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RSI issues in the UK today

RSI issues in the UK today. Stephen Fisher Chairman of Trustees RSI Action… ( the UK RSI charity) www.RSIaction.org.uk. UK RSI charities and support groups. Repetitive Strain Injury Association founded by Ron Mullelly in 1986 object: to support RSI sufferers

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RSI issues in the UK today

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  1. RSI issues in the UK today Stephen Fisher Chairman of Trustees RSI Action… (the UK RSI charity) www.RSIaction.org.uk

  2. UK RSI charities and support groups Repetitive Strain Injury Association • founded by Ron Mullelly in 1986 • object: to support RSI sufferers • liquidated Mar 2004 (office and 7staff, funding problems) RSI support groups • London, Manchester, Bradford, (Nottingham, East Lancs, Edinburgh) Need for RSI national voice • pump priming funding from Hazards Campaign • initial contact autumn 2004 – new organisation agreed autumn 05. RSI Action • Companies House Registration: Feb 2006 • Charity Commission Registration: July 2006 • Objects: (1) to prevent RSI; (2) to support RSI sufferers

  3. Types of RSI • Type 1 RSI conditions are localised, and tests for these conditions exist. • Type 1 conditions (CTS, or tennis elbow) often result from one intense activity. • Type 2 RSI conditions are diffuse, and are difficult to diagnose. • Type 2 conditions (often called Diffuse RSI) often result from computer and mouse work. • Most RSI conditions can be prevented. • Early treatment (within 3 months of first symptoms) is critical to full recovery. • Most conditions are not recognised for many months or years. • RSI is very difficult to treat.

  4. Degrees of RSI Definitions by Suparna Damany author of “Its not Carpal Tunnel Syndrome” www.RSIrescue.com 1st Degree RSI – Occasional unpredictable aching. Simple measures should result in full recovery. 2nd Degree RSI – Frequent or predictable burning, throbbing etc. Further measures & treatment should result in full recovery. 3rd Degree RSI – Constant pain, improper nerve sensations. Strength or endurance problems. Significant treatment, long partial recovery.

  5. UK RSI issues • RSI statistics • UK H&S Legislation • RSI prevention and management in the workplace • UK Health System • Benefits • Government Policy • Benefit Fraud • Work is good for you • Health and wellbeing (DH + DWP) • Personal injury cases • International situation

  6. HSE UK data - 1 • 2006/07 working days lost • 30 mil days lost due to illness • 10.7 mil days lost due to musculoskeletal disorders • 3.5 mil days lost due to work-related upper limb or neck disorders • 2006/07 incidence of illness • 38% of all illnesses in the working population are musculoskeletal disorders (MSD’s) • 18% of all illnesses in the working population are upper limb or neck disorders • 34% increase in people affected by upper limb or neck disorders since previous year

  7. HSE UK data - 2 • 2006/07 new cases of upper limb or neck work-related MSD • 370 people per 100,000 workers • up 37% since previous year • up 23% since 2001/02 (rate was falling in intervening years) • HSE Report RR561 (2007) • 73% of DSE (display screen equipment) users reported 1 or more MSD symptom. • 47% of DSE users had neck pain • 39% of DSE users had shoulder pain • 37% of DSE users had back pain • Prevalence of MSD symptoms in DSE users unchanged in 15 years

  8. European Union data • European Working Conditions Survey 2005 (published 2007) • 61% of workers work at high speed • 23% (54 million workers) muscular pain • 44% of workers in tiring or painful positions • 61% of workers have repetitive hand or arm movements • 50% of workers use a computer for 25% or more of the day • 55% by 2008 • 32% of workers used computer for 75% or more of the day • 38% by 2008

  9. UK Health and Safety Legislation • Health and Safety at Work Act 1974  • ‘Six-pack' regulations introduced in 1992 consisted of regulations on • Management of Health and Safety at Work Regulations 1999; • Workplace (Health, Safety and Welfare) Regulations 1992; • Health and Safety (Display Screen Equipment) Regulations 1992; • Manual Handling Operations Regulations 1992; • Provision and Use of Work Equipment Regulations 1998; • Personal Protective Equipment at Work Regulations 1992. • In the first 4 years of the DSE Regulations • 6 enforcement notices, no prosecutions • In the first 4 years of the other 5 sixpack regulations • Over 1,000 enforcement notices, over 100 prosecutions • 3 enforcement notices under DSE regulations since 1-1-2007 • no prosecutions ever under DSE regulations • And yet… 6 UK workers loose their job every day due to RSI!

