Effects of psychosocial factors on Swedish waste collectors musculoskeletal pain through the mediating roles of occupational fatigue and physical demands: a structural equation model

Abstract Background Musculoskeletal pain is waste collectors’ most common non-fatal and disabling health problem. However, research on how psychosocial factors affect musculoskeletal pain via physical and psychosocial pathways is limited. This study aimed to examine the effects of leadership quality...

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Main Authors: Wenchu Huang, Xu Jin, Longao Yang, Yidan Dong, Yun Wang, Lihua He, Liyun Yang, Mikael Forsman
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22903-0
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author Wenchu Huang
Xu Jin
Longao Yang
Yidan Dong
Yun Wang
Lihua He
Liyun Yang
Mikael Forsman
author_facet Wenchu Huang
Xu Jin
Longao Yang
Yidan Dong
Yun Wang
Lihua He
Liyun Yang
Mikael Forsman
author_sort Wenchu Huang
collection DOAJ
description Abstract Background Musculoskeletal pain is waste collectors’ most common non-fatal and disabling health problem. However, research on how psychosocial factors affect musculoskeletal pain via physical and psychosocial pathways is limited. This study aimed to examine the effects of leadership quality, social support, and job demands on musculoskeletal pain among Swedish waste collectors. In addition, the mediating roles of physical demands and occupational fatigue and their chain mediation were also examined. Methods A 2015 cross-sectional survey of all Swedish waste collectors utilized validated scales (COPSOQ II, SOFI-20, Nordic Questionnaire) to assess exposures (psychosocial factors), mediators (occupational fatigue, physical demands), and outcomes (musculoskeletal pain). Of 1005 eligible workers (≥ 1 year experience), 662 analyzed (65.9% response rate). Participants (median age = 47 years, IQR = 34–54; mean BMI = 27.1 ± 4.0 kg/m2) were primarily male (96.4%), operated rear-loader trucks (77.8%), and had 1–10 years of work experience (54.8%). Structural equation modeling and bias-corrected bootstrapping were used to assess direct/indirect pathways, with p ≤ 0.05 or 95% bootstrapped CIs excluded zero taken as significant. Results Occupational fatigue explains the majority of the intermediate processes. Specifically, occupational fatigue mediated the effects of job demands (β = 0.185, 95% CI: 0.134–0.246), leadership quality (β = -0.074, 95% CI: -0.123 - -0.031), and social support (β = -0.051, 95% CI: -0.095 - -0.007) on musculoskeletal pain. Physical demands mediated job demands (β = 0.113, 95% CI: 0.075–0.155) and leadership quality (β = -0.038, 95% CI: -0.077 - -0.003) on musculoskeletal pain. Physical demands also amplified occupational fatigue (β = 0.369, p < 0.001), forming a chain mediation pathway. Conclusions Leadership quality and job demands significantly influenced musculoskeletal pain through the mediating roles of occupational fatigue and physical demands, respectively. Social support’s impact was limited to occupational fatigue mediation. Physical demands may translate to occupational fatigue and be linked to musculoskeletal pain. Managers of waste collectors should prioritize leadership training and the construction of good psychosocial factors to manage physical demands, ensure mental health, and thereby mitigate musculoskeletal pain.
