Nature and number of RSI complaints vary by country

Occupational health professionals may need to revisit their assumptions about work-related wrist and hand injuries in the light of research that has suggested workers from different countries experience widely different rates of pain, even when doing similar types of work.

An international study for the Society of Occupational Medicine suggested the wider variation – with the prevalence among office workers using computers as much as 14 times higher in some countries – cannot be explained by known causes of wrist/hand disorders or by the availability of compensation for work-related illness such as repetitive strain injury (RSI).

Instead, it argued, it may be a consequence of differences in “culturally determined health beliefs and expectations”.

This is something that could potentially call into question the current emphasis in the UK workplace on ergonomic controls, such as the design of desks and computer equipment to prevent symptoms.

It is estimated that more than 5.4 million days are lost each year to sick leave because of hand and wrist problems, while 450,000 UK workers have disabling hand and wrist pain or RSI.

The international study was presented at the annual scientific meeting of the society in June.

It looked at 12,426 employees from 47 occupational groups across 18 countries, comparing rates of wrist/hand pain that had made it difficult or impossible to carry out everyday tasks, such as writing or opening bottles and jars. Most of the groups studied were office workers or nurses.

The society described the differences as “startling”, with rates in office workers ranging from 2% in Pakistan and Japan to 31% in Brazil and 32% in Nicaragua.

The prevalence in UK office workers was 11%. Rates in nurses tended to be lower than in office workers, but the differences between nurses and office workers from the same country were much smaller than those between office workers from different countries, the study found.

Lead author Professor David Coggon, professor of occupational and environmental medicine at the University of Southampton, said: “This study demonstrates that so-called ‘RSI’ is not a simple consequence of stressful physical activity. It is possible that overemphasis of health risks from activities such as the use of computer keyboards could promote the illness that it is trying to prevent.

“Disabling hand and wrist pain or ‘RSI’ is a type of musculoskeletal problem which, as a whole, accounts for the largest cause of sickness absence in the UK.

“This study shows that understanding how to treat people with these conditions is a complex issue and that there are many factors at work including the attitude and personality of the worker, culture and the physical and psychological demands of jobs.”

Dr Richard Heron, immediate past president of the society, said: “Occupational health doctors and nurses have a unique understanding of this interface between work and health and are able to support employees back to work.

“We need to ensure that all employees who are having these issues have access to this support and that there is more research undertaken into treatment and care.”

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