Document Type : Original Article


1 PhD candidate in Ergonomics, Department of Ergonomics, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Associate professor, Department of Ergonomics, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran

3 M.Sc. in Occupational Health, Department of Occupational Health, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

4 M.Sc. in Ergonomics, Health Center, Islamabad-e-Gharb Health Network, Kermanshah University of Medical Science, Kermanshah, Iran

5 M.Sc. in Ergonomics, Department of Ergonomics, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran

6 PhD in Occupational Health, Department of Occupational Health, School of Health, Yazd University of Medical Sciences, Yazd, Iran

7 M.Sc. student in Aging health, Department of Aging Health, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran


Background: Mental workloadis the operator´s mind effort, the excessive levels of which can endanger his/her health. Work-related musculoskeletal symptoms (WMSs) could be the result of a high mental workload. As the workload level depends on the task, this study aims to assess the relationship between mental workload and musculoskeletal symptoms in different working groups of a hospital.
Methods: This cross-sectional study was conducted on 240 employees in three main working groups including office staff, clinical employees, and service workers in a governmental hospital at Shiraz. Demographics, NASA Task Load Index, and Nordic musculoskeletal symptoms questionnaire were the data collection tools. SPSS, version 21, was used for data analysis.
Results: The mean mental workload was 66.03 in office staff, 67.86 in clinical employees, and 72.41 in service workers. The prevalence of WMSs was 67% in office staff, 62.5% in clinical employees, and 60.8% in service workers. The overall mental workload was related to symptom prevalence in the elbow, thighs, knee, and foot (P-value < 0.05).
Conclusion: Some domains of the mental workload are related to WMSs in the studied working groups. Paying attention to the special needs of each working group is necessary for reducing mental workload and WMSs.


