The association of socioeconomic status and psychosocial and physical workplace factors with musculoskeletal injury in hospital workers

Marion Gillen, Irene H. Yen, Laura Trupin, Louise Swig, Reiner Rugulies, Kathleen Mullen, Aurelio Font, David Burian, Greg Ryan, Ira Janowitz, Patricia A. Quinlan, John Frank, Paul Blanc

Research output: Contribution to journalArticlepeer-review


Background: The combined effect of socioeconomic, organizational, psychosocial, and physical factors on work-related musculoskeletal disorders (WRMSDs) were studied in a heterogeneous, socioeconomically diverse sample (cases and their matched referents) of hospital workers. Methods: Cases were defined by a new acute or cumulative work-related musculoskeletal injury; referents were matched by job group, shift length, or at random. Information was obtained through telephone interviews and on-site ergonomics observation. Questionnaire items included sociodemographic variables, lost work time, work effectiveness, health status, pain/disability, and psychosocial working conditions using Effort Reward Imbalance (ERI) and Demand-Control (DC) models. Two multivariate models were tested: Model 1 included occupation as a predictor; Model 2 included education-income as a predictor. Results: Cases reported greater pain, disability, lost time, and decreased work effectiveness than the referents. Model 1 was statistically significant for neck/upper extremity injury (Chi-square = 19.3, P = 0.01), back/lower extremity injury (Chi-square = 14.0, P = 0.05), and all injuries combined (Chi-square = 25.4, P = 0.001). "Other Clinical" occupations (34 % mental health workers) had the highest risk of injury (OR 4.5: 95%CI, 1.7-12.1) for all injuries. The ERI ratio was a significant predictor for neck and upper extremity (OR 1.5: 95%CI, 1.1-1.9) and all injuries (OR 1.3; 95%CI, 1.04-1.5), per SD change in score. Conclusions: In this study, the risk of WRMSDs was more strongly influenced by specific psychosocial and physical job-related exposures than by broad socioeconomic factors such as education and income.

Original languageEnglish
Pages (from-to)245-260
Number of pages16
JournalAmerican Journal of Industrial Medicine
Issue number4
Publication statusPublished - 20 Feb 2007


  • Demand-control model
  • Effort-reward imbalance
  • Ergonomics
  • Hospital occupations
  • Hospitals
  • Socioeconomic status
  • Work-related musculoskeletal disorders

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