High rates of MSD among supermarket workers

A survey among supermarket workers in the Marche region of Italy, carried out by the local branch of a trade union, finds high rates of work-related musculoskeletal disorders (MSD). Repetitive work is a feature of occupations within the sector; workers, however, have little awareness of risk. This seems to be at least partly due to their work status, as many of the employees have only been in their jobs for a short period and have non-standard work contracts.

The Italian Union for Workers in Commerce, Hotels and Services (Federazione Italiana Lavoratori Commercio Turismo e Servizi, Filcams-Cgil) carried out a survey on health and safety among workers in retail chains in the Italian Marche region, with the support of Ispesl, the National Agency for Health and Safety at Work, and Ires Marche, a local research institute affiliated to the General Confederation of Italian Workers (Confederazione Generale Italiana del Lavoro, Cgil).

The report, Workers’ health and safety in retail chains (in Italian; 1.13 Mb PDF), is available online.

Profile of survey respondents

A total of 400 questionnaires were collected – representing about 10% of the sector’s employees in the region – across a range of occupations in retail. Most of the respondents worked in supermarkets and hypermarkets; the sample was gathered using the ‘snowball’ technique, which relies on referrals from initial participants to generate additional respondents.

More than 64% of the respondents were women, most of whom worked as cashiers and in administration, with over 93% of the cashiers and 78.6% of administrative staff being female (Table 1). The male respondents were mostly warehouse workers, of whom 82.7% were men.

The number of years working with the organisation or length of tenure was relatively low: more than 65% of respondents indicated a tenure of less than 10 years (42.38% reported a tenure of one to five years). Furthermore, some 48% of respondents work on a part-time contract, with a majority of women (69%) doing part-time work. These figures are in line with the overall workforce composition in the sector.

Table 1: Distribution of respondents, by sex and occupation (%)
Distribution of respondents, by sex and occupation (%)
Occupation % of women in occupation % of men in occupation % of respondents in occupation
Cashiers 93.7 6.3 20.4
Shop assistants 71.0 29.0 41.0
Warehouse workers 17.3 82.7 13.4
Administrative staff 78.6 21.4 7.2
Butchers 20.0 80.0 3.9
Employees in cooking, baking and fish preparation 66.7 33.3 6.2
Others 42.4 57.6 7.9
Total 64.3 35.7 100.0

Source: Cgil Marche, 2006

High level of reported illness

Despite a good working environment, many workers complain of illness. Backache is the most common illness (reported by 44.7% of respondents), followed by headaches (30.8%) and articular diseases (25.3%). Generally, women report more illnesses than do men, particularly backache, headaches and anxiety; the latter symptoms may reflect the psychological stress of working with customers. Men complain of insomnia slightly more than do women (Table 2).

Table 2: Main illnesses reported, by sex (%, multiple responses possible)
Main illnesses reported, by sex (%, multiple responses possible)
  Women Men Total
Insomnia 8.0 8.7 8.3
Headaches 34.5 23.9 30.8
Anxiety 13.6 7.3 11.4
Stomach ache 14.1 12.3 13.4
Eye strain/disease 9.2 6.5 8.3
Skin disease 5.6 3.6 4.9
Backache 48.6 37.7 44.7
Articular pains 25.3 25.4 25.3
Menstrual problems 8.8 - 5.7
No illness 21.7 25.4 23.0

Source: Cgil Marche, 2006

Role of occupation in illness

The differences in reporting between men and women may be better understood by separating the figures by occupation. Backache is mainly experienced by butchers (60%), employees in baking, cooking and fish preparation (66%) and cashiers (49.4%); while articular pains are suffered by butchers (47%), employees in baking, cooking and fish preparation (37%) and warehouse workers (34.6%). Headaches are mainly reported by employees in baking, cooking and fish preparation (50%), sales assistants (32.9%) and cashiers (31.6%); while anxiety is noted by butchers and employees in baking, cooking and fish preparation (20%). Some 20% of butchers experience stomach ache, and 28.6% of all employees report eye strain or disease.

Physical and organisational demands

Tables 3 and 4 outline the physical and organisational demands, as reported by the workers. Some 74.2% of the respondents report having to carry heavy loads, 70.3% stated that their work causes them to sweat and 55.8% reported having to work in awkward positions or perform awkward movements.

