Policy case study. Germany. A systematic approach to preventing MSDs.

According to Eurostat, data from the EU Labour Force Survey ad hoc modules show that, in the 5 years from 2007 to 2013, the percentage of workers in Germany reporting some form of musculoskeletal disorder (MSD) decreased markedly, from 74.9 % to 64.5 %. As with many other EU countries, MSDs are the most common cause of absence from work in Germany, and a major contributor to disability and limited work capability.

A strong aspect of the policy approach adopted in Germany to address the problem of workplace MSDs is the collaboration at a strategic level between different partners, helping to ensure consistency and coordination. A key part of this is illustrated by the Joint German Occupational Safety and Health Strategy (Gemeinsame Deutsche Arbeitsschutzstrategie — GDA). The GDA is an initiative of the federal government, the federal states (Länder) and the accident insurance institutions. This alliance aims to improve the German occupational safety and health (OSH) system and help companies strengthen workplace health and safety. It is therefore a good example of collaborative partnerships being involved in national policies and strategic thinking. Established in 2008, the GDA is now in its third period (1).

The GDA is determined by the National Occupational Safety Conference (Nationale Arbeitsschutzkonferenz — NAK) (2). The NAK defines the direction of the GDA and identifies common priorities and safety and health goals. It appoints working groups to implement work programmes or steer their evaluation. GDA stakeholders cooperate with trade associations, safety experts and occupational physicians, as well as with the statutory health insurance funding bodies. These partners cooperate and contribute to the work programmes and participate in the further development of the GDA. Work programmes have included the GDA work programme on MSDs (2013-2018) ‘Prevention makes you strong
— including your back’ and the prevention campaign of the German Social Accident Insurance body
(Deutsche Gesetzliche Unfallversicherung — DGUV) ‘Think of me — your back’.

MSD risks are not unique to the workplace and distinctions between work, home and leisure are artificial. Such risks occur in all aspects of life and this is gradually becoming more widely recognised. A further strength of the German legislative framework is therefore the Preventive Health Care Act. (3) This act, formulated as part of public health legislation, focuses on the prevention of ill health and health promotion more generally, covering all settings where people live, learn and work. As such, it forms part of a more holistic approach to health, with a strong emphasis on prevention. A key objective of the act is to have closer links between OSH and workplace health promotion. The act therefore contributes to a strong policy framework, enabling the development of strategies and programmes for promoting health through the workplace. As part of this, it helps to improve OSH systems and promotes cooperation between health insurance and social accident insurance funds. The continuation of the GDA and the evaluative processes enshrined within it provide a strong example of this holistic approach, helping to provide and promote
consistent and lasting messages.