Restricted accessReview articleFirst published online 2026-2
Scoping review of studies on work-related musculoskeletal disorders: Quality of evidence,coverage of risk factors and types of risk assessment tools used
Despite continual efforts globally in preventing work-related musculoskeletal disorders (WMSDs), they remain one of the most common occupational injuries with individual, organisational and societal impacts.
Objective
This scoping review analysed 265 studies on WMSDs published between January 2013 and December 2024, aiming to assess the quality of evidence, identify risk factors, and examine risk assessment tools used.
Methods
A systematic search in Embase, PubMed, Web of Science, EBSCO, and Scopus, including subscription-based and open-access journals identified relevant studies. Inclusion criteria focused on WMSD risk assessment in occupational settings. Data extraction covered study characteristics, risk factors, assessment tools, and methodological quality.
Results
The review revealed a significant increase in WMSD research in recent years, particularly from 2021 to 2024, possibly influenced by the COVID-19 pandemic's impact on work tasks and conditions. Lower back, neck, and shoulder pain were the most prevalent WMSDs reported. The review identified 79 risk factors across five categories. Physical task factors were most frequently investigated, while psychosocial and environmental factors were underrepresented. Self-report tools, particularly the Nordic Questionnaire, were the most commonly used assessment methods. Our review also highlights the need for more comprehensive risk assessment approaches that consider the interconnected nature of WMSD risk factors. Additionally, about 28% of the reviewed studies did not meet adequate quality of evidence criteria, indicating a need for improved research methodologies.
Conclusions
This review provides valuable insights for researchers and practitioners in occupational health and safety, emphasising the importance of holistic approaches to WMSD risk assessment and management.
SoroushAShamsiMIzadiN, et al.Musculoskeletal disorders as common problems among Iranian nurses: a systematic review and meta-analysis study. Int J Prev Med2018; 9(1):27.
5.
BackL.Musculoskeletal disorders and the workplace. 2001.
6.
Safe Work Australia. Work-related injury fatalities-Key WHS statistics Australia 2019. Canberra, ACT: Safe work Australia; 2020.
7.
OakmanJWealeVKinsmanN, et al.Workplace physical and psychosocial hazards: a systematic review of evidence informed hazard identification tools. Appl Ergon2022; 100: 103614.
8.
JacksonJSundMBarlari LobosG, et al.Assessing the efficacy of a job rotation for improving occupational physical and psychosocial work environment, musculoskeletal health, social equality, production quality, and resilience at a commercial laundromat: protocol for a longitudinal case study. BMJ Open2023; 13(5).
9.
YangHLuMLHaldemanS, et al.Psychosocial risk factors for low back pain in US workers: data from the 2002–2018 quality of work life survey. Am J Ind Med2023; 66: 41–53.
10.
GómezMM. Prediction of work-related musculoskeletal discomfort in the meat processing industry using statistical models. Int J Ind Ergon2020; 75: 102876.
11.
HassaniMKabieszPHesampourR, et al.Prevalence of musculoskeletal disorders, working conditions, and related risk factors in the meat processing industry: comparative analysis of Iran-Poland. Work2023; 74: 309–325.
12.
HassaniMHesampourRBartnickaJ, et al.Evaluation of working conditions, work postures, musculoskeletal disorders and low back pain among sugar production workers. Work2022; 73: 273–289.
13.
VeerendraUBashaPABinduBN, et al.Prevalence of musculoskeletal disorders and health related quality of life (HRQoL) in patients visiting secondary healthcare setting. Int J Pharm Investig2023; 13(3):632-40.
14.
KaranikasNJaniBD. Frequency of examination and perceived contribution of factors relating to work-related musculoskeletal disorders of physiotherapists. Int J Occup Saf Ergon2021; 28: 1112–1129.
15.
SaureECastrénMMikkolaK, et al.Intellectual disabilities moderate sex/gender differences in autism spectrum disorder: a systematic review and meta-analysis. J Intellect Disabil Res2023; 67: 1–34.
16.
D’OnofrioGKirschnerJPratherH, et al. . Musculoskeletal exercise: Its role in promoting health and longevity. Prog Cardiovasc Dis. Prog Cardiovasc Dis2023; 77: 25–36.
17.
