Personal service assistance: musculoskeletal disorders and injuries in consumer-directed home care

Am J Ind Med. 2013 Apr;56(4):454-68. doi: 10.1002/ajim.22133. Epub 2013 Feb 8.


Background: Like other types of care for disabled or elderly adults, consumer-directed personal assistance services may present multi-factorial risks for work-related musculoskeletal disorders (WRMSDs).

Methods: Using survey data, we compared providers experiencing WRMSDs in the previous year to those who did not, seeking to identify functional, temporal, physical, and relationship risk factors for transient and chronic conditions.

Results: Longer work experience with the recipient and more frequent bending increased the risk of being in the most chronic group (≥12 painful episodes), whereas predictable work hours with rest breaks and greater social support from the recipient appeared protective. For transient conditions (one to two episodes), longer work experience with the recipient and predictable hours with rest breaks appeared protective.

Conclusions: We offer recommendations to improve hazard assessment as well as training and information distribution related to home care programs. With the population aging, home care jobs require increasing oversight to prevent WRMSDs.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • California
  • Cohort Studies
  • Data Collection
  • Female
  • Health Services for the Aged / statistics & numerical data*
  • Home Care Services / statistics & numerical data*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Models, Theoretical
  • Musculoskeletal Diseases / epidemiology*
  • Occupational Injuries / epidemiology*
  • Personal Health Services / statistics & numerical data*
  • Workforce