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ISSN No. 2454-6186 | DOI: 10.47772/IJRISS | Volume IX Issue X October 2025

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Participatory Ergonomic Intervention Approach on

Musculoskeletal Disorder (MSD) in Construction Sectors: A

Systematic Review

Siti Maisarah Binti Amdan

1,2*

, Siti Nurhafizah Saleeza Binti Ramlee

and Dian Darina Indah Binti

Daruis

Faculty of Defence Studies and Management, National Defence University of Malaysia

Faculty of Technology and Applied Sciences, Open University Malaysia

Faculty of Defence Studies and Management, National Defence University of Malaysia

Faculty of Engineering, National Defence University of Malaysia

*Corresponding Author

DOI: https://dx.doi.org/10.47772/IJRISS.2025.910000134

Received: 30 September 2025; Accepted: 06 October 2025; Published: 05 November 2025

ABSTRACT

Musculoskeletal disorders (MSDs) remain a critical occupational health concern in the construction sector

due to the physical demands of repetitive lifting, awkward postures, and heavy manual handling. This

systematic literature review examines the role of participatory ergonomic (PE) interventions in reducing

MSDs and explores the use of technology to enhance ergonomic risk assessment and prevention. Guided

by PRISMA methodology, articles published between 2019 and 2024 were retrieved from Scopus,

ScienceDirect, and PubMed, with 30 studies meeting the eligibility criteria. Findings indicate that PE

interventions, including exoskeletons, workstation redesign, semi-automation, and task reorganization,

significantly reduce biomechanical strain, discomfort, and MSD prevalence while improving productivity

and worker satisfaction. However, limitations such as cost, device-related discomfort, and organizational

barriers affect long-term sustainability. In addition, technological solutions such as wearable sensors,

machine learning, cyber-physical training, and vision-based monitoring demonstrated high accuracy in

detecting ergonomic risks and provided real-time feedback for prevention. Despite their effectiveness,

issues such as secondary risks, acceptance, and cost justification must be addressed. Overall, the review

highlights that integrating participatory approaches with technological innovations offers substantial

potential to reduce MSDs among construction workers. Success depends on tailoring interventions to task-

specific demands, ensuring organizational commitment, and adopting a holistic view that considers both

physical and psychosocial dimensions of worker health.

Keywords:

Participatory ergonomics; Musculoskeletal disorders; Construction; Technology

INTRODUCTION

Musculoskeletal Disorders (MSDs) represent a significant concern in the construction industry, known for its

physically demanding nature and high incidence of work-related injuries (Chatterjee & Sahu, 2018).

Construction workers frequently perform tasks involving repetitive motions, awkward postures, and heavy

lifting, which contribute to the development of MSDs. These disorders affect muscles, nerves, tendons, and

joints, leading to pain, functional impairment, and, consequently, a decline in productivity and quality of life.

The economic burden of MSDs is substantial, encompassing direct costs related to healthcare and indirect costs

such as lost workdays and decreased efficiency.

In recent years, there has been a growing recognition of the need for effective interventions to mitigate the risks

associated with MSDs. Traditional approaches, often reactive and compliance-driven, have shown limited

success in reducing the prevalence of these disorders. As a result, there is a shift towards more proactive and

participatory strategies that involve workers in the identification and resolution of ergonomic issues.

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Participatory Ergonomic (PE) interventions have emerged as a promising approach, leveraging the insights and

experiences of workers to design and implement solutions that are practical, sustainable, and context-specific

(Bernardes et al., 2021; Lin et al., 2022; Lund Rasmussen et al., 2022).

Participatory Ergonomic interventions focus on engaging workers at all levels in the ergonomic improvement

process. This collaborative approach not only empowers workers by valuing their input but also fosters a sense

of ownership and commitment to the implemented changes. The use of Ergonomic Data Sheets (EDS) is a critical

component of this approach, providing a structured method for documenting ergonomic risks and facilitating

communication between workers and management (Katode et al., 2021; Morse et al., 2001; Varghese &

Panicker, 2022). EDS serve as a tool for capturing detailed information about specific tasks, identifying risk

factors, and prioritizing interventions based on their potential impact.

The construction sector, with its diverse and dynamic work environment, presents unique challenges and

opportunities for the application of PE interventions. The variability in tasks, work settings, and worker

demographics requires tailored solutions that can adapt to the specific needs of different construction sites.

Effective PE interventions in construction involve a multi-faceted approach, including ergonomic training,

regular assessments, and continuous feedback mechanisms (Hignett et al., 2005; Visser et al., 2014; Zhang &

Lin, 2024). By integrating ergonomic principles into daily practices and promoting a culture of safety and health,

PE interventions aim to create a more sustainable and resilient workforce.

Numerous studies have highlighted the effectiveness of PE interventions in reducing MSD risks and improving

worker well-being (Lallemand, 2012). These interventions have been shown to lead to significant reductions in

discomfort and pain, improvements in work practices, and enhanced overall job satisfaction (Batubara &

Dharmastiti, 2017; Ketola et al., 2002). Moreover, the participatory nature of these interventions often results in

higher levels of compliance and sustained ergonomic improvements, as workers are more likely to adhere to

changes they helped design.

