Dr Kirsten Huysamen, lead human factors specialist at the Rail Safety and Standards Board (RSSB), led a survey focused on musculoskeletal risks in UK rail. Here’s her helpful summary of the findings.

Musculoskeletal disorders (MSDs) are a growing problem in transport. They’re one of the leading causes of absences in GB rail, according to RSSB’s Annual Health and Safety Report 2024/25. The rail industry asked RSSB to carry out a survey, which ran from July to December 2024, to provide more reliable data on the prevalence and types of MSDs, the job roles affected, and the tasks or risk factors that contribute to their development. 

This study confirmed that data on MSDs across the industry is limited. This is partly due to underreporting, but it’s also because of how MSD data is managed within organisations. Those that didn’t collect standardised data or store it in a centralised location found it challenging to identify key trends and insights, develop targeted interventions, and determine where to focus their efforts.

RSSB developed the survey with rail companies and trade unions. There were over 6,000 responses to it, across more than 50 mainline rail job roles. More than half the responses were from train operating companies. 

In summary, more than 94% of respondents to the survey had experienced a musculoskeletal issue in the past year. Over 40% identified work as the cause. Some roles were more confident than others that their work led to their musculoskeletal issue. For example, 68% of respondents in buffet trolley management felt their work had caused their knee issue.
Lower back issues were most common across all roles, affecting 64%. After that, the areas of the body affected depended on the job role and tasks. Often, roles where people sit for long periods were associated with lower back, neck, and shoulder issues. Roles involving physical or full-body effort were often linked with lower back, knee, and shoulder issues, and issues with the ankles or feet commonly appeared for roles where staff stand for long periods.

Impact of MSDs

In the survey, respondents reported impacts such as:

  • time off work
  • limitations in carrying out work duties
  • disruptions to personal lives
  • needing medication or seeking medical advice or treatment.

For example, a third of respondents who work in ticket offices had taken sick leave due to a lower back issue, and almost half reported that it prevented them from doing their normal work duties.

Underreporting

The survey data suggests MSDs are underreported by around 12%, with some roles showing estimates of 20–25%. The findings point to organisational culture and reporting procedures as key barriers to reporting. The top five reasons given for not reporting MSDs were: 

  • worrying about management responding negatively
  • believing that aches, pain, and discomfort are part of the job
  • believing that nothing will be done if they report it
  • fear of potential job loss
  • preference to not change their duties or job.

Remember: if you prefer to report in confidence, you can raise concerns about the risk of MSDs to CIRAS confidential safety hotline. We’ll listen and pass your concern to the right people without revealing your identity. We’ll let you know the company’s response. You can use CIRAS to raise concerns to your employer or to another company, and you don’t need to have reported internally first.

What’s next?

The research showed four key areas for improvement.

  1. Mitigate high-risk tasks and MSD risk factors in the workplace by assessing those identified in the research and implementing targeted interventions to reduce associated risks.
  2. Improve frontline reporting of musculoskeletal issues by improving organisations’ workplace culture and reporting procedures.   
  3. Improve the collection and management of MSD data within organisations by establishing a single, centralised process that captures and records the right type of data.
  4. Develop rail-specific MSD guidance to support organisations in preventing and managing MSDs.

RSSB is seeking the support and input of various industry working groups to help guide the next steps. Contact kirsten.huysamen@rssb.co.uk for more information. 

Case study: Southeastern    

Southeastern’s train drivers were reporting lower back pain (71%), neck pain (53%), and shoulder pain (53%). Southeastern heard the main problem was the lack of in-cab monitors. Train drivers had to therefore twist and stretch their necks to see platform monitors at stations. This could be an issue across train companies.

Southeastern then measured their driver cabs and set up a group to identify the issues drivers faced. These included:

  • cab seat defects, and seat quality/comfort
  • Drivers Safety Device pedal force
  • platform monitors
  • side window defects (hard to pull down)
  • lack of driver knowledge about MSDs.

It brought in physiotherapy and advisory services organisation Back in Action to help drivers already experiencing MSDs, and to provide a preventative service for everyone else. Together, they produced eight videos on minimising MSD risks through correct cab setup, turning the seat correctly at stations, standing and stretching during a diagram (work schedule), about the differences in rolling stock, and using lumbar supports. These were launched as part of a mandatory e-learning module for drivers.

Southeastern provided inflatable lumbar supports at all depots for drivers to use. It worked with Network Rail to lower platform monitors at its stations to driver eye level, adding barriers to protect passengers. It has also been improving its depots, yards, and sidings by providing high-level walkways to enter cabs, with fall-from-height protection. This work is ongoing over the next three years.

Find out more

The first industry-wide survey to understand the extent and causes of MSDs in UK heavy rail [RSSB research catalogue]

Focusing in on musculoskeletal concerns raised with CIRAS 

Simple stretches you can do to improve musculoskeletal health

Need-to-know guide to musculoskeletal health

Managing musculoskeletal health in the rail industry [RSSB website]

The Annual Health and Safety Report for the rail industry [RSSB website]