Abstract:
Background: The CUPID (Cultural and Psychosocial Influences on Disability) study was established to explore the hypothesis
that common musculoskeletal disorders (MSDs) and associated disability are importantly influenced by culturally
determined health beliefs and expectations. This paper describes the methods of data collection and various characteristics
of the study sample.
Methods/Principal Findings: A standardised questionnaire covering musculoskeletal symptoms, disability and potential risk
factors, was used to collect information from 47 samples of nurses, office workers, and other (mostly manual) workers in 18
countries from six continents. In addition, local investigators provided data on economic aspects of employment for each
occupational group. Participation exceeded 80% in 33 of the 47 occupational groups, and after pre-specified exclusions,
analysis was based on 12,426 subjects (92 to 1018 per occupational group). As expected, there was high usage of computer
keyboards by office workers, while nurses had the highest prevalence of heavy manual lifting in all but one country. There
was substantial heterogeneity between occupational groups in economic and psychosocial aspects of work; three- to five fold variation in awareness of someone outside work with musculoskeletal pain; and more than ten-fold variation in the
prevalence of adverse health beliefs about back and arm pain, and in awareness of terms such as ‘‘repetitive strain injury’’
(RSI).
Conclusions/Significance: The large differences in psychosocial risk factors (including knowledge and beliefs about MSDs)
between occupational groups should allow the study hypothesis to be addressed effectively.