ShabaniTJerieSShabaniT. A review of the role of behaviour-based procedures in work safety analysis in the medical sector of Zimbabwe. Life Cycle Reliab Saf Eng2023; 12: 219–234.
18.
LathaHPatilSKiniPG. Influence of architectural space layout and building perimeter on the energy performance of buildings: a systematic literature review. Int J Energy Environ Eng2023; 14: 431–474.
19.
AsliK. Risk factors associated with musculoskeletal disorders among professional drivers in Asian countries: a systematic review. Jurnal Sains Kesihatan Malaysia2023; 21: 143–155.
20.
IgweAEEzeobiAAOkekeFO, et al. (eds). Causes and remedies of sick building syndrome: a systematic review. In: E3S web of conferences. EDP Sciences, 2023.
21.
RajaeeMAArjmandNShirazi-AdlA, et al.Comparative evaluation of six quantitative lifting tools to estimate spine loads during static activities. Appl Ergon2015; 48: 22–32.
22.
HenschkeJKaplickHWochatzM, et al.Assessing the validity of inertial measurement units for shoulder kinematics using a commercial sensor-software system: a validation study. Health Sci Rep2022; 5: e772.
23.
LuninAGlockCH. Systematic review of Kinect-based solutions for physical risk assessment in manual materials handling in industrial and laboratory environments. Comput Ind Eng2021; 162: 107660.
24.
OakmanJKinsmanN.A Workplace Evaluation of a Participative Hazard Identification and Risk Management Toolkit for the Work-Related Musculoskeletal Disorders. 2023.
25.
OakmanJMacdonaldW. The APHIRM toolkit: an evidence-based system for workplace MSD risk management. BMC Musculoskelet Disord2019; 20: 1–11.
26.
RasmussenCSvendsenMJHoltermannA (eds). A participatory ergonomic intervention aiming at reducing physical exertion and musculoskeletal pain among childcare workers–a cluster-randomized controlled trial. In: 20th congress international ergonomics association, 2018.
27.
TriccoACLillieEZarinW, et al.PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med2018; 169: 467–473.
28.
ArkseyHO’malleyL. Scoping studies: towards a methodological framework. Int J Soc Res Methodol2005; 8: 19–32.
29.
AdamsRRyanTWoodE. Understanding the factors that affect retention within the mental health nursing workforce: a systematic review and thematic synthesis. Int J Ment Health Nurs2021; 30: 1476–1497.
30.
RubinsteinSMvan EekelenROosterhuisT, et al.The risk of bias and sample size of trials of spinal manipulative therapy for low back and neck pain: analysis and recommendations. J Manipulative Physiol Ther2014; 37: 523–541.
31.
ShaikhAMMandalBBMangalavalliSM. Causative and risk factors of musculoskeletal disorders among mine workers: a systematic review and meta-analysis. Saf Sci2022; 155: 105868.
32.
ÇelikkalpÜIrmakAYAydınGÖ, et al.Musculoskeletal disorders and the affecting factors among teachers: an example from Turkey. Work2022; 72: 1015–1024.
33.
CiminoAGnoniMGLongoF, et al.A risk assessment framework based on ergonomic methods and AHP for prioritizing interventions to prevent container terminal operator's musculoskeletal disorders. Saf Sci2023; 159: 106017.
34.
WangSWangY. Musculoskeletal model for assessing firefighters’ internal forces and occupational musculoskeletal disorders during self-contained breathing apparatus carriage. Saf Health Work2022; 13: 315–325.
35.
LuJ-MTwuL-JWangM-JJ. Risk assessments of work-related musculoskeletal disorders among the TFT-LCD manufacturing operators. Int J Ind Ergon2016; 52: 40–51.
36.
Cruz-AusejoLCopez-LonzoyAVilela-EstradaAL, et al.Can working at home be a hazard? Ergonomic factors associated with musculoskeletal disorders among teleworkers during the COVID-19 pandemic: a scoping review. Int J Occup Saf Ergon2023; 29: 1335–1344.
37.
Dos SantosINPernambucoMLda SilvaAMB, et al.Association between musculoskeletal pain and telework in the context of the COVID 19 pandemic: an integrative review. Revista Brasileira de Medicina do Trabalho2021; 19: 342.
38.
