Mixed adverse ergonomic factors exposure in relation to work-related musculoskeletal disorders: a multicenter cross-sectional study of Chinese medical personnel

Exposure to adverse ergonomic factors is associated with elevated risk of work-related musculoskeletal disorders (WMSDs) in medical personnel. We aimed to reveal how different adverse ergonomic factors act individually and in combination to influence the risk of WMSDs in medical personnel. From June 2018 to December 2020, we applied multistage cluster random sampling to select a total of 6,099 medical personnel from 54 hospitals in 12 cities in China. All participants were aged over 18 years and had at least one year of hospital working experience. The weighted quantile sum (WQS) model was employed to evaluate the effect of mixed exposures of multiple adverse ergonomic factors on the risk of WMSDs. Compared to a single factor, multiple adverse ergonomic factors significantly increased the risk of WMSDs across body parts, with an OR ranging from 2.83 (95% CI: 2.33, 3.43) to 6.92 (95% CI: 4.91, 9.74). "Working in awkward positions" had the greatest impact on the risk of WMSDs in the neck, shoulder, upper back, and lower back, while "standing for prolonged periods of time" mostly affected the risk of WMSDs in the foot, leg, and knee. Compared with single factor exposure, mixed exposure resulted in a higher risk of WMSDs.