In recent years, the number of Chinese expatriate construction workers has reached a considerable scale, but now little is known about the characteristics of occupational ergonomics exposure, the scores of qualities of life, and the prevalence of musculoskeletal disorders for this special group.

This study aims to identify occupational ergonomic exposure patterns of Chinese expatriate and Sri Lankan local construction workers with different types of work, and to investigate the relationships of country of origin and type of work with major health outcomes (quality of life and musculoskeletal disorders).

A cross-sectional survey was conducted among 300 workers respectively at a Chinese construction site and 300 workers at a local construction site in Sri Lanka from October to December 2018, using Chinese version and Sinhala version of World Health Organization's Quality of Life Brief (WHOQOL-BREF) and Musculoskeletal Disorders Questionnaire respectively. t test, chi-square test, linear regression, and logistic regression were used to identify differences in health outcomes among different countries and jobs.

A total of 581 valid questionnaires were collected, including 281 questionnaires from Chinese workers and 300 questionnaires from Sri Lankan workers. The occupational ergonomic exposure patterns for Chinese expatiates: the management and logistics workers were mainly exposed to sedentary working postures (59.6%), or awkward neck (50.6%) and wrist (78.7%) postures, while the front-line workers had high proportions of awkward postures (44.8%-58.9%), heavy load (58.3%-75.0%), repetitive operation (54.7%), and other adverse ergonomic factors. The exposure proportions of heavy load > 5 kg (75.0%, 81.9%), reaching with arms or hands (80.1%, 87.5%), and standing for a long period (78.1%, 92.0%) were highest in both groups, but the Chinese expatiates had higher proportions of slight bending and twisting (58.9%) and insufficient operating space (34.4%), while the local construction workers had higher proportions of awkward wrist posture (64.6%), heavy load (67.7%-81.9%), and repetitive operation (69.1%). The scores of quality of life among Chinese expatriate construction workers were significantly lower than those of local workers in physical (56.2±12.2 vs. 72.9±8.6, China vs. Sri Lanka, thereafter), psychological (55.5±14.5 vs. 75.9±6.4), social relationship (61.7±17.2 vs. 70.0±8.7), and environmental (51.2±16.9 vs. 67.2±6.9) domains. The prevalence rate of musculoskeletal disorders in the past year among Chinese expatriate management and logistics workers reached 50.6%, higher than that of 28.1% and 34.0% among Chinese and Sri Lankan front-line workers (P<0.001). The interaction analysis results revealed an interaction between country of origin and awkward posture in social and environmental domains, and an interaction between types of job and awkward posture in musculoskeletal disorders (P<0.05).

Occupational ergonomic exposure patterns vary in different countries and jobs. Management and logistics workers are largely exposed to sedentary behaviors and upper body awkward postures; front-line workers have higher exposure proportions to a variety of adverse ergonomic factors, of which Chinese workers report higher proportions of bending and twisting and insufficient operating space, while Sri Lankan workers show more awkward wrist posture, heavy load, and repetitive operation. The scores of quality of life among Chinese expatiate construction workers are much lower than those of local workers, and the prevalence of musculoskeletal disorders among Chinese management and logistics workers is much higher than that of other groups.