Table 3: Physical factors, by occupation (% of positive answers)
Physical factors, by occupation (% of positive answers)
  Cashiers Shop assistants Warehouse workers Administrative staff Butchers Employees in cooking, baking and fish preparation Total
Poor workspace 46.1 25.8 34.6 17.9 26.7 54.2 31.3
Awkward positions/movements 49.4 58.7 73.1 21.4 60.0 70.0 55.8
Inappropriate tools 29.5 35.5 38.9 25.0 20.0 37.5 31.8
Work causes sweat 50.6 80.0 86.5 25.0 73.3 83.3 70.3
Carrying loads 64.6 88.4 84.6 7.1 93.3 100.0 74.2

Source: Cgil Marche, 2006

Table 4: Organisational factors, by occupation (% of positive answers)
Organisational factors, by occupation (% of positive answers)
  Cashiers Shop assistants Warehouse workers Administrative staff Butchers Employees in cooking, baking and fish preparation Total
Pace of work 41.0 52.9 45.1 46.4 53.3 41.7 47.3
Monotony 62.8 27.1 51.0 21.4 40.0 16.7 61.5
Repetitiveness 93.7 77.4 75.0 42.9 80.0 75.0 76.2
Ability to change the order of tasks 30.4 47.1 34.6 25.0 53.3 50.0 50.7
Ability to vary movements 48.1 45.8 46.1 21.4 53.3 50.0 43.7
Ability to vary the pace of work 62.0 51.6 57.7 25.0 66.7 54.2 51.9
Tiring responsibilities 21.8 27.1 44.2 22.9 20.0 25.0 31.3
Use of visual display units, such as computer screens 0.0 20.0 57.7 96.4 0.0 12.5 28.8

Source: Cgil Marche, 2006

Repetitiveness (76.2%) and monotony (61.5%) are the most commonly reported organisational demands, and cashiers report the highest incidence of both (93.7% and 62.8%, respectively). Shop assistants and butchers report the highest incidence of pace of work (52.9% and 53.3%, respectively).

The potential to adjust the work routine varies significantly among the occupations: butchers and cashiers have most opportunity to vary the pace of work (66.7% and 62%, respectively) and to vary movements (53.3% and 48.1%, respectively), while butchers and employees in cooking, baking and fish preparation report the greatest scope for changing the order of tasks (53.3% and 50% respectively). Administrative staff cite lower than average levels of monotony and repetitiveness, but have less scope to vary their work routine. Only warehouse workers complain of relatively high levels of responsibilities that cause tiredness.

The working environment is perceived as good by most workers in terms of ventilation (79% of respondents), lighting (78%), noise (82%), dust (67%), smoke, vapours or gas (85%), harmful fluids (90%), electromagnetic fields (70%) and biological factors such as viruses and bacteria (71%). A positive rating for the latter two factors may seem surprising considering the fact that the staff have direct contact with customers, and are surrounded by electric and electronic machinery.


The report Workers’ health and safety in retail chains is probably the first Italian survey carried out in this sector, which is one of the fastest growing in Italy. The workers are mainly young women, having low tenure, non-standard labour contracts and poor identification with their job, reinforced by high rates of monotony and repetitive strain, and irregular working times. Some two thirds of staff work in unusual shift structures: 52.4% of those doing shift work stated that they are ‘too complicated to explain’ and, in 50% of cases, their schedules cover seven days a week because of frequent instances of Sunday opening.

Unfortunately, the report does not provide any specific evidence about the causes of illnesses reported by the respondents; however, analysis by occupation and sex supports the view that monotony and repetitiveness are most likely associated with MSDs, while working with customers and in irregular work shifts could have a positive association with headaches, anxiety and biological risks.

It is worth emphasising that the workers are not well aware of their working conditions and, therefore, underestimate such risks; their work status, as outlined above, offers a good explanation for this information gap. Evidence from the report Workers’ health in Marche (in Italian; 4.4 Mb PDF) shows a significant increase in work-related diseases in the retail sector since 1999.

Mario Giaccone, Fondazione Pietro Seveso

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