Ergonomic risk factors for wrist pain among smartphone-using university students: A cross-sectional study

Abstract

Introduction: Smartphone use has become integral to university students’ academic and social activities, but prolonged use combined with non-ergonomic wrist positions and body postures may increase biomechanical strain and contribute to wrist pain. This study examined ergonomic risk factors associated with wrist pain among smartphone-using university students. Methods: A quantitative observational cross-sectional study was conducted from June to July 2026 among undergraduate Public Health students at Universitas Tamalatea Makassar. A total of 78 students were recruited using accidental sampling from a population of 336 students. Smartphone use, wrist position, and body posture were assessed using an ergonomics-based questionnaire referring to Rapid Upper Limb Assessment principles, while wrist pain was measured using the Numeric Rating Scale. Associations were analyzed using Pearson’s Chi-square test, with odds ratios (ORs) and 95% confidence intervals (CIs) estimated from the 2×2 contingency tables. Results: Wrist pain was reported by 64 students (82.1%). High smartphone use was associated with greater odds of wrist pain than low use (OR=3.44; 95% CI: 1.03–11.51; p=0.038). A non-ergonomic wrist position showed the strongest association with wrist pain (OR=10.14; 95% CI: 2.52–40.78; p<0.001). Non-ergonomic body posture was also significantly associated with wrist pain (OR=4.77; 95% CI: 1.34–16.98; p=0.011). Conclusion: Smartphone-related ergonomic exposures were significantly associated with wrist pain among university students, particularly non-neutral wrist positioning. Campus-based ergonomic education should emphasize neutral wrist alignment, appropriate posture, reduced prolonged smartphone use, and regular rest breaks to minimize musculoskeletal strain.