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This study aimed to identify biomechanical risk factors of musculoskeletal disorders (MSD) among nurses.A cross sectional survey-structured by the Nordic MSDs questionnaire- was conducted through a representative sample of the 1179 paramedics providing nursing care in two university hospital in Tunisia (n=301). A representative work period in each department was identified. A multidisciplinary working group, according to estimated usual physical load, divided theses departments into four homogeneous groups. Semi quantitative biomechanical constraints based on 56 direct observations with encoding software and over 2 hours each one was conducted, in accordance with the homogeneous exposure group sampling table. Physical load scores were elaborated according to the posture adopted, gestures performed and characteristic of handling (type, assistance, weight and autonomy of the patient) and assessed on the Chamoux physical strain scale.The prevalence of the back MSDs was equal to 70.3%. Variable prevalence of the upper limbs MSDs was noted according to the anatomical area (43.68% for neck, 40.27% for shoulders, 15.01% for elbows and 29.35% for wrists).Observational study concluded that handling activity, as well as type and duration of constraining postures, were variable in function of the department of assignment. According to Chamoux scale the average physical load score was variable from 7.76 in departments with ‘heavy physical requirement» to 7.25 in those associated to ‘low’ physical requirement. Multivariate analysis showed a significant difference concerning the thrust and the traction of light and heavy load, the activity of handling and the characteristics of the handled patients. It also concluded that paramedics affected to departments associated to heavier and less autonomous patient handling activity, were most affected by back MSD.Our investigation identifies biomechanical risk factor of MSD among nurses and suggests the necessity of preventive actions according to exposure leve.