Objectives Commercial janitors are a relatively unseen and understudied segment of the workforce. Janitors report increasing work pressures over the past few years. We conducted a cross-sectional survey among janitors to evaluate the association of changes in work intensity and other aspects of work organisation on injury, musculoskeletal pain, disability, and stress.

Method We conducted a cross-sectional survey among commercial janitors, including both union and non-union workers, and a comparison group of union security guards using peer interviewers and electronic data collection. Work intensity was measured using a 10-point scale and outcomes including injury, musculoskeletal pain, disability, and stress were assessed for the current year, and two previous years. The association between work intensity and each outcome was evaluated, controlling for group and demographics.

Results Surveys were collected among 276 union and 78 non-union janitors, and 76 security guards, 76% of whom were immigrants. An increase in work intensity among union janitors, and strong trend of increasing injury, pain, upper extremity disability and stress associated with work intensity was observed. Union janitors report an increase in injury over the past 3 years from 6.3 to 13.5%. Multi-variable models further explore the impact of demographics and work characteristics on the increase in risk.

Conclusions Anecdotal reports of increased workload among janitors are substantiated by the reported increase in work pressure over the past three years and its association with stress, pain and injury among janitors.