The home healthcare (HHC) industry is growing rapidly and few studies have been performed analyzing worker risks for musculoskeletal disorders (MSDs). HHC Aides perform patient transfers and are considered the high exposure group. Nurses are considered an intermediate exposure group and other workers (e.g., therapists) are a low exposure group. We recruited 883 subjects in Utah, Wisconsin, Iowa and Canada from 24 agencies. The participation rate averaged >95%. The crude 1 year prevalence rate ratio (PRR) for low back pain (LBP) for Aides was 3.44 (95% Confidence Interval (CI) 2.25,5.29) compared to the low exposure group. For Nurses the PRR was 2.09 (95% CI 1.34,3.27). For neck pain, the PRR for Aides was 1.68 (95% CI1.07, 2.69) and for Nurses was 1.82 (95% CI 1.14,2.97) compared to the low exposure group. For shoulder pain PRRs for Aides and Nurses were 2.03 (95% CI 1.27,3.32) and 1.87 (95% CI 1.14,3.12) respectively. Logistic regression was used to adjust for age, gender, body mass index, tobacco, work-related and personal psychosocial stressors. The adjusted PRR for Aides for HHC related back pain was 3.36 (95% CI 2.18, 5.18) and for Nurses was 1.96 (95% CI 1.26, 3.06). The adjusted PRRs for HHC related neck pain were 1.74 (95% CI 1.08, 2.80) and 1.96 (95% CI 1.21,3.20) for Aides and Nurses respectively. The adjusted PRR for HHC related shoulder pain for Aides was 1.81 (95% CI 1.12,2.94) and for Nurses was 1.68 (95% CI 1.02,2.75). >From these data we conclude that Aides and Nurses appear to be at increased risk for HHC related back, shoulder and neck pain, with Aides at generally higher risk.