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Relationship Between Musculoskeletal Pain and Sleep Quality in Prehospital Emergency Health Workers

Year 2025, Volume: 14 Issue: 3, 610 - 618, 31.10.2025

Abstract

Objective: This study aimed to examine the prevalence of musculoskeletal disorders and sleep problems among prehospital emergency health workers, explore the relationship between musculoskeletal pain and sleep disturbances. Materials and Methods: This descriptive and cross-sectional study included 167 prehospital emergency health workers. Data were collected using a demographic questionnaire, the Pittsburgh Sleep Quality Index, and the Extended Nordic Musculoskeletal Questionnaire. The data were analyzed using descriptive statistics, independent samples t-test, Pearson correlation analysis, and logistic regression analysis. Results: The prehospital emergency health workers had a mean age of 33.14 ± 5.98 years and an average work experience of 11.22 ± 6.29 years. Notably, 76% reported poor sleep quality, and 80.8% experienced musculoskeletal pain. Poor sleep quality was not associated with gender, marital status, smoking, alcohol use, work schedule, regular physical activity, age, BMI, or work experience (p>0.05). Those with musculoskeletal pain were 91.8% less likely to have good sleep quality (p=0.001; OR=0.019; 95% CI=0.005-0.065). Conclusions: Musculoskeletal pain and poor sleep quality are common in prehospital emergency health workers. Many reported lower back, neck, and shoulder pain, which may impact productivity and healthcare use. Poor sleep quality was associated with musculoskeletal pain, regardless of demographic and occupational factors, and sleep disturbances increased with the number of painful body regions.

Ethical Statement

Institution: The Social Sciences and Humanities Research Ethics Committee of Tokat Gaziosmanpaşa University Date: 24.12.2024 Approval no: 24.12.2024/01-51

