Under the Hood \u2013 Decoding Musculoskeletal Health among Vehicle Mechanics in Urban Mumbai: A Cross-Sectional Study

Background Low back pain (LBP) remains a major occupational health issue, particularly in developing countries like Indonesia, where nurses are frequently exposed to prolonged standing, heavy lifting, and poor ergonomic practices. These conditions contribute to decreased productivity and quality of life. Objective This study aimed to examine the characteristics of low back pain among nurses at Royal Prima General Hospital Medan and to assess the relationship between postural risk (REBA scores) and disability level (ODI scores). Methods A cross-sectional study was conducted in May 2025, involving 65 nurses selected using proportional stratified random sampling. Data were collected using a demographic questionnaire, the Rapid Entire Body Assessment (REBA) for postural analysis, and the Indonesian version of the Oswestry Disability Index (ODI) to measure disability. Data were analyzed using Spearman correlation and the Mann-Whitney U test. Results The mean REBA score was 5.48 ± 2.67, and the mean ODI score was 11.68 ± 13.42. A significant positive correlation was found between REBA and ODI scores (r = 0.267, p = 0.033), indicating a weak but significant association between poor posture and increased disability. Nurses working ≥8 hours per day had significantly higher ODI and REBA scores (p < 0.05). No significant differences were found based on gender, work unit, or length of employment. Conclusion Prolonged working hours are associated with increased postural risk and disability levels among nurses. A weak but significant correlation exists between postural risk and low back disability. Early ergonomic interventions and better shift duration management are recommended to reduce the incidence of LBP. To our knowledge, this is one of the first studies in Indonesia utilizing both REBA and ODI among hospital nurses, contributing valuable local evidence to inform occupational health strategies

Introduction: Musculoskeletal disorders (MSDs) are injuries or disorders affecting muscles, nerves, tendons, joints, cartilage, and spinal discs. Work-related musculoskeletal disorders (WMSDs) are significantly influenced by the work environment and performance, often exacerbated by job conditions. WMSDs affect various body parts associated with movement, including upper and lower limbs and the back, caused or aggravated by work activities. Factors like joint positions, repetitive motions, and high static muscle loads contribute to these issues. Grocery store workers, particularly those involved in manual labor and repetitive tasks, have a high incidence of WMSDs, with prevalent complaints of lower back, knee, and upper extremity pain. Materials & Methods: This cross-sectional study involved 96 participants aged 18-50, working a minimum of 5 hours daily with at least one year of experience in material handling. Exclusions were made for those receiving treatment for musculoskeletal diseases, with deformities, degenerative conditions, unwilling participants, or cash register workers. Data collection included the Nordic Musculoskeletal Questionnaire (NMQ) in Hindi and photographs of participants in their most attended work postures. The Rapid Entire Body Assessment (REBA) was used to evaluate ergonomic risks. Results: The study found a high prevalence of musculoskeletal discomfort among grocery store workers, particularly in the lower back, knees, neck, and ankles. The number of working years which shows that 50% of the population lies in the range of 1-5 years followed by 30.02% in 6-10 Years. The number of working hours which shows that 42.7% of subjects work for 6-7 hours and 20.83% for 9-10 hours. The REBA scores indicated that 42.7% of participants were at high risk (scores 8-10), 38.54% at medium risk (scores 4-7), and 14.5% at very high risk (scores 11-15), necessitating immediate ergonomic interventions. Conclusion: Grocery store workers are at a high risk of developing WMSDs, with significant discomfort in the lower back, knees, ankles, and neck. Limitations include lack of segregation among working patterns, and not considering rest intervals or BMI. Future research should focus on intervention studies, segregating working patterns, and advising preventive measures to mitigate these risks. Keywords: Work-related musculoskeletal disorders, Ergonomic risk assessment, Grocery store workers, Musculoskeletal disorder prevalence, Nordic Musculoskeletal Questionnaire, REBA (Rapid Entire Body Assessment)

