Determinants of Musculoskeletal Disorder in Formal and Informal Workers in Indonesia

Musculoskeletal disorders (MSDs) are a leading cause of disability globally and are strongly influenced by occupational conditions. Evidence comparing MSD risk between formal and informal workers remains limited, particularly in developing countries. This study examined the association between individual and job-related factors with MSD symptoms among formal and informal workers in Indonesia. A cross-sectional study was conducted among 1,089 workers in North Sumatra Province, Indonesia, from August 2024 to December 2025. Participants were recruited using stratified convenience sampling from both the formal (office and health workers) and informal (drivers, traders, and farmers) sectors. MSD symptoms were assessed using the Nordic Body Map questionnaire and categorized into low, moderate, and high-risk levels. Independent variables included age, sex, work experience, and job type. Data were analyzed using Chi-square tests and multivariate logistic regression. Overall, 31.6% of workers reported moderate-to-high MSD symptoms. Informal workers had significantly higher odds of MSD symptoms (OR = 1.607; 95% CI: 1.20–2.10; p-value <0.001). Male workers were more likely to report MSD symptoms (OR = 3.65; 95% CI: 2.7–4.9; p-value <0.001). Longer work experience (>5 years) was associated with lower MSD risk (OR = 0.46; 95% CI: 0.34–0.63; p-value <0.001), while age was not a significant predictor. MSDs remain a substantial occupational health problem among Indonesian workers, particularly in the informal sector. Targeted ergonomic interventions and occupational health programs are needed to reduce disparities and improve workers’ health in developing-country settings.

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