Work 51 (2015) 645–656 645

DOI 10.3233/WOR-152027
IOS Press

Review Article

Comparative study of the relevance of

musculoskeletal disorders between the
Spanish and the European working population
José Maria Rivas Moara,∗ , José Maria Alvarez-Campanab, José Luis Míguezc and D.G. Ramosd
a
Safety and Health Department, RMCI, A Coruña, Spain
b
Health Care and Rehabilitation, Mutua Gallega de Accidentes Rehabilitation Society, Spain
c
Industrial Engineering School, University of Vigo, Spain
d
Polytechnic Institute of Cávado and Ave, Technology School, Barcelos, Portugal

Received 18 May 2013

Accepted 24 November 2014

Abstract.
BACKGROUND: Musculoskeletal disorders (MSDs) are diseases of high prevalence. The extent to which our work is causing
or aggravating them is still questioned because their causes are heterogeneous and usually combined in the same person, and can
be attributed to any of them.
OBJECTIVE: The objective of this paper is to compare Spain with the rest of Europe concerning MSDs.
METHODS: The study is based on a comparison between Spanish and European data. The difficulty is that the lists of occupa-
tional diseases in the various States of the European Union (EU) are different, and therefore it is difficult to compare data.
The study compares two types of data: the views of workers, and the official results of workplace accidents. In the first case,
the results of the VII Spanish National Survey of Working Conditions were compared to the V European Working Conditions
Survey. In the second case, we compare accident data, published by the Spanish Labour Authorities, to data provided by Eurostat
(Statistical Office of the European Communities).
RESULTS: During the development of this study, we have proved the importance and significance of MSDs on the Spanish
working population in relation to the European one.
First, we have discovered a great difference between Spanish and European workers views about the relationship between work
and heath.
Then, we detected some more important ergonomics risk factors within the Spanish workforces’ opinions. These are repetitive
movements, tiring positions, and exposure to vibrations. However concerning heavy loads, lifting or moving people, the views of
Spanish workers are more carefree than European ones.
If we only consider the official results of workplace accidents and diseases, we find Spanish rates higher than the European
average.
CONCLUSIONS: The incidence of MSDs on the Spanish working population significantly exceeds European records in this
matter. MSDs account for between 35–40% of Work Accidents and between 70–88% of Occupational Diseases in Spain so, we
can see why Spain has one of the top Occupational Accidents rates in Europe.
Spain should try to improve this issue by concentrating only on three factors: repetitive work of upper extremities, tiring positions
and exposure to vibrations.

Keywords: Work-related diseases, Labour Statistics and Health and Safety Survey

∗ Corresponding author: José Maria Rivas Moar, Safety and

Health Department, RMCI, Ada. Alfonso Molina, 6 1◦ D 15006, A Coruña, Spain. E-mail: josem.rivas.moar@gmail.com.

1051-9815/15/$35.00 
c 2015 – IOS Press and the authors. All rights reserved
646 J.M.R. Moar et al. / Comparative study of the relevance of MSDS between the Spanish and the European working population

