متد مدیریت ریسک در محل کار جهت جلوگیری از اختلالات عضلانی و اختلالات روانی Workplace risk management practices to prevent musculoskeletal and mental health disorders: What are the gaps?

1. Introduction Over recent decades ‘psychosocial risk’ has become a familiar term within the occupational health management domain (European Agency for Safety and Health at Work, 2007; Jain et al., 2011). This term refers to health risks arising from work-related ‘psychosocial hazards’, which have been defined as “aspects of the design and management of work and its social and organisational contexts that have the potential for causing psychological or physical harm” (Leka and Cox, 2008) p. 1. It is well established that in the causal mechanism linking psychosocial hazards to workers’ health, ‘stress’ plays a key role (Chandola et al., 2008; Cox, 1978; Karasek and Theorell, 1990; Kim and Kang, 2010; Kompier, 2003; Kompier and Van der Beek, 2008; Macdonald, 2012; Macdonald and Evans, 2006; Marmot et al., 1999). Two of the most prevalent and costly of the occupational health problems influenced by psychosocial hazards are musculoskeletal and mental health disorders (MSDs and MHDs). In Australia, for example, musculoskeletal injuries and disorders are by far the most prevalent type of work-related injury or illness, with mental disorders being the second most prevalent (Safe Work Australia, 2015). Quantitative international comparisons are hindered by wide variation in definitions and data recording systems, but prevalence levels are similarly high in most industrially developed countries (e.g. Montano, 2014) Various guidance documents have been developed to help workplaces manage health risks from psychosocial hazards and associated stress, but this guidance has a strong focus on risk of mental health disorders (British Standards Institute, 2011; Canadian Standards Association, 2013; Health and Safety Executive, 2012; International Labour Office, 2012; Safe Work Australia, 2014). This is probably helpful in workplaces where mental health is the main concern, since psychosocial hazards are the main ones affecting such risk. However, there is a large body of evidence that psychosocial hazards can also have substantial effects on workers’ physical health, including risk of musculoskeletal disorders (MSDs) (Eatough et al., 2012; Gerr et al., 2014; Kompier and Van der Beek, 2008; Lang et al., 2012; Macdonald and Evans, 2006; National Research Council (US) & Institute of Medicine (US) Panel on Musculoskeletal disorders and the workplace, 2001). In workplaces where MSDs are the main OHS problem, the focus of stress-related guidance material on mental health is likely to present a barrier to more effective MSD risk management (Macdonald and Oakman, 2015), and this problem is exacerbated by current MSD risk management guidance. The best of this guidance includes mention of psychosocial hazards, but relatively little information is included about how to assess and control associated risks; for example see reviews by Macdonald et al. (2003), Macdonald and Evans (2006) and online guidance of the UK Health and Safety Executive (2012), SafeWork Australia (2016a), and the Occupational Health & Safety Council of Ontario (2013).