Workplace health: what if we finally connected the dots? MSDs, psychosocial risks… and beyond.

Written by : Alice Thomas

Before working in MSD prevention and discovering the world of ergonomics, I spent nearly eight years in a company specialising in the prevention of psychosocial risks (PSR). At the time, the subject was on everyone’s lips: conferences, national agreements, HR action plans, internal barometers, etc. RPS was, and still is, at the heart of prevention strategies, widely reported by the media and supported by increasingly precise regulations.

What a surprise it was, when we came to MSDs, to find such a stark contrast: a subject that is profoundly human – because it’s really about the health of the body at work – but about which little is said, with HR often not very concerned, no updated national plan and virtually non-existent budgets.

After two years, I had to ask myself one question: why such a huge gap? And above all, is it reasonable to deal with these issues separately when they are all part of the same approach to preventing ill health in the workplace?

Author’s note: “Before you complain (yes, yes, I know you’re dying to), promise me you’ll read it all the way through. With a few years spent talking to ergonomists and psychologists, I swear it’s all connected. And that’s exactly why I wanted to write this article.”

Two realities, two levels of treatment

An observation that we must dare to make (I’m a little afraid of the comments that will follow, but nothing ventured, nothing gained!): between MSDs and PSRs, there are two realities and two ways of dealing with them.

Focus on MSDs

Musculoskeletal disorders (MSDs) account for more than 85% of recognised occupational illnesses (source: Assurance Maladie). In 2022, almost 40,000 cases were reported, despite significant under-reporting. No sector has been spared: industry, logistics, health, personal assistance, retail and catering. The consequences are far-reaching: chronic pain, prolonged sick leave, forced retraining, loss of employment. For companies, the cost exceeds €2 billion a year in care, absences and lost productivity.

Focus on psychosocial risks

Psychosocial risks (PSR) affect more than 40% of employees (CSA barometer for Malakoff Humanis, 2022). Chronic stress, burn-out, mental overload, conflicts, loss of meaning… Support functions, middle management, health and education are among the most exposed. There are an estimated 20,000 cases of long-term sick leave linked to RPS, although their coding in sick leave remains unclear.

Differences in regulatory and budgetary treatment

Focus on MSDs

While the regulations require all risks to be recorded in the DUERP, there is no specific obligation targeting MSDs. Since the 2010-2014 national plan, there have been no major initiatives. Prevention therefore relies mainly on HSE departments, a few ergonomists (when there are any) and occupational medicine. HR departments are rarely involved, and the budgets allocated are low in relation to the issues at stake.

Focus on RPS

Conversely, when it comes to RPS, cross-industry agreements (stress at work in 2008, QWL in 2013, health at work in 2020) provide a framework for prevention. Their assessment is compulsory in the DUERP.

Internal tools, social barometers, listening units, training courses, QVCT charters: these measures are commonplace. Since 2009, with the DARCOS plan and the obligation to put in place an agreement or action plan to prevent stress in the workplace, private service providers have proliferated, offering a multitude of platforms and applications to “prevent risk”. The subject is integrated into HR policies and often monitored at COMEX level, with a dedicated budget.

Clear figures, glaring imbalance

Even if it is disturbing, the facts are clear:

→ MSDs are more widespread, more costly and older, but remain discreet and poorly treated.

→ RPS have benefited from strong political and media coverage, which has structured visible actions and placed them at the heart of HR strategies.

Are we seeing media coverage of one issue while the other remains in the shadows?

Why such a difference?

It’s not a question of pitting the two subjects against each other or ranking their importance. But when I see, for example, a teaser announcing a television programme in which celebrities talk about their burn-out, to remind us that mental health is a major issue, I say to myself that this is a first line of thought. MSDs, on the other hand, have no right to this kind of platform. Are they seen as too technical a problem, reserved for experts, with no story to tell the general public? Aren’t prevention policies, by their very nature, more sensitive to subjects that “speak” and move people?

Another major difference is that PSR is now an integral part of HR and management strategy, thanks in particular to QWL initiatives. They affect people who are ‘sensitive’ for the company: executives, managers, support functions. This makes it easier to deal with them at the highest level.

MSDs, on the other hand, are still seen as an operational problem, confined to manual jobs and managed by HSE or occupational medicine. Result: fewer relays, less budget.

Finally, in some professions, physical pain is still seen as an inevitability: “it’s the job that wants it that way”. This normalisation delays fundamental action. On the other hand, psychological suffering, which has only recently come to the forefront of public debate, has aroused indignation and mobilisation.

Basically, we might wonder whether this difference in treatment is simply a reflection of the way French companies are organised: issues affecting management and central functions are quickly incorporated into HR and QWL strategies, while those affecting the field remain confined to technical and operational matters. In other words, it is perhaps less a question of media visibility than a direct consequence of the way we structure and manage occupational health.

The real obstacle: organisational compartmentalisation?

Why are these issues still treated separately? Why are there clearly identified budgets for RPS and so few for TMS? Why are there visible QWL policies and virtually no MSD plans?

The answer may lie in the internal organisation of companies themselves: management in silos, compartmentalised departments, fragmented budgets and policies driven by different players, with no common vision. In my opinion, what is holding us back is not so much the nature of the risks as the way in which French companies are structured: there is too much separation of responsibilities (HR, HSE, QVT, production), budgets and scopes of action.

→ HR manages QWL and RPS; HSE and occupational medicine deal with TMS and EPI; work organisation often remains the preserve of management or production.

As a result, no comprehensive approach has really taken hold, with everyone managing “their own risk” without seeing the links.

Given this situation, it has become essential to break out of the silo approach and build a truly integrated, coherent and comprehensible prevention system for all. In practical terms, this means :

• Combining skills: HR, HSE, ergonomists, managers – all involved in the same strategy.
• Linking approaches: QWL, ergonomics, workstation design, work organisation and management should no longer be dealt with separately.
• Involve senior management: make working conditions a major strategic issue, and not just an expense item or a publicity ploy.
• Provide long-term training and raise awareness: understand that preventing physical pain also means preventing psychological suffering – and vice versa.

To conclude…

In conclusion, I started this article by making an observation which, let’s be honest, annoyed me: we hear about RPS everywhere, but almost nowhere about TMS. Yes, I’m caricaturing a bit, but you have to admit that it’s not far off.

But as I was writing and researching, I realised that there was something else going on. Basically, everything is linked (as any occupational health professional knows): RPS, TMS, work organisation, management, environment, everything feeds on each other. And yet we continue to deal with them piece by piece, department by department, budget by budget.

So I ask the question: why not go further? Why not demand a clear, comprehensive, compulsory policy that requires all companies to consider all workplace health factors, with no hierarchy between head and body? Why not make dedicated budgets, articulated action plans and measurable results targets? Please, it’s time to move away from the silo approach. Workplace health is not “either mental, physical, organisational or …..”: it’s a whole. And it’s a right.

Let’s stop choosing between our work and our health.