1. Introduction has its limitations, since the comparison between coun-

tries with different laws is difficult.
The World Health Organisation [1], defines “Mus- Particularly in the European Union, the lists of Oc-
culoskeletal disorders” (MSDS) as a locomotor system cupational Diseases are not organized in the same way.
health problem, that is, tendons, skeleton, ligaments, Some states define, very precisely, the various MSDs
nerves, cartilage, etc. It is a broad definition which in- that are recognized, while others have a list with major
cludes heterogenic diseases. This increases the diffi- groups, without going into great detail.
culty of the study, investigation or statistical analysis To make matters worse, most states have an open
of their impact. system of recognition in which the physician, by his
There has never been international consensus when sole discretion, has authority to classify the disorder.
defining this group of diseases, nor uniformity when In Spain, given the difficulty in the actual count
defining exactly what diseases make it up. Different of MSDs, i.e., the coexistence of the two profes-
terms have often appeared in literature and each term sional contingencies, the Spanish Social Security sys-
captures the group of pathologies selected by a country tem has recently created a data file called “Pan-
in its statistical controls. otrass [10]”, which corresponds to Non-Traumatic
The interest in this group of injuries, from a work Pathologies caused by work. The aim is to facilitate
perspective, was probably not very relevant 30 years knowledge of those non-traumatic pathologies, which
ago, but as government health and safety organisa- have no place on the list of occupational diseases, and
tions (EU-OSHA in the European Union, NIOSH and yet are receiving protection as work accidents when
OSHA in the U.S., INSHT in Spain, HSE in Britain, it’s proven that the cause is exclusively work related.
CCOHS in Canada, SWA in Australia, etc.) have begun Many MSDs are in this situation, thus it is understood
to discriminate and classify health damage, we have that their cataloging and detection will be easier in the
also begun to discover the true extent of the problem, future.
increasing the interest in this matter. The aim of this paper is to make a sufficiently rigor-
The real cost of MSDs is difficult to calculate, ous comparison between Spanish and European data,
mainly because of the lack of their standardization. whilst trying to overcome the difficulties described.
Some reports [2] from the European Agency for Health
and Safety at Work, have published the rating 0.5–2%
of GNP. Therefore, in any case, it is a priority health 2. Materials and methods
problem in the Euro Zone.
In recent years there have been numerous arti- It is often said that there are two categories of re-
cles [2–9] and research on MSDs with very heteroge- search and analysis of work conditions [11], the first
neous methodologies on differentiated groups of peo- of which considers that valuation must be made by the
ple. For this reason, it is difficult to get an overall re- workers themselves and, therefore, can only be carried
sult. There are still doubts on key issues. out by asking them (via survey). The second category
What diseases are included in MSDs? What is the disregards any subjective assessments to focus on ob-
weight of work factors regarding personal factors? jective findings.
What are the risk factors associated with the pathol- Regarding MSDs, the data source must be selected
ogy of each joint? Which diseases should be consid- conveniently and we must make sure that there is no
ered work related and which not? group bias. Differences between the trade unions and
The MSDs classified as professional contingencies business organizations are not uncommon, and the se-
make up a group of diseases that can be processed as lected samples in the commissioned studies are not al-
work accidents (WA) or occupational diseases (OD). ways representative.
Generally, when there is an immediate cause-effect re-
lationship we consider it a work accident, and, if the
disorder comes from prolonged exposure over time, 2.1. Considered databases
it is called occupational disease. For a disorder to be
considered a work related disease, we need a diagno- The data considered have the following origin:
sis and identification of the working conditions or its a) Data provided by Spanish workers through the
causative agent, which is included in the list of Occu- Spanish National Survey of Working Conditions
pational Diseases. Therefore, any analysis of the MSDs (ENCT) [12].
 J.M.R. Moar et al. / Comparative study of the relevance of MSDS between the Spanish and the European working population 647

