Relations between occupational, psychosocial and individual factors and three different categories of back disorder among supermarket workers

  • Francesco S. Violante
  • Francesca Graziosi
  • Roberta Bonfiglioli
  • Stefania Curti
  • Stefano Mattioli
Original Article


Objectives: Up-to-date store-wide studies regarding low back pain (LBP) among supermarket/hypermarket workers are lacking. We investigated 12-month store-wide prevalence of different categories of LBP and possible associated biomechanical, individual/psychosocial risk factors across a large supermarket/hypermarket chain. Methods: We performed a cross-sectional study of 3,702 subjects working in a group of small/medium-sized supermarkets (n=100) and large hypermarkets (n=7) belonging to a single chain in central-northern Italy applying established ergonomics/job-satisfaction policies. Data regarding the various departments were collected by a medical check-list, physical examination and questionnaire—all conducted by qualified physicians—and were analyzed in relation to a comprehensive biomechanical risk analysis. Results: The overall 12-month prevalence of LBP in our sample (with a 82% response rate) was 34.5% (36.6% for females and 30.7% for males), with few differences being found between supermarkets and hypermarkets. Different types of LBP showed significant associations with stress-related psychosomatic symptoms, but not with job satisfaction (which was high). Conclusions: These encouraging data provide relevant information regarding workers operating in supermarkets/hypermarkets with an active commitment to ergonomic and job-satisfaction policies.


Low back pain Grocery stores Psychological stress Job satisfaction Ergonomic policy 