In conclusion, the Participatory Ergonomic Intervention Approach offers a robust framework for addressing

MSDs in the construction sector. By involving workers in the ergonomic improvement process and utilizing

tools like EDS, this approach not only addresses the immediate ergonomic risks but also fosters a proactive and

inclusive safety culture. As the construction industry continues to evolve, the adoption of PE interventions

represents a critical step towards enhancing worker health, safety, and productivity.

LITERATURE REVIEW

The application of Participatory Ergonomics (PE) has received growing attention across multiple

industries as an effective approach to reduce Musculoskeletal Disorders (MSDs). In the construction

environment, where physical workloads, irregular postures, and temporary workplaces are common,

PE offers a structured method for improving safety through active worker involvement. The reviewed

literature can be conceptually grouped into three main themes: studies directly within construction,

studies from other industrial sectors offering transferable insights, and cross-sector analyses

identifying research gaps and practical lessons. This thematic organisation helps clarify how

participatory approaches function across different contexts while emphasising their relevance to

construction work.

PE has shown measurable success in improving health and productivity outcomes. Fonseca et al.

(2016) reported that an ergonomic intervention programme in an industrial plant improved worker

satisfaction and reduced strain by engaging employees in identifying and resolving workplace design

issues. Similarly, Choobineh et al. (2021) found that participatory interventions in a steel

manufacturing complex, supported by training and workstation redesign, resulted in significant

reductions in Work-Related Musculoskeletal Disorders (WMSDs). Both studies demonstrate that

continuous participation and management commitment are vital elements for sustaining ergonomic

improvement. Mishra et al. (2021) strengthened this argument by proposing a structured framework

for PE implementation and highlighting critical factors for success, such as clear objectives, top-

management support, and participatory feedback mechanisms.

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Although these studies originate primarily from manufacturing environments, their approaches are

applicable to the construction sector. Jakobsen et al. (2016) investigated a participatory organisational

intervention that improved assistive-device use in healthcare. Despite the different work settings, the

study demonstrates that engaging workers in the intervention process increases compliance and

adoption of ergonomic tools an outcome directly relevant to construction sites where safe equipment

use often depends on behavioural participation. Likewise, Colim et al. (2020) examined robotic-aid

development in furniture manufacturing, showing that worker input during validation ensured design

practicality and comfort. These results underline the universal benefit of participatory decision-making

in ergonomics, regardless of industry.

In contrast, several studies highlight contextual challenges that limit PE effectiveness. Norouzi et al.

(2021) implemented a participatory health-promotion model among Iranian housewives and

confirmed reductions in MSD symptoms but noted that psychosocial factors were equally important

as physical modifications. This observation is critical for construction workers, where psychosocial

stress and fatigue are often intertwined with biomechanical risk. Stock et al. (2018), through a

systematic review of work-organisation interventions, found moderate evidence that rest breaks reduce

MSD symptoms but identified inconsistencies in the strength of other interventions. These findings

point to a need for higher-quality, longitudinal research especially in dynamic work environments such

as construction.

Despite its advantages, PE implementation is not without obstacles. Rodríguez and Pérez (2021)

analysed a Colombian manufacturing company where ergonomic redesigns were proposed through

participatory methods but were only partially implemented due to resistance and lack of follow-up.

Such organisational barriers mirror those in construction, where subcontracting structures and project-

based employment can disrupt continuity. Arikan and Erdem (2023) also emphasised that ergonomic

strategies must account for task variability and environmental constraints to remain effective. These

limitations underscore the importance of sustained leadership involvement and institutional support

throughout the intervention process.

Studies specific to construction demonstrate the practicality of PE in addressing job-site risks.

Boulefaa et al. (2020) described ergonomic improvements in sewer pipe rehabilitation projects, where

collaboration among all stakeholders helped identify hazards and align preventive measures with

performance goals. The participatory approach led to both safety and productivity gains, illustrating

how inclusion of different hierarchy levels fosters sustainable ergonomic practices. Similarly,

Mallampalli (2024) reported notable decreases in lower-back, hand, and shoulder MSDs among female

workers after a participatory redesign of task-specific workstations. Although conducted in the cashew

industry, the study’s findings reinforce the potential benefits of participatory design in repetitive or

manual construction tasks.

Rostami et al. (2022) further confirmed the role of participatory approaches in improving worker

health and productivity. Their ergonomic intervention programme in the steel industry reduced MSD

prevalence and occupational fatigue while improving resource efficiency. Barbosa et al. (2022) also

demonstrated that participatory feedback in a textile factory allowed workers to identify posture-

related risks, resulting in effective and sustainable workstation redesigns. Lima and Coelho (2019)

evaluated the Ergo@Office programme, noting reductions in musculoskeletal complaints and higher

job satisfaction when employees were engaged in preventive strategies. Chanchai et al. (2016) found

similar benefits among hospital orderlies, reporting decreased symptoms and improved psychosocial

conditions following participatory ergonomics training. These studies collectively highlight that

participatory models are adaptable and effective across sectors, providing valuable frameworks for the

construction industry.

