Endoscopy-related musculoskeletal injuries in gastrointestinal endoscopists: a systematic review and meta-analysis

Aims Endoscopy-related musculoskeletal injuries (ERIs) are a major occupational hazard, impacting career longevity and personal well-being. This systematic review and meta-analysis aimed to update and expand on previous findings by assessing the prevalence, risk factors, and management of ERIs among gastrointestinal endoscopists.

Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic search of MEDLINE, Web of Science, and Scopus databases to identify relevant studies published since the last comprehensive review. Additionally, we reviewed manuscripts and references from studies included in the previous meta-analysis to identify any updates, corrections, or re-evaluations necessary for our analysis. Outcomes of interest included the prevalence of ERIs, common pain syndromes, risk factors, and preventive or treatment measures. The quality of studies was assessed using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

Results The analysis included 30 studies, incorporating data from 7,646 endoscopists, with a pooled prevalence of overall ERI of 62.5% (CI 52.6–71.8, I²=98%, p<0.01), including pain syndromes (67.5%; CI 46.4–85.6%; I²=98%, p<0.01), and numbness syndromes (12.4%; 95% CI 6.6–19.7%; I²=98%, p<0.01). For pain syndromes, the most prevalent affected areas were the hand (28.2%; CI 19.2–38.2%; I²=99%, p<0.01), lower back (27.3%; CI 20.1–35.2%; I²=97%, p<0.01), thumb (27.1%; CI 18.9–37.7%; I²=99%, p<0.01) and neck (25.7%; CI 19.3–32.7%; I²=98%, p<0.01). Finally, higher procedural volume, years in practice and female gender were consistently reported as risk factors for ERIs. Data on treatment revealed that 41.8% of endoscopists used medications such as analgesics (CI 31.2–52.8%; I²=94%, p<0.01), while 28.2% engaged in physical therapy (CI 18.2–39.5%; I²=96%, p<0.01). Additionally, 13.8% of endoscopists reported taking sick leave (CI 7.9–20.9%; I²=94%, p<0.01). Practice modifications to manage ERIs included adjusting video monitor positioning (45.5%, CI 22.2–69.9%; I²=96%, p<0.01) and table height (32.4%, CI 14.5–53.5%; I²=97%, p<0.01), but also reducing the number of cases per endoscopy session (14.6%; CI 10.4-19.4%; I²=72%, p<0.01).

Conclusions Endoscopy-related injuries are highly prevalent among gastroenterologists, driven by procedural volume, years in practice, and gender. Enhanced ergonomic training and workplace adaptations are needed to reduce these risks and support career sustainability.

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Artikel online veröffentlicht:
27. März 2025