Musculoskeletal Disorders as Common Problems among Iranian Nurses: A Systematic Review and Meta‑analysis Study
Abstract
Background: Considering the importance of musculoskeletal disorders (MSDs) as one of the health consequences of job stress among nurses and signifcant contradictions in prevalence in different parts of the body, this study was carried out to determine the prevalence of MSDs among Iranian nurses.
Methods: All published studies from June 2000 until June 2015 were considered in reliable databases such as PubMed, Google Scholar, Google search, Scopus, ScienceDirect, and Persian databases such as SID, Iran Medex, and Magiran. These studies, after quality control, were entered into meta‑analysis using the random effects model, a total of 41 papers were assessed between 2004 and 2015.
Results: The prevalence rate of these disorders was 60.98%, 47.76%, 46.53%, 44.64%, 42.8%, 36.8%, 24.61%, and 17.5%, respectively, obtained for the back, neck, knees, upper back, ankles, shoulders, hands, hips, thighs, and elbows. Prevalence of MSDs will lead to high costs of medical, absenteeism from work, or even unemployment.
Conclusions: Due to high prevalence of these disorders among Iranian nurses, providing effective training in the feld of ergonomics and undergoing appropriate exercises are necessary to control it.
Keywords: Iran, meta-analysis, musculoskeletal disorders, nurses
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Sadeghian F, Hosseinzadeh S, Aliyari R. Do psychological
factors increase the risk for low back pain among nurses? A
comparing according to cross‑sectional and prospective analysis.
Saf Health Work 2014;5:13‑6.
Smith DR, Leggat PA, Speare R. Musculoskeletal disorders and
psychosocial risk factors among veterinarians in Queensland,
Australia. Aust Vet J 2009;87:260‑5.
Warnakulasuriya SS, Peiris‑John RJ, Coggon D, Ntani G,
Sathiakumar N, Wickremasinghe AR. Musculoskeletal pain in
four occupational populations in Sri Lanka. Occup Med (Lond)
;62:269‑72.
Chung YC, Hung CT, Li SF, Lee HM, Wang SG, Chang SC,
et al. Risk of musculoskeletal disorder among Taiwanese
nurses cohort: A nationwide population‑based study. BMC
Musculoskelet Disord 2013;14:144.
Ferreira RC, Griep RH, Fonseca Mde J, Rotenberg L.
A multifactorial approach to sickness absenteeism among nursing
staff. Rev Saude Publica 2012;46:259‑68.
Shafizadeh KR. Prevalence of musculoskeletal disorders among
paramedics working in a large hospital in Ahwaz, southwestern
Iran in 2010. Int J Occup Environ Med 2011;2:157‑65.
Souza AC, Alexandre NM. Musculoskeletal symptoms, work
ability, and disability among nursing personnel. Workplace
Health Saf 2012;60:353‑60.
Abedini R, Choobineh A, Hasanzadeh J. Musculoskeletal load
assessment in hospital nurses with patient transfer activity. Int J
Occup Hyg 2013;5:39‑45.
Choobineh A, Rajaeefard A, Neghab M. Association
between perceived demands and musculoskeletal disorders
among hospital nurses of Shiraz University of Medical
Sciences: A questionnaire survey. Int J Occup Saf Ergon
;12:409‑16.
Attar SM. Frequency and risk factors of musculoskeletal pain
in nurses at a tertiary centre in Jeddah, Saudi Arabia: A cross
sectional study. BMC Res Notes 2014;7:61.
Ferrie JE, Kivimäki M, Head J, Shipley MJ, Vahtera J,
Marmot MG. A comparison of self‑reported sickness
absence with absences recorded in employers’ registers:
Evidence from the Whitehall II study. Occup Environ Med
;62:74‑9.
Karimian R, Rahnama N, Habibi E, Ghasemi GA, Karimian M.
The effect of corrective exercises on musculoskeletal disorders.
Health System Research Fall 2010;6:540‑48.
Alexopoulos EC, Burdorf A, Kalokerinou A. Risk factors for
musculoskeletal disorders among nursing personnel in Greek
hospitals. Int Arch Occup Environ Health 2003;76:289‑94.
Smith DR, Mihashi M, Adachi Y, Koga H, Ishitake T. A detailed
analysis of musculoskeletal disorder risk factors among Japanese
nurses. J Safety Res 2006;37:195‑200.
Aghakhani N, Javad A, Baghaei R, Rahbar N, Khodaei H.