Supporting Institution

None

Thanks

None

References

  • Aasa, U., Barnekow-Bergkvist, M., Ängquist, K. A., & Brulin, C. (2005). Relationships between work-related factors and disorders in the neck-shoulder and low-back region among female and male ambulance personnel. Journal of Occupational Health, 47(6), 481–489. https://doi.org/10.1539/JOH.47.481
  • Ağargün, M. Y., Kara, H., & Anlar, O. (1996). Pittsburgh Uyku Kalitesi indeksinin Gecerligi ve Guvenirligi. Turk Psikiyatri Dergisi, 7(2), 107–115. https://cir.nii.ac.jp/crid/1572543024182338176
  • Alaca, N., Safran, E. E., Karamanlargil, A. İ., & Timucin, E. (2019). Translation and cross-cultural adaptation of the extended version of the Nordic musculoskeletal questionnaire into Turkish. Journal of Musculoskeletal & Neuronal Interactions, 19(4), 472–481.
  • Arial, M., Benoît, D., & Wild, P. (2014). Exploring implicit preventive strategies in prehospital emergency workers: a novel approach for preventing back problems. Applied Ergonomics, 45(4), 1003–1009. https://doi.org/10.1016/J.APERGO.2013.12.005
  • Ayşin, A., & Ayten, D. (2020). THE VIEWS OF 112 EMERGENCY MEDICAL PERSONNEL ON OCCUPATIONAL HEALTH AND OCCUPATIONAL DISEASES: CASE OF ÇANAKKALE PROVINCE. The Journal of International Social Research, 13(71), 1104–1111. https://doi.org/10.17719/JISR.10581
  • Babatunde, O. O., Jordan, J. L., Van Der Windt, D. A., Hill, J. C., Foster, N. E., & Protheroe, J. (2017). Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PloS One, 12(6). https://doi.org/10.1371/JOURNAL.PONE.0178621
  • Broniecki, M., Esterman, A., May, E., & Grantham, H. (2010). Musculoskeletal disorder prevalence and risk factors in ambulance officers. Journal of Back and Musculoskeletal Rehabilitation, 23(4), 165–174. https://doi.org/10.3233/BMR-2010-0265
  • Brown, W. E., Dickison, P. D., Misselbeck, W. J. A., & Levine, R. (2002). L Ongitudinal E Mergency M Edical T Echnician A Ttribute And D Emographic S Tudy (Leads): A N I Nterim R Eport. Prehospital Emergency Care, 6(4), 433–439. https://doi.org/10.1080/10903120290938085
  • Buysse, D. J., Reynolds, C. F., Monk, T. H., Hoch, C. C., Yeager, A. L., & Kupfer, D. J. (1991). Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep, 14(4), 331–338. https://doi.org/10.1093/SLEEP/14.4.331
  • Cash, R. E., Anderson, S. E., Lancaster, K. E., Lu, B., Rivard, M. K., Camargo, C. A., & Panchal, A. R. (2020). Comparing the Prevalence of Poor Sleep and Stress Metrics in Basic versus Advanced Life Support Emergency Medical Services Personnel. Prehospital Emergency Care, 24(5), 644–656. https://doi.org/10.1080/10903127.2020.1758259
  • Chaise, F. de O., Furlanetto, T. S., Candotti, C. T., Kasten, A. P., Vieira, A., & Paiva, L. L. (2018). Dor, Dort e doenças cardiovasculares em profissionais do SAMU 192 de Porto Alegre/RS. Revista de Terapia Ocupacional Da Universidade de São Paulo, 29(3), 204–214. https://doi.org/10.11606/ISSN.2238-6149.V29I3P204-214
  • Coffey, B., MacPhee, R., Socha, D., & Fischer, S. L. (2016). A physical demands description of paramedic work in Canada. International Journal of Industrial Ergonomics, 53, 355–362. https://doi.org/10.1016/J.ERGON.2016.04.005
  • Dawson, A. P., Steele, E. J., Hodges, P. W., & Stewart, S. (2009). Development and test-retest reliability of an extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E): a screening instrument for musculoskeletal pain. The Journal of Pain, 10(5), 517–526. https://doi.org/10.1016/J.JPAIN.2008.11.008
  • Dong, H., Zhang, Q., Zhang, Z., & Zhu, C. (2022). Association of sleep disturbance with shift work, occupational stress, and musculoskeletal pain in Chinese public hospital emergency workers: A multicentre cross-sectional study. Chronobiology International, 39(6), 886–894. https://doi.org/10.1080/07420528.2022.2048662
  • Hansen, C. D., Rasmussen, K., Kyed, M., Nielsen, K. J., & Andersen, J. H. (2012). Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel - A cross-sectional study. BMC Public Health, 12(1). https://doi.org/10.1186/1471-2458-12-534/TABLES/6