(1) Background: Work-related musculoskeletal disorders (WMSDs) are a major occupational health concern in the construction industry owing to the physically demanding tasks and poor ergonomic conditions present. Limited data exist on the prevalence of WMSDs and their ergonomic determinants among construction workers in India. This study investigated the prevalence of work-related musculoskeletal disorders (WMSDs) and the associated ergonomic risk factors among construction workers in India. (2) Methods: This cross-sectional study was conducted among 250 construction workers in India. Data on musculoskeletal disorders were collected using the Nordic Musculoskeletal Questionnaire (NMQ), and ergonomic risk was assessed using the Rapid Entire Body Assessment (REBA) tool. Logistic regression was used to identify factors associated with WMSDs, and Spearman’s correlation was used to assess the relationship between the REBA scores and the number of affected body regions. (3) Results: The prevalence of WMSDs was 60.4%. The most affected regions were the lower back (48%), knees (45%), shoulders (40%), and the neck (30%). The REBA scores indicated that 60% of the workers were at high or very high ergonomic risk and 30% at medium risk. Workers in the high/very high-risk category had significantly higher odds of developing WMSDs (OR = 4.5, 95% CI: 1.8–11.2, p = 0.001). Age above 40 years was also significantly associated with WMSDs (OR = 3.5, 95% CI: 1.2–10.2, p = 0.02). (4) Conclusions: This study demonstrated a high prevalence of WMSDs among Indian construction workers and established a clear association with poor ergonomic conditions. Targeted ergonomic interventions, including posture improvement, tool redesign, and safety training, are essential for reducing the risk of WMSDs in this population.

Impact of a simulation-based ergonomics training curriculum on work-related musculoskeletal injury risk in colonoscopy

This study applies a digital human modelling–driven approach to ergonomic risk assessment, workstation redesign, and usability evaluation in a manufacturing assembly line. Work-related musculoskeletal disorders (WMSDs) remain a major occupational health concern in manufacturing environments, particularly in standing manual assembly workstations. Inadequate workstation design often leads to awkward postures, prolonged static loading, and repetitive movements, contributing to discomfort, fatigue, and reduced productivity. This study evaluates ergonomic risks associated with working postures at a manual insert workstation in an air-conditioner manufacturing company using Digital Human Modelling (DHM) integrated with Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA). A cross-sectional assessment involving ten female operators was conducted using observational analysis, anthropometric measurement, and the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Existing work postures were simulated in CATIA to quantify ergonomic risk levels. Based on identified risk factors, an ergonomically improved workstation was designed and re-evaluated using RULA. Results showed that the existing workstation posed medium to very high ergonomic risks (RULA scores up to 7; REBA scores up to 11), particularly affecting the neck, lower back, and lower limbs. The redesigned workstation reduced the RULA score to 3, indicating a substantial improvement in postural risk. The findings demonstrate the effectiveness of DHM-supported ergonomic interventions in reducing WMSDs risk and highlight the importance of user-centered workstation design in manufacturing settings.

Purpose: To assess the ergonomic risk faced by clinical physiotherapists and identify factors predicting risk. Relevance: Physiotherapists frequently engage in repetitive, physically demanding tasks, increasing their risk for work-related musculoskeletal disorders (WRMSDs) which impact work performance. Participants: 166 registered (GSCPT) physiotherapists with minimum one year of experience from various clinical settings of Vadodara were included. Those who were pregnant, had congenital or non-occupational musculoskeletal disorders, or not working were excluded. Methods: Eligible participants underwent face-to-face interview covering socio-demographic (age, gender, education, marital status, BMI, addiction) and occupational factors. Their treatment sessions were video recorded for ergonomic risk assessment using Rapid Entire Body Assessment (REBA). Analysis: Data were analyzed using SPSS 23.0, employing descriptive statistics and Spearman’s Correlation to assess relationships with REBA scores. Stepwise multiple linear regression identified predictors of ergonomic risk, with REBA as dependent variable (p<0.05). Results: Participants had mean age of 28±4.34 years, predominantly female (86.1%), with most holding bachelor’s degree and 61.8% unmarried. Mean BMI was 23.37±4.19 kg/m², and 36.7% classified as obese. They had 5.44±4.32 years of experience, primarily in private sector (71.08%), treating average 10.5 patients/day. 41.9% reported WRMSDs, with back pain (17%) commonest. Majority (66.26%) faced medium ergonomic risk on REBA (6.39±1.69). Only 24.7% stretched before treating, and 48.8% performed repetitive tasks. Many felt physically exhausted (42.4%) and reported uneven workload (53%). Higher BMI (r=0.16) and poorer job quality [time (r=-0.16), workload (r=-0.19)] correlated with higher REBA scores (p<0.05), with perceived work quality and standing hours negatively predicting REBA (R²=0.064, p=0.005). Conclusion: The study highlights significant ergonomic risks and work-related health issues among physiotherapists, emphasizing the impact of physical workload and job satisfaction. Implications: Improved ergonomics, workload management, wellness programs are essential to reduce WRMSD risk and enhance job satisfaction.

