Prevalence and Risk Factors of Work-Related Musculoskeletal Disorders among Radiographers: A Proposed Systematic Review and Meta-analysis Protocol

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These conditions contribute to pain, disability, and reduced productivity, emphasizing the need for targeted prevention and management strategies. Despite the growing recognition of WRMSDs, no systematic reviews or meta-analyses have comprehensively synthesized the prevalence and associated risk factors among Radiographers. Method This protocol outlines the methods for a systematic review and meta-analysis to investigate the prevalence of WRMSDs and identify key risk factors in Radiographers. A thorough search of 6 electronic databases will be conducted from inception to June 2025, using predefined inclusion criteria. The methodological quality of the included studies will be assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Pooled prevalence estimates and risk factor analyses will be performed using meta-analytic techniques, and heterogeneity will be assessed using standard statistical methods such as Cochran’s Q test and I 2 . Discussion The findings of this review will give critical insights into the burden and underlying causes of WRMSDs within this occupational group, emphasizing the need for supporting evidence-based interventions and workplace modifications to enhance their health and productivity. Additionally, this review is expected to inform policy development in the healthcare sector, guiding the implementation of ergonomic equipment design, workplace health promotion strategies, and targeted training programs. By addressing these challenges, the review will support a comprehensive approach to enhance occupational health and fostering a safe, more efficient work environment for Radiographers. Systematic review registration PROSPERO, CRD42024565835 Medical imaging professionals WRMSDs workplace injuries musculoskeletal disorders occupation health Background Work-related musculoskeletal disorders (WRMSDs) are injuries or illnesses affecting the musculoskeletal system caused or exacerbated by occupational activities ( 1 ). They are a major contributor to the global burden of disability, with significant economic and social consequences. Musculoskeletal disorders (MSDs) accounted for approximately 150.08 million disability-adjusted life years (DALYs) globally in 2019, with low back pain contributing to 36.8% of cases. The burden of MSDs is rising, particularly in developed countries, driven by occupational risks, lifestyle factors, high body mass index(BMI), and smoking. Women experience a disproportionate burden, with 1.45 times more DALYs than men ( 2 ). WRMSDs are prevalent across various occupational groups, including allied health professionals (AHPs), with reported 12-month prevalence rate ranging from 28–96%. Regions such as Africa and Europe reported higher prevalence rates compared to Asia and Americas, reflecting regional disparities in the occupational hazards faced by healthcare professionals. WRMSDs are complex multifaceted conditions influenced by a combination of physical, occupational, environmental, and individual factors, requiring comprehensive strategies for their prevention and management ( 3 – 5 ). Among these AHPs affected are Radiographers, also known as X-ray technicians or medical imaging technologists, who are healthcare professionals specialized in diagnostic imaging procedures. Their work involves handling heavy imaging equipment, adopting awkward postures during patient positioning, and maintaining prolong visual attention during image acquisition and reporting ( 6 ). Additionally, Radiographers often face the challenge of balancing the need to deliver accurate and timely reports with the realities of crowded scanning rooms and the significant time required for each scan, creating a demanding and stressful work environment that heightens their occupational strain ( 7 , 8 ). Recent studies from various geographical regions reported an elevated prevalence of WRMSDs among Radiographers. A study from Western Switzerland found a 12-month WRMSD prevalence of 94.7%, with the neck and low back being the most affected areas. Awkward postures, work stress and being female Radiographers were key risk factors ( 9 ). In the United States, 81% of Radiographers experienced pain or discomfort while handling patients, with significant predictors including poor perceived health, fluoroscopy work and psychological stress ( 10 ). In India, a predictive model developed from a cross-sectional survey identified a 12-month prevalence of 75.2%, with sustained postures, prolonged standing, underweight BMI, and fixed work schedules significantly associated with WRMSD symptoms ( 11 ). A qualitative study from Ghana also reported high rates of low back and neck pain, which affected clinical task performance and contributed to absenteeism and presenteeism. Factors such as lack of assistance, inadequate workforce planning and poor workplace ergonomics were also associated with the development of WRMSDs ( 12 ). These studies collectively highlight the widespread and multifactorial origins of WRMSDs. These disorders not only lead to chronic pain, reduced functional capacity, and absenteeism but also, in some cases early career attrition, all of which will compromise the quality and efficiency of diagnostic imaging services ( 8 ). Although the high prevalence and occupational risk are well documented in individual studies, there is lack of comprehensive synthesis of global data on the prevalence and risk factors of WRMSDs among Radiographers. Understanding the epidemiology of WRMSDs in Radiographers is crucial for identifying modifiable risk factors, designing effective prevention strategies, and improving workplace ergonomics to mitigate their associated economic and health burdens ( 7 ). Therefore, a systematic review and meta-analysis is essential to address these gaps by synthesizing evidence on the prevalence and factors affecting WRMSDs among this professional group. The findings will provide a robust evidence base to support workplace interventions, ergonomic modifications, and targeted training programs, thereby enhancing the health, safety and productivity of the radiography workforce. Research question What is the prevalence of WRMSDs among Radiographers, and what are the associated risk factors? The objective of this study is to systematically review and synthesize evidence on the prevalence of work-related musculoskeletal disorders (WRMSDs) among Radiographers and to identify factors contributing to their development. Methods Protocol registration and reporting This systematic review protocol is reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement ( 13 , 14 ). The protocol of this systematic review has been registered in the Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024565835). Eligibility: Inclusion criteria 1) The study population will be Radiographers (registered or certified) who perform diagnostic tests like X-ray, CT and MRI. 2) Participants exposed to working conditions of diagnostic radiography environment. 