Musculoskeletal discomfort, urinary incontinence, and health-related quality of life in female farmers aged 40–65 years: a cross-sectional comparative study from rural Türkiye

BACKGROUND: Female farmers are exposed to combined biomechanical and pelvic-floor stressors during agricultural work. However, musculoskeletal discomfort, urinary incontinence, and health-related quality of life have seldom been evaluated together in this population. This exploratory study therefore compared these outcomes between female farmers and rural homemakers and examined associations between regional discomfort and quality of life. METHODS: This cross-sectional comparative study included 70 women recruited by snowball sampling: 35 farmers and 35 homemakers aged 40-65 years from rural districts of Aydın Province, Türkiye. Outcomes were assessed using the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and the 36-item Short Form Health Survey (SF-36). Group comparisons, regression models adjusted for age, body mass index, and menopausal status, and Spearman correlations corrected for the false discovery rate (FDR; significance at q < 0.05) were performed. RESULTS: Farmers reported a higher discomfort prevalence in 12 of 18 CMDQ regions. The largest unadjusted differences were observed for the left shoulder (48.6% vs. 26.5%; +22.1% points), left knee (65.7% vs. 45.7%; +20.0), hip (42.9% vs. 25.7%; +17.1), and right forearm (20.0% vs. 8.6%; +11.4). These differences were not statistically robust: no region remained significant after FDR correction (minimum q = 0.626), and adjusted logistic models showed no independent group associations (p = 0.081-0.993). ICIQ-SF scores tended to be higher among farmers (4.0 ± 3.8 vs. 3.0 ± 4.2; unadjusted p = 0.127; adjusted p = 0.578), and self-reported leakage during physical activity/exercise was more frequent (31.4% vs. 11.4%; p = 0.078). SF-36 domains were numerically lower among farmers, with no significant adjusted differences (adjusted p ranging from 0.296 for role emotional to 0.886 for physical functioning). FDR-significant inverse correlations included farmers' upper-back discomfort with general health (rho=-0.700, q < 0.001), farmers' right-knee discomfort with bodily pain (rho=-0.672, q < 0.001), and homemakers' low-back discomfort with bodily pain (rho=-0.632, q = 0.003). CONCLUSIONS: In this exploratory rural sample, female farmers showed a broader distribution of musculoskeletal discomfort and a nonsignificant tendency toward more activity-related urinary leakage. Adjusted analyses did not confirm independent group effects; the results should therefore be interpreted as hypothesis-generating. They nonetheless suggest the value of considering combined musculoskeletal and urinary screening, and of more detailed exposure assessment, in rural women's health.