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Prevalence and Risk Factors of Work-Related Musculoskeletal Disorders Among Dockworkers: The Role of Psychosocial Stress and Physical Demands in an Iranian Port

Health Sci Rep. 2026 Mar 8;9(3):e71840. doi: 10.1002/hsr2.71840. eCollection 2026 Mar.

ABSTRACT

BACKGROUND AND AIM: With the development of trade between countries, the transportation of goods has increased, and ports struggle to accommodate the demands of unloading and loading operations. Seaport workers may experience work-related musculoskeletal disorders (WMSDs), which in many cases result in disabilities. Few studies have investigated the prevalence of work-related musculoskeletal disorders (WMSDs) and associated psychological factors among dock workers in Iran. Existing findings indicate a high prevalence of WMSDs in these settings, primarily attributed to adverse working conditions such as repetitive movements, awkward postures, heavy lifting, and excessive physical strain. Moreover, there is a scarcity of research examining the impact of psychological factors on musculoskeletal disorders within this occupational group. This study investigated the relationship between work-related psychological factors and job characteristics and WMSDs at the Port of Shahid Rajaee in Bandar Abbas, Iran, from December 2023 to April 2024.

METHODS: In this cross-sectional study, all 351 dock workers were enrolled as research subjects. Dock workers in our study encompassed four distinct occupational roles with different physical and postural demands, including Trans Trainer Operators, Gantry Crane Operators, Tractor Drivers, and warehouse workers. To collect data, the Job Content Questionnaire (JCQ) and the Nordic Musculoskeletal Questionnaire (NMQ) were used. The sampling method used in this study was a census approach, encompassing all eligible workers at Sina port and Marine Service Development Company. Statistical analyses included descriptive statistics, independent t-tests, Pearson’s correlation coefficients, and one-way analysis of variance (ANOVA).

RESULTS: The NMQ scores across the four groups were highest for the neck, shoulder, and upper back regions, with a mean score of 38.02, and lowest for the upper limb region, with a mean score of 10.40. Trans trainer and gantry crane operators and warehouse workers had significantly higher WMSDs in neck, shoulder, and upper back than tractor drivers (p < 0.001). Additionally, NMQ scores for the lower back were significantly correlated with the job type (p < 0.001), with warehouse workers having the highest MSD scores (22.85). Higher psychological job demands and psychosocial and physical stress were associated with more severe WMSDs for the workers. In addition, type of the job, age, work experience, marital status, and high job insecurity were significant factors influencing WMSDs.

CONCLUSION: Work-related psychosocial factors play an important role in the development of work-related musculoskeletal disorders (WMSDs) among port workers. To mitigate these risks, it is essential to address psychological stress and job demands. Additionally, improving communication between port workers and management may contribute to a healthier and more supportive work environment.

PMID:41804502 | PMC:PMC12967559 | DOI:10.1002/hsr2.71840

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