Associations between physical or psychosocial risk factors and work-related musculoskeletal disorders in construction workers based on literature in the last 20 years: A systematic review

A study by Anwer et al. (2021) systematically reviewed 20 years of literature to explore how physical and psychosocial risk factors are associated with work-related musculoskeletal disorders (WRMSDs) in construction workers. The review included 20 studies involving nearly 195,000 participants across 11 countries. The study investigated WRMSDs, which are injuries or disorders affecting muscles, joints, tendons, or nerves, often caused or aggravated by workplace activities. It examined both:

1. physical risk factors: awkward postures, heavy lifting, prolonged standing, repetitive movements, squatting, manual handling

2. psychosocial risk factors: high job demands, mental stress, job insecurity.

The Main Concerns Identified

Prevalence:

1. 12-month WRMSD prevalence ranged from 25% to 96% across studies

2. Low back pain was the most common complaint, followed by shoulder, neck, knee, and wrist/hand pain

3. High costs and absenteeism linked to WRMSDs (e.g., US$400+ million in annual compensation in the U.S. construction sector)

Physical Risk Factors

1. Awkward postures (e.g., twisting, bending): 2.4 times more likely* (see explanation below)

2. Manual material handling (MMH): 2.2 times more likely

3. Prolonged static work: 4 times more likely

4. Overhead work: 3.1 times more likely

5. Vibration exposure: 3.2 times more likely

6. Repetitive tasks: 3.3 times more likely (very limited evidence)

Psychosocial Risk Factors

1. High job demands: 1.6 times more likely (strong evidence)

2. Mental stress: 1.8 times more likely (strong evidence)

3. Low job satisfaction: 1.5 times more likely (moderate evidence)

4. Low job control / job insecurity: about 1.4 times more likely (very limited evidence)

How to Interpret These Figures "Times more likely" shows how much a risk factor increases the chance of harm compared to not having that exposure.

1. 1 = no difference

2. More than 1 = increased risk

Example: Workers doing prolonged static work were 4 times more likely to report musculoskeletal disorders than those who weren't.

Proposed Solutions To reduce WRMSDs in construction workers, the review recommends:

1. Engineering controls: redesign tools and tasks to minimise awkward postures and heavy lifting

2. Ergonomic assessments: use validated tools like REBA, RULA, or OWAS to evaluate risk

3. Psychosocial interventions: manage workload, provide support, address stress and satisfaction

4. Use of wearable sensors: enable real-time monitoring of posture and workload

5. Trade-specific analysis: tailor prevention strategies to specific construction roles

Why This Matters The findings highlight that WRMSDs in construction are not just a result of physical strain—they are also shaped by how work is organised, how much control workers feel, and the stressors they face on the job. Current prevention efforts often ignore these psychosocial dimensions. A systems approach that combines physical ergonomics and psychosocial risk management is essential for long-term injury prevention.

Citation: Anwer, S., Li, H., Antwi-Afari, M. F., & Wong, A. Y. L. (2021). Associations between physical or psychosocial risk factors and work-related musculoskeletal disorders in construction workers based on literature in the last 20 years: A systematic review. International Journal of Industrial Ergonomics, 83, 103113. https://doi.org/10.1016/j.ergon.2021.103113