Type of Article:  Original Research

Volume 9; Issue 3 (June 2021)

Page No.: 3817-3824

DOI: https://dx.doi.org/10.16965/ijpr.2021.120

Work-related risk associated with musculoskeletal disorders amongst flower farm workers in Kenya

J. M. Munala *1, B. Olivier 2.

*1 Department of Physiotherapy, Faculty of Rehabilitative Sciences, Kenya Medical Training College, Nairobi, Kenya.

2 Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Pretoria, South Africa.

Corresponding Author: J. M. Munala, Department of Physiotherapy, Faculty of Rehabilitative Sciences, Kenya Medical Training College, Nairobi, Kenya. E-Mail: jothampt@gmail.com


Background: Work-related musculoskeletal disorders (WRMSDs) are a public concern to social-care and health systems, as well as individuals. Globally, WRMSDs are classified as one of the prevalent causes of disability.

Objectives: The primary objective of this study was to determine work-related risk associated with musculoskeletal disorders amongst flower farm workers. The secondary objective was to determine the relationship between WRMSD risk over the previous 12 months and socio-demographic characteristics.

Method: A cross-sectional descriptive study was conducted. A sample of 270 participants was drawn from 897 farm workers, of which 184 presented with WRMSD as assessed using the Nordic Musculoskeletal Questionnaire. Quantitative data were collected using the Rapid Entire Body Assessment questionnaire. Inferential statistics were analyzed using the Pearson’s chi-squared test (X2) test and based on an alpha level of p< 0.05. Descriptive statistics were presented using frequencies and percentages.

Results: Respondents who reported medium risk were 49 (26.6%), 80 (43.5%) reported high risk while 55 (29.9%) reported very high risk. There was no relationship between WRMSD risk and socio-demographic characteristics.

Conclusions: Flower farm workers in Kenya were found to be at risk of sustaining WRMSDs although socio-demographic factors did not play a role in the level of risk.

Clinical Implications: The high prevalence of WRMSDs necessitates policy reform in the flower farm industry. Furthermore, the timely identification of potential disorders and the associated risk factors is necessary to ensure early intervention.

Keywords: Work-related risk, Work-related musculoskeletal disorders, Farmworkers.


