Cross-Sectional Associations of Work Fatigue with Repetitive-Task Risk, Sleep Quality, and Body Mass Index among Informal Fish-Smoking Workers
DOI:
https://doi.org/10.56338/mppki.v9i9.9759Keywords:
Body Mass Index, Informal Workers, Repetitive-Task Risk, Sleep Quality, Work FatigueAbstract
Introduction: Workers in informal industries are routinely exposed to physical, environmental, and ergonomic stressors that may be associated with fatigue and musculoskeletal strain. This study examined the cross-sectional associations of repetitive-task risk, sleep quality, body mass index, and selected individual characteristics with work fatigue among fish-smoking workers in Semarang, Indonesia.
Methods: Using a cross-sectional design, data were collected from 64 workers through structured questionnaires, observational assessments, and anthropometric measurements. Fatigue levels were measured using the Indonesian version of the Japanese Industrial Fatigue Research Committee (JIFRC) Fatigue Questionnaire, repetitive-task risk was assessed using the Assessment of Repetitive Tasks (ART) method, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), which evaluates subjective sleep quality over the preceding month.
Results: Moderate fatigue was reported by 59.4% of participants. In the bivariate analysis, left-hand repetitive-task risk was associated with fatigue (p = 0.037), whereas right-hand repetitive-task risk and the dichotomised sleep-quality category were not associated with fatigue. In the adjusted linear regression model, the left-hand association was attenuated (B = 0.028, p = 0.839), while BMI remained associated with the coded fatigue outcome (B = 0.181, 95% CI 0.047 to 0.316, p = 0.009). The overall regression model explained 21.3% of the variation in fatigue (R² = 0.213; adjusted R² = 0.115) and did not reach the conventional threshold for statistical significance (F (7, 56) = 2.166, p = 0.051). These estimates should be interpreted cautiously because of the small sample and imbalanced categories.
Conclusion: Among workers in the participating fish-smoking centres, BMI was associated with the coded fatigue outcome after adjustment, while the unadjusted association involving left-hand repetitive-task risk was not retained in the adjusted model. Because the overall regression model was marginally non-significant, the individual adjusted associations should be interpreted cautiously. The findings identify anthropometric assessment, fatigue screening, and further task-specific ergonomic evaluation as priorities for future health-promotion research. Longitudinal and intervention studies are needed before conclusions can be drawn regarding causality, intervention effectiveness, or productivity.
Downloads
References
Kementerian Kesehatan RI. Hidupkan Pos UKK Agar Pekerja Sektor Informal Tersentuh Layanan Kesehatan Kerja. Kementerian Kesehatan RI [Internet]. 2016 Nov 8. Available from: https://www.kemkes.go.id/id/hidupkan-pos-ukk-agar-pekerja-sektor-informal-tersentuh-layanan-kesehatan-kerja
Maisel P, Baum E, Donner-Banzhoff N. Fatigue as the Chief Complaint. Dtsch Arztebl Int [Internet]. 2021 Aug 23; Available from: https://www.aerzteblatt.de/10.3238/arztebl.m2021.0192
Husaeni N, Thamrin Y, Muis M, Wahyu A, Jafar N. Analysis of Factors Influencing Work Fatigue Among Workers in Noise-Exposed Environments at The Antang Furniture Industrial Area. Salud, Cienc y Tecnol [Internet]. 2025;5. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-105016806275&doi=10.56294%2Fsaludcyt20252175&partnerID=40&md5=fecf0d0b40f446393ef30c641e971e02
Russeng SS, Saleh LM, Wahyulianti WN, Palutturi S. The Effect of Age and Workload on Work Posture toward Musculoskeletal Disorders Complain on Loading and Unloading Workers. Open Access Maced J Med Sci [Internet]. 2021 Nov 9;9(E):1115–21. Available from: https://oamjms.eu/index.php/mjms/article/view/7277
Sunaryo M, Ratriwardhani RA. The effect of workload and length of work on the occurrence of fatigue in workers in the informal industry. Bali Med J [Internet]. 2022;11(1):310–4. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85129338653&doi=10.15562%2Fbmj.v11i1.3110&partnerID=40&md5=b154e021de3013086129269d6677465b
Thamrin Y, Muis M, Wahyu A, Hardianti A. Seaweed farmers and work fatigue: A mixed-method approach. Open Access Maced J Med Sci [Internet]. 2020;8(T2):192–5. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85097566047&doi=10.3889%2Foamjms.2020.5226&partnerID=40&md5=877ee8faa82f3096e336e85454dd8e1e