3) Studies must clearly define the WRMSDs of interest such as low back pain, carpel tunnel syndrome or report on any WRMSD affecting relevant body part like neck, shoulder. 4) Studies investigating risk factors associated with WRMSD like individual, occupational, psychosocial or environmental factors. 5) All empirical studies including observational designs including but not limited to longitudinal cohorts, cross-sectional studies, case studies, case series, and case-control studies will be included. 6) Only peer-reviewed articles published in English, with no restrictions on geographic area, will be included. The review will cover studies published up to June 2025. Eligibility: Exclusion criteria Studies not focusing on Radiographers as the primary study population, studies not investigating WRMSDs and those published in languages other than English will be excluded. Study designs such as letter to editors, commentaries, conference proceedings, book chapters, unpublished thesis work, and preprints will also be excluded. Data sources and search strategy A thorough literature search will be performed across six databases: MEDLINE, Scopus, The Cochrane Library, Embase, Web of Science and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to August 2024. The search strategy will follow Population, Exposure, Outcome, and Study design (PEOS) framework. The search strategy will involve a combination of MeSH terms, Boolean operators, and truncation techniques to ensure comprehensive retrieval of relevant studies. The strategy will initially be developed for MEDLINE and then adapted for other databases, to align with their specific indexing systems and search functionalities. The final search strategy will be reviewed and refined by all authors and in consultation with medical librarian to ensure its accuracy and relevance to the study objectives. Study selection Following the literature search, the identified articles will be imported to RAYYAN AI literature review software and de-duplication will be done ( 15 ). Title and abstract screening will be done independently performed by three reviewers (UN, SM and MR) using predefined inclusion and exclusion criteria. The screening process will be blinded to minimize bias. Conflicts will be resolved by a consensus meeting. Quality appraisal The quality assessment will be performed using Joanna Briggs Institute (JBI) critical appraisal checklists ( 16 ). For prevalence studies, the “JBI checklist for prevalence study” tool will be used; for field test studies, the “JBI checklist for analytical cross-sectional studies” tool will be used, and for mixed method studies, the “JBI checklist for qualitative research” tool will be used ( 17 – 19 ). To quantify the study quality a quantitative scoring system will be implemented, assigning 1 point for each ‘Yes’ response and 0 for ‘No’ or ‘Unclear’. Scores will be converted to percentages for comparison across studies. Studies will be classified as high quality (> 70%), moderate quality (50–69%), or low quality (< 50%) ( 20 ). This facilitates consistent scoring across various quality assessment tools used, enabling reliable comparisons between studies. Data extraction The data extraction sheet will be developed by (UN), (SM) and (MR). The data sheet will be pilot tested on 25% of the included data and will then be refined. The data extraction sheet will contain first author; year of publication; country; journal; title; prevalence rate; study design; sample size; inclusion/exclusion criteria used; outcome measure used; participant characteristics- age, gender and work experience; annual prevalence of body regions; factors affecting; key findings; strengths and limitations; and future recommendations. The primary outcome of interest will be 12-month prevalence of WRMSDs among Radiographers and the secondary outcomes will focus on identifying risk factors associated with it (individual factors, psychosocial factors, workplace factors). The data will be extracted by single author (UN) and will be reviewed by (MR) (BG) and (AGM) and any doubts and clarifications will be sought by discussion. Statistical analysis All the statistical analysis will be performed using R statistical software ( 21 ). The prevalence of WRMSDs among Radiographers will be pooled using both common and random effect model. The random effects model will be chosen as the primary approach to account for anticipated variability both within and between studies, providing more generalized estimates. Heterogeneity among studies will be assessed using Cochran’s Q test and the I 2 statistics ( 22 , 23 ). A p-value < 0.05 in Cochran’s Q test will indicate significant heterogeneity, while I 2 values ≥ 50% will be interpreted as substantial heterogeneity, and values < 50% will reflect low heterogeneity. Subgroup analysis will be conducted to explore sources of heterogeneity. Publication bias will be assessed both visually and statistically. Funnel plots will be generated to examine symmetry, and Egger’s test will be used to evaluate bias, with a p-value < 0.05 indicating significant asymmetry ( 24 ). The pooled prevalence of WRMSDs will be reported with corresponding 95% confidence intervals (CIs), and where possible, separate estimates for specific body regions affected will be reported. Discussion This protocol is a critical step toward consolidating evidence on the prevalence and risk factors of WRMSDs among