Understanding the evidence on the impacts of COVID-19 on work-related musculoskeletal disorders

What is the issue?

Work-related musculoskeletal disorders (WRMSD) are injuries and conditions that are caused or made worse by work, and can affect the back, joints and limbs. They account for 30 per cent of all work-related ill-health and result in more than 8 million lost working days each year. Prior to the coronavirus pandemic, the rate of self-reported WRMSDs showed a generally downward trend. However, the COVID-19 pandemic required rapid changes to working practices and environments at the individual, organisational and national levels to protect people from infection. These changes may have affected exposure to known WRMSD risk factors, and some of the changes to working practices and environments may become permanent.

How did we help?

To investigate these issues, the Health and Safety Executive (HSE) commissioned RAND Europe to undertake a rapid evidence assessment (REA) and stakeholder consultation. This work aimed to understand the changing world of work during the COVID-19 pandemic, the effect on WRMSDs and post-pandemic considerations for WRMSDs.

What did we find?

Based on evidence from the literature and stakeholder consultations, we identified three main groups of workers to broadly represent experiences during the pandemic: key workers, furloughed workers and people who continued their roles by working from home.

The literature we identified on WRMSD risk factors pre-COVID-19 (24 sources published between 2002 and 2021) showed that the most commonly reported WRMSDs affected the upper limbs (shoulders, neck, arms, wrists, hands and fingers), lower back, or were related to hip/knee osteoarthritis. Common physical risk factors associated with these WRMSDs included prolonged work, repetitive movements, heavy lifting, computer use, awkward postures, prolonged standing, vibrations, inappropriate furniture, intense physical exertion and walking on uneven ground. Common psychosocial risk factors associated with these WRMSDs were stress, high job demands, time pressures, low job satisfaction, ‘boring’ work, insufficient social support, lack of control around decision-making at work and poor work-life balance.

The literature we identified on the impact of COVID-19 on risk factors (20 sources published between January 2020 and April 2021) highlighted the detrimental effect COVID-19 had on psychosocial risk factors associated with WRMSDs across key worker and work-from-home populations. There was only limited evidence of an impact on psychosocial risk factors for furloughed worker populations from the evidence summary.

In addition, limited evidence suggested increases in physical risk factors were reported among work-from-home and key worker populations, and the potential for physical deconditioning was mentioned for furloughed workers. The published scientific literature reported minimal evidence (four studies) of increased WRMSD symptoms such as musculoskeletal discomfort, neck, shoulder and back pain during the COVID-19 pandemic in key worker and work-from-home populations. However, it was too early for conclusive evidence of the pandemic’s impact on WRMSD outcomes at the time of data collection.

Evidence from the supporting stakeholder consultation suggested that working hours and intensity may have increased for key worker and work-from-home populations during the pandemic, thereby increasing psychosocial risk factors for WRMSDs. However, stakeholders also reported that health and wellbeing were more widely spoken about due to the pandemic, with some workplace changes offering potential methods for reducing WRMSD risk among work-from-home and furloughed workers; for instance, flexible working hours and more time for habits supporting musculoskeletal health.

What can be done?

The literature and supporting stakeholder consultation provided various suggestions for addressing the physical and psychosocial risk factors of WRMSDs.

For physical risk factors, they suggested that the following control measures could be considered by duty holders, where it was appropriate, by:

• providing aids for lifting
• ensuring ergonomically sound workstation set-ups
• encouraging regular postural changes
• providing easy-to-apply guidance on display screen equipment across varied workplace settings, including for home settings.

For psychosocial risk factors, it was suggested that the following control measures could be considered by duty holders, where it was appropriate, by:

• the provision of mental health support
• encouraging peer support
• helping workers manage their workload
• fostering teamwork.