Malaysian Journal of Medicine and Health Sciences (eISSN 2636-9346) ORIGINAL ARTICLE Distribution of Musculoskeletal Symptoms and Ergonomic Risk Assessment Among Housekeepers at Budget Hotels in Sepang, Selangor ‘Aina Rusydina Ahmad Raji1, Emilia Zainal Abidin1 1 Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia ABSTRACT Introduction: : Hotel housekeepers are exposed to various ergonomic risks and there is a need to assess the physical risk factors for the work tasks performed. This study aims to determine the distribution of musculoskeletal symp- toms (MSS) and perform ergonomic risk assessment among hotel housekeepers working in budget hotels in District of Sepang, Selangor. Methods: A cross-sectional study was conducted among hotel housekeepers from 13 budget hotels around District of Sepang. Nordic questionnaire was used for the assessment of MSS. The overall risk level was determined by Workplace Ergonomic Risk Assessment (WERA) while Rapid Entire Body Assessment (REBA) was used to evaluate the whole body postural risks. Data obtained were entered into statistical program for further analysis according to objectives. Results: This study received 67.0% (n=40) response rate. In total, MSS was reported by 100% (n=40) of the participants in this study. Lower back is the most affected region (77.5%, n=31) and this was followed by heels (57.5, n=23) and shoulders (52.5%, n=21). WERA results showed that all housekeepers are found to be in medium action level of risk meanwhile REBA assessment reported scores that are categorised into medium, high and very high risk. This study suggests that there is the need for changes being implemented in daily work tasks performed. Conclusion: Hotel housekeepers were exposed to high body postural risk due to exposure to highly re- petitive movements and awkward posture while performing work tasks. Effective ergonomic intervention is needed for prevention of debilitating musculoskeletal disorders besides to increase work productivity. Keywords: Musculoskeletal disorder, Work-related musculoskeletal disease, Occupational risk factors, Ergonomic, Hospitality service Corresponding Author: increasing number of incoming tourist who seeks for Emilia Zainal Abidin, PhD accommodation services while on vacation or for any Email: [email protected] other purposes (3). In addition, in 2010, the number of Tel: +603-9769 2643 workers employed in tourism and hospitality industry was recorded as the second biggest total employment INTRODUCTION after manufacturing sector, which was 12% due to booming tourism industry (4). Occurrence of musculoskeletal symptoms (MSS) among the working population are commonly reported and Hotel housekeepers are part of the main operating usually involves symptoms such as pain and discomfort divisions in the organisation of any hotel and acts as in the areas of the upper body such as the neck, shoulders, the major player in the production of basic hotel’s wrists and hands and the lower body such as the upper services which are rooms (5). Thus, they have a crucial and lower back and feet and ankles (1). A research has role in ensuring quality of the service provided to the reported that risk factors such as awkward postures, customers. Such role exposes them work tasks that repetitive movements and forceful exertions are the linked to repetitive movement, excessive force, non- most common physical factors found to be significantly neutral and stationary postures and others identified linked to the development of musculoskeletal disease as the causal factors of work-related musculoskeletal (2). disorders (MSD) (6). In Malaysia, the uptrend and expansion of tourism Specific work tasks related to hotel industry such as industry has led to the growth of many new small changing bedsheets, keeping rooms tidy and cleaning and large hotels throughout the country due to the toilets are among the physically demanding tasks Mal J Med Health Sci 16(SUPP11): 101-108, Nov 2020 101 Malaysian Journal of Medicine and Health Sciences (eISSN 2636-9346) performed by housekeepers as reported in a local study MATERIALS AND METHODS that involved 65 local housekeepers from 10 different hotels around Malaysia (7). In terms of international Study design and setting literature, a study conducted at a Finnish hotel reported This was a cross-sectional study that was conducted that almost all hotel housekeepers experienced shoulder among hotel housekeepers that are employed in budget and back pain because of the heavy and repetitive work hotels across the Sepang District, Selangor. Data that need to be completed and this is compounded by collection was performed starting from January until the need to perform work tasks at a fast pace (8). April 2018. Sepang was selected because the district has become the favorite area for travelers who need The Malaysian legal framework requires the reporting to transit for a short or longer stay since Kuala Lumpur of diagnosed MSD at the workplace under Notification International Airport (KLIA) and KLIA2 are situated