Radiographers. It represents the first systematic review specifically addressing this population, summarizing the global prevalence of WRMSDs and identifying the factors contributing to their development. The use of six databases and comprehensive search strategies reflects best practices in systematic reviews, enhancing the likelihood of capturing relevant studies and ensuring a robust synthesis of the existing evidence. Unlike reviews limited to a single study design, this review will include diverse observational study designs that report factors contributing to WRMSDs among Radiographers. This broad inclusion ensures a comprehensive representation of the current literature and addresses critical gaps in understanding the unique challenges faced by this professional group. To assess the quality of these varied study designs, the JBI critical appraisal tools will be adapted ( 16 ). The quality grading will involve converting scores into percentages to categorize studies as high, medium or low quality, further enhancing the reliability of the review findings ( 20 ). While this protocol provides a comprehensive framework, certain limitations and challenges need to be acknowledged. The study is restricted to English-language publications, which may result in the exclusion of valuable information from non- English-speaking regions with potentially high WRMSD prevalence. This limitation could introduce language bias, affecting the global applicability of the findings. Additionally, subgroup analyses are planned to explore specific factors such as geographic region, years of work experience, type of imaging technology used and work environment. However, the availability and quality of data in primary studies may pose significant challenges. Many studies may lack detailed or standardized reporting on these variables potentially limiting the depth and robustness of subgroup analyses. This variability could contribute to heterogeneity, making it complicated to synthesize results and draw meaningful conclusion from them. In cases where original data are not accessible, verifying data accuracy and consistency becomes difficult, potentially affecting the reliability of pooled estimates. Furthermore, the inability to access raw data may limit opportunities for adjustment or deeper analysis to address confounding factors comprehensively. Despite these limitations, this protocol adopts rigorous methodological approaches, including structured quality appraisal processes, sensitivity analyses, and subgroup analyses, to mitigate these challenges where possible. These methods enhance the reliability of the findings and provide a transparent foundation for evidence synthesis. The findings from this review are anticipated to offer critical insights into the burden and determinants of WRMSDs among Radiographers. They are expected to inform the development of targeted workplace interventions, ergonomic improvements, and specialized training programs aimed at reducing the prevalence and impact of WRMSDs. Moreover, the review will support healthcare administrators and policymakers in designing sustainable occupational health strategies that prioritize the well-being of Radiographers. By addressing these challenges and presenting actionable recommendations, this review will contribute to a safer and more productive working environment for Radiographers while promoting overall healthcare efficiency. Systematic review registration The protocol of this systematic review and meta-analysis has been registered in the international prospective register of systematic reviews (PROSPERO) of the National Institute of Health Research available at https://www.crd.york.ac.uk/prospero/ with PROSPERO registration number: CRD42024565835. This review will include all empirical studies including observational designs (longitudinal cohorts, cross-sectional studies, case studies, case series, and case-control studies) and published from inception to August 2024. Any amendments to the review protocol and progress will be documented in PROSPERO. Upon completion, the final manuscript will be submitted to a peer-reviewed journal for dissemination. Abbreviations WRMSDs: Work-related musculoskeletal disorders; MSDs: Musculoskeletal disorders; JBI: Joanna Briggs Institute; DALYs: Disability-adjusted life years; BMI: Body mass index; AHPs: Allied health professionals; PRISMA: Preferred Reporting Items for Systematic Review and Meta-Analysis Declarations Ethics approval and consent to participate Not required Consent for publication All authors consent and approve the manuscript for publication. Availability of data and materials Not applicable Declaration of generative AI and AI-assisted technologies in the writing process During the preparation of this work the author(s) used Chat GPT-4o to check grammar and sentence flow. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication. Competing interests The authors declare no competing interests Funding No funding agency or organization. This systematic review and meta-analysis will be done without the help of government/ research organization. Authors' contributions Ullas U Nayak: Conceptualization, Methodology, Investigation, Data curation, Writing- original draft. Bincy M George: Conceptualization, Methodology, Writing-review & editing, Supervision, Validation. Sidhiprada Mohapatra: Conceptualization, Methodology, Investigation, Data curation, Supervision, Validation. Vennila J: Conceptualization, Methodology, Data synthesis. G. Arun Maiya: Conceptualization, Writing-review & editing, Validation. Mohandas Rao KG: Conceptualization, Methodology, Data curation, Writing-review & editing, Supervision, Supervision, Validation, Guarantor. The final manuscript was approved by all the authors. Acknowledgements The authors would like to thank the Manipal Academy of Higher Education (MAHE), Manipal for providing all the support and resources. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Author details 1 Division of Anatomy, Department of Basic Medical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India. 2 Division of Anatomy, Department of Basic Medical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India. 