The epidemiology of work-related musculoskeletal disorders in office-based workers residing in low middle-Income countries (LMICs): a systematic review and meta-analysis

Dreyer, Kirsten Robyn

The epidemiology of work-related musculoskeletal disorders in office-based workers residing in low middle-Income countries (LMICs): a systematic review and meta-analysis

Thesis / Dissertation

2026

Publisher

University of Cape Town

Department

Department of Public Health and Family Medicine

Faculty

Faculty of Health Sciences

Abstract

Background: Work-related musculoskeletal disorders (WMSD) are a significant health concern worldwide, accounting for 1% of disability adjusted life years in developing countries. In occupational health, the prevalence of work-related musculoskeletal disorders (WMSDs) is heightened in roles with varied risks—such as office work—due to exposures like awkward or static postures, repetitive movements, and psychosocial strain, underscoring the need for targeted research. Currently, the extent of WMSD in developing countries among office workers is largely undocumented. Objective: To conduct a systematic review and meta-analysis on the prevalence of WMSDs in office-based workers residing in Low and Middle-Income Countries (LMICs) and, secondly to document putative risk factors associated with WMSD. Search Strategy: PubMed and Scopus were searched, from their respective earliest dates to 31 October 2024, for cross-sectional and cohort studies assessing WMSD in office workers in LMICs, excluding studies from high income counties underlying musculoskeletal disorders (MSD). Study appraisal and synthesis methods: Two researchers independently screened and extracted data, applying RoB-SPEO, and conducted a meta-analysis using a random effects model to estimate pooled prevalence of WMSD by affected body regions and risk ratios for associated risk factors. Deviations from the protocol were recorded in the discussion. Results: The systematic review included 25 studies (3 cohort and 22 cross-sectional, n= 9842 from 14 LMICs). Pooled prevalence of WMSD were 70% (95% CI 51% to 85%; 5 studies; n = 1236, I2 = 97.8%). Pooled estimates of WMSD by body region were lower back (44%), (95% CI 36% to 53%, I2 = 96.5%), neck, 38% (95% CI 31% to 46%, I2 = 96.4 and back, 37% (95% CI 15% to 62%, I2 = 98.4). The remaining body regions (arm, elbow, hand, shoulder, wrist and hand and wrist) each amounted to prevalence estimates of below 30%. Subgroup analysis of putative risk factors (BMI, age and length of day) and WMSD found no statistical association. Conclusions: High WMSD prevalence among office workers in LMICs, notably in the lower back region, was found. Limited data and categorization variability, hindered risk identification, highlighting the need for additional research. Recommendations include office layout assessment and more frequent breaks from static positions.