Database

Perhaps unsurprisingly the group of people who report feeling exhausted is more likely to include people with ill health. Causal direction and validity cannot be determined from this study but the study will inspire such investigations. Evidence from: T Honkonen et al. J Psychosom. Res. (2006) Vol. 61 p 59 – 66 “The association between burnout and physical illness in the general population—results from the Finnish Health 2000 Study” Is burnout work related? On present evidence it is not possible to determine whether the physical illness reduced the capacity to cope, or the burnout caused the physical illness, or burnout and physical illness are both the result of some other pathological mechanism. If a physical, objective health outcome was associated with occupational stress, the scope for claims would be greatly increased. Further detail: 6#5-6 42

Should the employer be vicariously liable for the wrongs committed by the employee? Yes. Even if the wrong is criminal, a limit on vicarious liability would have to be explicitly stated in the statute. Evidence from: Majrowski v Guy’s and St Thomas’ Trust [2006] UKHL 34 Vicarious liability is a common law principle of strict, no-fault liability. Under this principle a blameless employer is liable for a wrong committed by his employee while the latter is acting in the course of his employment. Foreseeability is not an issue. It is no defence that the employer had taken all reasonable measures to prevent the wrong. The principle is implied in all statutes unless the statute specifically limits it. Further detail: 6#5-6 41

There is limited evidence to support the theory that mismatch between work demands and functional capacity would increase the risk of a pain problem. The evidence is highly inconsistent but the theory cannot be discounted altogether. Evidence from: HH Hamberg van Reenen et al. Scand. J. Work and Environ. Health. (2006) Vol. 32#3 p 190 – 197 “Is an imbalance between physical capacity and exposure to work-related physical factors associated with low-back, neck or shoulder pain?” Further detail: 6#5-6 40

Regulations provide very clear guidance as to the types of interventions required to protect workers from injury or adverse symptoms caused through the use of display screen equipment. This review examines all the literature related to assessing the benefits of these and other interventions. No clear benefits could be found for any interventions, save for a possibility that alternative pointing devices could be beneficial. The accuracy of the DSE regulations could be called into question. Evidence from: S Brewer et al. J Occup Rehabil. (2006) Vol. 16 p 325 – 358 “Workplace interventions to prevent musculoskeletal and visual symptoms and disorders among computer users: A systematic review” The most positive finding here was possibly that DSE style interventions had not been shown to do harm. Further detail: 6#5-6 39

A review of research into work hours and postures while using a computer keyboard. The review finds that hours and posture are associated with adverse upper limb symptoms often enough to consider that an association is meaningful. Symptoms are not the same as injuries. Evidence from: F Gerr et al. J Occup. Rehab. (2006) Vol.16 p 265 – 277 “Keyboard use and musculoskeletal outcomes among computer users” The authors conclude that exposure measurement is a key weakness of studies of proposed links between keyboard use and upper limb symptoms. As it stands there is a slight balance in favour of a conclusion that longer hours of use increase the rate of adverse hand/arm symptoms. Further detail: 6#5-6 38

The department of health provides for the formation of multidisciplinary teams to manage musculoskeletal disorders. Coordination of rehabilitative efforts seems to have been left to chance; leaving an opportunity for private case managers to exploit. Evidence from: Department of Health June 2006 “The Musculoskeletal Services Framework” The Framework identifies a lack of organised provision of rehabilitation services and interventions. This provides an opportunity for the private sector to step in. Where the disorder is work-related this could involve a liability insurer. Further detail. 6#5-6 37