  • Jones, A. Y., & Lee, R. Y. (2005). Cardiopulmonary resuscitation and back injury in ambulance officers. International Archives of Occupational and Environmental Health, 78(4), 332–336. https://doi.org/10.1007/S00420-004-0577-3
  • Lavender, S. A., Conrad, K. M., Reichelt, P. A., Johnson, P. W., & T. Meyer, F. (2000). Biomechanical analyses of paramedics simulating frequently performed strenuous work tasks. Applied Ergonomics, 31(2), 167–177. https://doi.org/10.1016/S0003-6870(99)00040-X
  • Lin, M. H., Huang, Y. C., Chen, W. K., & Wang, J. Y. (2020). Sleepiness and injury risk in emergency medical service workers in Taiwan. PloS One, 15(2). https://doi.org/10.1371/JOURNAL.PONE.0229202
  • Maguire, B. J., Hunting, K. L., Guidotti, T. L., & Smith, G. S. (2005). Occupational injuries among emergency medical services personnel. Prehospital Emergency Care, 9(4), 405–411. https://doi.org/10.1080/10903120500255065
  • Ngan, K., Drebit, S., Siow, S., Yu, S., Keen, D., & Alamgir, H. (2010). Risks and causes of musculoskeletal injuries among health care workers. Occupational Medicine (Oxford, England), 60(5), 389–394. https://doi.org/10.1093/OCCMED/KQQ052
  • Patterson, P. D., Suffoletto, B. P., Kupas, D. F., Weaver, M. D., & Hostler, D. (2010). Sleep quality and fatigue among prehospital providers. Prehospital Emergency Care, 14(2), 187–193. https://doi.org/10.3109/10903120903524971
  • Patterson, P. D., Weaver, M. D., Frank, R. C., Warner, C. W., Martin-Gill, C., Guyette, F. X., Fairbanks, R. J., Hubble, M. W., Songer, T. J., Callaway, C. W., Kelsey, S. F., & Hostler, D. (2012). Association between poor sleep, fatigue, and safety outcomes in emergency medical services providers. Prehospital Emergency Care, 16(1), 86–97. https://doi.org/10.3109/10903127.2011.616261
  • Santos, R. A. V. dos, Raposo, M. C. F., & Melo, R. de S. (2021). Prevalence and associated factors with musculoskeletal pain in professionals of the Mobile Emergency Care Service. BrJP, 4, 20–25. https://doi.org/10.5935/2595-0118.20210013
  • Sedrez, J. A., Da Silva Kasten, A. P., De Oliveira Chaise, F., & Candotti, C. T. (2017). Risk factors for work-related cardiovascularand musculoskeletal diseasesamong prehospital urgent care workers: a systematic review. Revista Brasileira de Medicina Do Trabalho : Publicacao Oficial Da Associacao Nacional de Medicina Do Trabalho-ANAMT, 15(4),355–363. https://doi.org/10.5327/Z1679443520170050
  • Senol, V., Soyuer, F., Guleser, G. N., Argun, M., & Avsarogullari, L. (2016). The Effects of the Sleep Quality of 112 Emergency Health Workers in Kayseri, Turkey on Their Professional Life. Turkish Journal of Emergency Medicine, 14(4), 172–178. https://doi.org/10.5505/1304.7361.2014.60437
  • Studnek, J. R., & Fernandez, A. R. (2008). Characteristics of emergency medical technicians involved in ambulance crashes. Prehospital and Disaster Medicine, 23(5), 432–437. https://doi.org/10.1017/S1049023X00006166
  • Tam, G. Y. T., & Yeung, S. S. (2006). Perceived effort and low back pain in non-emergency ambulance workers: Implications for rehabilitation. Journal of Occupational Rehabilitation, 16(2), 231–240. https://doi.org/10.1007/S10926-006-9019-2/TABLES/4
  • Trockel, M. T., Menon, N. K., Rowe, S. G., Stewart, M. T., Smith, R., Lu, M., Kim, P. K., Quinn, M. A., Lawrence, E., Marchalik, D., Farley, H., Normand, P., Felder, M., Dudley, J. C., & Shanafelt, T. D. (2020). Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors. JAMA Network Open, 3(12), E2028111. https://doi.org/10.1001/JAMANETWORKOPEN.2020.28111
  • Weaver, M. D., Patterson, P. D., Fabio, A., Moore, C. G., Freiberg, M. S., & Songer, T. J. (2015). An observational study of shift length, crew familiarity, and occupational injury and illness in emergency medical services workers. Occupational and Environmental Medicine, 72(11), 798–804. https://doi.org/10.1136/OEMED-2015-102966

