OCCUPATIONAL MUSCULOSKELETAL DISORDERS IN ROMANIA OCCUPATIONAL MUSCULOSKELETAL DISORDERS IN ROMANIA (statistics, legislation) Adriana Todea Aurelia Ferencz Institute of Public Health, Bucharest

"Lighten the Load" Campaign The aims of the campaign: promoting actions to prevent occupational musculoskeletal disorders (MSD) Managing the retention, rehabilitation and return to work of those who suffer or have suffered from MSDs. Employers, employees and government working together to tackle MSDs

Musculoskeletal strain Romanian legislation Occupational morbidity on national level due to musculoskeletal disorders (data from the National Registry of Occupational Diseases)

Legislation Government Decision 1425/2006 regarding Application norms of the Law 319/2006 Annex 22 regarding the List of occupational diseases with compulsory reporting Government Decision 355/2007 regarding employees’ health surveillance

Annex 22 (1) OCCUPATIONAL DISEASE Mononeuropathy of upper limbs: Carpal, ulnar, radial tunnel syndrome Epitrochlear syndrome Other mononeuropathies of the upper limbs CAUSE Repetitive movemements Vibrations Extreme positions of the joints

Annex 22 (2) OCCUPATIONAL DISEASE Bursitis, epycondilitis, synovitis, tendinitis, tenosynovitis Meniscus lesions Arthroses, periarthritis Spine deformations Diskitis, herniated disk Fractures CAUZA Handling weights Repetitive movements Recurrent microtrauma Extreme, forced, prolonged position with joint strain: pressure, torsion Mechanical vibrations

GD 355/2007 Annex 1 Card no. 127 Musculoskeletal strain Periodical medical exam (clinical exam + ECG) Contraindications: Congenital malformations of the musculoskeletal system, depending on specific occupational strain Inflammatory or degenerative musculoskeletal disorders, tenosynovitis, miositis.

Data regarding temporary inability to work In Romania, a great number of the days away from work is due to musculoskeletal disorders from physical strain (22%). (according to the National Center for organizing and sustaining the health informational and informatics' system).

Comments on occupational morbidity (1) Weak points: A small number of new cases (47 new cases reported in 2006) The difficulty of reporting (traps): –most diseases due to strain are work-related –the need of hard evidence (occupational risk assessment): workplace visit: position, dynamic/static effort, weight lift greutăţi (how much?), rhythm, how many times in a shift, the duration of sustained effort, flat/inclined surface, increasing factors (cold microclimate, mechanical vibrations, other noxes, associated mental stress).

Comments on occupational morbidity (2) Strong points: The number of reported cases is growing (the number of new cases reported in the past six years is doubled) The percent from the total number of ODs reported is 5% (five times higher in 2006 than 2000).

The evolution of number of new reported cases of occupational musculoskeletal disorders

The evolution of the percentage of new reported cases of occupational musculoskeletal disorders

Counties 1.Dolj (20) 2.Alba (4) 3.Bucureşti (4) 4.Cluj (3) 5.Iaşi (2)

Most frequent types of disorders Chronic arthrosis Epicondylitis Tenosynovitis Carpal tunnel syndrome

Occupations 1.founder 2.ballerina 3.stock control clerk 4.miner 5.tool maker 6.acrobat 7.farmer 8.baker 9.metal worker 10.miller 11.instrumental performer 12.locksmith

Activities Food industry Sport activities Mining of metal ores Manufacture of basic metals Machinery and equipment industry Transport services Agriculture and related service activities Manufacture of wood and of products of wood Construction

October 24th, 2007 “Lighten the Load” The health and safety of workers exposed to musculoskeletal strain - a current priority