CROSS-SECTIONAL SURVEY OF MUSCULOSKELETAL DISORDERS PREVALENCE AND VIBRATION RISKS IN SWAT AUTO RICKSHAW DRIVERS, PAKISTAN

Abstract

Background Musculoskeletal disorders (MSDs) represent a critical occupational health concern for professional drivers, intensified by risk factors including vehicle vibration, postural stress, and confined workspaces. In Swat, Pakistan, auto rickshaw drivers encounter distinctive challenges from poor road conditions, overloading practices, and suboptimal ergonomic vehicle designs. This cross-sectional survey aimed to assess the 12-month MSD prevalence among these drivers and examine associations with rickshaw-specific risk factors such as vehicle vibration and workspace envelope. Methods Conducted from January to April 2023, the study surveyed 300 licensed auto rickshaw drivers in Swat via cluster sampling. Eligibility required at least one year of driving experience and Swat domicile, excluding those with pre-existing deformities or invalid licenses. MSD prevalence was evaluated using the Pashto-translated Nordic Musculoskeletal Questionnaire (NMSQ) targeting neck, shoulders, wrists, low back, knees, and lower legs. Objective risk factor measurements included vehicle vibration via a validated Android vibrometer app and workspace envelope (shoulder-to-handle distance and lower cabin space) using an inch tape. Analyses in SPSS v22 encompassed descriptive statistics, chi-square tests, and adjusted logistic regression (controlling for age, experience, and working hours) to derive odds ratios (ORs) with 95% confidence intervals (CIs); significance was set at p<0.05. Results All male participants averaged 45.2±9.5 years of age, 15.8±6.3 years of experience, and 55.4±8.7 weekly working hours. High 12-month MSD prevalence included neck (85%), right shoulder (75%), low back (70%), right wrist (70%), right knee (68%), and right lower leg (55%), with notable work interference (65%, 50%, 45%, 40%, 40%, and 35%, respectively). Vehicle vibration correlated with neck discomfort (OR 2.1, 95% CI: 1.5–3.2, p<0.01) and low back discomfort (OR 1.9, 95% CI: 1.3–2.7, p<0.01). Reduced cabin space associated with low back discomfort (OR 1.8, 95% CI: 1.2–2.8, p<0.05) and right knee discomfort (OR 1.6, 95% CI: 1.1–2.4, p<0.05). Conclusions Auto rickshaw drivers in Swat experience substantial MSD burdens, predominantly in the neck, shoulder, and low back, attributable to vehicle vibration and cramped cabin spaces. These results emphasize the necessity for ergonomic interventions, including enhanced vehicle design and road infrastructure improvements, to bolster occupational health in this at-risk population. Longitudinal studies are advised to confirm causality