Musculoskeletal disorders among children and young people: prevalence, risk factors, preventive measures
The European Agency for Safety and Health at Work (EU-OSHA), a lot of research has been done on musculoskeletal disorders (MSDs), but most reports focus on adults. This scoping review focuses on research in children and young people – both before and after joining the labour market.
As many MSD problems begin in childhood, it is important to identify how they can be prevented at an early age says EU-OSHA. Many factors influence the development of MSDs, including physical factors (eg obesity, lack of sleep, prolonged periods of sitting), socioeconomic factors and individual factors (eg gender, age). This review examines how these factors affect MSDs in children and young people, how they can be prevented and how good musculoskeletal health can become an integral part of education.
This report shows how important it is to adopt a ‘life course’ approach to studying musculoskeletal conditions and musculoskeletal health. Such an approach has the potential for a better understanding of how and why musculoskeletal conditions occur over the life course and how musculoskeletal health can be promoted. Its adoption ‘improves prevention for all workers (young and older) and reduces the damage to workers’ health while limiting early exit from work and improving the sustainability of work in jobs that have high physical demands’ (Belin et al. 2016). In this context, the lifelong impact of musculoskeletal pain needs to be considered.
Prevalence of MSDs was found to be already quite high in schoolchildren and young people (7 to 26.5 years old), with ~30 % on average suffering from an MSD. However, apprentices and young workers or students (15 to 32 years old) show a slightly higher average prevalence of MSDs of ~34 %.
It is suggested that there are several reasons for the rather high prevalence rates in children and young people. MSDs can be caused by acquired, individual or congenital risk factors. Most of the acquired risk factors, such as physical, psychological, socioeconomic and environmental risk factors, are largely preventable.
A considerable number of preventable, non-work-related risk factors have been suggested to be associated with a higher risk of MSDs in children and adolescents: malnutrition and overweight; very low and very high levels of physical activity, leisure activities or poor sleep; smoking and alcohol consumption; bad or incorrect postures caused by extended sitting, excessive use of electronic devices, backpack loads or playing an instrument; sports injuries; mental health problems; social status; and weather conditions. However, current studies show inconsistent results, and currently no definite evidence supports the association of most of these factors with a higher risk of MSDs in children and young people. This could certainly also be attributed to the limitations of some of the existing studies.
Work-related risk factors for young workers comprise physical workload, long-term unnatural working positions, repetitive work, working under pressure, bullying, job insecurity, professional challenges and extreme weather conditions. There is a lack of studies on young workers in occupations with high exposure to noise, vibration, heat or cold, and to physically demanding work factors such as working in awkward positions, handling heavy loads and repetitive work. Nevertheless, studies that examined specific sectors and occupations (eg professional musicians and workers in the health care sector) found young workers to be at high risk of developing MSDs.
In summary, irrespective of scientific evidence on the contribution of certain factors to the risk of developing MSDs, the prevalence among children, adolescents and workers is quite high. There is an urgent need for early promotion of musculoskeletal health in children and young people. Maintaining long-term adherence to a combination of education, physical training and ergonomic measures promises the best results in sustainably preventing or reducing MSDs for (working) life.
European Agency for Safety and Health at Work November 2021