Paskarini I, Dwiyanti E, Mahmudah M, Widarjanto W, Nugroho SA, Syaiful DA. The interplay of ergonomic risk factor and lifestyle factors on Potter’s well-being and work fatigue in Magelang’s tourism village. BMC Public Health [Internet]. 2025;25(1). Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-105003811405&doi=10.1186%2Fs12889-025-22780-7&partnerID=40&md5=1aab994ec778629f81e67ed0e4dc0f0d
Pabala JL, Roga AU, Setyobudi A. Hubungan Usia, Lama Kerja dan Tingkat Pencahayaan dengan Kelelahan Mata (Astenopia) pada Penjahit di Kelurahan Kuanino Kota Kupang. Media Kesehat Masy [Internet]. 2021 Aug 6;3(2):215–25. Available from: http://ejurnal.undana.ac.id/index.php/MKM/article/view/3258
Intranuovo G, De Maria L, Facchini F, Giustiniano A, Caputi A, Birtolo F, et al. Risk assessment of upper limbs repetitive movements in a fish industry. BMC Res Notes [Internet]. 2019 Dec 24;12(1):354. Available from: https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-019-4392-z
Anbazhagan S, Ramesh N, Surekha A, Fathima F, Melina, Anjali. Estimation of work capacity and work ability among plantation workers in South India. Indian J Occup Environ Med [Internet]. 2016;20(2):79. Available from: http://www.ijoem.com/text.asp?2016/20/2/79/197525
Santos M, Gabani FL, de Andrade SM, Bizzozero-Peroni B, Martínez-Vizcaíno V, González AD, et al. The bidirectional association between chronic musculoskeletal pain and sleep-related problems: a systematic review and meta-analysis. Rheumatology [Internet]. 2023 Sep 1;62(9):2951–62. Available from: https://academic.oup.com/rheumatology/article/62/9/2951/7146025
Goossens Z, Van Stallen A, Vermuyten J, De deyne M, Rice D, Runge N, et al. Day-to-day associations between pain intensity and sleep outcomes in an adult chronic musculoskeletal pain population: A systematic review. Sleep Med Rev [Internet]. 2025 Feb; 79:102013. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1087079224001175
Boeselt T, Koczulla R, Nell C, Beutel B, Guenter K, Cassel W, et al. Sleep and rheumatic diseases. Best Pract Res Clin Rheumatol [Internet]. 2019 Jun;33(3):101434. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85071929772&doi=10.1016%2Fj.berh.2019.101434&partnerID=40&md5=efb48179bacdc35d2d1aaec688f38327
Fan J, Liu J, Smith AP. The Relationship Between Workload, Fatigue and Sleep Quality of Psychiatric Staff. In: Longo L, Leva MC, editors. Human Mental Workload: Models and Applications. Communications in Computer and Information Science. Vol. 1493. Cham: Springer; 2021. p. 151–164. Available from: https://doi.org/10.1007/978-3-030-91408-0_10
Huyghebaert T, Gillet N, Beltou N, Tellier F, Fouquereau E. Effects of workload on teachers’ functioning: A moderated mediation model including sleeping problems and overcommitment. Stress Heal [Internet]. 2018 Dec 14;34(5):601–11. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85058180208&doi=10.1002%2Fsmi.2820&partnerID=40&md5=2cab9efbb727f422da4fc2332edf6d23
Dwilago IT, Anggraini MT, Setiawan MR. Relationship between Repetitive Movements and Work Position with Complaints of Musculoskeletal Disorders in Fish Fillet Workers in Tegal. Medica Arter. 2022;4(2):90–7.
Yu N, Hong L, Guo J. Analysis of upper-limb muscle fatigue in the process of rotary handling. Int J Ind Ergon [Internet]. 2021;83. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85102266796&doi=10.1016%2Fj.ergon.2021.103109&partnerID=40&md5=78e79f1195f8c6bc85add61251687001
Hilmi DAH, Hamid ARA. Innovations in Ergonomic Risk Assessment and Intervention in Material Handling. MJEr. 2023;5(1):35–46.
Castro LSR, Nogueira DSS, Fu C, Casarotto RA. Work-related musculoskeletal complaints of physiotherapists working in intensive care units: Frequency analysis, risk factors, management and prevention strategies. Work [Internet]. 2024;79(4):1815–1827. Available from: https://doi.org/10.3233/WOR-230422
Pan KY, Nevriana A, Almroth M, Falkstedt D. Person-related work and the risk of type 2 diabetes: a Swedish register-based cohort study. Occup Environ Med [Internet]. 2025 Apr;82(4):161–7. Available from: https://oem.bmj.com/lookup/doi/10.1136/oemed-2025-110088
Zakaria AA, Lestantyo D, Jayanti S. Analysis of Fatigue Risk Factors on Workers in X Tofu Factory, Semarang. J Kesehat Masy. 2024;12(2):148–53.