3 Centre for Comprehensive Rehabılıtatıon, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India, Email ID: [email protected] , ORCID ID: 0000-0002-6343-8195 4 Statistics Department, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India. 5 Department of Physiotherapy, Centre for Podiatry & Diabetic Foot Care and Research, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India. 6 Division of Anatomy, Department of Basic Medical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India References Bernal D, Campos-Serna J, Tobias A, Vargas-Prada S, Benavides FG, Serra C. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5840559","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":472607575,"identity":"99a97995-f50b-4443-9ace-48a1cddea8cb","order_by":0,"name":"Ullas U Nayak","email":"","orcid":"","institution":"Manipal Academy of Higher Education","correspondingAuthor":false,"prefix":"","firstName":"Ullas","middleName":"U","lastName":"Nayak","suffix":""},{"id":472607576,"identity":"947d3358-4146-44cb-81d2-0af483ceef03","order_by":1,"name":"Bincy M George","email":"","orcid":"","institution":"Manipal Academy of Higher Education","correspondingAuthor":false,"prefix":"","firstName":"Bincy","middleName":"M","lastName":"George","suffix":""},{"id":472607577,"identity":"d1e6bcbd-4bfb-4fa1-b2ba-6674fb0b606c","order_by":2,"name":"Sidhiprada Mohapatra","email":"","orcid":"","institution":"Manipal College of Health Professions","correspondingAuthor":false,"prefix":"","firstName":"Sidhiprada","middleName":"","lastName":"Mohapatra","suffix":""},{"id":472607578,"identity":"2fb1ebe4-ec80-49b7-b6c8-ce40306c197a","order_by":3,"name":"Vennila J","email":"","orcid":"","institution":"Manipal College of Health Professions","correspondingAuthor":false,"prefix":"","firstName":"Vennila","middleName":"","lastName":"J","suffix":""},{"id":472607579,"identity":"3a38cb4d-571d-4cde-96c0-e94a69a3a1a0","order_by":4,"name":"G. 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They are a major contributor to the global burden of disability, with significant economic and social consequences. Musculoskeletal disorders (MSDs) accounted for approximately 150.08\u0026nbsp;million disability-adjusted life years (DALYs) globally in 2019, with low back pain contributing to 36.8% of cases. The burden of MSDs is rising, particularly in developed countries, driven by occupational risks, lifestyle factors, high body mass index(BMI), and smoking. Women experience a disproportionate burden, with 1.45 times more DALYs than men (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWRMSDs are prevalent across various occupational groups, including allied health professionals (AHPs), with reported 12-month prevalence rate ranging from 28–96%. Regions such as Africa and Europe reported higher prevalence rates compared to Asia and Americas, reflecting regional disparities in the occupational hazards faced by healthcare professionals. WRMSDs are complex multifaceted conditions influenced by a combination of physical, occupational, environmental, and individual factors, requiring comprehensive strategies for their prevention and management (\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e–\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAmong these AHPs affected are Radiographers, also known as X-ray technicians or medical imaging technologists, who are healthcare professionals specialized in diagnostic imaging procedures. Their work involves handling heavy imaging equipment, adopting awkward postures during patient positioning, and maintaining prolong visual attention during image acquisition and reporting (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Additionally, Radiographers often face the challenge of balancing the need to deliver accurate and timely reports with the realities of crowded scanning rooms and the significant time required for each scan, creating a demanding and stressful work environment that heightens their occupational strain (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRecent studies from various geographical regions reported an elevated prevalence of WRMSDs among Radiographers. A study from Western Switzerland found a 12-month WRMSD prevalence of 94.7%, with the neck and low back being the most affected areas. Awkward postures, work stress and being female Radiographers were key risk factors (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). In the United States, 81% of Radiographers experienced pain or discomfort while handling patients, with significant predictors including poor perceived health, fluoroscopy work and psychological stress (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). In India, a predictive model developed from a cross-sectional survey identified a 12-month prevalence of 75.2%, with sustained postures, prolonged standing, underweight BMI, and fixed work schedules significantly associated with WRMSD symptoms (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). A qualitative study from Ghana also reported high rates of low back and neck pain, which affected clinical task performance and contributed to absenteeism and presenteeism. Factors such as lack of assistance, inadequate workforce planning and poor workplace ergonomics were also associated with the development of WRMSDs (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThese studies collectively highlight the widespread and multifactorial origins of WRMSDs. These disorders not only lead to chronic pain, reduced functional capacity, and absenteeism but also, in some cases early career attrition, all of which will compromise the quality and efficiency of diagnostic imaging services (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Although the high prevalence and occupational risk are well documented in individual studies, there is lack of comprehensive synthesis of global data on the prevalence and risk factors of WRMSDs among Radiographers.\u003c/p\u003e \u003cp\u003eUnderstanding the epidemiology of WRMSDs in Radiographers is crucial for identifying modifiable risk factors, designing effective prevention strategies, and improving workplace ergonomics to mitigate their associated economic and health burdens (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Therefore, a systematic review and meta-analysis is essential to address these gaps by synthesizing evidence on the prevalence and factors affecting WRMSDs among this professional group. The findings will provide a robust evidence base to support workplace interventions, ergonomic modifications, and targeted training programs, thereby enhancing the health, safety and productivity of the radiography workforce.