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Work-related musculoskeletal disorders: report, workshop summary, and workshop papers.
  1. KEITH PALMER

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    Work-related musculoskeletal disorders: report, workshop summary, and workshop papers. Edited by: steering committee for the workshop on work-related musculoskeletal injuries, and the national research council. (Pp 229; £33.95) 1999. Washington, DC: National Academy Press. ISBN 0-309-06397-3.

    In August 1998 a 2 day workshop was held under the auspices of the United States National Research Council (NRC) to examine the research base on work related musculoskeletal disorders, and this was later followed by some deliberations of the steering committee. The report of the steering committee and the proceedings and scientific papers from the workshop are presented in this monograph.

    The NRC workshop, which was attended by leading scientists from the fields of orthopaedic surgery, occupational medicine, public health, and human factors deliberated over several major topics: the biological responses of muscles, tendons, and nerves to biomechanical stressors; the biomechanics of work stressors; the epidemiology of physical factors; non-biomechanical (psychosocial) factors that might affect the musculoskeletal system; and possible risk mitigating interventions. Under each topic there were commissioned presentations, which are reproduced fully in this monograph, together with some written and oral responses and a considered overview.

    The committee's efforts were focused in particular towards answering seven specific questions posed by Congressman Robert Livingston. These concerned the identity, diagnosis, and classification of such disorders, their causes, incidence, and prevention, and the major areas of research uncertainty. (Needless to say, not all of the questions could be answered confidently!)

    In reviewing this book, I could not help reflecting on the role of workshop proceedings and who might wish to buy such a summary; also, whether the book represented an important advance on existing major competition—such as the comprehensive critical review by NISOH, or the detailed Work-related musculoskeletal disorders: a reference book for prevention, published by Taylor and Francis. The proceedings of meetings can be a mixed feast, with tasty new morsels, meaty dishes, and stale fare served up together. The best of offerings have the following recipe: one conscientious editor, a peer review process, and a liberal helping of original research papers, written up as formally and thoroughly as they would be when freely submitted to a journal in open competition. The compilation that occupies the second half of this book does not match this recipe, but does represent a series of interesting reviews and synopses in important areas of research interest.

    Of course the scope of the book is broader in seeking to distil and summarise, rather than to break new ground, and in this respect it partially succeeds. But the advance is a fairly small one. Those with an interest in work related musculoskeletal disorders will want to read this book, but perhaps not to possess it. One section which is likely to be of particular interest to them, concerns invited experts' views on the adequacy and limits of the NISOH review already mentioned, which, paradoxically, represents a more essential addition to the occupational physician's library.

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