Work

Work-related musculoskeletal disorders and associated factors among hospital sanitary workers in public hospitals of Eastern Ethiopia

Year: 2025

Type: article

Abstract: Work-related Musculoskeletal disorders (WMSDs) are serious problems of public health at health care facilities that reduce health quality of the workers. These issues arise from poor work design, unsafe and unhygienic conditions, lack of ergonomic practices, and inadequate occupational health and safety (OHS) services, which are common in low-middle-income countries, which remain underexamined among hospital sanitation workers (SWs) in eastern Ethiopia. This study aimed to assess WMSDs and associated factors among public hospital SWs in eastern Ethiopia. Hospital based cross sectional study was conducted in eastern Ethiopia in 2023. A well-structured questionnaire prepared. The internal consistency (α value) for the prepared questions was 0.95. Simple random sampling was used to choose eight hospitals among a total of fourteen public hospitals in these areas. A single proportion formula long with design effect of 2.0 and 5% of non-response rate was calculate the sample size and obtained 791 SWs, which is approaching actual number of SWs within selected hospitals. Thus, all (809) of SWs were recruited for the study. Face-to-face interview was conducted. Epi Data version 3.1 was used for data entry and Stata version 17MP was used for the data analysis. Data quality was ensured through training of data collectors, language translation, pretesting, and adjusting for confounders. The robust Modified Poisson/MP regression was used to identify predictors of WMSDs. Bi-variate MP model was used to perform un-adjusted prevalence ratio (UPR). While, MP multi-variable was used to analysis the adjusted prevalence ratio (APR) for predictors with significant values of p ≤ 0.20. The results were deemed statistically significant at the two-tailed level with a 95% confidence interval (CI:95%) and a p-value of 0.05. Finally, seven variables those have ≤ p-value 0.05 at APR were candidate for Structural equation modeling (SEM) to estimate the correction and direction of risk factors for WMSDs. Out of a total of 809 SWs, 729 (90.11%) of them responded. The current study found self-reported WMSDs among SWs was 51.17% (95% CI: 0.48, 0.55). Multivariable MP regression model shows that SWs with acquired diseases (APR: 1.85; 95% CI: 1.62, 2.12), SWs with occupational injuries (APR: 1.16, 95% CI: 1.04, 1.33) and those exposed with occupational hazards (APR:1.42; 95% CI: 1.18, 1.70) were more likely to report WMSDs. Similarly, those didn’t get health and safety training (APR:1.20; 95% CI: 1.03, 1.43), those had workload (APR: 1.36; 95% CI: 1.05, 1.76) and non-adhered to personal protective equipment [PPE] (APR: 1.17; 95% CI: 1.00, 1.38) were more likely to report high WMSDs. SEM found that hazards exposures (β = 0.25; 95% CI: 0.18, 0.33) and workload (β = 0.06; 95% CI: 0.03,0.15) were positive correlations. While, compliance with PPE (β= -0.09; -0.16, -0.01) and provide OHS training (β= -0.23; 95% CI: -0.342, -0.03) have negative correlation with WMSDs (p-value < 0.05). The study found that more than half of SWs were suffered with WMSDs. The main attributed risk factors were poor work conditions, lack of ergonomic applications, a lack of institutional supports, and behavioral factors. Thus, the study highlights the critical policy requirement to enhance ergonomic application and health and safety improvement in order to lower WMSDs. The hospitals should provide interventions such as training on ergonomic concepts, adapt the guideline and adhere the ergonomic policies and regulations. Federal ministry of health and Federal ministry of labor and social affairs should cooperatively set standards, support and monitoring compliance, provide resources and enforce protocols in order to lower WMSDs among these vulnerable work-forces. What Is already known on this topic? The burden of work-related musculoskeletal disorders (WRMSDs) among hospital sanitation workers (SWs) in eastern Ethiopia has been previously studied. However, this study specifically evaluates WRMSDs in public hospitals, where workers face hazardous and unhygienic conditions, heavy waste exposure, and increased workloads due to high patient volumes. Numerous studies, including this one, have shown that hospital SWs, such as cleaners and waste collectors, are vulnerable to a variety of occupational risks and incidents. In addition, the study highlights that due to their working conditions, the society treats SWs unfairly leading to a violation of their rights and a disregard for their well-being, which needs to be addressed through improved policies and support. What this study adds? This study highlights the role of poor ergonomic practices and inadequate work design in contributing to WRMSDs among sanitation workers in public hospitals. By conducting this study, the research offers robust and generalizable prevalence estimates WRMSDs among SWs in public hospitals of eastern Ethiopia. The study identified the highest prevalence of WMSDs and outlines the primary ergonomic and risk factors contributing to these disorders. Consequently, this study provides a concise overview of WRMSDs in public hospitals, together with the variables affecting these groups and the settings under which they operate. How this study might affect the research, practice and/or policy? The findings highlight the need for targeted ergonomic interventions and preventive strategies in high-risk sectors like health care including hospitals. These insights can guide policymakers and occupational health practitioners in developing tailored health programs, potentially reducing WMSDs incidence and improving workforce productivity. Implementing these measures could reduce the incidence of WMSDs, lower the economic burden associated with these disorders, and improve overall workforce well-being. Thus, the study advised that government bodies, particularly the Ministry of Health and the Ministry of Social Affairs, as well as other associations, should amend and incorporate WMSDs mitigation and develop ergonomically policies, regulations, and workplace guidelines among sanitation workers.

Source: BMC Musculoskeletal Disorders

DOI: 10.1186/s12891-025-08873-9

Authors: Sina Temesgen Tolera, Tesfaye Gobena, Abraham Geremew, Elka Toseva, Nega Assefa

Institutions: Haramaya University, Medical University Plovdiv

Language: English

Topic: Occupational Health and Safety in Workplaces

Subfield: Occupational Therapy

Field: Health Professions

Domain: Health Sciences

SDGs: Good health and well-being, Decent work and economic growth

Open Access status: gold

Estimated APC paid: $3,090