Objectives:Rapid urbanization has intensified the demand for human labor, including in sectors like food delivery, where workers are prone to work-related musculoskeletal disorders (WMSDs). This study aimed to assess the ergonomic risks among food delivery riders in Eastern Peninsular Malaysia using the Rapid Entire Body Assessment (REBA) method.Material and Methods:A cross-sectional study was conducted among 191 food delivery riders in September 2021 – March 2022. The REBA method, a paper-and-pen observational tool, was utilized to evaluate the postural risks associated with WMSDs. Data on demographics and working conditions were collected through interviews and observations. Descriptive statistics were used to summarize REBA scores, with mean scores compared between motorcycle types using t-tests.Results:The mean final REBA score was 5, indicating a medium risk for developing WMSDs. Scores of 4, 5, and 6 were observed in 36.1%, 31.4%, and 31.9% of riders, respectively. Riders using scooters generally had lower REBA scores than those using sedan motorcycles.Conclusions:The study highlighted a medium risk of WMSDs among food delivery riders. Ergonomic interventions, particularly in motorcycle design, are necessary to mitigate these risks and improve occupational safety and health.

Background: Work-related musculoskeletal disorders (WMSDs) are prevalent among orthopaedic surgeons as a result of prolonged exposure to non-neutral postures and forceful manual tasks during surgery. Although working height is a key determinant of trunk and upper-limb posture, the systematic evaluation of ergonomic working-height recommendations in orthopaedic surgery remains limited. Methods: A simulated left total knee arthroplasty (TKA) was divided into twelve critical surgical steps and analysed across four commonly used surgeon positions (A-D). Two conditions were compared: uncorrected working height (N) and working height corrected according to Canadian Centre for Occupational Health and Safety (CCOHS) recommendations (C). Joint angles were measured from standardized photographs using Kinovea software, and postural load was quantified with the Rapid Entire Body Assessment (REBA) method. Two trained evaluators conducted three independent assessments, yielding 288 REBA scores. Results: Mean REBA scores decreased across all surgeon positions following ergonomic correction, with statistically significant reductions observed in positions A, B, and D. When pooled across all position-step combinations (n = 48), the mean reduction was 0.92 REBA points (95% CI 0.50-1.33; p < 0.001). Notably, 27 of the 48 position-step comparisons exceeded the minimal detectable change threshold. The largest reductions occurred during force-intensive surgical steps, including bone cutting, drilling, and implant impaction. Conclusions: Adjusting working height in accordance with CCOHS ergonomic recommendations reduces surgeons' postural load during TKA. These findings support the integration of evidence-based ergonomic adjustments into routine orthopaedic surgical practice.

Ergonomics is an emerging concept in the neurosurgical operating theatre, where neurosurgeons work under great concentration and frequently neglect their uncomfortable body posture. Work-related musculoskeletal disorders (WMSD) are becoming a widespread burden in the neurosurgical community. WMSD have a negative impact on surgical performance and decrease the surgeons' quality of life. Here we present our single-centre 2-month experience with the Aesculap AEOS® Robotic Digital Microscope (RDM) and prospectively calculate the REBA (Rapid Entire Body Assessment) scores and compare them with similar neurosurgical cases operated with a conventional operative microscope (OPMI).Materials and Methods: For a period of 2months at the Department of Neurosurgery of the University Hospital Pirogov, Sofia, Bulgaria, 41 consecutive patients were operated on using RDM. The REBA employee assessment worksheets were filled in prospectively to assess the ergonomics of the senior author (N.G.) while using the RDM and the OPMI.Results and Conclusion: The ergonomics during neurosurgical operations could be substantially improved with the implementation of the exoscope. For challenging cranial approaches, where the operator must frequently "look around corners" the exoscope has a major advantage compared with the OPMI-the REBA score is 2.6 times lower for the exoscope and reaches a low risk for WMSD. For spinal operations, the neck score as part of the REBA score is three times lower for the exoscope.

