## 4 Discussion  
In this study, the working conditions in the food manufacturing industry were found to have an impact on musculoskeletal pain. This was consistent with the results that automobile manufacturing, construction, and nursing workers have also complained of musculoskeletal pain due to work environments with conditions such as noise, vibration, and low temperature [20, 21, 34]. The impact of the work environment is not specific to the food manufacturing industry but rather a common characteristic across all industries. This indicates that improvements to the work environment are necessary to prevent workers from experiencing musculoskeletal pain. The study also revealed that work-family conflict affects musculoskeletal pain. This finding aligns with the fact that work-family conflict significantly contributes to lower back and neck pain [36]. In addition, the results were consistent with the finding that work-family conflict is a risk factor for neck and back pain in workers of the service and production sectors and nurses [35, 59]. Therefore, it is essential to prevent work-family conflict in order to reduce musculoskeletal pain among food manufacturing workers. Sleep-related problems among food manufacturing workers were influenced by work-family conflict and musculoskeletal pain but not by the work environment. This was in line with the finding that nurses' sleep quality worsened as work-family conflict  
Figure 2: Final structural equation model of this study. Rectangle represents measurement variable, and ellipse represents latent variable. \(D_{i}\): disturbance or residual; \(e_{i}\): measurement error. increased [60] and that sleep-related problems in construction industry workers and IT workers were also affected by work-family conflict [61; 62]. In addition, several previous studies have shown that higher levels of work-family conflict are associated with an increased risk of sleep-related problems such as waking up multiple times at night, difficulty falling asleep again, and waking up tired [63; 64; 65]. Chronic back pain can cause sleep-related issues, such as decreased sleep quality and a longer time to fall asleep [66]. Additionally, more severe neck and shoulder pain leads to worse sleep quality [67]. Musculoskeletal pain and sleep-related problems were found to affect food manufacturing workers' burnout. This finding aligns with a study indicating that the intensity of neck, shoulder, and wrist pain is associated with an increased likelihood of burnout among doctors and nurses [68], as well as with another study suggesting a connection between neck and shoulder pain and burnout in healthcare workers [69]. Moreover, findings indicated that sleep quality plays a crucial role in burnout [70]. According to research, doctors were four times more likely to experience burnout if they reported sleep-related issues [71], and nurses were similarly affected by burnout when they reported sleep-related problems [72]. This study is significant, as it revealed that musculoskeletal pain and sleep problems impact burnout among food manufacturing workers, similar to medical workers. Efforts are necessary to address musculoskeletal pain and sleep-related issues among food manufacturing production workers to prevent burnout since occupational burnout has a negative impact on workers' well-being and physical and mental health [73]. This study offers practical strategies for food manufacturing employees to address musculoskeletal pain, sleep-related problems, and burnout. First, workers in food manufacturing production are experiencing burnout influenced by sleep-related problems and musculoskeletal pain. Of the two factors, sleep-related problems were found to have a more significant impact. Therefore, it is crucial to prioritize the management of workers who are dealing with sleep-related problems. In particular, it suggests that management is required to address the issues of 'frequent waking up' and 'difficulty falling asleep' among production workers in the food manufacturing industry.