Occupational Musculoskeletal Health Among Hospital Service Workers: Anatomical Distribution, Pain Severity, and Associated Factors Running title :Musculoskeletal Health Among Hospital Service Workers

In the bustling ecosystem of a hospital, the focus often falls on the doctors and nurses who heal the sick. Yet, the facility itself relies on a different, equally vital workforce: the service staff who clean the floors, manage waste, and maintain the environment. These workers perform physically demanding tasks that involve constant movement, lifting heavy carts, and standing for long periods. In the world of occupational health, such repetitive motions and awkward postures are known to strain the body's muscles and joints, leading to conditions collectively called musculoskeletal disorders. These are not merely minor aches; they are a leading cause of pain and disability for workers worldwide, affecting their ability to function and their overall quality of life. While much research has focused on clinical staff, the physical toll on the service workers who keep hospitals running has remained largely in the shadows, leaving a gap in our understanding of the specific risks they face.

To bring this hidden burden into the light, a team of researchers in western Iran set out to examine the physical well-being of hospital service workers at a specialized heart hospital in Hamadan. In 2024, they invited sixty workers from various departments to share their experiences. The researchers used a detailed questionnaire designed to track where and how often these workers felt discomfort, along with a simple scale to measure the intensity of their pain. They asked the participants to report on their bodies from head to toe, noting any pain in the neck, back, arms, legs, or knees, and whether that pain made their daily tasks difficult. The goal was not just to count how many people were in pain, but to map exactly which parts of the body were under the most stress and to see if factors like age, gender, or how long someone had worked there made a difference.

The results painted a clear picture of where the strain was concentrated. The workers reported that their bodies were most frequently bothered in the neck, the lower back, and the knees. These areas, which form the central axis of the body, bore the heaviest load. The lower back, in particular, was the most common site of complaint, with many workers experiencing discomfort daily. The knees followed closely behind, suggesting that the constant walking, standing, and bending required by their jobs were taking a significant toll on their joints. While the neck and shoulders also saw their share of pain, the hands, wrists, and forearms were generally less affected. This distribution makes sense when considering the nature of the work; these service staff spend their shifts on their feet, pushing heavy equipment and bending over to clean, placing sustained pressure on their spines and leg joints.

Interestingly, the study found that the severity of the pain was often manageable in the moment. Most workers reported that their discomfort did not stop them from doing their jobs, or only interfered slightly. This suggests a high level of resilience or perhaps a willingness to push through discomfort to keep the hospital functioning. However, the researchers noted that just because the pain does not stop work today does not mean it is harmless. Persistent, low-level pain can accumulate over time, potentially leading to more serious, chronic issues down the road. The study also looked for patterns related to the workers' personal characteristics. They found that a worker's dominant hand did influence where they felt pain, with right-handed workers reporting more issues in their right arm, hip, and leg. Surprisingly, however, the study found no clear link between the amount of pain a worker felt and their age, gender, or how many years they had been on the job. This lack of connection suggests that the physical demands of the work itself are the primary driver of pain, affecting workers regardless of their background or experience level.

The findings serve as a reminder that the health of a hospital depends on the well-being of every person who works within its walls, not just the medical professionals. The high prevalence of pain in the lower back and knees among these service workers highlights a need for specific changes in how their work is organized. The researchers suggest that simple measures, such as better training on how to lift safely, rotating tasks to give muscles a break, and providing equipment that reduces the need for awkward bending, could make a significant difference. By addressing these ergonomic challenges, hospitals can protect the physical health of the staff who keep their environments clean and safe, ensuring that the workforce remains strong and capable for the long term.