Nevertheless, not all studies show consistent results. Hoe et al. (2018) reviewed ergonomic

interventions aimed at preventing upper-limb and neck MSDs among office workers and concluded

that while participatory methods show promise, the evidence base remains inconsistent due to

variations in research design and outcome measures. This observation mirrors challenges in

INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN SOCIAL SCIENCE (IJRISS)

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construction ergonomics, where short project cycles and diverse job types make it difficult to collect

long-term follow-up data. Moreover, recent meta-analyses, such as those by Varghese and Panicker

(2022) and Zhang and Lin (2024), have stressed the importance of standardised evaluation criteria and

industry-specific evidence recommendations particularly pertinent to construction research.

Comparative analysis across sectors suggests several recurring themes. Active worker involvement

consistently leads to greater ownership of ergonomic change, while management engagement ensures

institutional continuity. Yet, despite widespread reporting of biomechanical improvements, few

studies evaluate long-term adoption or include economic outcomes such as cost–benefit analyses or

return on investment. Another gap lies in integrating psychosocial risk factors alongside physical

ergonomics, an omission that limits understanding of how participatory interventions affect overall

well-being and productivity. Furthermore, the heterogeneity of outcome measures ranging from

subjective discomfort ratings to electromyographic data restricts cross-study comparability.

Addressing these methodological inconsistencies would enable stronger synthesis and clearer

evidence on intervention effectiveness.

The reviewed literature collectively supports PE as an effective and flexible approach to reducing

MSDs and enhancing workplace health across diverse sectors. The inclusion of workers in identifying

hazards, developing solutions, and monitoring results promotes both safety and performance

improvements. However, for the construction sector, further research is required to evaluate long-term

outcomes, psychosocial integration, and scalability of interventions under field conditions. Given the

sector’s project-based and transient nature, participatory ergonomics represents a practical strategy

that aligns health and productivity objectives, provided that implementation is supported by consistent

management commitment and structured feedback systems.

Research Question

The following are the research questions for this study:

How effective are participatory ergonomic interventions in reducing musculoskeletal disorders

among construction workers?

How can technology be used in participatory ergonomics to assess and reduce ergonomic risks

in construction work?

Material and methods

This review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews

and Meta-Analyses) guidelines to ensure a structured, transparent, and replicable approach. PRISMA

is widely recognised in systematic review research for its focus on minimizing bias and improving the

clarity and quality of reporting. The framework divides the review process into four main phases:

identification, screening, eligibility, and data extraction (refer to Figure 1). In the identification phase,

relevant literature was gathered using carefully constructed search strings that combined key terms

related to participatory ergonomics, musculoskeletal disorders (MSDs), and the construction sector.

Searches were performed across three major academic databases: Scopus, ScienceDirect, and PubMed.

These databases were selected for their extensive indexing of peer-reviewed journals and broad subject

coverage in both technical and health-related disciplines. It is acknowledged, however, that no single

database is comprehensive. Therefore, using multiple databases helped reduce the risk of missing

relevant studies due to coverage gaps or indexing limitations.

During the screening process, articles were first reviewed for duplication and then assessed based on

predefined inclusion and exclusion criteria, which considered publication year, language, document

type, and relevance to the research questions. Only full-text, peer-reviewed journal articles published

in English between 2019 and 2024 were considered. Non-article formats such as conference papers,

books, and editorials were excluded to maintain quality and consistency. The eligibility phase involved

a more detailed evaluation of the remaining articles, focusing on their alignment with the scope of the

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review. Studies that lacked empirical evidence, addressed unrelated topics, or had inaccessible full

texts were excluded. In the final phase, data extraction was performed by synthesising key information

from each included study, such as the intervention type, assessment method, outcomes measured, and

contextual relevance. This rigorous methodological process ensured the selection of high-quality

studies and enabled a comprehensive synthesis of evidence on participatory ergonomic interventions

for preventing musculoskeletal disorders in construction work environments

FIGURE 1.

Flow diagram of the proposed searching study (Moher D, Liberati A, Tetzlaff J, 2009)

Identification

At the outset of this review, a structured approach was applied to retrieve a broad range of relevant studies.

The process began with identifying key search terms and then extending them through the use of

dictionaries, thesauri, reference materials, and previous research to ensure comprehensive coverage. These

terms were systematically compiled to develop search strings for PubMed, ScienceDirect, and Scopus

databases (refer to Table 1). Using this strategy across the three selected databases produced an initial pool

of 278 publications related to the study topic.

Table 1

The search string.

Scopus

TITLE-ABS-KEY ( ( "participatory ergonomic" OR "ergonomic intervention" ) AND ( "musculoskeletal

disorder" OR "musculoskeletal injuries" ) AND ( "construction" OR "construction industry" ) ) AND PUBYEAR

> 2018 AND PUBYEAR < 2025 AND ( LIMIT-TO ( DOCTYPE , "ar" ) )

Date of Access: August 2024

Science

direct

( ( "participatory ergonomic" OR "ergonomic intervention" ) AND ( "musculoskeletal disorder" OR

"musculoskeletal injuries" ) AND ( "construction" OR "construction industry" ) )

Date of Access: August 2024

PubMed

( ( "participatory ergonomic" OR "ergonomic intervention" ) AND

("musculoskeletal disorder" OR "musculoskeletal injuries" ) AND (

"construction" OR "construction industry" ) )

Date of Access: August 2024

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Screening

In the screening phase, all potentially relevant studies were reviewed to determine their alignment with the

predefined research focus on Participatory Ergonomic Intervention Approaches targeting Musculoskeletal

Disorders (MSDs) in the Construction Sector. This stage included an initial filtering to remove duplicate records.

