Database

The study provides support for the use of cognitive behavioural therapy (CBT) in enabling people to cope with back pain. The beneficial effect seems to last at least 5 years. Evidence from: SJ Linton et al. Spine (2006) Vol.31(8) p 853 – 858 “A 5-Year Follow-Up Evaluation of the Health and Economic Consequences of an Early Cognitive Behavioral Intervention for Back Pain: A Randomized, Controlled Trial” The findings cast some doubt on occupational causation and injury status. Further detail: 6#3-4 28

Evidence from: The Industrial Injuries Advisory Council (IIAC) IIAC Annual Report 2005/6 The annual report confirms the intention to publish a literature review and opinion on the prescription of occupational back pain and cervical spondylosis. Comment In response to a call for comments, the UK’s leading back pain charity, BackCare, indicated that prescription might reinforce unhelpful beliefs about non-specific back pain and the role of work. The best advice for those with non-specific back pain is to remain active and this includes going to work. Expert reviews [e.g. in the development of the Faculty of Occupational Medicine (FOM) guidelines] have consistently concluded that non-specific back pain is not caused by work and neither is it prevented by following standard ergonomic recommendations. Prescription would be possible if IIAC considered that work more than doubled the risk of back pain. More than 20% of the workforce has problems with back pain every year. The numbers involved

This session of the Committee was set in motion by fears that the new Directive would restrict the use of medical MRI scanners. The effect would be to encourage the use of ionising radiation (X rays) as an alternative. The Committee concludes that the Directive was not as well advised as it could have been. Clarification of the meaning of exposure action levels is provided; it is a very precautionary standard. Evidence from: House of Commons Science and Technology Committee. June 2006 “Watching the Directives: Scientific advice on the EU Physical Agents (Electromagnetic Fields) Directive” Our long-held view has been that the action levels included in the Directive do not form a reasonable basis for judging breach of duty of care in civil cases. We see no reason to revise this view on reading the Committee report. Further detail: 6#3-4 26

Those who were employed to work night shifts had a lower chance of developing Parkinson’s disease. Risk decreased with increasing years of night shift work. Parkinson’s disease and night shift work both affect large numbers of people in the UK; the research provides some reassurance that a causal link between them will not be established. Evidence from: H Chen et al. Am J Epidemiol (2006) Vol.163(8) p 726 – 730 “A Prospective Study of Night Shift Work, Sleep Duration, and Risk of Parkinson’s Disease” Further detail: 6#3-4 25

Dysregulation of blood glucose is linked to a large number of serious disorders including heart disease. This study reports a link between shift work and elevated blood glucose levels [possibly a sign of diabetes]. Further work is needed to establish whether this is the norm or just a result of the timing of the testing work. Evidence from: Y Suwazono et al. J Occ Env Med (2006) Vol.48 p 455 – 461. “Long-Term Longitudinal Study on the Relationship Between Alternating Shift Work and the Onset of Diabetes Mellitus in Male Japanese Workers” A mechanism for harm adds weight to causation arguments. Further detail: 6#3-4 24

Demographic analyses help inform assessments of changes in liability exposure. Shift working, teleworking, outsourcing, self employment and migration are likely to have a significant effect on working conditions. Whether these increase or decrease future liability exposures requires detailed analysis. Evidence from: HSE Horizon Scanning Initiative. May 2006. “Demographics.” Further detail: 6#3-4 23