CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(05): E562-E569
DOI: 10.1055/a-1789-0506
Original article

Gastrointestinal endoscopy and work-related injuries: an international survey

Veronica Bessone
1   Department of Endoscope Engineering, Ambu Innovation GmbH, Augsburg, Germany
,
Sven Adamsen
2   Department of Clinical Application Ambu A/S, Ballerup, Denmark
3   Digestive Disease Centre, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
› Author Affiliations

Abstract

Background and study aims Recently, the awareness of work-related musculoskeletal injuries (MSIs) among gastrointestinal endoscopists has increased because of their effect on the private and work life of clinicians as well as on the health care system. The high injury incidence (reported to range from 37 % to 89 %) has been correlated with the intensive muscular demand required during a procedure.

Patients and methods An online survey with 32 questions was conducted globally. Clinically active endoscopists (doctors and nurses) participated anonymously and voluntarily. The questionnaire included questions about endoscopist anthropometrics, experience of MSI, treatment, and preventive measures such as ergonomic training. Descriptive statistics were used to analyse the data.

Results Of 204 clinicians (78 % males; 81 % > 35 years of age), 107 (53 %) stated to have experienced a work-related MSI. The most frequent locations were in the neck (n = 49), shoulder and thumb (n = 39, both). Female clinicians resulted to be significantly more prone to develop MSI. In addition, endoscopists who performed more than 15 hours of endoscopy or more than 15 procedures per week reported a significantly higher rate of MSI.

Conclusions The high frequency of MSIs among gastrointestinal endoscopists highlights the importance of implementing ergonomic training. Including simple precautions before and during endoscopy may reduce the risk of developing an injury.