Neck and shoulder discomfort found to be most prevalent in veterinary technicians. REBA posture analysis identifies areas of significant risk and provides a benchmark for improvements. Patient restraint and handling put veterinary technicians at significant risk for musculoskeletal disorders. Continuous improvement through the implementation of engineering and administrative controls is mandatory. Research addressing work-related musculoskeletal disorders (WMSDs) among veterinary technicians is limited. Veterinary technicians are exposed to several activities that require lifting and the adoption of non-neutral postures associated with WMSDs. It is essential to design interventions aimed at reducing WMSDs in this population. The goal of this study was to identify typical, prevalent work tasks that pose high ergonomic risk factors to veterinary technicians, as well as to determine the WMSD risk associated with the work tasks identified in order to implement interventions. A small-animal veterinary clinic in central Wisconsin was contacted for this study. Nine veterinary technicians and assistants participated in assessing musculoskeletal symptoms and identifying tasks with ergonomic risk factors. The tasks with a high count of risk factors were evaluated using the Rapid Entire Body Assessment (REBA). All participants in this study experienced musculoskeletal discomfort in five or more body regions. They also reported being unable to perform work over the last 12months due to WMSDs on shoulders, ankles, and feet (33%, n=3), neck and lower back (22%, n=2), and wrists, hands, hips, thighs, and knees 11% (n=1). One of the respondents reported no discomfort over the last seven days, while eight of them indicated discomfort in three or more body areas. Restraining and handling animals, sedation and recovery, and dental procedures were chosen for REBA analysis. Restraining and handling animals had a high-risk REBA score (ranging from 8to10). Sedation and recovery had a low to medium-risk REBA score (ranging from 3to5). Dental procedure recovery had a low to very high-risk REBA score (ranging from 2 to 11). Our findings suggest that most veterinary technicians come to work experiencing musculoskeletal discomfort and are exposed to significant WMSD risk levels when performing common tasks. This job assessment allows us to recommend administrative and engineering controls to reduce the risk of WMSDs associated with high-risk tasks.

The healthcare industry has one of the highest rates of work-related injuries. Ophthalmologists are at particularly high risk for developing musculoskeletal disorders (MSDs), which are often the result of repetitive movements, such as performing slit lamp examinations. Previous studies used the Rapid Entire Body Assessment (REBA) scale to determine the ergonomic risk of a particular task.Higher REBA scores correlate with increased risk of injury, which ranges from negligible risk (1) to very high risk (11+). Given the long-term implications of repetitive examinations by ophthalmologists, this study aims to describe the average ergonomic risk posed to residents using the REBA scale. This descriptive case study assessed four ophthalmology residents performing slit lamp examinations between September 2022 and February 2023. Photographs were taken of residents performing slit lamp examinations. Total REBA scores, Score A, Score B, and the REBA scores for each participant were calculated and compared. The average REBA score across all participants was 4.59 (SD±0.89). The highest score was 7.00 and the lowest was 3.00. The average Score A, representing posture for the head, leg, and trunk, was 3.54 (SD±0.74) and the average Score B, representing posture for the upper arm, lower arm, and wrist, was 3.18 (SD±1.22). Our study found that residents are at increased risk for developing MSDs. Furthermore, variation in REBA scores between residents indicates that not all residents are at equal ergonomic risk. This highlights an opportunity for ophthalmology residency programs to implement ergonomics training into their curriculum.

Introduction: Work-related musculoskeletal disorders (WRMDs) are one of the major health problems among physical therapists treating neurological patients. Therefore, this study aimed to determine the risk factors for developing WRMDs in physical therapists in South Korea treating neurological patients. Methods: This research is an analytical observational study with a cross-sectional design. In this study, 30 physical therapists who treat neurological patients were recruited by randomly selecting respondents to flyers posted throughout the hospital. To evaluate risk levels, during the transfer of the patient from the wheelchair to the treatment table and during treatment, the Rapid Entire Body Assessment (REBA) was performed. Moreover, physical therapists were assessed for musculoskeletal symptoms through the Nordic Musculoskeletal Questionnaire (NMQ) survey. Results: The findings revealed that during the treatment session, the REBA score was 43.33% for medium and high risk level and 13.33% for very high risk level. Meanwhile, during the transfer session, the REBA score was 40% for high risk level and 60% for very high risk level. The results of the Nordic musculoskeletal questionnaire showed that physical therapists felt significant pain in the wrist/hand, shoulders, neck, lower back, and knee. Conclusion: Physical therapists treating neurological patients have a high risk of developing WRMDs. Thus, changes need to be made regarding the working pattern of physical therapists, and more detailed evaluations of ergonomic risk factors are required.