  10. European Union Inspection Campaign • 2007 European campaign on manual handling of loads • Transport industry • 23 countries, 881 inspectors involved • 2365 companies inspected • Intervention in 1916 companies (81% of companies inspected) • Verbal and written warnings, administrative fines, cessation of work and legal prosecution • Care industry • 21 countries, 2217 inspectors involved • 3042 companies inspected • Intervention in 2531 companies (83% of companies inspected) • UK – MSD priority programme relies on guidance, rather than enforcement

  11. RSI prevention & management in the workplace • UK legislation in place since 1992 • MSD prevention • few good employers minimise risks and provide physiotherapists • Some employers take no preventative action • Many employers do minimum, treat risk assessment as an unfortunate waste of time. • Lack of health and safety training, early RSI symptoms not identified • The limitations and vulnerability of RSI sufferers is often not recognized in the workplace. • Pressure for an early return to work. • Red / Yellow / Blue / Black flags

  12. Medical Early Retirement • Depends on pension scheme rules • Rules often require health condition and disability to be permanent • Occupational health doctors usually deny that RSI is permanent

  13. UK Health System • No UK centre of excellence for RSI • Little training for doctors on upper limb disorders • Only a few consultants helpful in RSI conditions • NHS physiotherapy – limited • Private treatment – can be good, expensive • UK health provision is influenced by the Medical Royal Colleges (MRCs) • Diffuse RSI is not understood by MRCs

  14. NHS plus ULD guidelines • DH placed contract on Royal College of Physicians (RCP) to develop guidelines for the management of ULDs in the workplace. • Quality conditions (SIGN 50) require patient representation • RSI Action and RSI Support Groups have been excluded • Royal Colleges have admitted they have no RSI expert! • RSI Action campaigning for representation

  15. Benefits • Disability Living Allowance (DLA) • £17 per week, criteria - cannot prepare and cook fresh meal • not means tested • Incapacity Benefit (IB) • physical or mental incapacity resulting in being unable to work • assessment doctors often do not recognize RSI • frequently need to go to appeal • new regulations will make it much more difficult to qualify • £61 per week initially, £81 per week after a year • Industrial Injury (or disease) Disability Benefit (IIDB) • difficult for RSI to qualify • about £20 per week for RSI conditions

  16. Government Policy • Gordon Waddell & Kim Burton (from 2004) • Common Health Problems – includes ULDs • Read across from LBP to ULDs • Can not be prevented • Are not caused by work • Work is good for you, early RTW • 1st National Director for Health and Work • Benefit fraud • Welfare Reform Bill 2007 • Into work – off benefit

  17. Personal injury cases • No workers compensation system. • Some illnesses & injuries are prescribed under IIDB, and benefit paid. • Most rely on PI case in the courts. • Often less that £50K, can be upto £200K • Employers prefer to spend lots on defence than on prevention.

  18. International Commission Occupational Health • ICOH MSD Committee Chair – Professor Laura Punnett • Premus is ICOH’s Prevention of musculoskeletal disorders conference, held once every three years. • Premus 2007 – Boston USA • 467 delegates from international scientific research • RSI was major topic, computer use was dominant problem • International researchers wanted to speak out, despite limited evidence • Lunchtime discussion with injured workers • Premus 2010 – Angers (France) September 2010 • Opportunity for plenary or symposium by/for injured workers • What do we want from research scientists?

  19. EU MSDs at Work Consultation • 1st phase consultation Nov 2004 to Jan 2005 • 2nd phase consultation Oct to Dec 2005 • Pressure for reducing regulation • Simplify and combine 90/269 and 90/270 • Rely upon non-regulatory guidance • ETUC response 3 May 2007 (Roger Gauthy) • Provision for victims of MSDs • Concern for reduced regulation • No representation of MSD victims

  20. EU MSDs at Work Consultation • Need for EU RSI groups to provide single voice in future EU regulation • Commissioner Vladimir Spidla at EU MSD Summit in Bilbao, 26 Feb 2008

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