Following this, a total of 202 publications were excluded based on the inclusion and exclusion criteria, resulting

in 76 articles selected for further assessment (see Table 2). The primary focus was on literature offering practical

and empirical insights; therefore, non-research formats such as reviews, meta-analyses, book chapters,

conference proceedings, and other grey literature were excluded. Additionally, only studies published in English

between 2019 and 2024 were considered eligible. During this process, two duplicate publication was identified

and removed.

TABLE 2

The selection criterion is searching

Criterion

Inclusion

Exclusion

Language

English

Non-English

Time line

2019 – 2024

< 2019

Literature type

Journal (Article)

Conference, Book, Review

Publication Stage

Final

In Press

Eligibility

In the eligibility phase, a total of 74 articles were initially shortlisted for detailed assessment. At this stage,

the titles and core content of each article were examined closely to confirm compliance with the established

inclusion criteria and relevance to the research objectives. Following this evaluation, 44 papers were

excluded because they were outside the study’s scope, had insufficiently relevant titles or abstracts, lacked

alignment with the research aims, or did not provide full-text access supported by empirical evidence.

Consequently, 30 articles were retained for the final stage of the review.

Quality of Appraisal

Based on the recommendations of Kitchenham and Charters (2007), once the primary studies were identified, it

was necessary to evaluate their quality and make quantitative comparisons. For this review, the quality

assessment method proposed by Abouzahra et al. (2020) was adopted, which includes six specific criteria

tailored for systematic literature reviews. Each study was rated using a three-point scale: “Yes” (Y) with a score

of 1 when the requirement was fully satisfied, “Partly” (P) with a score of 0.5 when the condition was partially

met but showed some limitations, and “No” (N) with a score of 0 when the requirement was not fulfilled.

TABLE 3 The Quality Assessment

Quality Assessment

Expert 1

Expert 2

Expert 3

Total Mark

Is the purpose of the study clearly stated?

Is the interest and the usefulness of the work clearly

presented?

Is the study methodology clearly established?

Are the concepts of the approach clearly defined?

Is the work compared and measured with other similar

work?

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The table summarises the quality assessment (QA) process, which was applied to evaluate each study based on

defined questions. Three reviewers independently assessed the studies, and each criterion was scored as Yes (Y

= 1), Partly (P = 0.5), or No (N = 0). The criteria are as follows:

1. Is the purpose of the study clearly stated?

This assesses whether the research objectives are explicitly described, as a clear aim provides proper

direction and scope for the work.

2. Is the interest and usefulness of the work clearly presented?

This examines whether the study’s significance and expected contributions are well explained, reflecting its

relevance and impact.

3. Is the study methodology clearly established?

This criterion evaluates whether the research methods are well defined and appropriate to meet the objectives,

which is essential for validity and reproducibility.

4. Are the concepts of the approach clearly defined?

This checks if the theoretical framework and main concepts are articulated with clarity, ensuring that the

approach can be properly understood.

5. Is the work compared and measured with other similar work?

This considers whether the study has been benchmarked against related research, helping to position it within

the broader academic field and highlight its contributions.

Each study was evaluated independently by the three experts using the specified criteria. The individual scores

were then combined to calculate a total quality score. To qualify for inclusion in the next stage, a study had to

achieve an overall score greater than 3.0. This cut-off point was applied to ensure that only research meeting

the required quality standards was retained for further analysis.

Data Abstraction and Analysis

An integrative analysis approach was applied in this study to evaluate and synthesise findings from various

research designs, with a primary focus on quantitative methods. The purpose of this stage was to identify key

themes and subthemes relevant to the research topic. The data collection process served as the initial step in

theme development. As illustrated in Figure 1, a total of 30 selected studies were carefully reviewed to extract

statements and content relevant to the scope of Participatory Ergonomic Intervention Approaches addressing

Musculoskeletal Disorders (MSDs) in the construction industry.

Each study was assessed in terms of its methodology and reported outcomes. Following this, the primary

researcher collaborated with co-authors to identify, group, and refine emerging themes grounded in the collected

evidence. Throughout the analysis, a logbook was maintained to document reflections, observations, and

analytical decisions made during the coding and interpretation process. Where differing interpretations arose,

they were resolved through discussion and consensus among the research team, ensuring consistency and

reliability in the final thematic structure.

The produced themes were eventually tweaked to ensure consistency. The analysis selection was carried out by

three experts: one is a researcher in ergonomics (Dr Ayuni Nabilah, researcher and academician), one in

industrial hygiene (Dr Hari Krishnan, consultant in ergonomics), and the other in industrial design (Dr Nor

Ziratul Aqma, expert in human factors), to determine the validity of the problems. The expert review phase

ensures the clarity, importance, and suitability of each subtheme by establishing the domain validity.