  1. Armstrong TJ (2000) Analysis and design of jobs for Control of Work Related Musculoskeletal Disorders (WMSDs). In: Violante FS, Armstrong T, Kilbom Å (eds) Occupational Ergonomics: work related musculoskeletal disorders of the upper limb and back. Taylor & Francis, London, pp 51–81Google Scholar
  2. Barnhart S, Rosenstock L (1987) Carpal tunnel syndrome in grocery checkers. A cluster of a work-related illness. West J Med 147:37–40PubMedGoogle Scholar
  3. Baron SL, Habes D (1992) Occupational musculoskeletal disorders among supermarket cashiers. Scand J Work Environ Health 18(suppl 2):127–129PubMedGoogle Scholar
  4. D’Agostino RB, Balanger A, D’Agostino RB Jr (1990) A suggestion for using powerful and informative tests of normality. Am Stat 44:316–321CrossRefGoogle Scholar
  5. Feyer AM, Herbison P, Willianson AM, de Silva I, Mandryk J, Hendrie L, et al (2000) The role of physical and psychological factors in occupational low back pain: a prospective cohort study. Occup Environ Med 57:116–120CrossRefPubMedGoogle Scholar
  6. Frisch H (1994) Systematic musculoskeletal examination Including manual medicine diagnostic techniques. Springer, Berlin Heidelberg New YorkGoogle Scholar
  7. Grant KA, Habes DJ (1995) An analysis of scanning postures among grocery cashiers and its relationship to checkstand design. Ergonomics 38:2078–2090PubMedCrossRefGoogle Scholar
  8. Harber P, Bloswick D, Beck J, Pena L, Baker D, Lee J (1993) Supermarket checker motions and cumulative trauma risk. J Occup Med 35(8):805–811PubMedCrossRefGoogle Scholar
  9. Hartvigsen J, Bakketeig L, Leboeuf-Yde C, Engberg M, Lauritzen T (2001) The association between physical workload and low back pain clouded by the “healthy worker” effect. Spine 26:1788–1793CrossRefPubMedGoogle Scholar
  10. Hartvigsen J, Lings S, Leboeuf-Yde C, Bakketeig L (2004) Psychosocial factors at work in relation to low back pain and consequences of low back pain; a systematic, critical review of prospective cohort studies. Occup Environ Med 61:e2PubMedGoogle Scholar
  11. Hillman M, Wright A, Rajaratnam G, Tennant A, Chamberlain MA (1996) Prevalence of low back pain in the community: implications for service provision in Bradford, UK. J Epidemiol Community Health 50:347–352PubMedCrossRefGoogle Scholar
  12. Hinnen U, Laubli T, Guggenbuhl U, Krueger H (1992) Design of check-out systems including laser scanners for sitting work posture. Scand J Work Environ Health 18:186–194PubMedGoogle Scholar
  13. Hoogendoorn WE, Van Poppel MNM, Bongers PM, Koes BW, Bouter LM (2000) Systematic review of psychosocial factors at work and private life as risk factors for back pain. Spine 25:2114–2125CrossRefPubMedGoogle Scholar
  14. Hoogendoorn WE, Bongers PM, de Vet HCW, Houtman ILD, Ariëns GAM, van Mechelen W, et al (2001) Psychosocial work characteristics and psychological strain in relation to low back pain. Scand J Work Environ Health 27:258–267PubMedGoogle Scholar
  15. Hosmer DW, Lemeshow S (1989) Applied logistic regression. Wiley, New YorkGoogle Scholar
  16. Karasek RA (1979) Job demands, job decision latitude, and mental strain: implications for job redesign. Admin Sci Q 24:285–308CrossRefGoogle Scholar
  17. Karasek RA, Theorell T (1990) Healthy work: stress productivity, and the reconstruction of working life. Basic, New YorkGoogle Scholar
  18. Lannersten L, Harms-Ringdahl K (1990) Neck and shoulder muscle activity during work with different cash register systems. Ergonomics 33:49–65PubMedCrossRefGoogle Scholar
  19. Lehman KR, Psihogios JP, Meulenbroek RG (2001) Effects of sitting versus standing and scanner type on cashiers. Ergonomics 44:719–38PubMedCrossRefGoogle Scholar
  20. Margolis W, Kraus JF (1987) The prevalence of carpal tunnel syndrome symptoms in female supermarket checkers. J Occup Med 29:953–956PubMedGoogle Scholar
  21. Mital A, Nicholson AS, Ayoub MM (1993) A guide to manual material handling. Taylor & Francis, LondonGoogle Scholar
  22. Morgenstern H, Kelsh M, Kraus J, Margolis W (1991) A cross-sectional study of hand/wrist symptoms in female grocery checkers. Am J Ind Med 20:209–218PubMedCrossRefGoogle Scholar
  23. Nakeseko M (1975) Problems of reducing work loads in cash register operation, 1 Comparison of work loads in usual cash register and electronic cash register operations. Jpn J Indust Health 17:168–169Google Scholar
  24. Niedhammer I, Landre MF, LeClerc A, Bourgeois F, Franchi P, Chastang JF, et al (1998) Shoulder disorders related to work organization and other occupational factors among supermarket cashiers. Int J Occup Environ Health 4:168–178PubMedGoogle Scholar
  25. Nishiyama K (1973) Cash register operators work and its hygienical problems in supermarket. Jpn J Indust Health 15:229–243Google Scholar
  26. Ohara H, Aoyama H, Itani T (1976) Health hazards among cash register operators and the effects of improved working conditions. J Hum Ergol 5:31–40Google Scholar
  27. Orgel DL, Milliron MJ, Frederick LJ (1992) Musculoskeletal discomfort in grocery express checkstand workers An ergonomic intervention study. J Occup Med 34:815–818PubMedCrossRefGoogle Scholar
  28. OSHA Draft Guidelines for Retail Grocery Stores ( html#executive accessed on 8 October 2004)
  29. Osorio AM, Ames RG, Jones J, Castorina J, Rempel D, Estrin W, et al (1994) Carpal tunnel syndrome among grocery workers. Am J Ind Med 25:229–245PubMedCrossRefGoogle Scholar
  30. Panzone I, Melosi A, Carra G, Rapazzo G, Innocenti A (1996) Repetitive movement of the upper lims: results of exposure evaluation and clinical investigation in cash register operators in supermarkets. Med Lav 87:634–639PubMedGoogle Scholar
  31. van Poppel MN, Koes BW, Deville W, Smid T, Bouter LM (1998) Risk factors for back pain incidence in industry: a prospective study. Pain 77:81–86CrossRefPubMedGoogle Scholar
  32. Ryan GA (1989) The prevalence of musculo-skeletal symptoms in supermarket workers. Ergonomics 32:359–371PubMedCrossRefGoogle Scholar
  33. Sakurai T, Miwa T (1975) Muscular burden derived from dynamic loading. Part 2: response to shock loading of cash register work in the hand-arm-shoulder system. Jpn J Indust Health 13:165–177CrossRefGoogle Scholar
  34. Theorell T (2000) Psychosocial factors at work in relation to musculoskeletal conditions-implications for job design and rehabilitation. Taylor & Francis, LondonGoogle Scholar
  35. Torp S, Riise T, Moen BE (2001) The impact of psychosocial work factors on musculoskeletal pain: a prospective study. J Occup Environ Med 43:120–126PubMedCrossRefGoogle Scholar
  36. van Tulder M, Koes B, Bombardier C (2002) Low back pain. Best Pract Res Clin Rheumatol 16:761–775CrossRefPubMedGoogle Scholar
  37. Violante FS, Fiori M, Fiorentini C, Risi A, Garagnani G, Bonfiglioli R, et al (2004) Associations of psychosocial and individual factors with three different categories of back disorder among nursing staff. J Occup Health 46(2):100–108CrossRefPubMedGoogle Scholar
  38. Wallersteiner U (1981) Occupational health disorders of cashier operators in supermarkets. In: Proceedings of the 14th annual general meeting of the human factors association of Canada, pp 79–83Google Scholar
  39. Waters TR, Putz-Anderson V, Garg A, Fine LJ (1993) Revised NIOSH equation for the design and evaluation of manual lifting tasks. Ergonomics 36:749–776PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Francesco S. Violante
    • 1
  • Francesca Graziosi
    • 1
  • Roberta Bonfiglioli
    • 1
  • Stefania Curti
    • 1
  • Stefano Mattioli
    • 1
  1. 1.Occupational Health Unit (Medicina del Lavoro) Alma Mater Studiorum-University of BolognaBolognaItaly

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