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CONCLUSIONS FROM THE WORKSHOPS. Workshop 3. Back to work and reintegration Conclusions Rapporteur José Ramón Biosca de Sagastuy European Commission. Work-related interventions improving return-to-work of workers with MSDs and some Dutch examples (Birgitte Blatter).
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Workshop 3 Back to work and reintegration Conclusions Rapporteur José Ramón Biosca de Sagastuy European Commission
Work-related interventions improving return-to-work of workers with MSDs and some Dutch examples (Birgitte Blatter) • Effectiveness of interventions in the workplace • Multidisciplinary approach more effective then single elements alone • The scientific evidence is somewhat limited, more research needed • Evaluation of workplace interventions should probably adopt different criteria than those of medical treatment • Lack of 100% evidence should not be an excuse for employers not to take action • Examples from the Netherlands’ ongoing projects • Insurance company that refers self employed persons with MSDs to physical training • A rehabilitation centre that developed a website • An occupational health service that started with implementing the Sherbrooke model (participative approach to implement work adaptations)
A nationwide programme for early rehabilitation of low back pain workersin Belgium (Philippe Mairiaux) • Back pain – the 1st recognised work-related disease (since 2004) • Pilot project ‘Multidisciplinary back rehabilitation program’ among nursing staff • Includes physical exercising, psychologist’s consultation and workplace ergonomics • Results: favourable (98,7% return to work before treatment ends), however – no control group • Barriers to participation: not aware of the programme, lack of motivation from sufferers and/or employers • Now this programme is part of health care system and extends to all workers and sectors
Repetitive Strain Injuries: Impact, recovery and successful return to work (Stephen Fisher) • Personal experience – Principal Engineer with major aerospace company, 32 years service • Intense PC work, long hours • No H&S assessment, no training, early symptoms missed • Then ‘a bolt of lightning hit the back of a hand’ • Medical retirement at 52, still not completely recovered • Formed new charity RSI action: identify problems and solutions, support to other workers with RSI • Early identification is key • Effective treatment includes physiotherapy, appropriate exercises and workplace adjustment through ergonomic measures
Discussion • A multidisciplinary approach to rehabilitation and return to work that starts early seems to be effective • It is supported by scientific and anecdotal evidence • While more research is needed, particularly on ULDs, this should be not be an excuse for inaction by employers or policy makers • Early identification and recognition of the problem and solution finding is vital – employer and workers can be trained to identify symptoms and risk factors • Comprehensive care, including medical, occupational and social rehabilitation, should be provided • Rehabilitation and return to work requires coordination between employer, worker, and the medical and social security systems
Discussion • There appears to be variation in the use and definition of MSD-related terminology, • The multi-factorial nature of MSDs mean that rehabilitation programmes should be tailored to the individual, but include both group and individual actions • A sectoral agreement in agriculture identifies a lack of harmonised statistics as a problem • Risk assessment is the key to prevention and managing return to work • SMEs face challenges in implementing rehabilitation approaches and need help • The involvement of all workers, not just injured workers, in programmes can help prevention and facilitate the early identification of problems