"Most housekeepers often suffer from musculoskeletal pain"

How did the idea of launching this project come about?

In the call for sustainable tourism tax funding, we saw there was room for research projects, and we felt the time was right. In primary care centres, housekeepers were constantly coming in with health problems, in both the high and low season. We’d already carried out a previous study in Arenal, and due to the vulnerability of this group, we decided to propose a more ambitious project involving the three main islands, and to make it as thorough as possible. It was selected and we were able to go ahead.

What were the main objectives?

I had three very clear objectives. The first was to gather knowledge about their health problems and fill a gap in that respect. The second was to carry out a complex, preventive intervention that would address both physical and psychological aspects and seek to improve their quality of life. Finally, the third was to give what we’d learned back to society: to share the results with the workers themselves, health professionals and society in general.

What kind of studies were conducted and how many workers were involved?

We started by reviewing all the existing literature and then conducted an exploratory qualitative study with housekeepers, but also with a committee of experts that included doctors, trade unionists, managers, employers, members of the Kellys association, etc. Once we had all this information, we designed a much broader descriptive study. A total of 1,043 randomly selected housekeepers took part, a representative sample from the Balearic Islands. Some 1,080 more were added in the intervention phase. In total, more than 2,000 female workers were involved in the project, making it the largest study of this group ever carried out.

Which data had the greatest impact on you?

Lots. On average they cleaned up 18 rooms and made 45 beds per day. One third described their work as very stressful, although 25% also found it fulfilling. The most recurrent finding was pain: 68% suffered from low back pain, 60% from pain in the arms and hands, and 55% from neck pain. In other words, most of them often had musculoskeletal problems, which affects their performance and quality of life. We also analysed drug consumption, use of health services, stress levels, etc. All this helped us to design the subsequent intervention.

What did this intervention consist of?

It was very comprehensive. It included nine visits: some individual, such as a first long visit with a nursing coordinator; one with physiotherapists to address pain and posture; and group sessions with psychologists specialising in work-related stress. There were also sessions focusing on diet, healthy habits and community activities, such as walking or aqua aerobics at municipal swimming pools. We wanted to provide them with resources and capabilities during the winter, so that they could better cope with the following tourist season.

What results did you obtain?

Here, we ran into a problem: COVID. The intervention started at the end of 2019 and after three months, lockdown happened. Lots of hotels were closed or had very short seasons, and this made it impossible to really see the impact on pain or quality of life. We did see improvements in some indicators, such as a predisposition to give up toxic habits or follow healthier diets, but we couldn’t clearly demonstrate effects on chronic pain or stress. Even so, the preliminary descriptive study was a milestone: a clinical trial specifically for housekeepers had never been done before.

What did the participating workers think of the study?

They were very grateful. They said it was a luxury to have an hour and a half with a nurse or physiotherapist dedicated just to them. Even those in the control group, who didn’t undergo the full intervention, at least experienced a limited version because we didn't want them to miss out. Many told us that finally, someone cared about them. It was only fair that a sustainable tourism project should take them into account.

The study also addressed the psychological impact of the work.

Yes, because although they valued positive things such as their schedule and team work, they all agreed that the overload is enormous. Having to do a lot of repetitive tasks, without being able to decide what order they do the rooms in or how to deal with unexpected events, leads to work stress. This not only has a physical impact, but also a psychological one. For this reason, we included psychologists specialised in stress and occupational health and safety, who offered them guidelines on how to better manage these situations.

Do you think this model can be applied in other industries?

Musculoskeletal problems are common in many repetitive and difficult jobs. The challenge is to incorporate this type of programme into working hours, because the pressure is so high. But we believe that the experience can serve as a guide for other industries. Moreover, primary care should focus more on prevention, not just on treating problems when they become serious.

After this long process, what would you say this project brings to the table?

Above all, it provides solid scientific knowledge and visibility for this group. We’ve published 11 articles, 2 doctoral theses and presented results at national and international conferences. I believe it’s left an important basis for designing policies and improvement programmes that could also be applied to other industries or trades.