Carried out by INSHT (Spanish National Insti- al/eurostat/home/ dated 02/14/2013 with the last
tute of Health and Safety at Work), with a sam- update of the data on 04-02-2013.
ple of 8,892 workers by personal interview in the e) Data on OD [15] in Spain are obtained from offi-
workers’ home and a questionnaire of 62 ques- cial indexes developed by the INSHT.
tions. From this group, 95% of people working The MSDs data classified as OD within the Span-
on the day of the interview, 80% were actively ish working population have been estimated from
registered with the Spanish social security system data provided by the CEPROSS, General Direc-
and 73.9% had a permanent contract. torate of Spanish System of Social Security. The
b) Data provided by the European workers via the INSHT has collected these results in its publica-
European Working Conditions Survey tion, “The musculoskeletal disorders in the work-
(EWCS) [13]. place in numbers” that has been used for this pur-
The EWCS of the European Foundation for the pose.
Improvement of Living and Working Conditions f) At a European level, the information on OD
(EFILWC) has a similar goal to the ENCT, i.e. comes from two different sources:
to obtain the views of workers, on the various – For the 2002–2005 period, we have used
factors that influence their working conditions. data from the European Occupational Diseases
The present study uses the fifth edition of the sur- Statistics (EODS), collected in the publication
vey, which has 44,000 workers from 34 European of European Agency for Health and Safety
Countries (the EU-27, Norway, Croatia, Macedo- at Work (EU-OSHA): OSH in figures, Work-
nia, Turkey, Albania, Montenegro and Kosovo). related musculoskeletal disorders in the EU.
Gallup Europe, addressed the issue of data col- Data come from across the EU except Ger-
lection in 2010, by interviews in the worker’s many, Greece and Ireland.
home, outside the workplace, with an average du- – For the 2006–2010 period, we have used
ration of 44 minutes per interview. records from four countries: France, Denmark,
The EWCS use the terms EU-12, EU-15 and EU- Great Britain and Germany. The source of
27, which means: these records can be found in EUROGIP pub-
– The EU-12 is formed by, Belgium, Denmark, lications, in the annual statistics of Health and
France, Germany, Greece, Ireland, Italy, Lux- Safety Executive and in DGUV publications.
embourg, the Netherlands, Portugal, Spain, We must point out that studies and research conducted
and the United Kingdom. by social agencies and NGOs involved in the matter
– The EU-15 is EU-12 plus Austria, Finland and have been left out because of possible biases that may
Sweden. occur (unions, prevention services, accident insurance,
– And the EU-27 is EU-15 plus Bulgaria, business associations, etc.).
Cyprus, Czech Republic, Estonia, Hungary,
Latvia, Lithuania, Malta, Poland, Romania, 2.2. Procedure
Slovakia and Slovenia.
c) Data on WA in Spain obtained from official in- The methodology involved the direct comparison of
dexes developed by the INSHT [14]. the different results obtained in Spain by ENCT or the
Data from MSDs listed as WA within the Span- accident statistics published by the INSHT, compared
ish working population have been estimated from to data from the European or the ECWS, Eurostat
the Spanish Labour Statistics Yearbooks. This in- statistics, EUROGIP, SHE or DGUV. In some cases
formation comes from the content of the offi- where a correspondence between ENCT and EWCS
cial reports of occupational accidents with time does not exist, we have compared the Spanish results
off work. We used an INSHT publication, “Acci- against the average European results in the EWCS sur-
dents at work by overexertion 2011”, which be- vey.
longs to the Department of Research and Infor- With regard to working conditions, we have anal-
mation. ysed:
d) Information concerning WA within the European – Views of workers on the relationship between
Union is obtained directly from Eurostat. health and work.
Information has been obtained at the web address – The incidence of major ergonomics hazards in
http://epp.eurostat.ec.europa.eu/portal/page/port their work place, namely:
648 J.M.R. Moar et al. / Comparative study of the relevance of MSDS between the Spanish and the European working population

∗ Repeated movements
∗ Tiring positions

Your work affect your health

∗ The handling of weights (loads and/or people)
32.9%
∗ Vibrations
Meanwhile, in terms of accidents, we used the fol-
EU-27
lowing variables for comparison: Percentage share of 22.4%
EU-15
MSDs of total WA (% MSDs-WA) and on total OD (%
MSDs-OD). EU-12
For WA, the Spanish data used are those occupa- 22.1%
tional accidents with sick leave that have been classi-
fied as code type 71 (physical overexertion-on muscu-
loskeletal system).
For the selection of European data, due to the mis- 0.0% 10.0% 20.0% 30.0% 40.0%
match of the different laws, it was necessary to filter
Fig. 1. Relationship between work and health. (Colours are visible
the WA published by Eurostat. Of the various existing in the online version of the article; http://dx.doi.org/10.3233/WOR-
fields in the description of the accident, we will use 152027)
“type of injury”, with only the following codes being
recorded: We have selected data from diseases recognized af-
ter the diagnosis process (regardless of the initial data).
– 031 Dislocations and subluxations
The results of Germany recorded only confirmed
– 032 Sprains and strains
cases of occupational diseases and, between them, we
– 039 Other types of dislocations, sprains and
have selected Subsection 2.1 of its list of professional
strains diseases, corresponding to mechanical agents: Muscle
The period analysed was 2008–2010, and all records diseases, meniscal injuries, back injuries, nerve pres-
are used for total activities and total accidents i.e. no sure injuries, etc.
more filters than those given to “the type of injury.” Finally, the approach followed in the case of MSDs
For the OD, we compare the results of % MSDs in Spain is the one used by INSHT in their reports
Spanish OD with the results provided by the European “Work Accidents by overexertion 2011” and “muscu-
Statistics on Occupational Diseases (EODS) over a pe- loskeletal disorder in the workplace in numbers”.
riod of four years. Later a second comparison, in a
more current period, with four EU countries: France,
UK, Germany and Britain. In the latter case, we have 3. Results and analysis
used the following criteria.
3.1. Results of workers surveys
The figures for France include the following dis-
eases as MSDs: 3.1.1. Relationship between work and health
– Joint diseases The content of the labor surveys should begin with
– Chronic lumbar conditions the workers’ views on the relationship between work
– Chronic meniscal injuries and health. In the EWCS, the question ”Does your
– Diseases induced by vibrations of machines. work affect your health?” has been answered “yes” in
For Britain, the total number of cases recorded in the the following percentages: 22.1% in EU-12, 22.4% in
last 12 months. The British statistical system does not EU-15 and 32.9% in EU-27 (Fig. 1).
Meanwhile the ENCT makes reference to this is-
match calendar years in other countries, therefore, we
sue by asking the workers, primarily, about perceived
have used the equivalence 2006 to 2006/2007, 2007 to
health problems and secondly, if they think their prob-
2007/2008, etc. . .
lems are aggravated by work.
In the case of Denmark, the following diseases have
The main health problems identified include: back-
been recorded as MSDs: ache, neck, upper extremities, lower extremities, tired-
– Lumbar affections ness, stress and headache (Fig. 2).
– Motricity diseases and other articular diseases The results show that the 27.8% of workers had no
– Nerve inflammation including carpal tunnel syn- problem whatsoever, which means that 72.2% of the
drome. working population suffers health problems.
 J.M.R. Moar et al. / Comparative study of the relevance of MSDS between the Spanish and the European working population 649