DavisKGKotowskiSE. Prevalence of musculoskeletal disorders for nurses in hospitals, long-term care facilities, and home health care: a comprehensive review. Hum Factors2015; 57: 754–792.
39.
Barneo-AlcántaraMDíaz-PérezMGómez-GalánM, et al.Musculoskeletal disorders in agriculture: a review from web of science core collection. Agronomy2021; 11: 2017.
40.
HeXXiaoBWuJ, et al.Prevalence of work-related musculoskeletal disorders among workers in the automobile manufacturing industry in China: a systematic review and meta-analysis. BMC Public Health2023; 23: 2042.
41.
DianatIAfshariDSarmastiN, et al.Work posture, working conditions and musculoskeletal outcomes in agricultural workers. Int J Ind Ergon2020; 77: 102941.
42.
PalADharaPC. Work related musculoskeletal disorders and postural stress of the women cultivators engaged in uprooting job of rice cultivation. Indian J Occup Environ Med2018; 22: 163–169.
43.
KatariaKKSharmaMKantS, et al.Analyzing musculoskeletal risk prevalence among workers in developing countries: an analysis of small-scale cast-iron foundries in India. Arch Environ Occup Health2022; 77: 486–503.
44.
Mehraban JahromiMAbolahrari-ShiraziSSafariS, et al.Prevalence of musculoskeletal disorders risk factors and ergonomic assessment of posture among senior students of rehabilitation school of shiraz university: a cross-sectional study. J Rehabil Sci Res2022; 9: 180–184.
45.
DarvishiEGhasemiFSadeghiF, et al.Risk assessment of the work-related musculoskeletal disorders based on individual characteristics using path analysis models. BMC Musculoskelet Disord2022; 23: 616.
46.
RuzairiKMJamaludinBSSukadarinEH, et al.A systematic review of risk factor associate with musculoskeletal disorder: biomechanical and psychosocial factor. In: Human-centered technology for a better tomorrow: proceedings of HUMENS 2021, 2022, pp.661–680.
47.
López-AragónLLópez-LiriaRCallejón-FerreÁ-J, et al.Applications of the standardized nordic questionnaire: a review. Sustainability2017; 9: 1514.
48.
Al MadaniDDababnehA. Rapid entire body assessment: a literature review. Am J Eng Appl Sci2016; 9: 107–118.
49.
SirisawasdSTaptagapornSBoonshuyarC, et al.Comparison of musculoskeletal load using two devices for manual height adjustment of the hospital bed. Int J Occup Saf Ergon2022; 28: 519–527.
50.
Van der KrukEReijneMM. Accuracy of human motion capture systems for sport applications; state-of-the-art review. Eur J Sport Sci2018; 18: 806–819.
51.
YahyaMShahJAKadirKA, et al.Motion capture sensing techniques used in human upper limb motion: a review. Sens Rev2019; 39: 504–511.
52.
DavidGC. Ergonomic methods for assessing exposure to risk factors for work-related musculoskeletal disorders. Occup Med (Chic Ill)2005; 55: 190–199.
53.
CarneiroPBragaACBarrosoM. Work-related musculoskeletal disorders in home care nurses: study of the main risk factors. Int J Ind Ergon2017; 61: 22–28.
54.
TesfayeAHKabitoGGAragawFM, et al.Prevalence and risk factors of work-related musculoskeletal disorders among shopkeepers in Ethiopia: evidence from a workplace cross-sectional study. Plos one2024; 19: e0300934.
55.
TalapatraSParvezMSahaP, et al.Assessing the impact of critical risk factors on the development of musculoskeletal disorders: a structural equation modelling approach. Theor Issues Ergon Sci2024; 25: 343–368.
56.
AndreasG-WJJohanssonsE. Observational methods for assessing ergonomic risks for work-related musculoskeletal disorders. A scoping review. Revista Ciencias de la Salud2018; 16(SPE): 8–38.
57.
LeeWLinJ-HHowardN, et al.Methods for measuring physical workload among commercial cleaners: a scoping review. Int J Ind Ergon2022; 90: 103319.
58.
VazquezACSPianezollaMHutzCS. Assessment of psychosocial factors at work: a systematic review. Estudos de Psicologia (Campinas)2018; 35: 5–13.
59.