[1]. Benos L, Tsaopoulos D, Bochtis D. A review on ergonomics in agriculture. Part I: Manual operations. Applied Sciences (Switzerland). 2020.
[2]. Nunes IL, Bush PM. Work-Related Musculoskeletal Disorders Assessment and Prevention. Ergon Syst Approach. 2011;1–31.
[3]. Vedovato TG, Monteiro I. Health Conditions and Factors Related to the Work Ability of Teachers. Ind Health. 2014;52(2):121–8.
[4]. Riccò M, Cattani S, Gualerzi G, Signorelli C. Work with visual display units and musculoskeletal disorders: A cross-sectional study. Med Pr. 2016;67(6):707–19.
[5]. Ganiyu S, Muhammad I, Olabode J, Stanley M. Patterns of occurrence of work-related musculoskeletal disorders and its correlation with ergonomic hazards among health care professionals. Niger J Exp Clin Biosci [Internet]. 2015;3(1):18. Available from: http://www.njecbonline.org/text.asp?2015/3/1/18/158153
[6]. Azim F. The prevalence of musculoskeletal disorders among madrassa teachers and students-a cross-sectional study. Int J Physiother. 2016;3(31):100–5.
[7]. Shafti A, Lazpita BU, Elhage O, Wurdemann HA, Althoefer K. Analysis of comfort and ergonomics for clinical work environments. In: Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS. 2016. p. 1894–7.
[8]. Fathallah FA, Miller BJ, Miles JA. Low back disorders in agriculture and the role of stooped work: Scope, potential interventions, and research needs. Journal of Agricultural Safety and Health. 2008.
[9]. Darwish MA, Al-Zuhair SZ. Musculoskeletal pain disorders among secondary school Saudi female teachers. Pain Res Treat. 2013;2013.
[10]. National statistics. Work-related Musculoskeletal Disorder Statistics, Great Britain 2016. Heal Saf Exec. 2016,
[11]. Zoer I, Frings-Dresen MHW, Sluiter JK. Are musculoskeletal complaints, related work impairment and desirable adjustments in work age-specific? Int Arch Occup Environ Health. 2014;87(6):647–54.
[12]. Buckle P, Devereux J. Work-related neck and upper limb musculoskeletal disorders. Appl Ergon [Internet]. 2002;33:207–17. Available from: http://scholar.google.com/scholar?cluster=5878916485553067887&hl=en#0
[13]. Nunes IL. FAST ERGO-X – A tool for ergonomic auditing and work-related musculoskeletal disorders prevention. Work. 2009;34(2):133–48.
[14]. Ekpenyong CE, Inyang UC. Associations between worker characteristics, workplace factors, and work-related musculoskeletal disorders: A cross-sectional study of male construction workers in Nigeria. Int J Occup Saf Ergon. 2014;20(3):447–62.
[15]. Costa BR, Vieira ER. Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal studies. Vol. 53, American Journal of Industrial Medicine. 2010. p. 285–323.
[16]. Wang J, Cui Y, He L, Xu X, Yuan Z, Jin X, et al. Work-related musculoskeletal disorders and risk factors among Chinese medical staff of obstetrics and gynecology. Int J Environ Res Public Health. 2017;14(6):1–13.
[17]. Pastre EC, Carvalho Filho G, Pastre CM, Padovani CR, Almeida JS De, Netto Jr J. Work-related musculoskeletal complaints by women in a social rehabilitation center. Cad saude publica / Minist da Saude, Fund Oswaldo Cruz, Esc Nac Saude Publica. 2007;23(11):2605–12.
[18]. Alghadir A, Zafar H, Iqbal ZA. Work-related musculoskeletal disorders among dental professionals in Saudi Arabia. J Phys Ther Sci [Internet]. 2015;27(4):1107–12. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4433988&tool=pmcentrez&rendertype=abstract
[19]. Tinubu BMS, Mbada CE, Oyeyemi AL, Fabunmi AA. Work-related musculoskeletal disorders among nurses in Ibadan, South-west Nigeria: a cross-sectional survey. BMC Musculoskelet Disord [Internet]. 2010;11(1):12. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2823665&tool=pmcentrez&rendertype=abstract%255Cnhttp://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-11-12
[20]. Shuai J, Yue P, Li L, Liu F, Wang S. Assessing the effects of an educational program for the prevention of work-related musculoskeletal disorders among school teachers. BMC Public Health. 2014;
[21]. Tebyetekerwa M, Akankwasa NT, Marriam I. The Current Working Conditions in Ugandan Apparel Assembly Plants. Saf Health Work. 2017;8(4):378–85.
[22]. Fathallah FA. Musculoskeletal disorders in labor-intensive agriculture. Appl Ergon. 2010;41(6):738–43.
[23]. Abdalla S, Apramian SS, Cantley LF, Cullen MR. Occupation and risk for injuries. In: Injury Prevention and Environmental Health. 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Oct 27. Chapter 6.
[24]. Osborne A, Blake C, Meredith D, Kinsella A, Phelan J, Mcnamara J, et al. Work-related musculoskeletal disorders among Irish farm operators. Am J Ind Med. 2013;56(2):235–42.
[25]. Cochran WG. Sampling techniques. Vol. 20, Wiley publisher. 1977. 448 pages.
[26]. Crawford JO. The Nordic Musculoskeletal Questionnaire. Occup Med (Chic Ill) [Internet]. 2007;57(4):300–1. Available from: https://academic.oup.com/occmed/article-lookup/doi/10.1093/occmed/kqm036
[27]. Middlesworth M. A Step-by-Step Guide to the REBA Assessment Tool. Dipetik Mei. 2015;17.
[28]. Moradi M, Poursadeghiyan M, Khammar A, Hami M, Darsnj A, Yarmohammadi H. REBA method for the ergonomic risk assessment of auto mechanics postural stress caused by working conditions in Kermanshah (Iran). Ann Trop Med Public Heal. 2017.
[29]. Hignett S, McAtamney L. Rapid Entire Body Assessment (REBA). Vol. 31, Applied Ergonomics. 2000. p. 201–5.
[30]. Kaewdok T, Sirisawasd S, Taptagaporn S. Agricultural risk factors related musculoskeletal disorders among older farmers in Pathum Thani Province, Thailand. Journal of agromedicine. 2020 Jul 18:1-8.
[31]. Das B, Ghosh T, Gangopadhyay S. Assessment of ergonomic and occupational health-related problems among female prawn seed collectors of sunderbans, West Bengal, India. Int J Occup Saf Ergon. 2012.
[32]. Ojha P, Kwatra S. An ergonomic study on the assessment of work related musculoskeletal disorder risks among agriculture workers of Uttarakhand, India. Int J Sci Eng Res. 2014;5(1):188–91.
[33]. Taghavi SM, Mokarami H, Ahmadi O, Stallones L, Abbaspour A, Marioryad H. Risk factors for developing work-related musculoskeletal disorders during dairy farming. Int J Occup Environ Med. 2017
[34]. Choi SD, Brings K. Work-related musculoskeletal risks associated with nurses and nursing assistants handling overweight and obese patients: A literature review. Work [Internet]. 2016;53:439–48. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26835850
[35]. Oakman J, Chan S. Risk management: Where should we target strategies to reduce work-related musculoskeletal disorders? Saf Sci. 2015;73:99–105.
[36]. Mahdavi S, Mahdavi M, Safary M, Rashidi R, Dehghani T, Kosari M. Evaluation of the risk of musculoskeletal disorders using Rapid Entire Body Assessment among hairdressers in Khorramabad, Iran, in 2014. J Occup Heal Epidemiol. 2013.
[37]. Okunribido OO, Wynn T, Lewis D. Are older workers at greater risk of musculoskeletal disorders in the workplace than young workers? – A literature review. Occupational Ergonomics. 2011.

Cite this article: Munala J. M, Olivier B.  Work-related risk associated with musculoskeletal disorders amongst flower farm workers in Kenya. Int J Physiother Res 2021;9(3):3817-3824. DOI: 10.16965/ijpr.2021.120