The authors also compared the findings to resolve any discrepancies in the theme creation process. Note that if

any inconsistencies in the themes arose, the authors addressed them with one another. Finally, the developed

themes were tweaked to ensure their consistency. To ensure the validity of the problems, the examinations were

performed by three experts, one specialising in anthropometric, the other in industrial ergonomic and industrial

design. The expert review phase helped ensure each sub-theme’s clarity, importance, and adequacy by

establishing domain validity. Adjustments based on the discretion of the author, based on feedback and

comments by experts, have been made.

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Result and Finding

Background of Selected Study

Author-title-journal-data from (Scopus, Science Direct, PubMed)

Table 4 The Selected Study

Authors

Title

Year

Journal

Scopus

Science

Direct

Seo H.; Pham H.T.T.L.;

Golabchi A.; Seo J.; Han

A case study of motion data-

driven biomechanical

assessment for identifying

and evaluating ergonomic

interventions in reinforced-

concrete work

2023

Developments in

the Built

Environment

Antwi-Afari M.F.; Li

H.; Anwer S.; Li D.; Yu

Y.; Mi H.-Y.; Wuni I.Y.

Assessment of a passive

exoskeleton system on

spinal biomechanics and

subjective responses during

manual repetitive handling

tasks among construction

workers

2021

Safety Science

Carlan N.; Vi P.; Yung

M.; Du B.; Bigelow

P.L.; Wells R.P.

Evolving pipe joining

methods and their

association to

musculoskeletal symptoms

for residential plumbers

2023

Work

Kim S.; Ojelade A.;

Moore A.; Gutierrez N.;

Harris-Adamson C.;

Barr A.; Srinivasan D.;

Rempel D.M.;

Nussbaum M.A.

Understanding contributing

factors to exoskeleton use-

intention in construction: a

decision tree approach using

results from an online

survey

2023

Ergonomics

Kusmasari W.; Sutarto

A.P.; Dewi N.S.;

Yassierli; Yudhistira T.;

Muslim K.; Sanjaya

K.H.; Haqiyah A.;

Lestari W.D.

Exploring the interaction

between physical,

psychosocial, and neck pain

symptoms in construction

workers

2024

Journal of

Occupational

Health

Gonsalves N.J.; Yusuf

A.; Ogunseiju O.;

Akanmu A.

