What are cost-effective ergonomics interventions for prevention and management of occupational musculoskeletal disorders: a systematic review of economic evaluation studies

PURPOSE: This study aimed to identify cost-effective ergonomic interventions implemented for the prevention and management of work-related musculoskeletal disorders by systematically reviewing economic evaluation studies in this area. METHODS: Randomized trials of workplace interventions with full economic evaluation were considered based on PRISMA 2020 guideline. RESULTS: All interventions were designed to manage and alleviate the adverse outcomes (of musculoskeletal disorders, particularly lower-back pain, and no preventive intervention had been considered, in healthcare workers in high-income countries. Among interventions with significant effectiveness, organizational interventions have shown the most promising results. Cost-effectiveness analysis was the most prevalent study type with a broad range of outcome measures. The most common outcome measure in cost-effectiveness studies was the number of days off work or the duration until recovery. Societal perspective was mostly selected to measure costs. CONCLUSION: The evidence on cost-effectiveness of ergonomic interventions is mixed and characterized by methodological heterogeneity. Current literature suggests a trend where organizational interventions are frequently identified among the effective strategies, particularly for managing conditions like low-back pain. However, significant gaps remain, including narrow cost perspectives, short time horizons, and a predominant focus on curative rather than preventive measures in high-income settings. Future economic evaluations should adopt broader societal cost assessments, longer follow-ups, and model-based approaches to better capture long-term value. Urgently, more research is needed in low- and middle-income countries to understand context-specific economic impacts.