this approach, contending that if family doctors had been required to supply a ‘fitness certificate’ (indicating how employees are still able to perform) rather than an ‘illness certificate,’ employers would see more clearly what affected employees can still do at work. This approach is put into use in Britain, and its introduction to Israel should also be considered.”
This approach, by which a patient’s position is to be preserved even during rehabilitation – rather than at its end – intrinsically differs from Israel’s current model guiding rehabilitation and return to work. This perception means that the patient’s employment should be preserved during the rehabilitation process as well.
The new study demonstrates how serious and immediate the problem is, Ribak concluded.
“The situation requires systemic treatment. As I have argued before, it’s the employers’ commitment to provide a healthy work environment and discover problems of their employees at an early stage. This may require legislation, preventive medical treatments, ergonomic level adjustment and an annual health survey for early detection of these disorders. In my opinion, employers should be compelled to conduct such a survey, as they are forced to install smoke detectors or insure their employees.”
Most of the recommendations are aimed at the state, which is required to systematically and comprehensively address the problem rather than its symptoms, adopting models that have been implemented in other countries.
The research concludes that the government must initiate a test-pilot program to examine whether early detection and treatment do, in fact, reduce pension expenses.
Welfare and Social Services Minister Isaac Herzog, who read the report, said he believes the study will serve as an important tool to decrease poverty and prevent job loss of thousands of people. “It can serve as an important tool in planning the national economy and social security. I instructed the rehabilitation department in my office to understand the issue thoroughly and transfer my recommendations for action.”
The global “Fit For Work?” project was made possible by an unconditional research grant from the Abbott pharmaceutical company, which has a branch in Israel.
“The company is deeply committed to its patients all over the world, which is why, upon our request, it agreed to include Israel in the global project,” said Tammy Altarac, general-manager of Abbott Pharma Israel.
“Now, for the first time, research-based data is available to professional bodies and decision-makers, which we hope will assist them in aiding the patient community.”