Musculoskeletal Symptoms, Upper-Limb Disability and Burnout Among Hairdressers Working in Women’s Hairdressing Salons in Istanbul, Turkey: A Cross-Sectional Study

Background: Hairdressing combines sustained arm elevation, repetitive precision grip, prolonged standing and high emotional labour, yet the joint contribution of physical and psychosocial load to musculoskeletal outcomes in this workforce is rarely quantified. We determined the twelve-month prevalence of musculoskeletal symptoms, upper-limb disability and burnout among hairdressers working in women’s hairdressing salons in Istanbul, Turkey, and identified factors associated with a high symptom burden. Methods: In this cross-sectional study, 100 hairdressers registered with the Istanbul Chamber of Women’s Hairdressers and Manicurists were assessed with the Standardised Nordic Questionnaire (Turkish version), the QuickDASH (Turkish version) and the Maslach Burnout Inventory (Turkish adaptation; emotional exhaustion, depersonalisation, personal accomplishment subscales). Participants were dichotomised a priori into low (≤2 affected regions, n = 43) and high (≥3 regions, n = 57) symptom-burden groups. Analyses included Spearman correlations, t/Mann–Whitney U tests (with Holm correction as a sensitivity analysis), multiple linear regression, univariable/multivariable logistic regression constrained by the events-per-variable rule, and sensitivity analyses modelling the continuous number of affected regions (Poisson regression with robust standard errors). Results: Participants (63 men and 37 women; mean age 35.3 ± 6.5 years; mean tenure 12.6 ± 5.8 years) reported symptoms in at least one region in 95% of cases (95% CI 88.7–98.4). Prevalence was highest for the neck (48%), upper back (44%), shoulder (41%), and lower back (38%). Mean QuickDASH was 30.5 ± 9.7, but it was not associated with regional symptom burden. The high-burden group reported higher emotional exhaustion (p = 0.029) and depersonalisation (p = 0.040), lower personal accomplishment (p = 0.014), and greater pain frequency (p = 0.002) and intensity (p < 0.001); after Holm correction, only the pain measures remained significant. In the multivariable model restricted to sociodemographic, occupational, and burnout variables, shorter occupational tenure remained associated with high burden (adjusted OR 0.92 per year, 95% CI 0.85–0.99; AUC = 0.714). In sensitivity analyses treating the number of affected regions as a continuous count, personal accomplishment was the only burnout dimension independently associated with symptom burden (incidence rate ratio 0.965, 95% CI 0.943–0.987), whereas the tenure association attenuated (p = 0.071). Conclusions: Musculoskeletal symptoms were near-universal in this sample and clustered in the neck–shoulder–upper back complex. All three burnout dimensions were worse in high-burden workers, with reduced personal accomplishment the most robust correlate of symptom burden, and workers earlier in their careers carried a higher multi-site burden—cross-sectional associations that are compatible with, but do not demonstrate, a healthy-worker survivor effect. These hypothesis-generating findings require confirmation in prospective, multicentre studies with objective exposure assessment and comparison groups. Preventive programmes should pair ergonomic redesign and exercise with measures that protect professional efficacy.