Publication History

Received: 02 September 2021

Accepted: 03 December 2021

Article published online:
13 May 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Siau K, Anderson JT. Ergonomics in endoscopy: Should the endoscopist be considered and trained like an athlete?. Endosc Int Open 2019; 7: E813-E815
  • 2 Anderson J. Colonoscopy: do operator motions and posture count?. Endosc Int Open 2015; 3: 627-628
  • 3 Yung DE, Banfi T, Ciuti G. et al. Musculoskeletal injuries in gastrointestinal endoscopists: a systematic review. Expert Rev Gastroenterol Hepatol 2017; 11: 939-947
  • 4 Shergill AK, McQuaid KR. Ergonomic endoscopy: An oxymoron or realistic goal?. Gastrointest Endosc 2019; 90: 966-970
  • 5 Lipowska AM, Shergill AK. Ergonomics in the unit: Modeling the environment around the endoscopist. TIGE 2020; 23: 256-262
  • 6 Cohen DL, Naik JR, Tamariz LJ. et al. The perception of gastroenterology fellows towards the relationship between hand size and endoscopic training. Dig Dis Sci 2008; 53: 1902-1909
  • 7 Centers for Disease Control and Prevention. Work-Related Musculoskeletal Disorders & Ergonomics. https://www.cdc.gov/workplacehealthpromotion/health-strategies/muscu-loskeletal-disorders
  • 8 Buschbacher R. Overuse syndromes among endoscopists. Endoscopy 1994; 26: 539-544
  • 9 Pawa S, Banerjee P, Kothari S. et al. Women in Gastroenterology Committee of the American College of Gastroenterology. Are All Endoscopy-Related Musculoskeletal Injuries Created Equal? Results of a National Gender-Based Survey. Am J Gastroenterol 2021; 116: 530-538
  • 10 Byun YH, Lee JH, Park MK. et al. Procedure-related musculoskeletal symptoms in gastrointestinal endoscopists in Korea. World J Gastroenterol 2008; 14: 4359-4364
  • 11 Battevi N, Menoni O, Cosentino F. et al. Digestive endoscopy and risk of upper limb biomechanical overload. Med Lav 2009; 100: 171-177
  • 12 Shergill AK, Asundi KR, Barr A. et al. Pinch force and forearm-muscle load during routine colonoscopy: a pilot study. Gastrointest Endosc 2009; 69: 142-146
  • 13 Shergill AK, Rempel D, Barr A. et al. Biomechanical risk factors associated with distal upper extremity musculoskeletal disorders in endoscopists performing colonoscopy. Gastrointest Endosc 2021; 93: 704-711
  • 14 Kuwabara T, Urabe Y, Hiyama T. et al. Prevalence and impact of musculoskeletal pain in Japanese gastrointestinal endoscopists: a controlled study. World J Gastroenterol 2011; 17: 1488-1493
  • 15 Ridtitid W, Coté GA, Leung W. et al. Prevalence and risk factors for musculoskeletal injuries related to endoscopy. Gastrointest Endosc 2015; 81: 294-302
  • 16 Singla M, Kwok RM, Deriban G. et al. Training the endo-athlete: an update in ergonomics in endoscopy. Clin Gastroenterol Hepatol 2018; 16: 1003-1006
  • 17 O'Sullivan S, Bridge G, Ponich T. Musculoskeletal injuries among ERCP endoscopists in Canada. Can J Gastroenterol 2002; 16: 369-374
  • 18 Al-Rifaie A, Gariballa M, Ghodeif A. et al. Colonoscopy-related injury among colonoscopists: an international survey. Endosc Int Open 2021; 9: E102-E109
  • 19 Villa E, Attar B, Trick W. et al. Endoscopy-related musculoskeletal injuries in gastroenterology fellows. Endosc Int Open 2019; 7: E808-E812
  • 20 Han S, Hammad HT, Wagh MS. High prevalence of musculoskeletal symptoms and injuries in third space endoscopists: an international multicenter survey. Endosc Int Open 2020; 8: 1481-1486
  • 21 Cappell MS. Colonoscopist's thumb: DeQuervains's syndrome (tenosynovitis of the left thumb) associated with overuse during endoscopy. Gastrointestinal End J 2006; 64: 841-843
  • 22 Harvin G. Review of musculoskeletal injuries and prevention in the endoscopy practitioner. J Clin Gastroenterol 2014; 48: 590-594
  • 23 Miller AE, MacDougall JD, Tarnopolsky MA. et al. Gender differences in strength and muscle fiber characteristics. Eur J Appl Physiol Occup Physiol 1993; 66: 254-262
  • 24 Gaudez C, Gilles M, Savin J. Intrinsic movement variability at work. How long is the path from motor control to design engineering?. Appl Ergon 2016; 53: 71-78
  • 25 Appleyard MN, Mosse CA, Mills TN. et al. The measurement of forces exerted during colonoscopy. Gastrointest Endosc 2000; 52: 237-240
  • 26 Waters TR, Dick RB. Evidence of health risks associated with prolonged standing at work and intervention effectiveness. Rehabil Nurs 2015; 40: 148-165
  • 27 Drysdale SA. The incidence of upper extremity injuries in endoscopy nurses working in the United States. Gastroenterol Nurs 2013; 6: 329-338
  • 28 Matern U, Faist M, Kehl K. et al. Monitor position in laparoscopic surgery. Surg Endosc 2005; 19: 436-440
  • 29 Haveran LA, Novitsky YW, Czerniach DR. et al. Optimizing laparoscopic task efficiency: the role of camera and monitor positions. Surg Endosc 2007; 21: 980-984
  • 30 Edelman K, Zheng J, Erdmann A. et al. Endoscopy-related musculoskeletal injury in AGA gastroenterologists is common while training in ergonomics is rare. Gastroenterol 2017; 152: S217
  • 31 Marlicz W, Koulaouzidis A, Koulaouzidis G. Future endoscopy-related injuries will be of different types and gender-equal. Am J Gastroenterol 2021; 116: 1960-1961
  • 32 Sharma P, Golchha V. Awareness among Indian dentist regarding the role of physical activity in prevention of work related musculoskeletal disorders. Indian J Dent Res 2011; 22: 381-384
  • 33 Campbell 3rd EV, Muniraj T, Aslanian HR. et al. Musculoskeletal pain symptoms and injuries among endoscopists who perform ERCP. Dig Dis Sci 2021; 66: 56-62
  • 34 Messing K, Tissot F, Stock S. Distal lower-extremity pain and work postures in the Quebec population. Am J Public Health 2008; 98: 705-713
  • 35 Shergill AK, McQuaid KR, Rempel D. Ergonomics and GI endoscopy. Gastrointest Endosc 2019; 70: 145-153