1.         Gopher D, Donchin E. Workload: An examination of the concept. 1986.
2.         Habibi E. Relationship between work ability and mental workload with musculoskeletal disorders in industrial jobs. Journal of Preventive Medicine. 2016;2(4):29-38.
3.         Backs RW, Ryan AM, Wilson GF. Psychophysiological measures of workload during continuous manual performance. Human Factors. 1994;36(3):514-31.
4.         Mohammadi M, NaslSeraji J, Zeraati H. Developing and accessing the validity and reliability of a questionnaire to assess the mental workload among ICUs Nurses in one of the Tehran University of Medical Sciences hospitals. J Sch Public Health Inst Public Health Res. 2013;11(2):87-96.
5.         Young G, Zavelina L, Hooper V. Assessment of workload using NASA Task Load Index in perianesthesia nursing. Journal of PeriAnesthesia Nursing. 2008;23(2):102-10.
6.         Sarsangi V, Saberi H, Hannani M, Honarjoo F, SalimAbadi M, Goroohi M, et al. Mental workload and its affected factors among nurses in Kashan province during 2014. Journal of Rafsanjan University of Medical Sciences. 2015;14(1):25-36.
7.         Babamiri M, Heidarimoghadam R, Saidnia H, Mohammadi Y, Joudaki J. Investigation of the Role of Mental Workload, Fatigue, and Sleep Quality in the Development of Musculoskeletal Disorders. Journal of Occupational Hygiene Engineering Volume. 2019;5(4):1-7.
8.         Haghshenas B, Habibi E, Haji Esmaeil Hajar F, Ghanbary Sartang A, van Wijk L, Khakkar S. The association between musculoskeletal disorders with mental workload and occupational fatigue in the office staff of a communication service company in Tehran, Iran, in 2017. Journal of Occupational Health and Epidemiology. 2018;7(1):20-9.
9.         Fallahi M, Motamedzade M, Heidarimoghadam R, Soltanian AR, Miyake S. Assessment of operators’ mental workload using physiological and subjective measures in cement, city traffic and power plant control centers. Health promotion perspectives. 2016;6(2):96.
10.       Kalantari R, Arghami S, Ahmadi E, Garosi E, ZANJIRANI FA. Relationship between workload and low back pain in assembly line workers. 2016.
11.       Bernal D, Campos-Serna J, Tobias A, Vargas-Prada S, Benavides FG, Serra C. Work-related psychosocial risk factors and musculoskeletal disorders in hospital nurses and nursing aides: a systematic review and meta-analysis. International journal of nursing studies. 2015;52(2):635-48.
12.       Punnett L, Wegman DH. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. Journal of electromyography and kinesiology. 2004;14(1):13-23.
13.       Bussières AE, Taylor JA, Peterson C. Diagnostic imaging practice guidelines for musculoskeletal complaints in adults—an evidence-based approach—part 3: spinal disorders. Journal of manipulative and physiological therapeutics. 2008;31(1):33-88.
14.       Arghami S, Kalantari R, Kionani EA, Zanjirani A. Assessing Prevalence of Musculoskeletal Disorders in Women Workers in an Automobile Manufacturing Assembly Line.
15.       Habibi E, Taheri MR, Hasanzadeh A. Relationship between mental workload and musculoskeletal disorders among Alzahra Hospital nurses. Iranian journal of nursing and midwifery research. 2015;20(1):1.
16.       Stellman JM. Safety in the health care industry. Occupational health nursing. 1982;30(10):17-21.
17.       Koepsell TD. Occupational injuries: a study of health care workers at a northwestern health science center and teaching hospital. Workplace Health & Safety. 1992;40(6):287.
18.       Cinaz B, La Marca R, Arnrich B, Tröster G, editors. Monitoring of mental workload levels. International Conference on e-Health sn: IADIS; 2010.
19.       bolghanabadi s, nayerabadi a, taheri m. Relationship of Musculoskeletal Disorders with Workload among the Workers of a Ceramic and Tile Factory in Neyshabur, Iran, in 2017. Journal of health research in community. 2017;3(3):25-33.
20.       Sekhar SC. Hospital Organisation Structure. Managing a Modern Hospital. 2008:48.
21.       Bakhshi E, Kalantari R. Investigation of quality of work life and its relationship with job performance in health care workers. Journal of Occupational Hygiene Engineering. 2017;3(4):31-7.
22.       Mohammadi M, Mazloumi A, Zeraati H. Designing questionnaire of assessing mental workload and determine its validity and reliability among ICUs nurses in one of the TUMS’s hospitals. Journal of School of Public Health and Institute of Public Health Research. 2013;11(2):87-96.
23.       Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Applied ergonomics. 1987;18(3):233-7.
24.       Buckle PW, Devereux JJ. The nature of work-related neck and upper limb musculoskeletal disorders. Applied ergonomics. 2002;33(3):207-17.
25.       Mohammady MJ, Sedighi A, Khaleghdoost T, Nejad EK, Javadi-Pashaki N. Relationship between Nurses’ Subjective Workload and Occupational Cognitive Failure in Intensive Care Units. 2018.
26.       Mahmoudifar Y, Seyedamini B. Investigation on the relationship between mental workload and musculoskeletal disorders among nursing staff. International Archives of Health Sciences. 2018;5(1):16.
27.       Vahdatpour B, Bozorgi M, Taheri MR. Investigating Musculoskeletal Discomforts and their Relation to Workplace Ergonomic Conditions among Computer Office Workers at Alzahra Hospital, Isfahan, Iran. Physical Medicine, Rehabilitation, and Electrodiagnosis. 2019;1(2):52-8.
28.       Zakerian SA, Garosi E, Abdi Z, Bakhshi E, Kamrani M, Kalantari R. Studying the influence of workplace design on productivity of bank clerks. Health and Safety at Work. 2016;6(2):35-42.
29.       Heidari M, Borujeni MG, Rezaei P, Abyaneh SK. Work-related musculoskeletal disorders and their associated factors in nurses: A cross-sectional study in iran. The Malaysian journal of medical sciences: MJMS. 2019;26(2):122.
30.       Bolghanabadi S, Bolghanabadi N. Relationship between Mental Workloadâ â and Musculoskeletalâ Disorders in Nurses Working at Day and Night Shifts in the Stateâ Hospitals. International Journal of Musculoskeletal Pain Prevention. 2018;3(1):7-11.
31.       Bork BE, Cook TM, Rosecrance JC, Engelhardt KA, Thomason M-EJ, Wauford IJ, et al. Work-related musculoskeletal disorders among physical therapists. Physical therapy. 1996;76(8):827-35.
32.       Darvishi E, Maleki A, Giahi O, Akbarzadeh A. Subjective mental workload and its correlation with musculoskeletal disorders in bank staff. Journal of manipulative and physiological therapeutics. 2016;39(6):420-6.
33.       Heidarimoghadam R, Saidnia H, Joudaki J, Mohammadi Y, Babamiri M. Does mental workload can lead to musculoskeletal disorders in healthcare office workers? Suggest and investigate a path. Cogent Psychology. 2019;6(1):1664205.