ECJ EUROPEAN Cleaning Journal

New research on musculoskeletal disorders in older cleaning operatives points to organisational and ergonomic levers that building managers and cleaning contractors control directly. Consultancy firm ValkarTech in the US tells us how an ageing workforce is not a problem to be managed, but a system to be redesigned. 

A SYSTEMATIC REVIEW published in Frontiers in Public Health has examined musculoskeletal disorders (MSDs) among hospital cleaning staff aged 50 and over - drawing on 11 international studies to map the physical demands, risk factors, and organisational conditions that determine whether older workers can sustain productive, injury-free employment.

The findings are directly relevant beyond the hospital context. The physical demands of cleaning - prolonged standing, repetitive bending, floor care, equipment handling - are consistent across facility types. And the organisational levers the review identifies as protective apply equally to office blocks, residential buildings and commercial environments. The message for building managers and cleaning contractors is clear: the risk is not primarily in the workers. It is in how the work is organised.

The review found MSD prevalence rates ranging from 49.1 per cent to 68.96 per cent among cleaning workers aged 50 and over, depending on the measurement window (seven-day or 12-month recall periods). The body regions most frequently affected were the lower back, upper back, shoulders, and knees - consistent with the biomechanical demands of floor cleaning, equipment handling and sustained awkward postures.

One important nuance: the review found that age alone does not in itself predict MSD risk. Some studies showed increased risk with age; others suggested a protective effect of accumulated professional experience. The authors attribute part of this inconsistency to the ‘healthy worker effect’: the tendency for the most physically compromised workers to exit the labour force earlier, leaving a relatively healthier cohort in active employment. This means MSD prevalence among workers who remain in the sector may actually understate the true burden.

Biomechanically demanding tasks

The review categorises cleaning tasks into five broad groups: surface and equipment cleaning, patient area work, floor care, waste handling and object transport. The biomechanically demanding tasks are:
• Floor washing and machine operation impose sustained forward bending and shoulder loading.
• Trolley handling requires significant pushing and pulling forces.
• Waste collection involves repeated trunk flexion under load.
• Prolonged standing throughout shifts contributes to lower limb fatigue and cumulative spinal loading.

These demands are not unique to hospitals. Any cleaning operation serving large, multi-floor facilities with significant floor area, heavy equipment, and continuous occupancy imposes comparable physical loads on its workforce.

The review identifies several factors beyond physical demand that contribute to MSD risk in older cleaning workers:
• Age-related physiological changes: reduced muscle strength and diminished recovery capacity mean the same task load imposes a proportionally greater physiological cost on older workers.
• Insufficient rest: workers who cannot recover adequately between shifts accumulate musculoskeletal load over time.
• Occupational stress: sustained work pace, irregular scheduling and limited social recognition of cleaning work are all identified as contributors to MSD risk.

Taking action

The interaction between these factors is significant. A worker managing elevated physical demands, limited recovery time and a high-stress work environment is substantially more at risk than any single factor would predict in isolation.

The most actionable section of the review concerns what the authors frame through the Person–Environment Fit model: the premise that MSDs arise when work demands exceed individual capacity in an organisational environment that fails to compensate or adapt. This framing shifts the analytical lens from the worker to the system.

Organisational risk factors include:
• Low work autonomy - limited ability for workers to pace themselves or sequence tasks
• Effort-reward imbalance - high physical output without commensurate recognition or compensation
• Insufficient communication between management and frontline staff
• Absence of ergonomic training
• Extended task repetition.

Conversely, operations characterised by task rotation, communication, structured training and adequate recovery time are associated with meaningfully better musculoskeletal health outcomes. The difference is not in the workforce - it is in how the work is organised.

On the equipment side, the review identifies specific technological improvements as effective risk-reduction measures:
• Adjustable handles on mops, brooms, and cleaning tools
• Ergonomic waste containers that minimise lifting and twisting
• Mechanical assists for heavy equipment transport

Structured ergonomic training, ie, teaching correct body mechanics for specific cleaning tasks, and adequate supervisory support are identified as independent protective factors.

The review’s conclusions translate directly into operational decisions that cleaning contractors and building managers can make:
• Task rotation: distributing physically demanding tasks across team members rather than concentrating them on specific individuals or shifts. 
• Strategic scheduling of rest: building recovery windows into shift schedules rather than treating rest as incidental. 
• Ergonomic equipment investment: adjustable tools, mechanical assists and purpose-designed containers are not premium options. 
• Structured ergonomic training: technique training for specific cleaning tasks should be part of every onboarding programme and reinforced through continuing development.
• Management-team communication: regular, substantive communication between supervisors and frontline staff about workload, physical constraints and task allocation is independently associated with better health outcomes.

The cleaning sector is experiencing demographic ageing. The workforce that maintains commercial and institutional buildings is older on average than it was 20 years ago, and the pipeline of younger replacement workers is constrained by well-documented labour market pressures. This is the operating environment, not a temporary condition.

www.valkartech.com