27.8% 6%

14.0% 15% Liing or moving people

Health problems idenfied

Ergonomic hazards
Never
17.2% Headache Thrust and drag forces
18%
Stress Heavy loads
18.9% 30%
Tiredness Sing posture

22.9% 31% Standing

Lower Extremies
Tiring posions
Upper Extremies
26.6% 36% Repeve movements
Neck
32.0% Backache 5 9%

50.3%
0% 20% 40% 60% 80%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% Fig. 4. Ergonomics hazards identified. (Colours are visible in the on-
line version of the article; http://dx.doi.org/10.3233/WOR-152027)
Fig. 2. Health problems. (Colours are visible in the online version of
the article; http://dx.doi.org/10.3233/WOR-152027)
Using these risk factors and taking into account ex-
70.0% posure to vibration (physical hazard with evidence of
62.4%
60.0%
its influence on MSDs of the back), then we will make
a comparison of the difference of opinion between Eu-
50.0%
ropean and Spanish workers in the key ergonomics fac-
40.0%
32,9% tors identified.
30.0%
22.1% 22.4%
20.0% 3.1.2.1. Repetitive work of upper extremities
This is a group of continuous movements of the up-
10.0%
per limbs, kept up at work, which damage the same
0.0%
musculoskeletal group. Repetitive work aggravates fa-
Your work affect your health
EWCS EU-12 EWCS EU-15 EWCS EU-27 ENCT
tigue, overload, and, ultimately, pain. This problem
usually appears with work cycles with similar patterns
Fig. 3. Comparative relationship between work and health. in terms of forces and displacements.
The following repeatability values are considered
In the second question, 86.4% of workers believed harmful in different body segments [17]:
that the health problem is produced or made worse – Shoulder: More than 2.5 repeats per minute
by work, yielding different percentages depending on – Arm/Elbow: More than 10 repetitions per minute
the different pathologies. This means that 62.4% of re-
– Forearm/Wrist: More than 10 repetitions per
spondents understood that work affects their health, a
minute
much higher percentage share when compared to data
– Fingers: Over 200 repetitions per minute
obtained at a European level (Fig. 3).
From the analysis we can observe that the Spanish On the other hand, generally, Silverstein [18–20]
working population believes that their work will affect stated that “work is considered repetitive when the du-
their health in a much higher percentage than the Eu- ration of the work cycle is less than 30 seconds.”
ropean average: 40.2% more than the EU-12, 39.9% The perception, in terms of exposure to repetitive
more than in the EU-15 and 29.4% than the EU-27. movements, of the Spanish workforce in the EWCS
(Fig. 5), is 40.9%, well above the European average:
3.1.2. Ergonomics risk 8.2% more than the EU-12, 8% more than the EU-15
The etiology of MSDs related ergonomics risk fac- and EU-27.
tors, such as repetitive work, painful and tiring pos-
tures, carrying/moving heavy loads and exposure to vi- 3.1.2.2. Tiring positions
bration as their main cause [16]. These are positions adopted at work which generate
The ENCT analyses the opinion of the workers on one or more anatomical regions to abandon a natural
these factors. The result obtained is shown in the Fig. 4. position of comfort to move to another position that
650 J.M.R. Moar et al. / Comparative study of the relevance of MSDS between the Spanish and the European working population