SobeihTMSalemODaraisehN, et al.Psychosocial factors and musculoskeletal disorders in the construction industry: a systematic review. Theor Issues Ergon Sci2006; 7: 329–344.
60.
BongersPMKremerAMLaakJ. Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist?: a review of the epidemiological literature. Am J Ind Med2002; 41: 315–342.
61.
AriënsGAvan MechelenWBongersPM, et al.Psychosocial risk factors for neck pain: a systematic review. Am J Ind Med2001; 39: 180–193.
62.
Van Der WindtDAThomasEPopeDP, et al.Occupational risk factors for shoulder pain: a systematic review. Occup Environ Med2000; 57: 433–442.
63.
HoogendoornWvan PoppelMBongersP, et al.Psychosocial factors at work and in the personal situation as risk for back pain. Spine2000; 25: 2114–2125.
64.
OllayCPereiraACotrimTP. Occup Environ Saf Health V2023, 745–751.
65.
Mateos-GonzalezLRodríguez-SuárezJLlosaJA. A systematic review of the association between job insecurity and work-related musculoskeletal disorders. Hum Factors Ergon Manuf Serv Ind2024; 34: 79–99.
66.
VerslootAHJacksonJAvan RijnRM, et al.Physical and psychosocial work-related exposures and the occurrence of disorders of the shoulder: a systematic review update. Appl Ergon2024; 118: 104277.
67.
BezzinaAAustinENguyenH, et al.Workplace psychosocial factors and their association with musculoskeletal disorders: a systematic review of longitudinal studies. Workplace Health Saf2023; 71: 578–588.
68.
MirzaeiEKouhnavardBDaneshmandiH, et al.Determining the effect of environmental factors, work postures and mental workload on musculoskeletal disorders in rescue workers and accidents of one of the water and sewage companies in Iran. Work2024; 78(4): 969–981.
69.
ZhangQXieQLiuH, et al.A pilot study of biomechanical and ergonomic analyses of risky manual tasks in physical therapy. Int J Ind Ergon2022; 89: 103298.
70.
YazdaniradSPourtaghiGRaeiM, et al.Development of modified rapid entire body assessment (MOREBA) method for predicting the risk of musculoskeletal disorders in the workplaces. BMC Musculoskelet Disord2022; 23: 82.
71.
AnwerSLiHAntwi-AfariMF, et al.Associations between physical or psychosocial risk factors and work-related musculoskeletal disorders in construction workers based on literature in the last 20 years: a systematic review. Int J Ind Ergon2021; 83: 103113.
72.
XuK. Associations between awkward work postures and musculoskeletal pain in home care workers: a cross-sectional study. Trondheim, Norway: Master’s thesis, Norwegian University of Science and Technology (NTNU), 2023.
73.
MebarkiBZaouiBMokdadM, et al.Patients’ handling tasks, awkward postures and work-related musculoskeletal disorders among nursing staff in critical care-units. 2023.
74.
AbdullahTPopplewellKPageC. A review of the support tools for the process of assembly method selection and assembly planning. Int J Prod Res2003; 41: 2391–2410.
75.
AziziAGhafoorpoor YazdiPHashemipourM. Interactive design of storage unit utilizing virtual reality and ergonomic framework for production optimization in manufacturing industry. Int J Interact Des Manuf (IJIDeM)2019; 13: 373–381.
76.
WangKZengXLiJ, et al.The prevalence and risk factors of work-related musculoskeletal disorders among nurses in China: a systematic review and meta-analysis. Int J Nurs Stud2024; :: 104826.
77.
OkunribidoOOWynnTLewisD. Are older workers at greater risk of musculoskeletal disorders in the workplace than young workers?–A literature review. Occup Erg2011; 10: 53–68.
78.
CiekalskiMRosolIFilipekM, et al.Work-related musculoskeletal disorders in Polish sonographers-A questionnaire study. Curr Probl Diagn Radiol2024; 53: 576–582.
79.
KennyGPYardleyJEMartineauL, et al.Physical work capacity in older adults: implications for the aging worker. Am J Ind Med2008; 51: 610–625.
80.
PrinceSARasmussenCLBiswasA, et al.The effect of leisure time physical activity and sedentary behaviour on the health of workers with different occupational physical activity demands: a systematic review. Int J Behav Nutr Phys Act2021; 18: 1–17.
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