\u003c/p\u003e\n\u003ch3\u003eResearch question\u003c/h3\u003e\n\u003cp\u003eWhat is the prevalence of WRMSDs among Radiographers, and what are the associated risk factors?\u003c/p\u003e \u003cp\u003eThe objective of this study is to systematically review and synthesize evidence on the prevalence of work-related musculoskeletal disorders (WRMSDs) among Radiographers and to identify factors contributing to their development.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Methods","content":"\u003ch2\u003eProtocol registration and reporting\u003c/h2\u003e\u003cp\u003eThis systematic review protocol is reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The protocol of this systematic review has been registered in the Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024565835).\u003c/p\u003e\u003cp\u003eEligibility: Inclusion criteria\u003c/p\u003e\u003cp\u003e1) The study population will be Radiographers (registered or certified) who perform diagnostic tests like X-ray, CT and MRI. 2) Participants exposed to working conditions of diagnostic radiography environment. 3) Studies must clearly define the WRMSDs of interest such as low back pain, carpel tunnel syndrome or report on any WRMSD affecting relevant body part like neck, shoulder. 4) Studies investigating risk factors associated with WRMSD like individual, occupational, psychosocial or environmental factors. 5) All empirical studies including observational designs including but not limited to longitudinal cohorts, cross-sectional studies, case studies, case series, and case-control studies will be included. 6) Only peer-reviewed articles published in English, with no restrictions on geographic area, will be included. The review will cover studies published up to June 2025.\u003c/p\u003e\n\u003ch3\u003eEligibility: Exclusion criteria\u003c/h3\u003e\n\u003cp\u003eStudies not focusing on Radiographers as the primary study population, studies not investigating WRMSDs and those published in languages other than English will be excluded. Study designs such as letter to editors, commentaries, conference proceedings, book chapters, unpublished thesis work, and preprints will also be excluded.\u003c/p\u003e\n\u003ch3\u003eData sources and search strategy\u003c/h3\u003e\n\u003cp\u003eA thorough literature search will be performed across six databases: MEDLINE, Scopus, The Cochrane Library, Embase, Web of Science and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to August 2024. The search strategy will follow Population, Exposure, Outcome, and Study design (PEOS) framework. The search strategy will involve a combination of MeSH terms, Boolean operators, and truncation techniques to ensure comprehensive retrieval of relevant studies. The strategy will initially be developed for MEDLINE and then adapted for other databases, to align with their specific indexing systems and search functionalities. The final search strategy will be reviewed and refined by all authors and in consultation with medical librarian to ensure its accuracy and relevance to the study objectives.\u003c/p\u003e\n\u003ch3\u003eStudy selection\u003c/h3\u003e\n\u003cp\u003eFollowing the literature search, the identified articles will be imported to RAYYAN AI literature review software and de-duplication will be done (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Title and abstract screening will be done independently performed by three reviewers (UN, SM and MR) using predefined inclusion and exclusion criteria. The screening process will be blinded to minimize bias. Conflicts will be resolved by a consensus meeting.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eQuality appraisal\u003c/h2\u003e \u003cp\u003eThe quality assessment will be performed using Joanna Briggs Institute (JBI) critical appraisal checklists (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). For prevalence studies, the \u0026ldquo;JBI checklist for prevalence study\u0026rdquo; tool will be used; for field test studies, the \u0026ldquo;JBI checklist for analytical cross-sectional studies\u0026rdquo; tool will be used, and for mixed method studies, the \u0026ldquo;JBI checklist for qualitative research\u0026rdquo; tool will be used (\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). To quantify the study quality a quantitative scoring system will be implemented, assigning 1 point for each \u0026lsquo;Yes\u0026rsquo; response and 0 for \u0026lsquo;No\u0026rsquo; or \u0026lsquo;Unclear\u0026rsquo;. Scores will be converted to percentages for comparison across studies. Studies will be classified as high quality (\u0026gt;\u0026thinsp;70%), moderate quality (50\u0026ndash;69%), or low quality (\u0026lt;\u0026thinsp;50%) (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). This facilitates consistent scoring across various quality assessment tools used, enabling reliable comparisons between studies.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData extraction\u003c/h3\u003e\n\u003cp\u003eThe data extraction sheet will be developed by (UN), (SM) and (MR). The data sheet will be pilot tested on 25% of the included data and will then be refined. The data extraction sheet will contain first author; year of publication; country; journal; title; prevalence rate; study design; sample size; inclusion/exclusion criteria used; outcome measure used; participant characteristics- age, gender and work experience; annual prevalence of body regions; factors affecting; key findings; strengths and limitations; and future recommendations. The primary outcome of interest will be 12-month prevalence of WRMSDs among Radiographers and the secondary outcomes will focus on identifying risk factors associated with it (individual factors, psychosocial factors, workplace factors). The data will be extracted by single author (UN) and will be reviewed by (MR) (BG) and (AGM) and any doubts and clarifications will be sought by discussion.