Region-specific prevalence and associated factors of work-related musculoskeletal disorders among pilots of a commercial airline: a cross-sectional study.

OBJECTIVES

To estimate the prevalence and anatomical distribution of work-related musculoskeletal disorders (WMSDs) among pilots of a Chinese commercial airline and identify factors associated with neck, shoulder and lower-back WMSDs.

DESIGN

Cross-sectional study.

SETTING

A commercial airline in China; data were collected during routine periodic medical examinations from 17 November 2025 to 31 December 2025.

PARTICIPANTS

A total of 1042 active commercial airline pilots (1030 men and 12 women) were included from 1200 invited pilots.

PRIMARY AND SECONDARY OUTCOME MEASURES: The prevalence of WMSDs across nine anatomical regions and factors associated with WMSDs in the neck, shoulders and lower back.

RESULTS

The overall prevalence of WMSDs was 21.50%; the most commonly affected regions were the lower back (11.52%), neck (11.32%) and shoulders (8.35%). Working in uncomfortable postures was associated with WMSDs across all three regions, particularly for 'often' exposure: neck (adjusted OR (aOR) 7.97, 95% CI 3.58 to 17.76), shoulders (aOR 5.48, 95% CI 2.35 to 12.80) and lower back (aOR 8.58, 95% CI 3.89 to 18.94). Neck WMSDs were associated with prolonged head-down posture and covering shifts for colleagues, whereas adequate rest time was inversely associated. Shoulder WMSDs were associated with prolonged static back posture. Lower-back WMSDs were positively associated with covering shifts and cold/temperature exposure and inversely associated with adequate rest, daily task variation and outdoor work.

CONCLUSIONS

WMSDs most commonly affected the lower back, neck and shoulders. Working in uncomfortable postures was consistently associated with WMSDs across these regions, while work-organisation and environmental factors showed site-specific associations.