Abstract:

Objective To evaluate the prevalence and distribution characteristics of work-related musculoskeletal disorders (WMSDs) among bus drivers in Fuzhou and to explore the influencing factors across multiple dimensions, including individual behaviors, work organization, and ergonomic environment.

Methods A cross-sectional survey was conducted from August 2024 to May 2025, targeting actively employed bus drivers from 14 directly operated fleets of the Fuzhou Public Transport Group. The participants voluntarily completed the questionnaire via QR code scanning. A total of 1 808 questionnaires were distributed and 1 640 valid ones were returned, with an effective response rate of 90.71%. The questionnaire was adapted from the Musculoskeletal Disorders Questionnaire compiled by the National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention. The information on demographic characteristics, individual behavioral habits, work organization factors, and ergonomic environment was collected. A Chi-square test and multivariate logistic regression model were used to analyze the association between various factors and WMSDs.

Results The overall prevalence of WMSDs was 31.3% (513/1 640). The three most commonly affected body parts were lower back (19.6%), neck (18.7%), and shoulder (14.6%), with 20.6% (338/1 640) of the drivers reporting multisite involvement. Multivariate analysis showed that, compared with those without prolonged head-down smartphone use, those who had it significantly increased the risks of drivers’WMSDs in the lower back (OR=1.749), neck (OR=2.439), and shoulder (OR=2.220). Compared with those with upright driving posture, drivers with forward-leaning driving posture had elevated risks of WMSDs in the lower back (OR=1.832) and neck (OR=1.502). Compared with those with driving experience ≤ 5 years, drivers with ≥ 21 years of driving experience had elevated risks of WMSDs in the neck (OR=1.908) and shoulder (OR=2.612). Compared with those who never felt nervous while driving, drivers who often felt nervous had elevated risks of WMSDs in the lower back (OR=2.986) and shoulder (OR=2.256). Compared with those with uncomfortable seats, drivers with comfortable seats had lower risks of WMSDs in the lower back (OR=0.258), neck (OR= 0.246), and shoulder (OR=0.268). Compared with those with insufficient rest time, drivers with adequate rest time had lower risks of WMSDs in the lower back (OR=0.681) and shoulder (OR=0.611). Compared with those who never exercised, drivers who exercised regularly (≥3 times/week) had a lower risk of shoulder WMSDs (OR=0.600). The above differences were all statistically significant (P<0.05).

Conclusions The incidence of WMSDs among bus drivers in Fuzhou was relatively high, and its occurrence was closely associated with unhealthy living habits, long-term occupational exposure, and poor ergonomic environment. It is recommended to adopt a comprehensive intervention strategy centered on improving the ergonomic design of vehicles, standardizing work-rest management, and strengthening health behavior education.