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Large International Study Shows Wide Variation In ‘RSI’

New scientific research shows that workers from different countries experience widely different rates of disabling wrist and hand pain even when doing similar types of work. Among using computers, prevalence was 14 times higher in some countries than others.

This huge variation could not be explained by known causes of wrist and hand disorders, or by the availability of compensation for work-related illness such as “RSI”. Instead, scientists suggest, the difference may be a consequence of differences in culturally determined health beliefs and expectations. This has important implications for the UK as it is estimated that over 5.4 million days are lost each year in sick leave due to hand and wrist problems. The research calls into question the current emphasis in the UK on ergonomic controls such as the design of desks and computer equipment to prevent symptoms. Approximately 450,000 workers in the UK have disabling hand and wrist pain or “RSI”.

The large international study presented at the Annual Scientific Meeting of the looked at 12,426 employees, from 47 occupational groups, across 18 countries. The scientists compared 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 differences were 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.

Professor David Coggon, the lead author from 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 muskuloskeletal 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,” said Dr Richard Heron, President of the Society of Occupational Medicine. “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 have access to this support and that there is more research undertaken into treatment and care.”



1. The countries that participated in the study were Australia, Brazil, Colombia, Costa Rica, Ecuador, Estonia, Greece, Iran, Italy, Japan, Lebanon, New Zealand, Nicaragua, Pakistan, South Africa, Spain, Sri Lanka and the UK

2. The Society of Occupational Medicine is the UK organisation for all doctors and associated health practitioners with an interest in work and health. The 2013 Annual Scientific Meeting is taking place at the Bournemouth International Conference Centre

3. Repetitive strain injuries (RSIs) or work-related upper limb disorders are injuries to the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression, or sustained or awkward positions.

Society of Occupational Medicine