Hastane Öncesi Acil Sağlık Çalışanlarında Kas-İskelet Sistemi Ağrısının Uyku Kalitesi ile İlişkisi

Year 2025, Volume: 14 Issue: 3, 610 - 618, 31.10.2025

Abstract

Amaç: Bu çalışma, hastane öncesi acil sağlık çalışanlarında kas-iskelet sistemi hastalıkları ve uyku problemlerinin yaygınlığını incelemeyi, kas-iskelet sistemi ağrısı ile uyku bozuklukları arasındaki ilişkiyi araştırmayı amaçlamıştır. Gereç ve Yöntem: Tanımlayıcı ve kesitsel nitelikteki bu çalışmaya 167 hastane öncesi acil sağlık çalışanı katılmıştır. Veriler, demografik bilgi formu, Pittsburgh Uyku Kalitesi İndeksi ve Genişletilmiş Nordic Kas-İskelet Sistemi Anketi kullanılarak toplanmıştır. Veriler tanımlayıcı istatistikler, bağımsız örneklem t-testi, Pearson korelasyon analizi ve lojistik regresyon analizi ile değerlendirilmiştir Bulgular: Katılımcıların yaş ortalaması 33.14±5.98 yıl, mesleki deneyim ortalaması ise 11.22±6.29 yıldır. Katılımcıların %76’sında kötü uyku kalitesi, %80.8’inde ise kas-iskelet sistemi ağrısı bildirilmiştir. Kötü uyku kalitesi; cinsiyet, medeni durum, sigara kullanımı, alkol kullanımı, çalışma düzeni, düzenli fiziksel aktivite, yaş, BKİ ve mesleki deneyim ile ilişkili bulunmamıştır (p>0.05). Kas-iskelet sistemi ağrısı olanların iyi uyku kalitesine sahip olma olasılığı %91.8 daha düşüktür (p=0.001; OR=0.019; %95 GA=0.005-0.065). Sonuç: Hastane öncesi acil sağlık çalışanlarında kas-iskelet sistemi ağrısı ve kötü uyku kalitesi yaygındır. Katılımcıların çoğu bel, boyun ve omuz ağrısından şikayetçidir, bu durum verimliliği ve sağlık hizmeti kullanımını etkileyebilir. Uyku kalitesinin düşüklüğü, demografik ve mesleki faktörlerden bağımsız olarak kas-iskelet sistemi ağrısıyla ilişkilidir ve ağrılı vücut bölgesi sayısı arttıkça uyku bozukluğu da artmaktadır.

Ethical Statement

Kurum: Tokat Gaziosmanpaşa Üniversitesi Sosyal Bilimler ve Beşeri Bilimler Araştırma Etik Kurulu Tarih: 24.12.2024 Onay no: 24.12.2024/01-51

