Occupational Health & Ergonomics

A Study of Work-Related Complaints of Arm, Neck and Shoulder (CANS) Among Office Workers in Selangor and Kuala Lumpur

Abstract and Background

The computer has become one of the most essential tools in the modern office environment, conferring substantial productivity benefits while silently contributing to a growing burden of musculoskeletal pain. Among the diverse musculoskeletal complaints experienced by computer users, complaints of arm, neck, and shoulder (CANS) represent the most common cluster of symptoms documented in developed countries. In Malaysia, where the labour force exceeds 15 million and office-based work continues to expand, CANS represents a significant but under-recognised occupational health challenge.

Despite the global recognition of CANS as a prevalent occupational complaint, definitive factors that can be consistently associated with its prevalence had not been firmly established in the Malaysian context. This study, published in the Malaysian Journal of Public Health Medicine, was conducted to identify the prevalence of CANS and factors associated with work-related complaints among office workers in Selangor and Kuala Lumpur, two of Malaysia’s most urbanised and commercially active states.

Study Design and Methodology

A cross-sectional survey design was employed, recruiting 110 office workers from government and private sector workplaces across the Selangor and Kuala Lumpur area over a five-month data collection period. Participants were required to complete two validated instruments: the Maastricht Upper Extremity Questionnaire (MUEQ) and the Level of Ergonomic Knowledge Questionnaire.

The MUEQ is a widely used and internationally validated instrument that assesses musculoskeletal complaints in the upper extremities across seven domains: workstation design, body posture, break time, job control, job demands, work environment, and social support. The Level of Ergonomic Knowledge Questionnaire assessed participants’ awareness and understanding of basic computer ergonomic principles. Data were analysed using SPSS version 18.0, with descriptive statistics and correlation analyses performed to examine relationships between CANS prevalence and potential risk factors.

Key Results

Prevalence of CANS

The study revealed a high prevalence of musculoskeletal complaints among the office worker population sampled. The neck region emerged as the most commonly affected area, with 53.6% of participants reporting neck-related complaints. Shoulder complaints followed closely at 53.0%. These findings align with international studies that consistently identify the neck and shoulders as the most vulnerable regions among computer-intensive workers.

Ergonomic Knowledge

A particularly concerning finding was the widespread lack of ergonomic awareness among participants. Only 19.09% (n=21) of office workers from the government sector and 10% (n=11) from the private sector reported having knowledge of computer ergonomics. The majority of participants lacked the basic understanding needed to implement correct computer ergonomics at their workstations, including knowledge of appropriate monitor height, chair adjustment, keyboard positioning, and rest break scheduling.

Risk Factor Associations

Correlation analysis revealed weak associations (r < 0.5) between CANS prevalence and work-related risk factors including workstation design, body posture, break time, and social support. While the associations were weak in magnitude, they were consistent with the multifactorial nature of CANS, where no single factor predominates but rather a constellation of ergonomic, psychosocial, and individual factors interact to influence symptom development. The weak association between CANS and duration of computer use was also noted, though prolonged usage remained a relevant exposure variable.

Comparison with International Literature

The prevalence rates found in this Malaysian study are broadly comparable to those reported in other countries. A study of 2,210 computer office workers in Sri Lanka found a 56.9% one-year CANS prevalence, with the forearm/hand being the most commonly affected region (42.6%), followed by neck (36.7%) and shoulder/arm (32.0%). A study of 181 computer professionals in Bangalore, India, found a CANS prevalence of 58.6%, with neck complaints again leading the list. A Pakistani study of 773 computer workers found shoulder pain in 42% and neck pain in 35% of participants.

These consistent findings across countries and cultures underscore the universal nature of CANS as an occupational health challenge in the digital age. In Malaysia, where musculoskeletal disorders are reported as the third most common occupational disease category after noise-related hearing disorders and occupational lung diseases, the need for preventive strategies is clear.

Implications for Practice

The findings point to an urgent need for comprehensive ergonomic education and workplace intervention programmes targeting office workers in Malaysia. Given the extremely low levels of ergonomic knowledge identified, even basic educational interventions could potentially yield significant improvements. Employer-led initiatives should include workstation ergonomic assessments and modifications, training programmes on correct posture and computer setup, structured break schedules incorporating stretching exercises, and psychosocial support mechanisms to address job demands and social support deficits.

From a policy perspective, occupational health guidelines for office-based workplaces should be strengthened, with the Department of Occupational Safety and Health (DOSH) playing a more active role in promoting ergonomic standards and conducting workplace assessments.

Limitations

The sample size of 110 participants, while providing useful preliminary data, is relatively small and may limit the generalisability of findings. The cross-sectional design cannot establish causation. The reliance on self-reported symptoms may be subject to recall bias. The study was geographically limited to the Klang Valley region, which may not represent working conditions in other parts of Malaysia. The weak correlations observed may partly reflect the multifactorial aetiology of CANS that makes it difficult to isolate individual risk factor contributions.

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