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Strategies for assessing these additional costs remain understudied and controversial and are one basis for the wide range of estimates cited above.

SUMMARY

There are sufficient data regarding the occurrence of musculoskeletal disorders in the general U.S. population, including workers and non-workers, to conclude that the musculoskeletal disorder problem is a major source of short- and long-term disability, with economic losses in the range of 1 percent of the gross domestic product. However, these sources suffer from severe limitations: (1) they use nonstandard criteria for designation of musculoskeletal disorders, making comparison among them impossible; (2) data points are infrequently collected, making analysis of trends or changes impossible; and (3) none is currently structured in such a way as to allow distinctions between musculoskeletal disorders that may be related to work activities and those that are not.

BLS and workers' compensation data are sufficient to (1) confirm that the magnitude of the work-related musculoskeletal disorder problem is very large; (2) demonstrate that rates differ substantially between industries and occupations consistent with the assumption that work-related risks are important predictors of musculoskeletal disorders; and (3) document that the rapid growth in the problem or its recognition that occurred in the 1980s has shown a slight decline in the 1990s. These data provide substantial information regarding those musculoskeletal disorders that are considered work related. Moreover, they have been obtained regularly and provide some insight into the relationship between certain kinds of industries and occupations and the rates of musculoskeletal disorders. In these databases, cases have been selected in variable, nonuniform ways that are likely to underrepresent the spectrum of work-related musculoskeletal disorders that occur; musculoskeletal disorders are coded in nonstandard ways, further limiting comparability between data sources; and information available in terms of demographic and occupational risks is very limited.

Taken collectively, review of all available data sources underscores the need for more complete, more frequent, and better standardized databases that include, at a minimum, uniform coding of musculoskeletal disorders and sufficient information about industry, occupation, and tasks to allow accurate quantification of the musculoskeletal disorder problem, separation into those aspects that are and those that are not related to work factors, and tracking to determine the effects of interventions as they are undertaken.



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