Objective To understand the current status of occupational stress among biosafety laboratory (BSL) staff in Xinjiang and to analyze its possible influencing factors and its association with work-related musculoskeletal disorders (WMSDs).

Methods A cluster sampling method was used to survey BSL staff across various regions in Xinjiang in May 2021. The effort-reward imbalance (ERI) questionnaire was used to assess occupational stress, and the Chinese Musculoskeletal Disorders Questionnaire was used to assess WMSDs. Multivariate logistic regression was used to analyze the influencing factors of occupational stress. Propensity score matching was used to match demographic variables and work-related factors of employees with and without WMSDs, followed by multivariate logistic regression to analyze the association of occupational stress and the risk of WMSDs in BSL staff.

Results A total of 7 924 staff were included in the study, with an occupational stress detection rate of 83.38% (6 607 individuals) and a WMSDs detection rate of 69.16% (5 480 individuals). The results of the multivariate logistic regression analysis revealed that the occupational stress of laboratory personnel working in BSL-2 facilities was 1.219 times (P < 0.05) higher than that in BSL-1 facilities. The staff in the 30 to 44 age group and the ≥ 50 age group exhibited 1.221-fold and 1.375-fold (both P < 0.05) higher risks of occupational stress, respectively, compared to the staff in the 20 to 25 age group. Laboratory workers with associate degrees and bachelor's degrees or higher had 1.527-fold and 2.379-fold (both P < 0.05) increased risks of occupational stress, respectively, compared to those with vocational education or below. Management personnel and laboratory technicians showed 1.772-fold and 1.840-fold (both P < 0.05) higher risks of occupational stress, respectively, compared to other positions (e.g., logistics staff, engineers). Laboratory personnel with monthly incomes ≥ 4 000 yuan had a 1.374-fold increased risk of occupational stress compared to those earning < 4 000 yuan (P < 0.05). Propensity score matching analysis indicated that before matching, most variables differed statistically significantly (P < 0.05) between the two groups of employees (with and without WMSDs). After matching, 2 223 pairs of BSL staff were obtained, with no statistically significant differences (all P > 0.05) between the groups in all demographic and work-related variables (gender, BSL level, age, education level, years of work experience, professional title, job category, marital status, and monthly income). Post-matching multivariate logistic regression analysis demonstrated that the risk of musculoskeletal disorders was positively related to the effort, reward, and overcommitment dimensions of the ERI scale among BSL staff (OR = 1.06, 1.01, and 1.06, all P < 0.001), respectively.

Conclusions Occupational stress and musculoskeletal disorders were prevalent among BSL staff, with occupational stress potentially increasing the risk of WMSDs. It is suggested that work tasks should be allocated reasonably based on individual capabilities, standardized work processes should be established, regular health education should be conducted, and timely psychological counseling and guidance should be provided to actively prevent psychological issues among BSL staff.