Analysis of Shoulder Pain among Female Cashiers Working in Supermarkets in Erbil City, Kurdistan Region of Iraq

Abstract

Work-related musculoskeletal disorders (WMSDs) rank among the most prevalent occupational health issues globally, especially in occupations characterized by repetitive upper limb motions and inadequate ergonomic conditions. Supermarket cashiers face an elevated risk of shoulder pain attributable to repetitive scanning activities, extended working hours, improper postures, overhead reaching, and insufficient rest breaks. This study seeks to analyze shoulder pain in female supermarket cashiers in Erbil city and to investigate its correlation with occupational risk factors associated with work-related musculoskeletal disorders (WMSDs). This cross-sectional descriptive study sought to ascertain the prevalence of shoulder pain among female supermarket cashiers in Erbil City and to investigate its correlation with occupational and ergonomic risk factors. Data were gathered from various supermarkets between December 25, 2025, and January 27, 2026. A convenience sample of 80 female cashiers, each possessing a minimum of six months of work experience, participated in the study. Data were gathered utilizing a structured questionnaire, specifically the Nordic Musculoskeletal Questionnaire (shoulder section), alongside the Numeric Pain Rating Scale (0–10). Statistical analysis was conducted utilizing SPSS version 19, with a significance threshold established at p < 0.05. The findings indicated a significant prevalence of shoulder pain, with 70% of participants experiencing symptoms in the past six months and 67.5% in the past seven days. Notable correlations were identified between shoulder pain and age (p < 0.001), BMI (p < 0.001 in the six-month analysis; p = 0.005 in the seven-day analysis), tenure as a cashier (p < 0.001), daily working hours (p = 0.004; p = 0.042), and weekly working days (p = 0.003; p = 0.025). Ergonomic factors such as the lack of regular rest breaks (p = 0.010; p = 0.006), frequent overhead reaching (p = 0.002; p = 0.001), and improper posture (p = 0.018; p < 0.001) were significantly correlated with shoulder pain. The findings suggest that shoulder pain in female cashiers constitutes a significant occupational health issue, heavily influenced by adjustable workplace factors.