1. CONCLUSIONS FROM THE WORKSHOPS

2. Workshop 3 Back to work and reintegration Conclusions Rapporteur José Ramón Biosca de Sagastuy European Commission

3. Work-related interventions improving return-to-work of workers with MSDs and some Dutch examples (Birgitte Blatter)  Effectiveness of interventions in the workplace oMultidisciplinary approach more effective then single elements alone oThe scientific evidence is somewhat limited, more research needed oEvaluation of workplace interventions should probably adopt different criteria than those of medical treatment oLack of 100% evidence should not be an excuse for employers not to take action  Examples from the Netherlands’ ongoing projects oInsurance company that refers self employed persons with MSDs to physical training oA rehabilitation centre that developed a website oAn occupational health service that started with implementing the Sherbrooke model (participative approach to implement work adaptations)

4. A nationwide programme for early rehabilitation of low back pain workers in Belgium (Philippe Mairiaux)  Back pain – the 1 st recognised work-related disease (since 2004)  Pilot project ‘Multidisciplinary back rehabilitation program’ among nursing staff  Includes physical exercising, psychologist’s consultation and workplace ergonomics  Results: favourable (98,7% return to work before treatment ends), however – no control group  Barriers to participation: not aware of the programme, lack of motivation from sufferers and/or employers  Now this programme is part of health care system and extends to all workers and sectors

5. Repetitive Strain Injuries: Impact, recovery and successful return to work (Stephen Fisher)  Personal experience – Principal Engineer with major aerospace company, 32 years service  Intense PC work, long hours  No H&S assessment, no training, early symptoms missed  Then ‘a bolt of lightning hit the back of a hand’  Medical retirement at 52, still not completely recovered  Formed new charity RSI action: identify problems and solutions, support to other workers with RSI  Early identification is key  Effective treatment includes physiotherapy, appropriate exercises and workplace adjustment through ergonomic measures

6. Discussion  A multidisciplinary approach to rehabilitation and return to work that starts early seems to be effective  It is supported by scientific and anecdotal evidence  While more research is needed, particularly on ULDs, this should be not be an excuse for inaction by employers or policy makers  Early identification and recognition of the problem and solution finding is vital – employer and workers can be trained to identify symptoms and risk factors  Comprehensive care, including medical, occupational and social rehabilitation, should be provided  Rehabilitation and return to work requires coordination between employer, worker, and the medical and social security systems

7. Discussion  There appears to be variation in the use and definition of MSD- related terminology,  The multi-factorial nature of MSDs mean that rehabilitation programmes should be tailored to the individual, but include both group and individual actions  A sectoral agreement in agriculture identifies a lack of harmonised statistics as a problem  Risk assessment is the key to prevention and managing return to work  SMEs face challenges in implementing rehabilitation approaches and need help  The involvement of all workers, not just injured workers, in programmes can help prevention and facilitate the early identification of problems