\u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eAll the statistical analysis will be performed using R statistical software (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The prevalence of WRMSDs among Radiographers will be pooled using both common and random effect model. The random effects model will be chosen as the primary approach to account for anticipated variability both within and between studies, providing more generalized estimates. Heterogeneity among studies will be assessed using Cochran\u0026rsquo;s Q test and the I\u003csup\u003e2\u003c/sup\u003e statistics (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). A p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 in Cochran\u0026rsquo;s Q test will indicate significant heterogeneity, while I\u003csup\u003e2\u003c/sup\u003e values\u0026thinsp;\u0026ge;\u0026thinsp;50% will be interpreted as substantial heterogeneity, and values\u0026thinsp;\u0026lt;\u0026thinsp;50% will reflect low heterogeneity. Subgroup analysis will be conducted to explore sources of heterogeneity. Publication bias will be assessed both visually and statistically. Funnel plots will be generated to examine symmetry, and Egger\u0026rsquo;s test will be used to evaluate bias, with a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicating significant asymmetry (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). The pooled prevalence of WRMSDs will be reported with corresponding 95% confidence intervals (CIs), and where possible, separate estimates for specific body regions affected will be reported.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis protocol is a critical step toward consolidating evidence on the prevalence and risk factors of WRMSDs among Radiographers. It represents the first systematic review specifically addressing this population, summarizing the global prevalence of WRMSDs and identifying the factors contributing to their development. The use of six databases and comprehensive search strategies reflects best practices in systematic reviews, enhancing the likelihood of capturing relevant studies and ensuring a robust synthesis of the existing evidence.\u003c/p\u003e \u003cp\u003eUnlike reviews limited to a single study design, this review will include diverse observational study designs that report factors contributing to WRMSDs among Radiographers. This broad inclusion ensures a comprehensive representation of the current literature and addresses critical gaps in understanding the unique challenges faced by this professional group. To assess the quality of these varied study designs, the JBI critical appraisal tools will be adapted (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). The quality grading will involve converting scores into percentages to categorize studies as high, medium or low quality, further enhancing the reliability of the review findings (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhile this protocol provides a comprehensive framework, certain limitations and challenges need to be acknowledged. The study is restricted to English-language publications, which may result in the exclusion of valuable information from non- English-speaking regions with potentially high WRMSD prevalence. This limitation could introduce language bias, affecting the global applicability of the findings.\u003c/p\u003e \u003cp\u003eAdditionally, subgroup analyses are planned to explore specific factors such as geographic region, years of work experience, type of imaging technology used and work environment. However, the availability and quality of data in primary studies may pose significant challenges. Many studies may lack detailed or standardized reporting on these variables potentially limiting the depth and robustness of subgroup analyses. This variability could contribute to heterogeneity, making it complicated to synthesize results and draw meaningful conclusion from them. In cases where original data are not accessible, verifying data accuracy and consistency becomes difficult, potentially affecting the reliability of pooled estimates. Furthermore, the inability to access raw data may limit opportunities for adjustment or deeper analysis to address confounding factors comprehensively.\u003c/p\u003e \u003cp\u003eDespite these limitations, this protocol adopts rigorous methodological approaches, including structured quality appraisal processes, sensitivity analyses, and subgroup analyses, to mitigate these challenges where possible. These methods enhance the reliability of the findings and provide a transparent foundation for evidence synthesis.\u003c/p\u003e \u003cp\u003eThe findings from this review are anticipated to offer critical insights into the burden and determinants of WRMSDs among Radiographers. They are expected to inform the development of targeted workplace interventions, ergonomic improvements, and specialized training programs aimed at reducing the prevalence and impact of WRMSDs. Moreover, the review will support healthcare administrators and policymakers in designing sustainable occupational health strategies that prioritize the well-being of Radiographers. By addressing these challenges and presenting actionable recommendations, this review will contribute to a safer and more productive working environment for Radiographers while promoting overall healthcare efficiency.\u003c/p\u003e "},{"header":"Systematic review registration","content":"\u003cp\u003eThe protocol of this systematic review and meta-analysis has been registered in the international prospective register of systematic reviews (PROSPERO) of the National Institute of Health Research available at \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.crd.york.ac.uk/prospero/\u003c/span\u003e\u003cspan address=\"https://www.crd.york.ac.uk/prospero/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e with PROSPERO registration number: CRD42024565835. This review will include all empirical studies including observational designs (longitudinal cohorts, cross-sectional studies, case studies, case series, and case-control studies) and published from inception to August 2024. Any amendments to the review protocol and progress will be documented in PROSPERO. Upon completion, the final manuscript will be submitted to a peer-reviewed journal for dissemination.