{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:28:53Z","timestamp":1784042933391,"version":"3.55.0"},"reference-count":20,"publisher":"Ubiquity Press, Ltd.","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["89"],"abstract":"<jats:p>Background: Musculoskeletal disorders (MSDs) are a major occupational health concern among nurses, particularly in high\u2011stress and resource\u2011constrained armed conflict settings. This study assessed the prevalence and occupational and environmental correlates of MSDs among nurses caring for critically ill patients in Gaza City hospitals during the 2023\u20132025 conflict.\nMethods: A cross\u2011sectional descriptive analytic study was conducted among 172 nurses in intensive care units (ICUs), emergency departments, operating rooms, and pediatric ICUs. Data were collected using a structured questionnaire adapted from the Arabic Nordic Musculoskeletal Questionnaire and ergonomic exposure assessment tools. Descriptive statistics summarized MSD prevalence and workplace exposures. MSD burden, defined as the number of affected body regions over the past 12 months, was analyzed using negative binomial regression, with logistic and multiple linear regression used as exploratory sensitivity analyses.\nResults: The 12\u2011month prevalence of MSDs was high, most commonly affecting the neck (69.2%), lower back (68.0%), and shoulders (64.5%). Pain intensity was moderate to high, particularly in the lower back (mean 5.31 \u00b1 3.08), and over 70% of nurses reported difficulty performing work tasks due to pain. Ergonomic risks were widespread, including prolonged neck flexion (84.3%) and trunk bending (67.4%). In multivariable negative binomial regression, being married was independently associated with fewer affected body regions (adjusted incidence rate ratio [aIRR] = 0.71, p = 0.002), while working in humid environments was associated with higher MSD counts (aIRR = 1.24, p = 0.026). Adequate rest showed a modest protective association (aIRR = 0.82, p = 0.045). Work pace and perceived stress were not independently associated with MSD burden.\nConclusion: Critical care nurses in conflict\u2011affected Gaza experience a high burden of MSDs, particularly in the neck and lower back. Workplace humidity and insufficient rest were key modifiable correlates. Occupational health interventions are urgently needed to protect nurses and sustain care delivery.<\/jats:p>","DOI":"10.5334\/aogh.5055","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T08:36:02Z","timestamp":1768898162000},"page":"6","source":"Crossref","is-referenced-by-count":1,"title":["Occupational and Environmental Determinants of Musculoskeletal Disorders Among Nurses in Conflict\u2011Affected Gaza Hospitals"],"prefix":"10.5334","volume":"92","author":[{"given":"Ahmed Z.","family":"Eleiwa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9538-2296","authenticated-orcid":false,"given":"Khalid Jamal","family":"Khadoura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3285","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"issue":"1","key":"key20260120083558_r1","doi-asserted-by":"crossref","first-page":"66","DOI":"10.3390\/jfmk10010066","article-title":"Work\u2011related musculoskeletal disorder prevalence by body area among nurses in Europe: Systematic review and meta\u2011analysis","volume":"10","year":"2025","journal-title":"J Funct Morphol Kinesiol"},{"issue":"1","key":"key20260120083558_r2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/s12891-025-08379-4","article-title":"Comprehensive investigation of ergonomic challenges and predictors of work\u2011related musculoskeletal disorders among intensive care unit nurses of Western India through convergent mixed methods study","volume":"26","year":"2025","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"key20260120083558_r3","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1186\/s13643-024-02687-x","article-title":"The distribution of work\u2011related musculoskeletal disorders among nurses in sub\u2011Saharan Africa: a scoping review","volume":"13","year":"2024","journal-title":"Syst Rev"},{"issue":"1","key":"key20260120083558_r4","first-page":"12","article-title":"Prevalence of work\u2011related musculoskeletal disorders among nurses: A systematic