Epidemiological study of back pain among nurses working
in teaching hospitals of Urmia. Fac Nurs Midwifery Kerman
;14:23‑32.
Maul I, Läubli T, Klipstein A, Krueger H. Course of low back
pain among nurses: A longitudinal study across eight years.
Occup Environ Med 2003;60:497‑503.
Whitehead A. Meta‑analysis of controlled clinical trials.
Chichester, England: John Wiley & Sons Inc; 2002. p. 216.
Knottnerus A, Tugwell P. STROBE – A checklist to strengthen
the reporting of observational studies in epidemiology. J Clin
Epidemiol 2008;61:323.
Sutton AJ, Abrams KR, Jones DR, Sheldon TA, Song F. Methods
for Meta‑analysis in Medical Research. Chichester, New York:
John Wiley and Sons; 2000.
Konstantopoulos S, Osborne JW. An introduction to meta‑
analysis. Best practices in quantitative methods. 2008. p. 177‑194.
Habibi E, Taheri MR, Hasanzadeh A. Relationship between
mental workload and musculoskeletal disorders among
Alzahra hospital nurses. Iran J Nurs Midwifery Res 2015‑Feb;
:1‑6.
Barzideh M, Choobineh AR, Tabatabaee HR. Job stress
dimensions and their relationship to musculoskeletal disorders in
Iranian nurses. Work 2014;47:423‑9.
Taheri MR, Habibi E, Hasanzadeh A, Mahdavi Rad M Relative
Stress Index (RSI): Macro‑Ergonomics Risk Assessment of jobs
in textile industry. J Health Syst Res 2014;10:775‑85.
Bahrami N, Hojjati H, Hosseine FH. Relationship between
backache and psychological and psychosocial job factors among
the nurses. Int J Nurs Midwifery 2011;3:86‑91.
Raeisi S, Hosseini M, Attarchi MS, Golabadi M, Rezaei MS,
Namvar M. The association between job type and ward of
service of nursing personnel and prevalence of musculoskeletal
disorders. Razi Journal of Medical Sciences 2013;20:1‑10.
Bahrami A, Akbari H, Namayindeh M, Abdollahi N. survey of
Musculoskeletal disorder health care workers hospitalsin Kashan
at 1385. Trauma Res 2009;12:2‑12.
Mehri EM, Poodineh Z, Kiani F. Survey of Musculoskeletal
disorders among nurses at hospitals releated of University of
Medical Sciences in Zahdan city Eleventh Seminar on Science
and Health; 2011.
Mosadeghrad AM. The relationship between knowledge of
ergonomics and occupational injuries among nurses. Shahrekord
Univ Med Sci 2004;3:2‑21.
Dadarkhah A, Azema K, Abedi M. Prevalence of musculoskeletal
pains among nursing staff in AJA hospitals‑Tehran. Ebnesina
;15:10‑17.
Ramazani BF, Nikbakht A, Mohammadpour A. Low‑back pain
prevalence and its risk factors in nurses. Iranian Journal of
Nursing Research 2006;1:37‑42.
Rahimi A, Ahmadi F, Akhoond MR. An Investigation into
the Prevalence of Vertebral Column Pains among the Nurses
Employed in Hamedan Hospitals, 2004. Razi Journal of Medical
Sciences 2006;13:105‑14.
Mohseni‑Bandpei MA, Fakhri M, Bargheri‑Nesami M,
Ahmad‑Shirvani M, Khalilian AR, Shayesteh‑Azar M. Survey
of risk factors associated with low back pain among nurses in
hospitaals of university of medical seince. Reg Mazandaran
;50:118‑24.
Chobineh A, Tabatabaei SH, Kamalinia M. The level of
knowledge of nurses working in hospitals Shiraz University of
Medical Sciences of the risk factors for low back pain. Health
Saf Work 2012;3‑3‑55:62.
Habibi E, Pourabdian S, Kianpour AA, Hosseini SM. Evaluation of work‑related psychosocial and ergonomics factors in relation
to low back discomfort in emergency unit nurses. Health System
Research Winter 2011;6:752‑61.
Kafaie S, Sarchahi K, Poor SA, Kazemi M. Prevalence of
herniated lumbar disk among nurses working in two educational
hospitals of Birjand University of Medical Sciences. Modern
Care Journal 2010;7:25‑9.
Eftekhar Sadat B, Babaei A, Amidfar N, Jedari Eslami MR.