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eWRMSDs: Work-related musculoskeletal disorders; MSDs: Musculoskeletal disorders; JBI: Joanna Briggs Institute; DALYs: Disability-adjusted life years; BMI: Body mass index; AHPs: Allied health professionals; PRISMA: Preferred Reporting Items for Systematic Review and Meta-Analysis\u0026nbsp;\u003c/p\u003e\n"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot required\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors consent and approve the manuscript for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of generative AI and AI-assisted technologies in the writing process\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring the preparation of this work the author(s) used Chat GPT-4o to check grammar and sentence flow. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding agency or organization. This systematic review and meta-analysis will be done without the help of government/ research organization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUllas U Nayak: Conceptualization, Methodology, Investigation, Data curation, Writing- original draft. Bincy M George: Conceptualization, Methodology, Writing-review \u0026amp; editing, Supervision, Validation. Sidhiprada Mohapatra: Conceptualization, Methodology, Investigation, Data curation, Supervision, Validation. Vennila J: Conceptualization, Methodology, Data synthesis. G. Arun Maiya: Conceptualization, Writing-review \u0026amp; editing, Validation. Mohandas Rao KG: Conceptualization, Methodology, Data curation, Writing-review \u0026amp; editing, Supervision, Supervision, Validation, Guarantor. The final manuscript was approved by all the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the Manipal Academy of Higher Education (MAHE), Manipal for providing all the support and resources. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDivision of Anatomy, Department of Basic Medical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eDivision of Anatomy, Department of Basic Medical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e3\u003c/sup\u003eCentre for Comprehensive Rehabılıtatıon, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India, Email ID: [email protected], ORCID ID: 0000-0002-6343-8195\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e4\u003c/sup\u003eStatistics Department, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e5\u003c/sup\u003eDepartment of Physiotherapy, Centre for Podiatry \u0026amp; Diabetic Foot Care and Research, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e6\u003c/sup\u003eDivision of Anatomy, Department of Basic Medical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBernal D, Campos-Serna J, Tobias A, Vargas-Prada S, Benavides FG, Serra C. Work-related psychosocial risk factors and musculoskeletal disorders in hospital nurses and nursing aides: A systematic review and meta-analysis. Int J Nurs Stud. 2015 Feb;52(2):635\u0026ndash;48. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0020748914002971\u003c/li\u003e\n\u003cli\u003eLiu S, Wang B, Fan S, Wang Y, Zhan Y, Ye D. Global burden of musculoskeletal disorders and attributable factors in 204 countries and territories: a secondary analysis of the Global Burden of Disease 2019 study. BMJ Open. 2022;12(6). \u003c/li\u003e\n\u003cli\u003eAnderson SP, Oakman J. Allied Health Professionals and Work-Related Musculoskeletal Disorders: A Systematic Review. Saf Health Work. 2016 Dec;7(4):259\u0026ndash;67. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2093791116300075\u003c/li\u003e\n\u003cli\u003eYasobant S, Rajkumar P. 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Available from: https://www.hindawi.com/journals/bmri/2022/5164970/\u003c/li\u003e\n\u003cli\u003eHarisinghani MG, Blake MA, Saksena M, Hahn PF, Gervais D, Zalis M, et al. Importance and effects of altered workplace ergonomics in modern radiology suites. Radiographics. 2004;24(2):615\u0026ndash;27. \u003c/li\u003e\n\u003cli\u003eRaj V V. Occupational stress and radiography. Radiol Technol. 2006;78(2):113\u0026ndash;22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17119177\u003c/li\u003e\n\u003cli\u003eFernandes K, S\u0026aacute; dos Reis C, Serranheira F. Radiographers\u0026rsquo; musculoskeletal health in Western Switzerland: WRMSDs symptoms prevalence and risk factors. Work. 2023 Apr 18;74(4):1527\u0026ndash;37. Available from: https://www.medra.org/servlet/aliasResolver?alias=iospress\u0026amp;doi=10.3233/WOR-211379\u003c/li\u003e\n\u003cli\u003eEvans KD, Sommerich CM, Stigall-Weikle AN, Stokes AD, Klatt MD. Work-related Musculoskeletal Disorders Among Radiographers: An Exploration of Self-reported Symptoms. Radiol Technol. 2021 Nov;93(2):161\u0026ndash;76. Available from: http://www.ncbi.nlm.nih.gov/pubmed/34728578\u003c/li\u003e\n\u003cli\u003eShanbhag S, Panakkal NC, Nayak UU, Mohapatra S. A regression model on work-related musculoskeletal disorders and associated risk factors among radiographers. Int J Occup Saf Ergon. 2024 Oct 26;30(4):1272\u0026ndash;82. Available from: https://doi.org/10.1080/10803548.2024.2387498\u003c/li\u003e\n\u003cli\u003eDonkor A, Anyitey-Kokor IC, Osei Tutu E, Bosomtwe D, Adjei ANA, Wiafe YA. Work-related back pain among diagnostic radiographers in Ghana: A qualitative study. Radiography. 2024 Jul;30(4):1187\u0026ndash;93. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1078817424001494\u003c/li\u003e\n\u003cli\u003eMoher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015 Dec 1;4(1):1. Available from: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/2046-4053-4-1\u003c/li\u003e\n\u003cli\u003eShamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015 Jan 2;349(jan02 1):g7647\u0026ndash;g7647. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.g7647\u003c/li\u003e\n\u003cli\u003eOuzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan\u0026mdash;a web and mobile app for systematic reviews. Syst Rev. 2016 Dec 5;5(1):210. Available from: http://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-016-0384-4\u003c/li\u003e\n\u003cli\u003eJoanna Briggs Institute. JBI critical appraisal tools. [cited 2024 Nov 5]. Available from: https://jbi.global/critical-appraisal-tools\u003c/li\u003e\n\u003cli\u003eJBI Global. Checklist for Prevalence Studies. https://jbi.global/sites/default/files/2020-08/Checklist_for_Prevalence_Studies.pdf. 2020; \u003c/li\u003e\n\u003cli\u003eMoola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, et al. Explanation of analytical cross sectional studies critical appraisal. JBI Man Evid Synth. 