Pushing and pulling in relation to musculoskeletal disorders: a review of risk factors

M J Hoozemans, Allard J. Van Der Beek, M. H. W. Frings-Dresen, F.J.H. Dijk, L H van der Woude

Research output: Contribution to JournalArticleAcademicpeer-review


The objective was to review the literature on risk factors for musculoskeletal disorders related to pushing and pulling. The risk factors have been described and evaluated from four perspectives: epidemiology, psychophysics, physiology, and biomechanics. Epidemiological studies have shown, based on cross-sectional data, that pushing and pulling is associated with low back pain. Evidence with respect to complaints of other parts of the musculoskeletal system is lacking. Risk factors have been found to influence the maximum (acceptable) push or pull forces as well as the physiological and mechanical strain on the human body. The risk factors have been divided into: (a) work situation, such as distance, frequency, handle height, and cart weight, (b) actual working method and posture/movement/exerted forces, such as foot distance and velocity, and (c) worker's characteristics, such as body weight. Longitudinal epidemiological studies are needed to relate pushing and pulling to musculoskeletal disorders.

Original languageEnglish
Pages (from-to)757-781
Number of pages25
Issue number6
Publication statusPublished - Jun 1998


  • Arm Injuries
  • Back Injuries
  • Biomechanical Phenomena
  • Disease Susceptibility
  • Human Engineering
  • Humans
  • Models, Anatomic
  • Musculoskeletal Diseases
  • Occupational Diseases
  • Occupational Exposure
  • Physical Exertion
  • Posture
  • Psychophysics
  • Risk Factors
  • Self-Assessment
  • Sex Factors
  • Work
  • Workload
  • Journal Article
  • Review


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