Supporting Institution

None

Thanks

None

References

  • Aasa, U., Barnekow-Bergkvist, M., Ängquist, K. A., & Brulin, C. (2005). Relationships between work-related factors and disorders in the neck-shoulder and low-back region among female and male ambulance personnel. Journal of Occupational Health, 47(6), 481–489. https://doi.org/10.1539/JOH.47.481
  • Ağargün, M. Y., Kara, H., & Anlar, O. (1996). Pittsburgh Uyku Kalitesi indeksinin Gecerligi ve Guvenirligi. Turk Psikiyatri Dergisi, 7(2), 107–115. https://cir.nii.ac.jp/crid/1572543024182338176
  • Alaca, N., Safran, E. E., Karamanlargil, A. İ., & Timucin, E. (2019). Translation and cross-cultural adaptation of the extended version of the Nordic musculoskeletal questionnaire into Turkish. Journal of Musculoskeletal & Neuronal Interactions, 19(4), 472–481.
  • Arial, M., Benoît, D., & Wild, P. (2014). Exploring implicit preventive strategies in prehospital emergency workers: a novel approach for preventing back problems. Applied Ergonomics, 45(4), 1003–1009. https://doi.org/10.1016/J.APERGO.2013.12.005
  • Ayşin, A., & Ayten, D. (2020). THE VIEWS OF 112 EMERGENCY MEDICAL PERSONNEL ON OCCUPATIONAL HEALTH AND OCCUPATIONAL DISEASES: CASE OF ÇANAKKALE PROVINCE. The Journal of International Social Research, 13(71), 1104–1111. https://doi.org/10.17719/JISR.10581
  • Babatunde, O. O., Jordan, J. L., Van Der Windt, D. A., Hill, J. C., Foster, N. E., & Protheroe, J. (2017). Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. PloS One, 12(6). https://doi.org/10.1371/JOURNAL.PONE.0178621
  • Broniecki, M., Esterman, A., May, E., & Grantham, H. (2010). Musculoskeletal disorder prevalence and risk factors in ambulance officers. Journal of Back and Musculoskeletal Rehabilitation, 23(4), 165–174. https://doi.org/10.3233/BMR-2010-0265
  • Brown, W. E., Dickison, P. D., Misselbeck, W. J. A., & Levine, R. (2002). L Ongitudinal E Mergency M Edical T Echnician A Ttribute And D Emographic S Tudy (Leads): A N I Nterim R Eport. Prehospital Emergency Care, 6(4), 433–439. https://doi.org/10.1080/10903120290938085
  • Buysse, D. J., Reynolds, C. F., Monk, T. H., Hoch, C. C., Yeager, A. L., & Kupfer, D. J. (1991). Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep, 14(4), 331–338. https://doi.org/10.1093/SLEEP/14.4.331
  • Cash, R. E., Anderson, S. E., Lancaster, K. E., Lu, B., Rivard, M. K., Camargo, C. A., & Panchal, A. R. (2020). Comparing the Prevalence of Poor Sleep and Stress Metrics in Basic versus Advanced Life Support Emergency Medical Services Personnel. Prehospital Emergency Care, 24(5), 644–656. https://doi.org/10.1080/10903127.2020.1758259
  • Chaise, F. de O., Furlanetto, T. S., Candotti, C. T., Kasten, A. P., Vieira, A., & Paiva, L. L. (2018). Dor, Dort e doenças cardiovasculares em profissionais do SAMU 192 de Porto Alegre/RS. Revista de Terapia Ocupacional Da Universidade de São Paulo, 29(3), 204–214. https://doi.org/10.11606/ISSN.2238-6149.V29I3P204-214
  • Coffey, B., MacPhee, R., Socha, D., & Fischer, S. L. (2016). A physical demands description of paramedic work in Canada. International Journal of Industrial Ergonomics, 53, 355–362. https://doi.org/10.1016/J.ERGON.2016.04.005
  • Dawson, A. P., Steele, E. J., Hodges, P. W., & Stewart, S. (2009). Development and test-retest reliability of an extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E): a screening instrument for musculoskeletal pain. The Journal of Pain, 10(5), 517–526. https://doi.org/10.1016/J.JPAIN.2008.11.008
  • Dong, H., Zhang, Q., Zhang, Z., & Zhu, C. (2022). Association of sleep disturbance with shift work, occupational stress, and musculoskeletal pain in Chinese public hospital emergency workers: A multicentre cross-sectional study. Chronobiology International, 39(6), 886–894. https://doi.org/10.1080/07420528.2022.2048662
  • Hansen, C. D., Rasmussen, K., Kyed, M., Nielsen, K. J., & Andersen, J. H. (2012). Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel - A cross-sectional study. BMC Public Health, 12(1). https://doi.org/10.1186/1471-2458-12-534/TABLES/6
  • Jones, A. Y., & Lee, R. Y. (2005). Cardiopulmonary resuscitation and back injury in ambulance officers. International Archives of Occupational and Environmental Health, 78(4), 332–336. https://doi.org/10.1007/S00420-004-0577-3