Evaluation of concrete

workers' interaction with a

passive back-support

exoskeleton

2023

Engineering,

Construction and

Architectural

Management

Zhang H,Lin Y

Modeling and evaluation of

ergonomic risks and

controlling plans through

discrete-event simulation

2023

Automation in

Construction

Motabar H,Nimbarte

The effect of task rotation

on activation and fatigue

response of rotator cuff

2021

Applied

Ergonomics

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muscles during overhead

work

e Silva Nascimento

JM,Bispo LG,da Silva

Risk factors for work-

related musculoskeletal

disorders among workers in

Brazil: A structural equation

model approach

2024

International

Journal of

Industrial

Ergonomics

Garosi E,Mazloumi

A,Jafari AH,Keihani

A,Shamsipour M,Kordi

R,Kazemi Z

Design and ergonomic

assessment of a passive

head/neck supporting

exoskeleton for overhead

work use

2022

Applied

Ergonomics

Li J,Chen G,Antwi-

Afari MF

Recognizing sitting

activities of excavator

operators using multi-sensor

data fusion with machine

learning and deep learning

algorithms

2024

Automation in

Construction

Ogedengbe TS,Abiola

OA,Ikumapayi

OM,Afolalu SA,Musa

AI,Ajayeoba AO,Adeyi

Ergonomics Postural Risk

Assessment and

Observational Techniques in

the 21st Century

2023

Procedia

Computer

Science

Zhang Z,Lin KY

Applying implementation

science to evaluate

participatory ergonomics

program for continuous

improvement: A case study

in the construction industry

2024

Applied

Ergonomics

Ijaz M,Ahmad

SR,Akram M,Khan

WU,Yasin NA,Nadeem

Quantitative and qualitative

assessment of

musculoskeletal disorders

and socioeconomic issues of

workers of brick industry in

Pakistan

2020

International

Journal of

Industrial

Ergonomics

Antwi-Afari MF,Qarout

Y,Herzallah R,Anwer

S,Umer W,Zhang

Y,Manu P

Deep learning-based

networks for automated

recognition and

classification of awkward

working postures in

construction using wearable

insole sensor data

2022

Automation in

Construction

Maciukiewicz

JM,Whittaker

RL,Hogervorst

KB,Dickerson CR

Wrapping technique and

wrapping height interact to

modify physical exposures

during manual pallet

wrapping

2021

Applied

Ergonomics

de Souza DS,da Silva

JM,de Oliveira Santos

Influence of risk factors

associated with

musculoskeletal disorders

2021

International

Journal of

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JV,AlcÃ¢ntara

MS,Torres MG

on an inner population of

northeastern Brazil

Industrial

Ergonomics

Akanmu AA,Olayiwola

J,Ogunseiju

O,McFeeters D

Cyber-physical postural

training system for

construction workers

2020

Automation in

Construction

Seo J,Lee S

Automated postural

ergonomic risk assessment

using vision-based posture

classification

2021

Automation in

Construction

Kumar A,Pramanik

A,Singh JK,Tiwari

RK,Jena S

An ergonomic intervention

for manual load carrying on

Indian farms

2021

International

Journal of

Industrial

Ergonomics

Ryu J,McFarland

T,Banting B,Haas

CT,Abdel-Rahman E

Health and productivity

impact of semi-automated

work systems in

construction

2020

Automation in

Construction

Cuny-Guerrier

A,Savescu A,Tappin D

Strategies to commit senior

subcontractor managers in

participatory ergonomics

interventions

2019

Applied

Ergonomics

GonzÃ¡lez Fuentes

A,Busto Serrano

NM,SÃ¡nchez Lasheras

F,Fidalgo Valverde

G,SuÃ¡rez SÃ¡nchez A

Work-related overexertion

injuries in cleaning

occupations: An exploration

of the factors to predict the

days of absence by means of

machine learning

methodologies

2022

Applied

Ergonomics

Das B

Improved work organization

to increase the productivity

in manual brick

manufacturing unit of West

Bengal, India

2021

International

Journal of

Industrial

Ergonomics

Wurzelbacher SJ,Lampl

MP,Bertke SJ,Tseng CY

The effectiveness of

ergonomic interventions in

material handling operations

2020

Applied

Ergonomics

Okunola A,Akanmu

A,Jebelli H

Fall risk assessment of

active back-support

exoskeleton-use for

construction work using

foot plantar pressure

distribution

2024

Advanced

Engineering

Informatics

Adeyemi

HO,Adejuyigbe

SB,Adetifa

BO,Akinyemi

OO,Martins OO

Safe lifting ergonomics

program for truck-loaders in

Nigerian block making

industries: A multi-site case

study with qualitative and

econometric analyses

2020

Scientific African

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Virmani N,Ravindra

Salve U

Assessment of key barriers

for incorporating

ergonomics inventions and

suppress work-related

musculoskeletal disorders

2021

Materials Today:

Proceedings

Umer W

Simultaneous monitoring of

physical and mental stress

for construction tasks using

physiological measures

2022

Journal of

Building

Engineering

Cruz AM,Murphy

J,Chohan AK,Quiroga

Torres DA,Izquierdo

Martinez LC,Rincon

Martinez DC,Liu L,Rios

Rincon AM

Comparing the

biomechanical and

perceived exertion imposed

on workers when using

manual mechanical and

powered cargo management

systems during ladder

loading and unloading tasks

2021

International

Journal of

Industrial

Ergonomics

Participatory ergonomic interventions effectiveness in reducing musculoskeletal disorders among

construction workers

Research evidence confirms that participatory ergonomic interventions are effective in lowering the risk of

musculoskeletal disorders (MSDs) among construction workers. For example, Seo et al. (2023, Developments

in the Built Environment) reported that posture-focused interventions reduced disc compression and joint loading

by more than 30%, demonstrating measurable benefits for spinal health. Similarly, Antwi-Afari et al. (2021,

Safety Science) showed that the application of a passive exoskeleton decreased lumbar erector spinae activity

by 33% and reduced discomfort scores by 42% during heavy material handling. In another context, Cruz et al.

(2021, International Journal of Industrial Ergonomics) highlighted that powered cargo systems lowered low-

back compression forces and shoulder flexor moments compared with manual lifting, proving the advantage of

integrating ergonomic technology in construction tasks.

Administrative and organizational approaches have also shown impact. Wurzelbacher et al. (2020, Applied

Ergonomics) found that ergonomic interventions in material handling operations reduced reports of low-back

and upper extremity pain among high-exposure workers. Similarly, Ryu et al. (2020, Automation in

Construction) observed that semi-automated systems reduced joint loading by 40% while improving productivity

by 10%. Zhang and Lin (2023, Automation in Construction) demonstrated through simulation modeling that

applying ergonomic design principles can balance productivity demands with worker fatigue, supporting the

integration of ergonomics into planning.

Nevertheless, limitations are evident. Gonsalves et al. (2023, Engineering, Construction and Architectural

Management) reported that while passive back-support exoskeletons alleviated lumbar strain, they caused

discomfort in the chest and thighs. Similarly, Garosi et al. (2022, Applied Ergonomics) found that a neck-

supporting device reduced sternocleidomastoid activity but simultaneously increased trapezius load, transferring

strain from one region to another. Maciukiewicz et al. (2021, Applied Ergonomics) identified mixed outcomes

when evaluating pallet-wrapping tasks, as muscle demand varied depending on wrapping technique and height.

