Occupational hazards have undergone significant changes since the middle of the 20th century. In the past, workers were exposed to serious chemical, physical and biological hazards. However, with the improvement of working conditions and reductions in harmful exposures, much of the morbidity and mortality attributable to those hazards has been reduced in high-income countries. Recently, attention has shifted to other disorders, rarely lethal and not exclusively caused by work, but which account for substantial costs and impact on workers’ well-being.1

Musculoskeletal disorders (MSDs) are a part of these ‘new’ work-related disorders. MSDs are a major cause of disability,2 affecting over 40 million West European workers, with direct costs in Europe estimated at between 0.5 and 2% of gross domestic product.3 Minimising occupational disability attributable to MSDs, and the associated costs, is one of the major challenges in industrialised countries.

A growing body of evidence, based largely on administrative data, suggests a decline in the incidence of work-related MSDs over the past decade among people of working age in …