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Further, research on MSD causation has not yet provided a clear picture of how physical workplace
and psychosocial factors together contribute to MSDs. Leaders in the field, including ergonomists, phys-
icians, and epidemiologists, generated a report suggesting that several types of factors likely are involved
and interact with one another to produce an MSD (National Research Council and Institute of Medicine,
2001). Here, these experts reviewed hundreds of research studies and determined that a variety of factors
must be considered to understand injury mechanisms. They developed a conceptual model of factors that
may affect MSD risk in the workplace, which is shown in Figure 25.1. This model approaches MSD risk
from a “whole person” perspective, meaning that it includes aspects both of the workplace (e.g., loads
imposed on the body, organizational factors, and social aspects of jobs) and the individual (e.g., phys-
iological responses to external loading, physical tissue tolerances, health outcomes, and personal
factors). The model also underscores the complex nature of MSD causation. These researchers concluded
that, “Because workplace disorders and individual risk and outcomes are inextricably bound, musculo-
skeletal disorders should be approached in the context of the whole person rather than focusing on body
regions in isolation.” Thus, it would appear that only by studying the entire work system (i.e., the inter-
action of physical, psychosocial, and individual factors) can we derive the root causes of MSDs.
Clearly, the range of factors considered psychosocial in nature is large and diverse. They include per-
sonal aspects of individuals as well as their perceptions of the work environment. Undoubtedly, different
individuals can view the same environment and work situation in a number of ways. Some may view
these environments as suitable to their preferred method of operating, or they may find the work organ-
ization too stressful. Thus, the psychosocial nature of an environment should perhaps be viewed from the
perspective of those evaluating and working within it. An understanding of personality and personality
theory may aid in this comprehension.
One's personality preferences can be included in the group of individual factors interacting with others
to affect MSD risk. There is general consensus that one's personality is, at least, in part, biologically based.
Jung (1923) proposed that human behavior was predictable, not random, that one's preferences emerge
early in life, and that these preferences form the basis for our attractions to and aversions from people,
The Workplace
The Person
Biomechanical Loading
Internal
Loads
External
Loads
Physiologic
Responses
Internal Tolerances
Mechanical
Strain
Organizational
Factors
Fatigue
Outcomes
Pain
Discomfort
Social
Context
Impairment
Disability
FIGURE 25.1 Conceptual model of likely groups of musculoskeletal disorder risk factors and their interactions.
(From National Research Council and Institute of Medicine, 2001, Musculoskeletal Disorders and the Workplace:
Low Back and Upper Extremities (Washington, DC: National Academy Press). With permission.)
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