ERGONOMIC INTERVENTIONS FOR REDUCING MUSCULOSKELETAL DISORDERS IN SMALL AND MEDIUM-SIZED ENTERPRISES: A SYSTEMATIC REVIEW

Background: Musculoskeletal disorders (MSDs) remain a significant occupational health concern in small and medium-sized enterprises (SMEs) particularly in labour-intensive sectors where workers are exposed to awkward postures, repetitive movements, manual handling and poor workstation design. 
Aim: This systematic review aimed to synthesize evidence on ergonomic interventions for reducing MSD risks among SME workers. 
Methods: The review was conducted in accordance with PRISMA 2020 guidelines. Four databases from PubMed, Scopus, IEEE Xplore and Google Scholar were searched for English-language studies published between 2020 and 2024. Studies were included if they focused on workplace ergonomic interventions, reported MSD or ergonomic risk-related outcomes and involved SME worker populations. Due to heterogeneity in intervention types, study designs and outcome measures, a narrative and descriptive synthesis was performed. Thirty-four studies were included in the final review.
Results: The findings showed that MSD prevalence among SME workers remained high, with common complaints involving the lower back, neck, shoulders, wrists/hands and knees. Effective interventions included workstation modifications, tool redesign, ergonomic training, participatory ergonomics, active breaks, job rotation and work-rest scheduling. These interventions were associated with reduced ergonomic risk scores, improved posture, lower discomfort and fatigue, and better worker health, efficiency and satisfaction. However, implementation was limited by low awareness, financial constraints, poor infrastructure and lack of occupational health support. 
Conclusion: Overall, ergonomic interventions, particularly multi-component approaches combining training with workstation or tool redesign, can help reduce MSD risks in SMEs. Future studies should assess long-term effectiveness, cost-effectiveness and scalability across different SME sectors.