Table 1
Joint limits
Joint Positions RULA ISO 11226 OSHA Keyserling Drury Occhipinti-Colombini
Shoulder Flexion > 90◦ > 60◦ Without support Without support 94◦ 80◦
Extension > 20◦ If there 31◦ 20◦
Abduction If there > 60◦ 67◦ 45◦
Elbow Flexion > 100◦ At the end 71◦ 60◦
Supination Maximum value At the end Fast movement If there 39–57◦ 60◦
Wrist Flexion > 15◦ At the end > 20◦ If there 45◦ 45◦
Extension > 100◦ At the end > 30◦ 50◦ 45◦
Radial Deviation If there At the end − 14◦ 15◦
Ulnar deviation If there At the end − 24◦ 20◦

Table 2 70.0%
Limit values of neck and trunk 59.0%
60.0%
Segment Position Intervals Assessment
Head Flexion > 20◦ Limit exposure time 50.0%
40.9%
Turn > 15◦ Limit exposure time 40.0%
< 45◦ 32.7% 32.9% 32.9%

< 45◦ Remove 30.0%

Lateral tilt Remove great inclinations 20.0%

Extension Remove
Trunk Flexion > 20◦ Reduce the angle 10.0%
< 60◦
> 60◦
0.0%
Remove Repeve movements
Lateral tilt > 15◦ Reduce the angle
> 15◦
EWCS Only Spain EWCS EU-12 EWCS EU-15 EWCS EU-27 ENCT
Turn Reduce the angle
< 45◦
Fig. 5. Comparative repetitive movements exposure.
> 45◦ Remove
Extension If there Remove
40.0%
35.8%
generates hyper flexion and/or osteoarticular hyper ro- 35.0%
tations.
30.0%
Usual results are muscle, tendon and joint fatigue,
25.0%
and usually occur when recommended limits are con-
20.0% 18.4%
tinuously exceeded. Conventional valuation methods 15.5% 15.3% 15.7%
identify the following values [21]: (Tables 1 and 2). 15.0%

The perception of Spanish workers, in terms of ex- 10.0%

posure to tiring positions, is 18.4%, against 15.5%, 5.0%
15.3% and 15.7% from EU-12, EU-15 and EU-27 0.0%
(Fig. 6). Tiring posions
The results show that the Spanish workforce is EWCS Only Spain EWCS EU-12 EWCS EU-15 EWCS EU-27 ENCT

higher than the European average on 2.9% 3.1% and

Fig. 6. Comparative tiring positions exposure.
2.7% respectively.

3.1.2.3. Carrying/moving heavy loads The result of the comparison of the perception of the
This risk factor encompasses acts of transporting or workers is:
handling of loads by workers, such as lifting, pushing, – Spanish workforce said that their job involves car-
positioning, traction or displacement, which generate rying or moving heavy loads in a 30.7%
the ergonomics risks of back injury.
– Workers from EU-12 answered in the same terms
With regards to this factor, there are different val-
in 32.5%
uation methodologies, the NIOSH equation being the
– Workers from EU-15 in 32.8%
most used. Using this equation, one can calculate the
– Workers from EU-27 in 33.5%
RWL (Recommended Weight Limit) for a particular
transport operation based on the weight of the load, the Apart from tiring positions and repetitive move-
relative position thereof, the vertical distance of ma- ments, the Spanish results are better than the European
nipulation, handling height and frequency surveys. average.
 J.M.R. Moar et al. / Comparative study of the relevance of MSDS between the Spanish and the European working population 651

40.0%

35.0% 32.5% 32.8% 33.5%

30.7% 14.0%
30.0%

25.0% 17.2%

Health problems idenfied ENCT

20.0% 17.8% Sleep problems

15.0% Stress
18.9%
10.0% Tiredness
5.0% 22.9% Muscular pain at Lower
0.0% extremies
Heavy loads Headache/Visual problems
32,9%
EWCS Only Spain EWCS EU-12 EWCS EU-15 EWCS EU-27 ENCT Backache

