This study was conducted in order to analyse checkout cashiers' movements at a checkout counter during interaction with customers and the prevalence of work-related stress and musculoskeletal disorders in checkout cashiers. In one shop, six cashiers were videotaped during the workday, and 50 cashiers from seven shops from the same chain of stores responded a questionnaire. Cashier activities and movements, customer interaction and counter design issues were analysed from the video data. Prevalence of work-related stress and musculoskeletal disorders was obtained from the questionnaire. It was found that 76% of all items were manually turned or angled. With a better adjustment of the scanner and a standardised positioning of the EAN-code, many of these movements could be avoided. Furthermore the prevalence of musculoskeletal disorders was quite high (68% for the neck). The questionnaire results showed that many cashiers experienced stress, giving a high percentage of cashiers in the "dedication under pressure" group. The behaviour of the customers was the major cause of stress. Other sources of stress arose from bad design or function of the computer system or other technical equipment. Relevance to industry: In this study several problems regarding cashier work were identified and solutions, relevant to counter and package designers, shop managers and cashiers are suggested. Data obtained on cashier movements and prevalence of musculoskeletal disorders are given.