Widjanarti MP, Rachmawati A. Work-Related Fatigue Risk-Determining Factors in Traditional Metal Casting Industry in Klaten. In: Proceedings of the 4th International Conference on Sport Science, Health, and Physical Education (ICSSHPE 2019) [Internet]. Paris, France: Atlantis Press; 2020. Available from: https://www.atlantis-press.com/article/125934720
Lemus SA, Mohammed J, Chen CB, Best TM, Tiozzo E, Travascio F. The role of obesity in physiological stress, balance, and proprioception during repetitive manual material handling tasks. Cè, E, editor. PLoS One [Internet]. 2025 May 29;20(5): e0324996. Available from: https://dx.plos.org/10.1371/journal.pone.0324996
Rahmah S, Herbawani CK. Faktor Risiko Penyebab Keluhan Musculoskeletal Disorders (MSDs) pada Pekerja: Tinjauan Literatur. Prepotif J Kesehat Masy. 2021;6(1):1–14.
Cunningham TR, Guerin RJ, Ferguson J, Cavallari J. Work‐related fatigue: A hazard for workers experiencing disproportionate occupational risks. Am J Ind Med [Internet]. 2022 Nov 27;65(11):913–25. Available from: https://onlinelibrary.wiley.com/doi/10.1002/ajim.23325
Kalteh HO, Mokarami H. A macroergonomics perspective for exploring safety culture factors: a qualitative content analysis approach. Int J Occup Saf Ergon [Internet]. 2022 Oct 2;28(4):2227–37. Available from: https://www.tandfonline.com/doi/full/10.1080/10803548.2021.1996070
Sandsund M, Øren A, Thorvaldsen T, Holmen I, Sønvisen S, Heidelberg CT, et al. Musculoskeletal symptoms among workers in the commercial fishing fleet of Norway. Int Marit Health [Internet]. 2019 Jun 25;70(2):100–6. Available from: https://journals.viamedica.pl/international_maritime_health/article/view/61456
Akbar KA, Try P, Viwattanakulvanid P, Kallawicha K. Work-Related Musculoskeletal Disorders Among Farmers in the Southeast Asia Region: A Systematic Review. Saf Health Work. 2023;14(3):243–9.
Cahyani CI, Sahri M. Analysis of Factors Related to Subjective Work Fatigue in Workers at PT. X. J Bahana Kesehat Masy (Bahana J Public Heal [Internet]. 2024 May 30;8(1):35–43. Available from: https://journal.poltekkesjambi.ac.id/index.php/JBKM/article/view/649
Ramdan IM. Measuring Work Fatigue on Nurses: A Comparison between Indonesian Version of Fatigue Assessment Scale (FAS) and Japanese Industrial Fatigue Ressearch Commite (JIFRC) Fatigue Questionnaire. J Keperawatan Padjadjaran [Internet]. 2019 Jul 31;7(2):143–53. Available from: https://doi.org/10.24198/jkp.v7i2.1092
Ihsan T, Edwin T, Azwir Y, Derosya V. Fatigue analysis to evaluate workloads in production area at crumb rubber factories of Padang city, West Sumatra Indonesia. Indian J Occup Environ Med [Internet]. 2020;24(3):148. Available from: http://www.ijoem.com/text.asp?2020/24/3/148/302819
Botti L, Mora C, Zecchi G. Engineering controls and industrial applications for ergonomics. In: Ergonomics: Challenges, Applications and New Perspectives [Internet]. Department of Management and Engineering, University of Padova, Vicenza, Italy: Nova Science Publishers, Inc.; 2016. p. 49–110. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85151534432&partnerID=40&md5=e8304c0bcf6e2701c6761a78089f9b5a
Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res [Internet]. 1989 May;28(2):193–213. Available from: https://doi.org/10.1016/0165-1781(89)90047-4
Yang CL, Huang WP, Lin WY, Tseng PC, Kuo H. Job-Related Stress Associated with Work-Related Upper Extremity Musculoskeletal Disorders (UEMDs) in Municipal Waste Collectors: The Moderation and Mediation Effect of Job Support. BMC Musculoskelet Disord. 2022;23(1).