50.3% Muscular pain, neck, shoulders

Fig. 7. Comparative heavy loads exposure. and upper extremies

10.0% 9.4% 9.5% 58.6%

8.9%
9.0%
8.0%
7.0% 6.5% Fig. 10. Health problems at ENCT. (Colours are visible in the online
6.0% 5.5% version of the article; http://dx.doi.org/10.3233/WOR-152027)
5.0%
4.0%
3.0%
2.0% 8.8%
1.0%
Health problems idenfied EWCS

0.0% Injuries
13.4%
Liing or moving people Stomach problems
EWCS Only Spain EWCS EU-122 EWCS EU-15 EWCS EU-27 ENCT
18.3% Sleep problems
Muscular pain at lower
Fig. 8. Comparative lifting or moving people exposure. extremies
30.0%
Headache/Visual problems
30.0% 32,9% Muscular pain, neck, shoulders
and upper extremies
25.0% 24.0%
21.8% 22.5% Backache
21.6% 42.8%
20.0%

14.0% 46.4%
15.0%

10.0%

5.0% Fig. 11. Health problems at EWCS. (Colours are visible in the online
version of the article; http://dx.doi.org/10.3233/WOR-152027)
0.0%
Vibraons

EWCS Only Spain EWCS EU-122 EWCS EU-15 EWCS EU-27 ENCT assessment in different hospital areas (wards, surgi-
cal areas and outpatient care), taking into account fac-
Fig. 9. Comparative vibrations exposure.
tors such as: number of patients per worker, number
of elevators, proportion of valid patients, provision of
3.1.2.4. Lifting and moving people wheelchairs, adjustable beds and specific training for
MSDs are a serious problem in the health sector, par- workers in the field.
ticularly for personnel who move patients, their trans- The comparison is similar to the above, the result
fer being the most common mechanism of injury. of the Spanish workers (Fig. 8) within the European
The difficulty of using traditional methods (Niosh survey was 6.5% against 9.4%, 9.5% and 8.9% corre-
equation, etc.) is that the load is the human body and sponding to the European averages. It seems accept-
manipulated weight calculation is extremely difficult able to think that the Spanish workers are carrying
despite knowing very precise estimates of the differ- loads less than the European average, which is the op-
ent body segments. Furthermore, the manipulations are posite to other risk factors.
performed in positions with high angles of flexion of
the spine and/or neck. 3.1.2.5. Vibrations
At present there is a specific method, the MAPO in- Mechanical vibrations cause a number of diseases
dex [22], a methodology which allows mobility risk when their occupational exposure is significant. There
652 J.M.R. Moar et al. / Comparative study of the relevance of MSDS between the Spanish and the European working population

70.0%
59.0%
60.0%
50.3%
50.0% 46.5%
42.8%
40.0%
30.0%
30.0% 22.9%
20.0%
10.0%
0.0%
Muscular pains, Neck, Shoulders Backache Muscular pains at lower
and upper extremies extremies
EWCS EU27 ENCT

Fig. 12. Comparative health problems. (Colours are visible in the online version of the article; http://dx.doi.org/10.3233/WOR-152027)