These findings indicate that although participatory ergonomics can reduce MSDs, their success depends on task

type, equipment design, and compatibility with work systems

Usage of Technology in Participatory Ergonomics to Assess and Reduce Ergonomic Risks in Construction

Work

Technological applications have increasingly enhanced participatory ergonomics by providing objective, data-

driven methods for assessing and reducing ergonomic risks. Seo and Lee (2021, Automation in Construction)

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achieved 89% accuracy in automated classification of construction postures using vision-based posture

recognition, demonstrating reduced reliance on subjective observational assessments. Similarly, Antwi-Afari et

al. (2022, Automation in Construction) applied wearable insole pressure sensors combined with recurrent neural

networks, achieving 99% accuracy in identifying awkward postures, showing the potential of sensor-based

monitoring for MSD prevention. Li et al. (2024, Automation in Construction) further demonstrated that multi-

sensor data fusion with deep learning achieved more than 98% accuracy in recognizing sitting behaviors among

excavator operators, providing reliable insights into operator ergonomics.

In terms of training and feedback, Akanmu et al. (2020, Automation in Construction) developed a cyber-physical

postural training system that combined wearable sensors with real-time feedback, which was positively received

by construction workers for improving posture awareness. Beyond construction, Kumar et al. (2021,

International Journal of Industrial Ergonomics) designed ergonomic load-carrying systems for agricultural

workers, showing that participatory and culturally adapted designs could reduce spinal strain, a lesson

transferable to construction tasks.

Despite these advances, challenges remain. Okunola et al. (2024, Advanced Engineering Informatics) found that

while active back-support exoskeletons reduced spinal loading, they increased plantar pressure by 7–51%,

raising potential fall risks during movement-intensive tasks. Acceptance of interventions has been shown to

increase when accompanied by economic benefits; for instance, Adeyemi et al. (2020, Scientific African)

demonstrated that ergonomic lifting programs in block-making industries reduced absenteeism by 66.7% and

medical costs by 98.3%, proving both health and financial benefits. Organizational support is also critical. Cuny-

Guerrier et al. (2019, Applied Ergonomics) emphasized that management commitment, steering committees, and

alignment with organizational goals were essential for sustaining participatory ergonomics programs. Similarly,

Zhang and Lin (2024, Applied Ergonomics) applied implementation science to participatory ergonomics,

achieving reductions in MSD injuries, improved worker knowledge, and a positive return on investment.

These findings collectively demonstrate that technology enhances the effectiveness of participatory ergonomics

in construction by improving assessment precision, supporting worker training, and providing real-time

monitoring. However, their long-term success depends on design improvements, financial justification, and

continuous organizational commitment

DISCUSSION AND CONCLUSION

Research evidence highlights that ergonomic interventions substantially reduce biomechanical strain and

improve musculoskeletal outcomes in construction activities. Seo et al. (2023) observed that posture-

oriented interventions lowered disc compression and joint moments by over 30%, indicating positive effects

across multiple body regions. Antwi-Afari et al. (2021) similarly found that a passive exoskeleton reduced

lumbar erector spinae activity by up to 33% and discomfort scores by 42% under heavy lifting, while Cruz

et al. (2021) demonstrated that powered cargo systems significantly decreased low-back compression

forces and shoulder flexor moments compared with manual handling. Positive impacts were also reported

in studies applying systemic and administrative approaches; Wurzelbacher et al. (2020) confirmed

reductions in reported upper extremity and low-back pain among highly exposed employees using

ergonomic interventions in material handling, and Ryu et al. (2020) showed that semi-automated systems

cut joint loads by 40% and improved productivity by 10%. Moreover, Zhang and Lin (2023) applied

simulation modeling to demonstrate that incorporating ergonomic principles into planning can balance

worker fatigue with productivity. Collectively, these studies underline that interventions whether

exoskeletons, semi-automation, or improved planning offer strong potential to mitigate musculoskeletal

disorders in construction work.

However, results also reveal limitations, trade-offs, and the need for iterative design improvements.

Gonsalves et al. (2023) found that while back-support exoskeletons reduced lumbar strain, they caused

discomfort in the chest and thighs, whereas Garosi et al. (2022) noted that neck-supporting devices

alleviated sternocleidomastoid activity but increased trapezius load, highlighting the issue of risk transfer

across body parts. Maciukiewicz et al. (2021) identified similar mixed effects, showing that wrapping

devices altered muscle demands differently depending on height, reducing postural risks in some cases

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while increasing muscular activation in others. Meanwhile, Motabar and Nimbarte (2021) showed that

specific task rotation sequences could lower shoulder muscle fatigue, although the effects varied by

exertion level. Carlan et al. (2023) also reported that the adoption of new pipe-joining methods has potential

to reduce risks but is limited by barriers such as cost and tool design. These findings demonstrate that while

ergonomic interventions are broadly effective in reducing exposure to musculoskeletal risks, their success

is highly dependent on task type, posture requirements, and device compatibility with existing work

systems, stressing the importance of context-specific design and implementation strategies.