Prevalence and risk factors for low back pain in nursing staffs
of Tabriz hospitals in 1387. J Urmia Nurs Midwifery Fac
;11:12‑20.
Habibzade H, Motearefi H, Jafarizade H, Airemlo A, Lak Kh
Ebadi R, et al. Study of lowback pain prevalence in nurses
who work in khoy hospitals in 1386. Journal of Nursing and
Midwifery Urmia University of Medical Sciences 2008;6:11‑25.
Choobineh A, Movahed M, Tabatabaie SH, Kumashiro M.
Perceived demands and musculoskeletal disorders in operating
room nurses of Shiraz city hospitals. Ind Health 2010;48:74‑84.
Zakerian SA, Monazzam MR, Dehghan SF, Mohraz MH,
Safari H, Asghari M. Relationship between knowledge of
ergonomics and workplace conditions with musculoskeletal
disorders among nurses: A questionnaire survey. World Appl Sci
J 2013;24:227‑33.
Pahlevan D, Azizzadeh M, Esmaili A, Ghorbani R,
Mirmohammadkhani M. Association of musculoskeletal
complaints with psychosocial factors among nurses in Semnan
hospitals. Middle East J Rehabil Health 2014;1(1).
Madani M, Masoudi Alavi N, Taghizadeh M. Non‑specific
musculoskeletal pain and Vitamin D deficiency in female nurses
in Kashan, Iran. J Musculoskelet Pain 2014;22:268‑74.
Attarchi M, Raeisi S, Namvar M, Golabadi M.
Association between shift working and musculoskeletal
symptoms among nursing personnel. Iran J Nurs Midwifery
Res 2014;19:309‑14.
Juibari L, Sanagu A, Farrokhi N. The relationship between
knowledge of ergonomic science and the occupational health
among nursing staff affiliated to Golestan University of Medical
Sciences. Iran J Nurs Midwifery Res 2010;15:185‑9.
Barkhordari A, Halvani G, Barkhordari M. The prevalence of
low back pain among nurses in Yazd, Southeast Iran. Int J Occup
Hyg 2013;5:19‑21.
Raeisi S, Namvar M, Golabadi M, Attarchi M. Combined
effects of physical demands and shift working on low back
disorders among nursing personnel. Int J Occup Saf Ergon
;20:159‑66.
Sharafkhani N, Khorsandi M, Shamsi M, Ranjbaran M. Low
back pain preventive behaviors among nurses based on the
health belief model constructs. SAGE Open 2014;4:1‑7.
Golabadi M, Attarachi M, Raeisi S, Namvar M. Effects of
psychosocial strain on back symptoms in Tehran general
hospital nursing personnel. Archives of Industrial Hygiene and
Toxicology 2013;64:505‑12.
Mohseni‑Bandpei MA, Fakhri M, Bagheri‑Nesami M,
Ahmad‑Shirvani M, Khalilian AR, Shayesteh‑Azar M.
Occupational back pain in Iranian nurses: An epidemiological
study. Br J Nurs 2006;15:914‑7.
Rezaee M, Ghasemi M. Prevalence of low back pain among
nurses: Predisposing factors and role of work place violence.
Trauma Mon 2014;19:e17926.
Imanzad M, Gharlipour Z, Kohpaie A, Mohebi S,
Arsang Gang S, Sayyarpour M, et al. Behavioral factors
related to musculoskeletal disorders in nurses based on theory
of planned behavior. J Shahid Beheshti Sch Nurs Midwifery
;23:5682.
Arsalani N, Fallahi‑Khoshknab M, Josephson M, Lagerström M.
Musculoskeletal disorders and working conditions among iranian
nursing personnel. Int J Occup Saf Ergon 2014;20:671‑80.
Nikpour S, Nooritajer M, Haghani H, Ravandi A. Musculoskeletal
disorders among nurses in teaching hospitals affiliated to Iran
university of medical sciences and health services. Iran J Nurs
;22:8‑18.
Mehrdad R, Dennerlein JT, Haghighat M, Aminian O.
Association between psychosocial factors and musculoskeletal
symptoms among Iranian nurses. Am J Ind Med 2010;53:1032‑9.
Mirmohammadi S, Yazdani‑Charati J. Prevalence of
work‑related musculoskeletal disorders and associated risk
factors among nurses in a public hospital. Iran J Health Sci
;2:55‑61.