69.4%

38.0% 68.7%
2010
74.7%
%MSDs-WA

2009
2010
37.6% 79.1% 2008
2009
%MSDs-OD

2007
2008 86.6%
2006
36.4% 87.4% 2005
2004
86.2%
2003

85.3% 2002
35.5% 36.0% 36.5% 37.0% 37.5% 38.0% 38.5%
82.5%
Fig. 13. Percentage share of MSDs over total WA in Spain. (Colours
are visible in the online version of the article; http://dx.doi.org/ 0% 20% 40% 60% 80% 100%
10.3233/WOR-152027)
Fig. 16. %MSDs-OD in Spain. (Colours are visible in the online ver-
are two categories in terms of their effects: vibrations sion of the article; http://dx.doi.org/10.3233/WOR-152027)
transmitted to “hand-arm”, which generate vascular,
bone or joint, neurological or muscular problems; and 3.1.3. Disorders
vibrations transmitted to the “full body” which usually Another consideration to determine the views of
cause back pain and spinal injuries. workers on the incidence of MSDs is to analyze the
In this physical factor, the technical criteria of eval- discomfort that they suffer. ENCT results show the fol-
uation is defined by the UNE-EN ISO 5,349-1 (2002) lowing conditions as the main ones (Fig. 10): Muscular
and UNE-EN ISO 2,631-1 (1997) regulations. The ex- pain, neck, shoulders and upper extremities were suf-
fered by 59% of the workers and backache by 50.3%.
posure limit for the “hand-arm” system is 5 m/s2 and
For their part, the EWCS results (Fig. 11), were:
“full body” 1.1 m/s2 . They are limits that correspond
Backache 46.4% and muscular pain, neck, shoulders
to the most efficient values of accelerations according
and upper extremities 42.8%.
to the three orthogonal axes defined in the rules.
The comparison of the results of both surveys shows
The comparison of this ergonomics risk factor is as
the following results (Fig. 12).
follows (Fig. 9): the results show that 24% of Span-
As we can see, disorders reported by Spanish work-
ish workers said that they are exposed to vibrations, at
ers in the ENCT outweigh the findings of the EU aver-
work, against 21.8%, 21.6% and 22.5% corresponding
age in EWCS so that:
to the European averages.
The end result shows that Spanish workers are more – Spanish workers show a 16.2% higher than the
conscious concerning ergonomics hazards from repet- EU-27 average, in neck, shoulder and upper ex-
itive movements, tiring positions and vibrations expo- tremity MSDs
sure, than European workers. Only in terms of carrying – 3.8% more on MSDS on Back
– 7.1% less on lower extremity MSDs (to a lesser
loads and lifting people, do European workers show
extent from a labor perspective)
greater sensitivity.
 J.M.R. Moar et al. / Comparative study of the relevance of MSDS between the Spanish and the European working population 653

%MSDs -WA

29.3%
EU-27 29.6%
29.5%

30.3% 2010
EU-15 30.6%
2009
30.9%
2008
30.4%
EU-12 30.8%
31.2%

28.0% 28.5% 29.0% 29.5% 30.0% 30.5% 31.0% 31.5%

Fig. 14. Percentage share of MSDS over total WA in Europe. (Colours are visible in the online version of the article; http://dx.doi.org/
10.3233/WOR-152027)

%MSDs-WA
40.0% 37.6% 38.0%
36.4%
35.0% 31.2% 30.8% 30.4% 30.9% 30.6% 30.3%
29.5% 29.6% 29.3%
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
EU-12 EU-15 EU-27 Spain

2008 2009 2010

Fig. 15. Comparative %MSDS-WA between Spain and EU. (Colours are visible in the online version of the article; http://dx.doi.org/10.3233/
WOR-152027)

3.2.1. Work accident

58.9% Official data of accidents are published by the Span-
ish National Observatory for Working Conditions.
2005 These are statistics that come from the public system
%MSDs-OD

55.2%
2004 to report accidents and therefore are always based on
2003
52.9% the diagnosis made by a physician.
2002
There is clear evidence that the accident rate in
52.8%
Spain is decreasing gradually, and, within this frame-
work, MSDs results continue to show a slight upward
48% 50% 52% 54% 56% 58% 60% trend while maintaining a level of about 36–38% of
WA (Fig. 13).
Fig. 17. %MSDs-OD in EU. (Colours are visible in the online ver- Meanwhile, in Europe, Eurostat estimates (no data
sion of the article; http://dx.doi.org/10.3233/WOR-152027)
from Holland and Portugal in 2008 or Greece) for these
three periods are (Fig. 14) somewhat lower.
The comparative between European and Spanish
3.2. Results of official accident statistics data is: (Fig. 15). As the graph shows, in Spain, the
percentage share of MSDs within WA is between 5%
and 8% higher than the European average.
In this chapter, we will use the results of occupa-
tional diseases diagnosed and legally notified by the 3.2.2. Occupational Diseases
Spanish national health system and the different esti- This type of data is more difficult to obtain because
mates made by Eurostat in this area. the Occupational Diseases lists are difficult to com-
654 J.M.R. Moar et al. / Comparative study of the relevance of MSDS between the Spanish and the European working population

%MSDs-OD
100.0%
85.3% 86.2% 87.4%
90.0% 82.5%
80.0%
70.0%
58.9%
60.0% 52.8% 52.9% 55.2%

50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
2002 2003 2004 2005
Europe Spain

Fig. 18. Comparative %MSDs-OD 02-05.

