Preventable strains arising in the workplace are estimated by official agencies around the world to cost many billions of pounds each year.

Britain's Health and Safety Executive estimated that work-related musculoskeletal disorders cost businesses up to £1.75 billion sterling in 1994.

In the US, the National Institute for Occupational Safety and Health (NIOSH) made the "conservative" estimate in 1997 that occupational musculoskeletal disorders cost at least $13 billion each year. The Dublin-based European Foundation for the Improvement of Living and Working Conditions found in its 1996 survey of working conditions that musculoskeletal disorders are the EU's premier workplace hazard.

Key causes were poorly designed workstations and excessive loads. The foundation found that work was becoming more intense with increased strain injury risks and that workers' inability to control their own work or to take breaks when needed left them vulnerable to musculoskeletal disorders.

In the light of the extent and cost of the problem, the Spanish-based European Agency for Safety and Health at Work has taken musculoskeletal disorders as its theme for the Europeanwide health and safety week next October. Europe Under Strain, a report by Mr Rory O'Neill, should help employers or managers with a health and safety brief to inform themselves about workplace strains, prevent needless injuries to workers and save money.

It documents the scale and cost of the problem internationally and shows how employers and workers alike can prevent strain injuries. According to Mr O'Neill, the causes for the problem in the modern workplace include: "highly paced work, long hours, tight deadlines, mechanisation, new technology, job insecurity and a lack of worker control over the design and execution of the job". Moreover, "old" hazards persist, such as lifting, carrying and repetitive work in traditional jobs.

He cites NIOSH scientific studies which show that the key risk factors for low back disorders include "lifting and forceful movements, bending and twisting in awkward postures and whole-body vibration". Neck and shoulder strains can arise from "sustained postures causing static contractions of neck and shoulder muscles" and "combinations of highly repetitive and forceful work involving the arm and hand".

Disorders of the hand, wrist and elbow can arise, for instance, from forceful and repetitive use of the hands and wrists or vibration from hand tools. Mr O'Neill presents researchers' solutions to the five risk factors of repetitiveness, mechanical stress, posture, vibration and psychosocial stresses.

Repetitiveness can be countered by the use of mechanical aids; rotating workers; increasing rest allowances; spreading work uniformly across work shifts and recasting tasks to include more diverse activities. Mechanical stress can be solved, for instance, by the use of pads and cushions; decreasing the weight of tools and parts; and optimising the size and shape of handles.

Solutions to posture problems include locating the work to reduce awkward postures; altering the position of tools to avoid bending the wrist; or moving the part closer to the worker.

Some of the ways vibration can be reduced include selecting tools with minimal vibration; using mechanical assistance; isolating tools that vibrate excessively; or by adjusting tool speed.

Psychosocial stresses can be alleviated by widening workers' duties, allowing greater worker control, providing "micro work pauses", minimising paced work and eliminating blind electronic monitoring, Mr O'Neill said.

Europe Under Strain presents NIOSH's five-part plan to prevent musculoskeletal disorders in the workplace. In summary:

1. Work-site analysis: This involves evaluating job demands by means of a task analysis and checklists to identify common hazards. Human capacities are evaluated, namely performance measures (e.g., frequency of occurrence), physiological measures (e.g., heart rate) and subjective assessment measures, i.e., how the worker rates the exertion.

2. Hazard control. This involves design changes to tools, handles, equipment, workstations or methods of working. If it's not possible to redesign problem areas and equipment then administrative controls should be implemented such as changing management policies or work practices.

3. Health surveillance, whether passive (e.g., use of health or compensation records etc.) or active (e.g., periodic health surveys).

4. Medical management, whether voluntary or mandatory, should include, for instance, the promotion of early reporting of symptoms, prompt access to health care and medical monitoring following a worker's return to work.

5. Education and training: the absence of training for supervisors, managers, engineers and purchasing agents is itself a risk factor for the development of musculoskeletal disorders at work.

Europe Under Strain: a report on trade union initiatives to combat workplace musculoskeletal disorders, by Rory O'Neill, published by the European Trade Union Technical Bureau for Health and Safety, 128 pages, price 19.83 euros.

Website: www.//etuc.org/tutb