2020;1\u0026ndash;5. Available from: https://joannabriggs.org/critical_appraisal_tools\u003c/li\u003e\n\u003cli\u003eJoanna Briggs Institute. Checklist for Qualitative Research. Joanna Briggs Inst. 2017;6. Available from: http://www.joannabriggs.org/assets/docs/critical-appraisal-tools/JBI_Critical_Appraisal-Checklist_for_Qualitative_Research.pdf\u003c/li\u003e\n\u003cli\u003eGoplen CM, Verbeek W, Kang SH, Jones CA, Voaklander DC, Churchill TA, et al. Preoperative opioid use is associated with worse patient outcomes after Total joint arthroplasty: a systematic review and meta-analysis. BMC Musculoskelet Disord [Internet]. 2019 Dec 18;20(1):234. Available from: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-019-2619-8\u003c/li\u003e\n\u003cli\u003eR Core Team. R: A Language and Environment for Statistical Computing [Internet]. Vienna, Austria; 2021. Available from: https://www.r-project.org/\u003c/li\u003e\n\u003cli\u003eCOCHRAN WG. THE COMPARISON OF PERCENTAGES IN MATCHED SAMPLES. Biometrika. 1950 Dec 1;37(3\u0026ndash;4):256\u0026ndash;66. Available from: https://academic.oup.com/biomet/article-lookup/doi/10.1093/biomet/37.3-4.256\u003c/li\u003e\n\u003cli\u003eHiggins JPT. Measuring inconsistency in meta-analyses. BMJ. 2003 Sep 6;327(7414):557\u0026ndash;60. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.327.7414.557\u003c/li\u003e\n\u003cli\u003eEgger M, Smith GD, Schneider M, Minder C. 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Available from: https://www.bmj.com/lookup/doi/10.1136/bmj.315.7109.629\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"systematic-reviews","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sysr","sideBox":"Learn more about [Systematic Reviews](http://systematicreviewsjournal.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/sysr/default.aspx","title":"Systematic Reviews","twitterHandle":"@MedicalEvidence","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Medical imaging professionals, WRMSDs, workplace injuries, musculoskeletal disorders, occupation health","lastPublishedDoi":"10.21203/rs.3.rs-5840559/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5840559/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWork-related musculoskeletal disorders (WRMSDs) are significant health concerns among Radiographers, arising from ergonomic challenges, repetitive tasks, and the physical demands of their profession. These conditions contribute to pain, disability, and reduced productivity, emphasizing the need for targeted prevention and management strategies. Despite the growing recognition of WRMSDs, no systematic reviews or meta-analyses have comprehensively synthesized the prevalence and associated risk factors among Radiographers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis protocol outlines the methods for a systematic review and meta-analysis to investigate the prevalence of WRMSDs and identify key risk factors in Radiographers. A thorough search of 6 electronic databases will be conducted from inception to June 2025, using predefined inclusion criteria. The methodological quality of the included studies will be assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Pooled prevalence estimates and risk factor analyses will be performed using meta-analytic techniques, and heterogeneity will be assessed using standard statistical methods such as Cochran’s Q test and I\u003csup\u003e2\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe findings of this review will give critical insights into the burden and underlying causes of WRMSDs within this occupational group, emphasizing the need for supporting evidence-based interventions and workplace modifications to enhance their health and productivity. Additionally, this review is expected to inform policy development in the healthcare sector, guiding the implementation of ergonomic equipment design, workplace health promotion strategies, and targeted training programs. By addressing these challenges, the review will support a comprehensive approach to enhance occupational health and fostering a safe, more efficient work environment for Radiographers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSystematic review registration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePROSPERO, CRD42024565835\u003c/p\u003e","manuscriptTitle":"Prevalence and Risk Factors of Work-Related Musculoskeletal Disorders among Radiographers: A Proposed Systematic Review and Meta-analysis Protocol","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-19 15:45:15","doi":"10.21203/rs.3.rs-5840559/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"","date":"2025-06-21T13:22:06+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-17T14:09:40+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-10T06:15:26+00:00","index":"","fulltext":""},{"type":"submitted","content":"Systematic Reviews","date":"2025-06-09T14:26:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"systematic-reviews","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sysr","sideBox":"Learn more about [Systematic Reviews](http://systematicreviewsjournal.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/sysr/default.aspx","title":"Systematic Reviews","twitterHandle":"@MedicalEvidence","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ddef16b5-c749-4b7f-b0e9-477a4cb13731","owner":[],"postedDate":"June 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-15T16:05:30+00:00","versionOfRecord":{"articleIdentity":"rs-5840559","link":"https://doi.org/10.1186/s13643-025-03017-5","journal":{"identity":"systematic-reviews","isVorOnly":false,"title":"Systematic Reviews"},"publishedOn":"2025-12-12 15:59:13","publishedOnDateReadable":"December 12th, 2025"},"versionCreatedAt":"2025-06-19 15:45:15","video":"","vorDoi":"10.1186/s13643-025-03017-5","vorDoiUrl":"https://doi.org/10.1186/s13643-025-03017-5","workflowStages":[]},"version":"v1","identity":"rs-5840559","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5840559","identity":"rs-5840559","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}