%MSDs -OD

5.1%
26.7%
2010
44.1%
85.3%

4.7%
27.5%
2009
45.2%
83.3%

5.5% Germany
27.0% Denmark
2008
45.5%
81.3% Britain
France
5.3%
29.3%
2007
42.8%
78.2%

5.1%
23.5%
2006
46.4%
76.9%

0% 20% 40% 60% 80% 100%

Fig. 19. %MSDs-OD Germany, Denmark, Britain y France 06–10. (Colours are visible in the online version of the article; http://dx.doi.org/
10.3233/WOR-152027)

pare in Europe for its lack of homogeneity. First, we The comparison (Fig. 18) regarding the relative
compare the Spanish results with the latest official data weight of MSDs in ODs declared in Spain leaves no
available at European level (2002–2005), and a second doubt.
more recent comparative will address data for four EU The percentage share of MSDs within ODs cata-
countries (France, Germany, UK and Denmark). loged in Spain by the health system is 30% higher than
First shown (Fig. 16), the percentage share of mus- the European average in the period 2002–2005.
culoskeletal disorders in the whole of the Occupational
Diseases diagnosed in Spain. MSDS are the main prob- 3.2.2.2. Period 2006–2010
lem in this area. The results for France [23], Great Britain [24], Den-
mark [25] and Germany [26] are shown in Fig. 19.
3.2.2.1. Period 2002–2005 Germany is about 5%, Denmark is between 25% and
The results at the European level over this period are 30%, Britain is about 45% and France is between 75%
between 50% and 60% (Fig. 17). and 85%.
 J.M.R. Moar et al. / Comparative study of the relevance of MSDS between the Spanish and the European working population 655

%MSDs-OD
100.0%
90.0% 86.6% 85.3%
81.3% 83.3%
78.2% 79.1%
80.0% 76.9%
74.7%
68.7% 69.4%
70.0%
60.0%
50.0% 46.4% 45.5% 45.2%
42.8% 44.1%

40.0%
29.3% 27.5%
27.0% 26.7%
30.0% 23.5%
20.0%
10.0% 5.1% 5.3% 5.5% 4.6% 5.1%

0.0%
2006 2007 2008 2009 2010

France Britain Denmark Germany Spain

Fig. 20. Comparative %MSDs-OD Spain, Germany, Denmark, Britain and France 06–10.

The comparison with Spanish results is shown in c) From official results of WA and OD, we obtain a
Fig. 20. similar result. The rates in the Spanish workplace
When comparing data, we can see the importance are worse than the European average. In WA, the
of MSDs on total ODs diagnosed in Spain, again con- difference is between 5–8% and in OD, the dif-
firmed in this analysis period. While Germany suffers ference is about 30% compared with Europe.
a percentage share of MSDs of about 5%, Denmark a The results are very clear although it would be more
25–30% and Great Britain a 45% share; Spain is lo- precise to unify the accounting methods used by Euro-
cated between 70 and 85%. This shows the importance pean countries. This would make it easier to compare
of such diseases within our workforce. data. We also need more homogenization of official list
of OD.
The above suggests, that the incidence of MSDs in
the Spanish working population significantly exceeds
4. Conclusions
European records in this area.
The conclusion is that Spain should improve its
This study shows the importance of MSDS in Spain “safety and health at work”. MSDs account for about
in relation with Europe. 35–40% of WA and between 70–88% of OD; for this
The results show curious issues: reason the first step should be to improve this issue.
a) The view of Spanish workers about the relation- Just by reducing MSDs, Spain would significantly
improve its “safety and health” ratios.
ship between work and health is worse than Eu-
The correct strategy in order to reduce the incidence
ropean workers. The difference is marked (62.3%
of MSDs in Spain would be to work on three factors:
against 22%, 22.4% and 32.9%).
repetitive work of upper extremities, tiring positions
b) If we talk about ergonomics risk factors, which and exposure of vibrations. This means we have to
was the purpose of this study, the comparison act on workplaces, reducing frequency of movements’,
gives us interesting results. Habitual factors like eliminating tiring positions and absorbing vibrations.
repetitive work of upper extremities, tiring posi- On top of this, the management of break times and
tions and exposure of vibrations are identified by “micro-pauses” should be changed to allow for recu-
Spanish workers with more emphasis than Euro- peration.
pean ones. The opinion of the Spanish workforce
compared to the European one is only better in
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