One hundred forty-four sewing machine operators answered questionnaires concerning occupational history and musculoskeletal symptoms adapted from the National Health and Nutrition Examination Survey. They were matched for age within 5 years, race, and sex with persons completing the HANES I Augmentation Survey, and the prevalence of self-reported musculoskeletal morbidity was compared. Operators complained significantly more often of knee pain (prevalence odds ratio [POR] = 1.84, p = .0001) and knee swelling (POR = 9.98, p less than .00001), although they were no more likely to have had knee surgery. Similar increases were reported for upper-back pain (POR = 2.13, p = .002) joint ache, and joint swelling (both were significant for fingers, wrists, elbows, and shoulders at p less than .05 levels). No differences in low-back pain or in hospitalization for joint conditions were noted. Ergonomic redesign of sewing machines needs to address knee and upper-back movements as well as the arm, wrist, and finger movements.