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spelling doaj-art-ffe48b2e7a75459e95612350c96176182025-08-20T03:45:32ZengBMCBMC Public Health1471-24582025-06-0125111410.1186/s12889-025-22903-0Effects of psychosocial factors on Swedish waste collectors musculoskeletal pain through the mediating roles of occupational fatigue and physical demands: a structural equation modelWenchu Huang0Xu Jin1Longao Yang2Yidan Dong3Yun Wang4Lihua He5Liyun Yang6Mikael Forsman7Department of Occupational and Environmental Health, School of Public Health, Peking UniversityDepartment of Occupational and Environmental Health, School of Public Health, Peking UniversityDepartment of Occupational and Environmental Health, School of Public Health, Peking UniversitySection of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Second University Hospital, Sichuan UniversityDepartment of Occupational and Environmental Health, School of Public Health, Peking UniversityDepartment of Occupational and Environmental Health, School of Public Health, Peking UniversityInstitute of Environmental Medicine, Karolinska InstitutetInstitute of Environmental Medicine, Karolinska InstitutetAbstract Background Musculoskeletal pain is waste collectors’ most common non-fatal and disabling health problem. However, research on how psychosocial factors affect musculoskeletal pain via physical and psychosocial pathways is limited. This study aimed to examine the effects of leadership quality, social support, and job demands on musculoskeletal pain among Swedish waste collectors. In addition, the mediating roles of physical demands and occupational fatigue and their chain mediation were also examined. Methods A 2015 cross-sectional survey of all Swedish waste collectors utilized validated scales (COPSOQ II, SOFI-20, Nordic Questionnaire) to assess exposures (psychosocial factors), mediators (occupational fatigue, physical demands), and outcomes (musculoskeletal pain). Of 1005 eligible workers (≥ 1 year experience), 662 analyzed (65.9% response rate). Participants (median age = 47 years, IQR = 34–54; mean BMI = 27.1 ± 4.0 kg/m2) were primarily male (96.4%), operated rear-loader trucks (77.8%), and had 1–10 years of work experience (54.8%). Structural equation modeling and bias-corrected bootstrapping were used to assess direct/indirect pathways, with p ≤ 0.05 or 95% bootstrapped CIs excluded zero taken as significant. Results Occupational fatigue explains the majority of the intermediate processes. Specifically, occupational fatigue mediated the effects of job demands (β = 0.185, 95% CI: 0.134–0.246), leadership quality (β = -0.074, 95% CI: -0.123 - -0.031), and social support (β = -0.051, 95% CI: -0.095 - -0.007) on musculoskeletal pain. Physical demands mediated job demands (β = 0.113, 95% CI: 0.075–0.155) and leadership quality (β = -0.038, 95% CI: -0.077 - -0.003) on musculoskeletal pain. Physical demands also amplified occupational fatigue (β = 0.369, p < 0.001), forming a chain mediation pathway. Conclusions Leadership quality and job demands significantly influenced musculoskeletal pain through the mediating roles of occupational fatigue and physical demands, respectively. Social support’s impact was limited to occupational fatigue mediation. Physical demands may translate to occupational fatigue and be linked to musculoskeletal pain. Managers of waste collectors should prioritize leadership training and the construction of good psychosocial factors to manage physical demands, ensure mental health, and thereby mitigate musculoskeletal pain.https://doi.org/10.1186/s12889-025-22903-0Musculoskeletal painPsychosocial factorPhysical demandOccupational fatigueWaste collector
spellingShingle Wenchu Huang
Xu Jin
Longao Yang
Yidan Dong
Yun Wang
Lihua He
Liyun Yang
Mikael Forsman
Effects of psychosocial factors on Swedish waste collectors musculoskeletal pain through the mediating roles of occupational fatigue and physical demands: a structural equation model
BMC Public Health
Musculoskeletal pain
Psychosocial factor
Physical demand
Occupational fatigue
Waste collector
title Effects of psychosocial factors on Swedish waste collectors musculoskeletal pain through the mediating roles of occupational fatigue and physical demands: a structural equation model
title_full Effects of psychosocial factors on Swedish waste collectors musculoskeletal pain through the mediating roles of occupational fatigue and physical demands: a structural equation model
title_fullStr Effects of psychosocial factors on Swedish waste collectors musculoskeletal pain through the mediating roles of occupational fatigue and physical demands: a structural equation model
title_full_unstemmed Effects of psychosocial factors on Swedish waste collectors musculoskeletal pain through the mediating roles of occupational fatigue and physical demands: a structural equation model
title_short Effects of psychosocial factors on Swedish waste collectors musculoskeletal pain through the mediating roles of occupational fatigue and physical demands: a structural equation model
title_sort effects of psychosocial factors on swedish waste collectors musculoskeletal pain through the mediating roles of occupational fatigue and physical demands a structural equation model
topic Musculoskeletal pain
Psychosocial factor
Physical demand
Occupational fatigue
Waste collector
url https://doi.org/10.1186/s12889-025-22903-0
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