Studies assessing musculoskeletal disorders (MSDs) in construction consistently reveal that both physical

and psychosocial exposures contribute significantly to workers’ health outcomes. Kusmasari et al. (2024)

showed that workers exposed to high physical and psychosocial demands were over twelve times more

likely to develop neck pain, while e Silva Nascimento et al. (2024) confirmed that maintaining awkward

lower limb positions increased the risk of MSDs in the thigh, leg, and foot, with psychosocial stressors

indirectly moderating these effects. De Souza et al. (2021) similarly found that back disorders in Brazilian

workers were influenced by curved spine postures, uncomfortable lower limb positions, long working

hours, and job insecurity, with psychosocial stress acting as an indirect factor. Supporting these findings,

Ogedengbe et al. (2023) emphasized that prolonged sitting, heavy lifting, and twisting are common postures

leading to elevated ergonomic risks, while Ijaz et al. (2020) documented that brick kiln workers faced very

high risk levels in tasks such as mixing and molding, reporting widespread pain across multiple body

regions. Das (2021) added that although brick manufacturing in India exposed workers to high-risk postures

under the OWAS method, reorganization of tasks improved productivity by 32% and reduced

biomechanical strain. Together, these findings underline that MSDs in construction emerge from a complex

interaction of biomechanical demands, psychosocial pressures, and workplace conditions, requiring holistic

risk assessment.

Technological and data-driven approaches have emerged as valuable tools to enhance risk evaluation and

management. Seo and Lee (2021) achieved nearly 89% accuracy in automated classification of construction

workers’ postures through vision-based methods, reducing reliance on traditional observational analysis

and minimizing observer bias. González Fuentes et al. (2022) demonstrated the predictive power of

machine learning in analyzing overexertion injuries in the cleaning industry, showing that absence duration

could be forecast using factors such as injury type and employment conditions, offering applications for

construction safety. Umer (2022) advanced this approach by demonstrating that physical and mental stress

can be simultaneously monitored with 94.7% accuracy using physiological measures and machine learning,

paving the way for comprehensive real-time monitoring of workload. Collectively, these results illustrate

that alongside traditional ergonomic assessments, advanced computational techniques and organizational

interventions provide promising pathways to predict, prevent, and mitigate the risks of MSDs in

construction work.

Technological innovations such as exoskeletons, wearable sensors, and cyber-physical systems are

increasingly applied in construction to prevent musculoskeletal disorders (MSDs), with evidence

highlighting both effectiveness and limitations. Kim et al. (2023) identified fatigue reduction, performance

gains, and standardization as key drivers influencing exoskeleton adoption, although actual use remains

low due to variable perceptions among workers. Li et al. (2024) demonstrated that multi-sensor data fusion

and deep learning achieved over 98% accuracy in recognizing excavator operators’ sitting postures,

offering reliable insights into operator behavior. Similarly, Antwi-Afari et al. (2022) achieved 99%

accuracy in classifying awkward postures using wearable insole pressure data with recurrent neural network

models, confirming the potential of sensor-based systems for proactive MSD prevention. Supporting this

direction, Akanmu et al. (2020) introduced a cyber-physical training system integrating sensors, virtual

reality, and real-time feedback, which was positively perceived by workers for learning safe postures

without disrupting tasks. Kumar et al. (2021) further contributed by designing ergonomic load-carrying

harnesses for agricultural workers, redistributing spinal loads and demonstrating that cultural practices can

be retained while reducing biomechanical strain. Collectively, these findings suggest that sensor-driven,

AI-enabled systems can significantly enhance ergonomic monitoring, training, and intervention in

construction environments.

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Nonetheless, emerging evidence also reveals challenges and unintended risks that must be considered for

sustainable adoption. Okunola et al. (2024) found that active back-support exoskeletons increased plantar

pressure in carpentry tasks by 7–51%, raising fall risks particularly during movement-intensive subtasks,

emphasizing the need for improved design to prevent secondary hazards. Adeyemi et al. (2020) showed

that ergonomic lifting programs not only reduced fatigue and musculoskeletal pain in block-making

industries but also delivered economic benefits, reducing absenteeism by 66.7% and medical costs by

98.3%, reinforcing that acceptance is higher when interventions provide measurable financial gains. Cuny-

Guerrier et al. (2019) highlighted that senior management commitment is critical for participatory

ergonomics programs, with strategies such as steering committees, knowledge transfer, and aligning

interventions with shared organizational goals fostering stronger engagement. Zhang and Lin (2024) also

demonstrated that applying implementation science frameworks to participatory ergonomics facilitated

continuous improvements, achieving reductions in MSD injuries, enhanced worker knowledge, and

positive return on investment. Finally, Virmani and Salve (2021) underscored that systemic and

organizational barriers, including costs, perceptions, and cultural resistance, often hinder the smooth

implementation of ergonomic programs. Taken together, these studies illustrate that while technological

and participatory innovations show high potential in reducing MSDs, their effectiveness depends on careful

integration of safety design, organizational strategies, and economic justification.

In conclusion, the reviewed evidence highlights the considerable promise of ergonomic strategies such as

exoskeletons and digital monitoring tools in reducing musculoskeletal disorders within construction

activities. The success of these interventions, however, depends greatly on designs tailored to specific work

contexts, sustained organizational support, and attention to both biomechanical and psychosocial risk

factors. These findings emphasize the importance of adopting a comprehensive approach to promoting

health and safety among construction workers.

Conflicts of Interest

The authors declare that they have no conflicts of interest to report regarding the present study

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