It was discovered that there were ergonomics risk factors towards machinists during manual handling of large work pieces that may affect the health of the machinists based on the initial ergonomics risk assessment conducted on the CNC turning machine shop in oil and gas manufacturing company. The study aims to determine and improve the ergonomics risk factor that the machinists may be exposed to. In this study, the data were collected and analyzed using Cornell Musculoskeletal Questionnaire, Rapid Entire Body Assessment (REBA) and torque analysis. Survey result from Cornell Musculoskeletal Questionnaire found that most of the turning machinists experienced ache, pain and discomfort on their lower back, right hand shoulder and upper back. REBA analysis indicated that body posture applied during tightening headstock jaws is categorized as very high risk with REBA score of 11 and immediate improvement action is required. The root cause was identified using 5 Why methodology where torque wrench design limitation has been identified as the main contributor to the very high REBA score. The input torque applied by the machinist was reduced, and the location of the tightening torque applied for clamping and adjusting purposes was changed using manual torque multiplier equipment. The input torque applied by machinist reduced from 1200Nm to 44.4Nm, and the pulling force applied was reduced from 128.7kgf to 9.1kgf, significantly lowering the REBA score from 11 (very high risk) to 3 (low risk). The objective of the study has been achieved by significant improvement of REBA score for the very high-risk postures that the machinists are exposed to.

Background: Security guards usually work for long hours, often standing or sitting without changing their posture. Staying in the same position for too long can cause tiredness, muscle pain, and long-term musculoskeletal problems. The Rapid Entire Body Assessment (REBA) scale helps identify how harmful a person’s working posture is and whether they are at risk of developing Musculoskeletal Disorders (MSDs). Objective: To assess the posture of security guards during their working hours and identify their level of risk for musculoskeletal problems using the REBA method. Materials and Methods: This observational study included 100 security guards from different areas of Bengaluru. A questionnaire was used to collect details about their age, work type, daily working hours, and any discomfort they experienced. Their working posture was then evaluated using the REBA scale. Data were analysed using descriptive statistics, likelihood ratio tests, and Pearson correlation. A p-value &lt; 0.05 was considered significant. Results: Out of 100 guards, 72 percent were in the medium-risk category, 20 percent were in the high-risk category, and only 8 percent were in the low-risk category according to REBA scoring. A large number of guards (86%) reported discomfort during work, mainly in the lower back and legs/feet. Age, height, and weight showed a positive correlation with the REBA score, meaning these factors increased the risk of poor posture. Conclusion: Most security guards are at medium to high risk for developing musculoskeletal problems due to standing or sitting for long hours without changing posture. There is also a lack of ergonomic awareness and training. Providing posture education, regular breaks, better workplace ergonomics, and routine assessments can help reduce this risk. Major Findings: 72% of security guards were classified under medium ergonomic risk and 20% under high risk using REBA. 86% reported musculoskeletal discomfort, mainly affecting the lower back and lower limbs.

Introduction Veterinary technicians in small-animal clinics are often exposed to activities associated with work-related musculoskeletal disorders (WMSDs), but the available research is limited. This multi-method case study identifies prevalent tasks with ergonomic hazards and defines the associated risk levels. Potential interventions are discussed. Methods Nine technicians participated in assessing symptoms and identifying tasks with ergonomic risk factors. A modified NORDIC questionnaire was administered to determine WMSD discomfort. A focus group identified activities with ergonomic risk factors. The jobs with high-risk factors were further evaluated using the Rapid Entire Body Assessment (REBA). Results All participants experienced musculoskeletal discomfort in at least five body regions. They reported being unable to perform work over the last 12 months due to WMSDs on shoulders, ankles, and feet 33% (n=3), neck and lower back 22% (n=2), and wrists, hands, hips, thighs, and knees 11% (n=1). One respondent reported no discomfort over the last seven days, while eight indicated discomfort in three or more body areas. Three tasks were chosen for REBA analysis. Restraining and handling animals had a high-risk REBA score (ranging from 8 to 10). Sedation/recovery had a low to medium-risk REBA score (3 to 5). Dental procedure recovery had a low to very high-risk REBA score (ranging from 2 to 11). Discussion The findings indicate that most veterinary technicians experience musculoskeletal discomfort and are exposed to significant WMSD risk levels when performing everyday tasks. Conclusion This assessment produced several administrative and engineering controls to reduce the risk of WMSDs in the selected tasks.