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Stephen  Bevan

Is the Japanese Workforce ‘Fit for Work?’

Authors: Stephen Bevan Stephen Bevan

21 November 2012

The publication of our Fit for Work? reports in Australia and New Zealand earlier this year confirmed that the initiative now has a global ‘reach’. With Canada, Israel and Turkey the subject of previous reports (and Russia, Brazil and the USA in the pipeline) the Fit for Work? messages are really gathering momentum. And last Friday I had the honour to be in Tokyo to present the findings of our Fit for Work? research in Japan.

As in many other countries, musculoskeletal disorders (MSDs) represent a significant driver of ill-health in Japan’s working age population. Our research identified that:


  • Almost 90m Japanese citizens over the age of 30 report having pain in their lower backs, hips and knees
  • The direct costs of MSDs in Japan (mainly medical costs) are ¥2bn each year – this figure excludes the financial implications of sickness absence, lost productivity and the wider societal impact;
  • Prevalence of MSDs by occupation shows higher rates in professional jobs (20%) and among those in office and technical roles (18%) than in agriculture (12%);
  • However, only 42% of people with an MSD seek medical help;
  • It is estimated that 53% of lost work productivity in Japan is attributable to chronic pain;
  • Sickness absence rates are hard to determine because of issues of data definition and capture – only absences longer than 4 days are recorded and there is strong anecdotal evidence that a significant proportion of Japanese workers take holiday rather than sick leave;
  • Over 20% of the Japanese population are now ‘obese’ and obesity rates have trebled since the early 1960’s, a trend felt to be driven by the increasing adoption of western diets. Obesity, of course, is a risk factor for type 2 diabetes and for osteoarthritis;
  • By 2055 it is estimated that 25% of all citizens over 30 will have back pain.

  • These statistics are of particular concern because economic growth in Japan is in decline and, although unemployment rates are low compared with those in Europe, there is a fear that ill-health-related job loss might increase as the population ages. In addition, there is growing awareness of the links between physical and mental health and the impact of such ‘comorbidity’ on work productivity and return to work – although healthcare and workplace interventions to deal with this problem are only in their infancy.

    Despite, Japan has a number of potential advantages in its infrastructure. For example, employers are required by law to retain access to an Occupational Health professional and to conduct annual health checks on employees. As in Europe, application of these regulations in small and medium-sized enterprises is patchy, with over half of employees in firms with fewer than 5 staff missing out on these assessments. Professor Shinya Matsuda and his colleagues at the University of Occupational and Environmental Health (UOEH), who were our partners during our research, and who presented at the launch of our report, feel very strongly that Occupational Health physicians could do still more to ensure that prevention and early intervention for people of working age with MSDs could be improved if healthcare and vocational support were more closely integrated.

    Our core recommendations included:
    • To improve the collection of reliable and standardised data on the prevalence of MSDs in Japan and to standardise data collection methods and definitions of MSDs;
    • To prioritise early diagnosis and intervention as these are essential to prevent the costs associated with temporary and permanent work incapacity attributable to MSDs;
    • To coordinate action between individuals, employers, occupational physicians, clinicians and policy makers to prevent premature job loss and help people with MSDs back to work.

    • We are hoping to continue our collaboration with Professor Matsuda and his colleagues as they look to progress these and other recommendations in Japan, and I am optimistic that the issue of workforce health and productivity will gain even higher prominence among Japanese policy-makers, clinicians and employers in the coming months.