at of Accident, Dangerous Occurrence, Occupational this district. Besides, this district also has few tourist Poisoning and Occupational Disease 2004 (9). Statistics attractions area such as the Bagan Lalang beach and the are collected and reported by the Department of Sepang International Racing Circuit. The management Occupational Safety and Health however the available of all operating budget hotels listed in various hotel data does not describe the reported cases according to reservation websites across the Sepang area was the specific sectors such as the hotel industry in Malaysia. contacted and invited to take part in this study. A total However, there was a previous study that reported low of 13 budget hotels management agreed to take part in back pain (60%), wrists or hands (42%) and knees (37%) this study. as the most affected body part in the last 12 months among the hotel housekeepers in Malaysia (7). Despite This study recruited housekeepers according to the the distribution of MSS, no data regarding their exposure following inclusion criteria; they were Malaysians, were to ergonomic risk factors associated with their daily employed for minimum of one year and aged between tasks were reported in the previous study. Bhattacharya 18 to 60 years old. Pregnant women, people whom any (10) believed that higher prevalence of MSDs among health practitioner diagnosed with heart disease and employees led to decrease of the productivity and those who had undergo any musculoskeletal surgery increase of loss workdays. In the long run, MSD can were excluded from this study. Essentially, all employed bring permanent detrimental effects on the workers if no housekeepers in each of the hotel were invited to take prevention and control methods are being developed to part in this study and a purposive sampling method was protect this subgroup of working populations. used. A total of 40 housekeepers consented to participate in this study and were recruited. Budget hotels are increasing in numbers in urban areas in Malaysia (11). Rooms in a budget hotel are cheaply Among the tools used in this study is a set of Malay- priced and contains basic facilities for a large cross- translated questionnaire that consist of several parts. section of customers. Budget hotels are usually small Part A of the questionnaire consisted of items on socio- and are commonly family-run, as such the number of demographic background, general occupational traits, workers including housekeepers are relatively small. lifestyle and medical history while Part B consisted Within such settings, the housekeepers may have to also items from the standardized Nordic Musculoskeletal perform other work tasks related to hotel activities which Symptoms questionnaire by Kuorinka et al. (12). may expose them further to more ergonomic risks. In Interview-based questionnaire was the method used addition, the work done usually involves more manual to collect data. The Nordic questionnaire was used to handling and may have added physical demands due to obtain information about the symptoms at 9 body parts the use of manual tools, as opposed to large chain hotels, which includes neck, shoulder upper and lower back which are more technologically equipped. However, no areas, elbows, hand/wrists, waist/thighs, knees and study has been done locally among housekeepers in ankle/legs regions for the past 12 months. The standard such local settings. questionnaire was back-to-back translated from English to Malay in order to ensure there are no changes to the This study aims to determine the prevalence of MSS actual questionnaire originally provided in English. and to perform objective measurements of ergonomic risks associated with housekeeping work tasks. Data Workplace Ergonomic Risk Assessment (WERA) obtained from the study can help to address the current Next, Workplace Ergonomic Risk Assessment (WERA) MSS problems among the workers in order to make an worksheet was used as the observational tool to identify estimation of the health impacts to the individual and physical risk factor exposures that associated with how it affects their daily performance in addition to help Work-related MSDs (13). WERA consist of physical provide recommendations to protect the workers. risk factors linked with ergonomic hazard which were 102 Mal J Med Health Sci 16(SUPP11): 101-108, Nov 2020 posture, repetition, forceful, vibration, contact stress from 13 budget hotels located in District of Sepang. and task duration and involving shoulder, wrist, back, There was an average of 3 housekeepers employed at neck and leg. WERA uses a scoring system and comes each of the budget hotel. up with action levels that are used to determine the risk level and if there is the need for action to conduct more Socio-demographic characteristics detailed assessment. Recorded videos of housekeepers The respondents had mean (Standard Deviation; SD) performing work tasks were used to assist observation age of 32.8 (11.2) years old. Next, the mean (SD) BMI of by the researcher.