Characterization of cashier shoulder and low back muscle demands

- Work intensity has the largest influence on muscular demand in cashiers.
- Shoulder muscles were more sensitive to height and packaging than low back muscles.
- Rotate cashiers to express lanes whenever possible to process smaller orders.
- Encourage cashiers to lower bagging heights to 10-15 cm below elbow height.
- Encourage customers to use bins rather than plastic or reusable bags.

Cashiers commonly report musculoskeletal discomfort in their shoulders, neck, and low back. This may result from excessive loading, awkward postures, insufficient rest, or task repetition. Recently, widespread introduction of reusable, consumer-supplied bags has introduced challenges in assessing exposures in this occupational group. Limited information exists on the physical demands associated with cashier work, particularly in the context of multiple bagging formats; this study was thus designed to generate a novel data set describing standard grocery packaging tasks. Twenty-five experienced cashiers completed 36 grocery packaging tasks consisting of twice performing all combinations of workload intensity (6, 20 items), workstation height (low, medium, high), and packaging type (plastic bags, reusable bags, bins). Surface electromyography (EMG) was measured bilaterally for 5 shoulder and 3 low back muscles and processed to generate integrated muscle demand for each combination evaluated. A mixed effect ANOVA was used to assess the influences of gender, intensity, package type, side, (muscles on the right or left side of the body) and workstation height on individual and total muscular demands. High workload intensity combined with several other factors to increase muscle demands, including using plastic or reusable bags for packaging and increasing workstation height. Gender and side also interacted with workload intensity to influence muscle activity. Encouraging rest breaks, the use of bins for packaging, and decreasing cashier workstation height may help reduce potentially injurious muscular effort for cashiers.