What are cost-effective ergonomics interventions for prevention and management of occupational musculoskeletal disorders: a systematic review of economic evaluation studies.

PURPOSE: This study aimed to identify cost-effective ergonomic interventions implemented for the prevention and management of work-related musculoskeletal disorders by systematically reviewing economic evaluation studies in this area.

METHODS

Randomized trials of workplace interventions with full economic evaluation were considered based on PRISMA 2020 guideline.

RESULTS

All interventions were designed to manage and alleviate the adverse outcomes (of musculoskeletal disorders, particularly lower-back pain, and no preventive intervention had been considered, in healthcare workers in high-income countries. Among interventions with significant effectiveness, organizational interventions have shown the most promising results. Cost-effectiveness analysis was the most prevalent study type with a broad range of outcome measures. The most common outcome measure in cost-effectiveness studies was the number of days off work or the duration until recovery. Societal perspective was mostly selected to measure costs.

CONCLUSION

The evidence on cost-effectiveness of ergonomic interventions is mixed and characterized by methodological heterogeneity. Current literature suggests a trend where organizational interventions are frequently identified among the effective strategies, particularly for managing conditions like low-back pain. However, significant gaps remain, including narrow cost perspectives, short time horizons, and a predominant focus on curative rather than preventive measures in high-income settings. Future economic evaluations should adopt broader societal cost assessments, longer follow-ups, and model-based approaches to better capture long-term value. Urgently, more research is needed in low- and middle-income countries to understand context-specific economic impacts.