Paradox in Practice: Work-Related Musculoskeletal Disorder Prevalence and Reporting among Construction Workers in Kuwait and Denmark

Abstract

Work-related musculoskeletal disorders (WMSDs) are a significant health issue among construction workers, with prevalence influenced by factors such as personal demographics, exposure to work risk factors, and working conditions. This study addresses a research gap by comparing WMSD prevalence between Kuwait and Denmark; two countries with contrasting working conditions. Data were collected from 117 workers in Kuwait and 47 in Denmark using the Nordic Musculoskeletal Questionnaire (NMQ). Results showed that 78.72% of Danish workers reported discomfort in at least one body part compared to 52.14% in Kuwait, despite Denmark’s comparatively better working conditions. Additionally, absenteeism due to WMSDs was higher in Denmark (29.79%) than in Kuwait (9.40%). This paradoxical finding led to further analysis using logistic regression that indicated country was a significant predictor of WMSD reporting (OR=3.38, p<0.05), with Danish workers being substantially more likely to report WMSDs than their Kuwaiti counterparts. This suggested potential underreporting in Kuwait, prompting an investigation into organizational, economic, and cultural factors that may influence reporting behaviors. Specifically, Kuwait’s high power distance and uncertainty avoidance may contribute to miscommunication and underreporting, while Denmark’s individualistic culture encourages transparency. This study makes two primary contributions to the construction engineering and management body of knowledge by: (1) providing the first cross cultural analysis of WMSD prevalence between Gulf Cooperation Council and Nordic construction sectors, and (2) demonstrating that country factors—likely cultural in nature—are stronger predictors of WMSD reporting than individual worker personal demographics. For Kuwait, this implies a need for improved reporting systems, greater worker empowerment, and enhanced working conditions, while Denmark would benefit from a focus on strengthening preventive measures. Future research should further explore the role of cultural influences on WMSD reporting. This study underscores the importance of culturally informed approaches in developing effective workplace health and safety strategies. This research reveals important insights about how country-specific characteristics affect the reporting of work-related musculoskeletal disorders (WMSDs) in construction projects. By comparing construction workers in Kuwait and Denmark, we found that despite better working conditions in Denmark, Danish workers reported more WMSDs than their Kuwaiti counterparts. This unexpected finding highlights that workplace culture significantly influences whether workers report health issues. For construction managers and safety professionals, these findings suggest: (1) Traditional health and safety metrics may underestimate WMSD prevalence in cultures where workers are hesitant to report issues. (2) Anonymous reporting systems could encourage more accurate WMSD reporting in high power-distance cultures. (3) Worker empowerment programs and supportive leadership are crucial for creating an environment where health concerns can be openly discussed. (4) Safety training programs should be culturally adapted rather than using a one-size-fits-all approach. (5) Regular ergonomic assessments should be combined with efforts to understand and address cultural, organizational, and economic barriers to reporting. These insights are particularly relevant for international construction companies operating across different cultural contexts and for organizations employing multicultural workforces.