Global prevalence and associated risk factors of work-related musculoskeletal disorders among steelworkers: a systematic review and meta-analysis

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Background: The prevalence of work-related musculoskeletal disorders (WMSDs) among steelworkers is high due to occupational exposures including high temperatures, vibrating tools, and intense physical loads. Given the varying prevalence estimates and associated risk factors of WMSDs among existing studies and the lack of a meta-analysis dedicated specifically to steelworkers, this meta-analysis aimed to comprehensively evaluate the prevalence of and risk factors associated with WMSDs among steelworkers. Methods: A systematic literature search of the PubMed, Web of Science, Embase, Scopus, Ovid Medline, Wanfang Data, VIP Database, China National Knowledge Infrastructure, and China Biomedical Literature Service System (SinoMed) databases for published studies reporting the prevalence of and factors associated with WMSDs among steelworkers was performed. Two reviewers independently screened citations, extracted information, and performed quality assessment of the included studies. Results: Analysis of 35 studies comprising 38,774 participants revealed an annual prevalence of WMSDs of 69.2% (95% CI 56.7%-81.7%) among steelworkers. Subgroup analysis revealed a yearly prevalence rate of WMSDs in Asian nations of 72.1% (95% CI 53.3%-91.0%), which was greater than that for non-Asian countries. The annual prevalence rates reported for 2011-2025 differed significantly from those for 2000-2010 [78.0% (95% CI 67.1%-88.8%) vs. 55.5% (95% CI 40.3%-70.7%), respectively], with lower back injury accounting for the highest annual prevalence [57.2% (95% CI 50.0%-64.5%)], followed by the shoulders and neck [44.7% (95% CI 29.4%-60.0%) and 42.1% (95% CI 27.8%-56.4%), respectively]. At most anatomical sites, except the elbow and hip/leg, the 12-month prevalence was higher than the 7-day prevalence. Risk factors for WMSDs among steelworkers included age ≥30 years, smoking, psychosocial vulnerability, night-shift work, prolonged working hours, use of vibrating tools, lifting heavy loads, low education, high-risk jobs, and poor posture. Scheduled rest breaks were a protective factor. Conclusion: Steelworkers exhibited a substantial annual prevalence of WMSDs (69.2%), predominantly affecting the lower back, neck, shoulders, and knees. Prioritized implementation of integrated interventions is critical for ergonomic tool optimization, mechanical lifting assistance, targeted health training programs, and systematic high-risk group surveillance to reduce disease burden and safeguard worker wellbeing. Systematic review registration: [https://www.crd.york.ac.uk/prospero], identifier [CRD420251065458].

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