Saremi M, Khayati F, editors. Evaluation of Ergonomic
Risk of Manual Handling of Patients with MAPO Index and
its Relationship with Incidence of Low Back Pain among
Nurses. Advanced Engineering Forum. Vol. 10. Switzerland:
Trans Tech Publ.; 2013. p. 257‑62.
Faraz R, Kalroozi F, Pishgooie A, Taheriyan A, Lak M.
Prevalence of spinal pain (upper and lower) and its related
factors in Nurses of AJA. Milit Caring Sci 2014;1:36‑42.
Lorusso A, Bruno S, L’Abbate N. A review of low back pain and
musculoskeletal disorders among Italian nursing personnel. Ind
Health 2007;45:637‑44.
Carugno M, Pesatori AC, Ferrario MM, Ferrari AL, Silva FJ,
Martins AC, et al. Physical and psychosocial risk factors for
musculoskeletal disorders in Brazilian and Italian nurses. Cad
Saude Publica 2012;28:1632‑42.
Freimann T, Coggon D, Merisalu E, Animägi L, Pääsuke M. Risk
factors for musculoskeletal pain amongst nurses in Estonia: A
cross‑sectional study. BMC Musculoskelet Disord 2013 1;14:334.
Louw QA, Morris LD, Grimmer‑Somers K. The prevalence
of low back pain in Africa: A systematic review. BMC
Musculoskelet Disord 2007;8:105.
Bernal D, Campos‑Serna J, Tobias A, Vargas‑Prada S,
Benavides FG, Serra C. Work‑related psychosocial risk factors
and musculoskeletal disorders in hospital nurses and nursing
aides: A systematic review and meta‑analysis. Int J Nurs Stud
;52:635‑48.
Long MH, Bogossian FE, Johnston V. The prevalence of
work‑related neck, shoulder, and upper back musculoskeletal
disorders among midwives, nurses, and physicians: A systematic
review. Workplace Health Saf 2013;61:223‑9.
Schluter PJ, Dawson AP, Turner C. Pain‑related psychological
cognitions and behaviours associated with sick leave due to neck
pain: Findings from the Nurses and Midwives e‑Cohort Study.
BMC Nurs 2014;13:5.
Jensen RC. Back injuries among nursing personnel related to
exposure. Appl Occup Environ Hyg 1990;5:38‑45.
Smedley J, Egger P, Cooper C, Coggon D. Manual handling
activities and risk of low back pain in nurses. Occup Environ
Med 1995;52:160‑3.
Hoe VC, Kelsall HL, Urquhart DM, Sim MR. Risk factors for
musculoskeletal symptoms of the neck or shoulder alone or
neck and shoulder among hospital nurses. Occup Environ Med
;69:198‑204.
Oude Hengel KM, Visser B, Sluiter JK. The prevalence
and incidence of musculoskeletal symptoms among hospital
physicians: A systematic review. Int Arch Occup Environ Health
;84:115‑9.
Devereux JJ, Vlachonikolis IG, Buckle PW. Epidemiological
study to investigate potential interaction between physical
and psychosocial factors at work that may increase the risk of symptoms of musculoskeletal disorder of the neck and upper
limb. Occup Environ Med 2002;59:269‑77.
Waters TR. When is it safe to manually lift a patient? Am J Nurs
;107:53‑8.
Fredriksson K, Alfredsson L, Köster M, Thorbjörnsson CB,
Toomingas A, Torgén M, et al. Risk factors for neck and upper
limb disorders: Results from 24 years of follow up. Occup
Environ Med 1999;56:59‑66.
Raeisi S, Hosseini M, Attarchi MS, Golabadi M, Rezaei MS,
Namvar M. The association between job type and ward of
service of nursing personnel and prevalence of musculoskeletal
disorders. Razi J Med Sci 2013;20:1‑10.
Reed LF, Battistutta D, Young J, Newman B. Prevalence and risk
factors for foot and ankle musculoskeletal disorders experienced
by nurses. BMC Musculoskelet Disord 2014;15:196.
Menz HB, Jordan KP, Roddy E, Croft PR. Musculoskeletal
foot problems in primary care: What influences older people to
consult? Rheumatology (Oxford) 2010;49:2109‑16.
Menz HB, Jordan KP, Roddy E, Croft PR. Characteristics
of primary care consultations for musculoskeletal foot
and ankle problems in the UK. Rheumatology (Oxford)
;49:1391‑8.
Dargahi H, Saraji J, Sadr J, Sadri G. Ergonomics in Dentistry.
Journal of Dental Medicine 2009;22:199‑207.