  • Lavender, S. A., Conrad, K. M., Reichelt, P. A., Johnson, P. W., & T. Meyer, F. (2000). Biomechanical analyses of paramedics simulating frequently performed strenuous work tasks. Applied Ergonomics, 31(2), 167–177. https://doi.org/10.1016/S0003-6870(99)00040-X
  • Lin, M. H., Huang, Y. C., Chen, W. K., & Wang, J. Y. (2020). Sleepiness and injury risk in emergency medical service workers in Taiwan. PloS One, 15(2). https://doi.org/10.1371/JOURNAL.PONE.0229202
  • Maguire, B. J., Hunting, K. L., Guidotti, T. L., & Smith, G. S. (2005). Occupational injuries among emergency medical services personnel. Prehospital Emergency Care, 9(4), 405–411. https://doi.org/10.1080/10903120500255065
  • Ngan, K., Drebit, S., Siow, S., Yu, S., Keen, D., & Alamgir, H. (2010). Risks and causes of musculoskeletal injuries among health care workers. Occupational Medicine (Oxford, England), 60(5), 389–394. https://doi.org/10.1093/OCCMED/KQQ052
  • Patterson, P. D., Suffoletto, B. P., Kupas, D. F., Weaver, M. D., & Hostler, D. (2010). Sleep quality and fatigue among prehospital providers. Prehospital Emergency Care, 14(2), 187–193. https://doi.org/10.3109/10903120903524971
  • Patterson, P. D., Weaver, M. D., Frank, R. C., Warner, C. W., Martin-Gill, C., Guyette, F. X., Fairbanks, R. J., Hubble, M. W., Songer, T. J., Callaway, C. W., Kelsey, S. F., & Hostler, D. (2012). Association between poor sleep, fatigue, and safety outcomes in emergency medical services providers. Prehospital Emergency Care, 16(1), 86–97. https://doi.org/10.3109/10903127.2011.616261
  • Santos, R. A. V. dos, Raposo, M. C. F., & Melo, R. de S. (2021). Prevalence and associated factors with musculoskeletal pain in professionals of the Mobile Emergency Care Service. BrJP, 4, 20–25. https://doi.org/10.5935/2595-0118.20210013
  • Sedrez, J. A., Da Silva Kasten, A. P., De Oliveira Chaise, F., & Candotti, C. T. (2017). Risk factors for work-related cardiovascularand musculoskeletal diseasesamong prehospital urgent care workers: a systematic review. Revista Brasileira de Medicina Do Trabalho : Publicacao Oficial Da Associacao Nacional de Medicina Do Trabalho-ANAMT, 15(4),355–363. https://doi.org/10.5327/Z1679443520170050
  • Senol, V., Soyuer, F., Guleser, G. N., Argun, M., & Avsarogullari, L. (2016). The Effects of the Sleep Quality of 112 Emergency Health Workers in Kayseri, Turkey on Their Professional Life. Turkish Journal of Emergency Medicine, 14(4), 172–178. https://doi.org/10.5505/1304.7361.2014.60437
  • Studnek, J. R., & Fernandez, A. R. (2008). Characteristics of emergency medical technicians involved in ambulance crashes. Prehospital and Disaster Medicine, 23(5), 432–437. https://doi.org/10.1017/S1049023X00006166
  • Tam, G. Y. T., & Yeung, S. S. (2006). Perceived effort and low back pain in non-emergency ambulance workers: Implications for rehabilitation. Journal of Occupational Rehabilitation, 16(2), 231–240. https://doi.org/10.1007/S10926-006-9019-2/TABLES/4
  • Trockel, M. T., Menon, N. K., Rowe, S. G., Stewart, M. T., Smith, R., Lu, M., Kim, P. K., Quinn, M. A., Lawrence, E., Marchalik, D., Farley, H., Normand, P., Felder, M., Dudley, J. C., & Shanafelt, T. D. (2020). Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors. JAMA Network Open, 3(12), E2028111. https://doi.org/10.1001/JAMANETWORKOPEN.2020.28111
  • Weaver, M. D., Patterson, P. D., Fabio, A., Moore, C. G., Freiberg, M. S., & Songer, T. J. (2015). An observational study of shift length, crew familiarity, and occupational injury and illness in emergency medical services workers. Occupational and Environmental Medicine, 72(11), 798–804. https://doi.org/10.1136/OEMED-2015-102966
There are 29 citations in total.

Details

Primary Language English
Subjects Public Health (Other)
Journal Section Articles
Authors

Sevil Okan 0000-0002-0446-6866

Fatih Okan 0000-0002-7544-9051

Publication Date October 31, 2025
Submission Date June 25, 2025
Acceptance Date August 19, 2025
Published in Issue Year 2025 Volume: 14 Issue: 3

Cite

APA Okan, S., & Okan, F. (2025). Relationship Between Musculoskeletal Pain and Sleep Quality in Prehospital Emergency Health Workers. Balıkesir Sağlık Bilimleri Dergisi, 14(3), 610-618. https://doi.org/10.53424/balikesirsbd.1727516

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