review and meta\u2011analysis","volume":"22","year":"2023","journal-title":"BMC Nurs"},{"key":"key20260120083558_r5","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1186\/s12891-021-04057-3","article-title":"Prevalence of musculoskeletal disorders among perioperative nurses: A systematic review and meta\u2011analysis","volume":"22","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"key20260120083558_r6","first-page":"25","article-title":"Work\u2011related musculoskeletal disorders: A systematic review providing an overview of occupational activities and MSD impact","volume":"74","year":"2024","journal-title":"Occup Med"},{"key":"key20260120083558_r7","first-page":"104523","article-title":"The prevalence and risk factors of work\u2011related musculoskeletal disorders among nurses in China: A systematic review and meta\u2011analysis","volume":"148","year":"2024","journal-title":"Int J Nurs Stud"},{"issue":"5","key":"key20260120083558_r8","first-page":"764","article-title":"Occupational risk factors for musculoskeletal disorders in nurses: A systematic review and meta\u2011analysis","volume":"11","year":"2023","journal-title":"Healthcare"},{"issue":"3","key":"key20260120083558_r9","first-page":"e12345","article-title":"Work\u2011related musculoskeletal disorders among nurses: A meta\u2011analysis of prevalence and risk factors","volume":"64","year":"2022","journal-title":"J Occup Health"},{"key":"key20260120083558_r10","first-page":"104187","article-title":"Psychosocial work factors and musculoskeletal disorders among healthcare workers: A systematic review","volume":"128","year":"2022","journal-title":"Int J Nurs Stud"},{"key":"key20260120083558_r11","first-page":"104110","article-title":"Work\u2011related musculoskeletal disorders among European nurses: A systematic review and meta\u2011analysis","volume":"120","year":"2025","journal-title":"Appl Ergon"},{"issue":"7","key":"key20260120083558_r12","first-page":"1231","article-title":"Occupational stress, workload, and musculoskeletal disorders among healthcare professionals: A systematic review and meta\u2011analysis","volume":"96","year":"2023","journal-title":"Int Arch Occup Environ Health"},{"key":"key20260120083558_r13","first-page":"11589","article-title":"Environmental and ergonomic risk factors for musculoskeletal pain among healthcare workers: A systematic review","volume":"12","year":"2024","journal-title":"Front Public Health"},{"issue":"9","key":"key20260120083558_r14","first-page":"3561","article-title":"Physical and environmental risk factors for work\u2011related musculoskeletal disorders among nurses: A systematic review","volume":"79","year":"2023","journal-title":"J Adv Nurs"},{"issue":"3","key":"key20260120083558_r15","first-page":"123","article-title":"Demographic profile of emergency department nurses in Gaza Strip governmental hospitals","volume":"11","year":"2024","journal-title":"Int J Community Med Public Health"},{"issue":"4","key":"key20260120083558_r16","first-page":"e12378","article-title":"Psychosocial and sociodemographic correlates of musculoskeletal pain among nurses: A systematic review","volume":"64","year":"2022","journal-title":"J Occup Health"},{"issue":"2","key":"key20260120083558_r17","first-page":"145","article-title":"Workplace interventions for preventing musculoskeletal disorders among nurses: A systematic review and meta\u2011analysis","volume":"21","year":"2024","journal-title":"Int J Environ Res Public Health"},{"issue":"10","key":"key20260120083558_r18","first-page":"1339","article-title":"Work design and musculoskeletal disorders: A systematic review of intervention studies","volume":"64","year":"2021","journal-title":"Ergonomics"},{"issue":"1","key":"key20260120083558_r19","first-page":"18","article-title":"Musculoskeletal disorders among nurses in low\u2011and middle\u2011income countries: A systematic review","volume":"22","year":"2023","journal-title":"BMC Nurs"},{"key":"key20260120083558_r20","first-page":"112","article-title":"Effectiveness of multifactorial ergonomic interventions to reduce musculoskeletal pain among health workers: A systematic review","volume":"24","year":"2023","journal-title":"BMC Musculoskelet Disord"}],"container-title":["Annals of Global 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