Setyowati A, Chung M. Validity and reliability of the Indonesian version of the Pittsburgh Sleep Quality Index in adolescents. Int J Nurs Pract [Internet]. 2021 Oct;27(5): e12856. Available from: https://doi.org/10.1111/ijn.12856
Backhaus J, Junghanns K, Broocks A, Riemann D, Hohagen F. Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res [Internet]. 2002 Sep;53(3):737–40. Available from: https://doi.org/10.1016/s0022-3999(02)00330-6
Arby Yudha Maulana, Ferida Yuamita. Analisis Kelelahan Kerja Operator Produksi Menggunakan Metode Cardiovascular Load (CVL) dan Industrial Fatigue Research Committee (IFRC) (Studi kasus PT. Alis Jaya Cipta Tama). J Cakrawala Ilm [Internet]. 2023 Jul 23;2(11):4141–52. Available from: https://bajangjournal.com/index.php/JCI/article/view/6120
Kim J, Kim DH, Kwak SG. Comprehensive guidelines for appropriate statistical analysis methods in research. Korean J Anesthesiol [Internet]. 2024 Oct 1;77(5):503–17. Available from: http://ekja.org/journal/view.php?doi=10.4097/kja.24016
Zele YT, Kumie A, Deressa W, Bråtveit M, Moen BE. Registered Health Problems and Demographic Profile of Integrated Textile Factory Workers in Ethiopia: A Cross-Sectional Study. BMC Public Health. 2021;21(1).
Zain NSM, Lee LK. Health Complaints, Mental Status and Quality of Life among the Aquaculture Workers: A Cross-Sectional Study in Northern Region of Peninsular Malaysia. Int J Environ Res Public Health [Internet]. 2022;19(23):16371. Available from: https://www.proquest.com/scholarly-journals/health-complaints-mental-status-quality-life/docview/2748548003/se-2?accountid=49069
Konya I, Watanabe K, Shishido I, Sugimura N, Matsushita Y, Yamaguchi S, et al. Post-Work Recovery from Fatigue and Sleep Episodes among Nurses Who Are Engaged in 16-Hour Night Shifts: A Prospective Observational Study. Healthcare [Internet]. 2022 Jun 11;10(6):1089. Available from: https://www.mdpi.com/2227-9032/10/6/1089
Ong-Artborirak P, Kantow S, Seangpraw K, Tonchoy P, Auttama N, Choowanthanapakorn M, et al. Ergonomic Risk Factors for Musculoskeletal Disorders among Ethnic Lychee–Longan Harvesting Workers in Northern Thailand. Healthc [Internet]. 2022;10(12). Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85144681119&doi=10.3390%2Fhealthcare10122446&partnerID=40&md5=132db09038baf1d4c0291a4b81296ee8
Bouffard J, Yang C, Begon M, Côté JN. Sex Differences in Kinematic Adaptations to Muscle Fatigue Induced by Repetitive Upper Limb Movements. Biol Sex Differ. 2018;9(1).
Cowley JC, Gates DH. Proximal and Distal Muscle Fatigue Differentially Affect Movement Coordination. PLoS One. 2017;12(2): e0172835.
Kusmawan D, Izhar MD, Aswin B. Assessing the Relationship Between Mental Workload and Work Fatigue Among Oil and Gas Workers in PT X, Jambi Province, Indonesia: PLS-SEM Analysis. J Public health Res. 2024;13(4).
Kim I. An Ergonomic Focus Evaluation of Work-Related Musculoskeletal Disorders Amongst Operators in the UAE Network Control Centres. Heliyon. 2023;9(10): e21140.
Nygaard NPB, Thomsen G, Rasmussen J, Skadhauge L, Gram B. Ergonomic and Individual Risk Factors for Musculoskeletal Pain in the Ageing Workforce. BMC Public Health. 2022;22(1).
Sumardiyono S, Chahyadhi B, Suratna FSN, Fauzi RP, Wijayanti R, Widjanarti MP, et al. Effect of Noise, Blood Glucose, and Body Mass Index on Lactate Levels in Textile Industry Workers. J Penelit Pendidik Ipa. 2023;9(SpecialIssue):81–7.
Bazaluk O, Tsopa V, Cheberiachko S, Deryugin O, Radchuk D, Borovytskyi O, et al. Ergonomic risk management process for safety and health at work. Front Public Heal [Internet]. 2023 Nov 9;11. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1253141/full
Wang Q, Ding J, Dai Y, Yang S, Zhou Z. Occupational Stress, Burnout, and Fatigue Among Healthcare Workers in Shanghai, China: A Questionnaire-Based Cross-Sectional Survey. Healthcare. 2025;13(13):1600.
Borowiec A, Drygas W. Work–Life Balance and Mental and Physical Health Among Warsaw Specialists, Managers and Entrepreneurs. Int J Environ Res Public Health. 2022;20(1):492.
Hudson H, Schill A, Richards R. An Exploratory, Qualitative Study of How Organizations Implement the Hierarchy of Controls Applied to Total Worker Health®. Int J Environ Res Public Health. 2021;18(19):10032.