Smart Moves: The workplace needn't be a pain in the neck

Philip Schofield on attempts to banish back problems

Absenteeism cost British employers pounds 10.2bn last year according to the CBI. And back pain alone costs British industry pounds 6bn a year in lost production, according to the Back Pain Association. It is fitting therefore that a world authority on spinal problems and chronic back pain, Professor Malcolm Pope, was appointed last August as director of a new pounds 5m occupational health centre at Aberdeen University.

The Liberty Safework Research Centre, funded by one of the world's top occupational health insurers, Liberty Mutual, is being built on a 4.5 acre campus next to the Aberdeen University medical school. It will work closely with the university's department of environmental and occupational medicine to promote developments in occupational health through training, teaching and research. The aim is to help employers reduce the direct and indirect costs of work-related ill-health and absenteeism.

The centre has its origins in a joint venture between Shell, Esso, BP and Aberdeen University in 1977. Bill Gunnyeon, an occupational physician and chief executive and director of occupational health at Liberty Occupational Health, explains: "The oil companies needed emergency medical support for offshore operations which were not covered by the NHS. They also needed to assess the fitness of people to work offshore." Later the company broadened its scope to provide occupational health services to non-oil- related companies as well. In 1988, the oil companies donated their shares to the university. Eventually the university realised that the company needed a new parent if it was to develop and grow, and sold it to Liberty Mutual in 1996.

Liberty Mutual had set up a US research centre in 1954 at Hopkinton, Massachusetts. This had developed partnerships with the Harvard School of Public Health, the Shanghai Medical University and the British Health and Safety Laboratory. Mr Gunnyeon says Liberty aims "to help people lead safer and more secure lives by trying to reduce the incidence of injuries at home, on the roads and at work".

Professor Pope, formerly director of the Iowa Spine Research Centre at the University of Iowa, says the new research centre already exists in terms of the work going on and in having staff. "But it doesn't have a physical home as yet - that's going to be finished next February."

"We have shifted focus to concentrate more heavily on the occupational side of things. Our emphasis is on evaluating the workplace, putting together prevention strategies, trying to work closely with a variety of industries, and doing some work on treatment and diagnosis. But occupational back pain is still by far the greatest area of emphasis. Although we also do some general ergonomics work the main emphasis is on lower back pain."

He says that there are a variety of well established causes for low back pain, such as manual materials handling. But, he says: "Increasingly we understand that other factors can exacerbate the problem, such as lifting in a twisted posture and 'sudden loading' when one slips." As another example of sudden loading, he says that "in the healthcare industry, lifting a patient who may suddenly move their centre of gravity is a major risk factor".

"We also know that whole-body vibration from travelling in vehicles is another risk factor - particularly in off-the-road vehicles, construction vehicles, short-haul lorries and fork-lift trucks. There are a variety of vehicles that impart quite a substantial vibration to the human body. And increasingly the population has become sedentary, and sitting in fixed postures for long periods of time puts a substantial strain on the neck and back."

The centre also provides consultancy on changing work methods. "We are doing a project with a large computer manufacturing company where they have a lot of repetitive tasks. We are also doing a study with a helicopter company evaluating the workplace of pilots."

Recommendations based on the team's measurements can involve persuading an organisation to change the equipment being used. Professor Pope recalls a success in the US. "We found that a very specialised vehicle used for transporting containers from ships across to trains had very poor vibration damping. As a direct consequence of our efforts a new vehicle was born."

The human cost of back pain is alarming. According to the Health & Safety Executive, 650,000 people reported workplace linked low-back pain disorder in 1995. And Professor Pope says this was under-reported. He also says that it is a leading cause of disability, affecting 1.1 million people, adding: "The more we can do on the prevention side the better. If we can work more closely with industry, we can perhaps prevent some low back pain. We can also get people back to work faster be encouraging early treatment and adaptation of the workplace. I think that makes sound business sense."