Are All Endoscopy-Related Musculoskeletal Injuries Created Equal? Results of a National Gender-Based Survey

Abstract

INTRODUCTION: Endoscopy-related injury (ERI) is common in gastroenterologists (GI). The study aim was to assess the prevalence of self-reported ERI, patterns of injury, and endoscopist knowledge of preventative strategies in a nationally representative sample. METHODS: A 38-item electronic survey was sent to 15,868 American College of Gastroenterology physician members. The survey was completed by 1,698 members and was included in analyses. Descriptive, univariate, and multivariate analyses were conducted to evaluate the likelihood of ERI based on workload parameters and gender. RESULTS: ERI was reported by 75% of respondents. ERI was most common in the thumb (63.3%), neck (59%), hand/finger (56.5%), lower back (52.6%), shoulder (47%), and wrist (45%). There was no significant difference in the prevalence of ERI between men and women GI. However, women GI were significantly more likely to report upper extremity ERI while men were more likely to report lower-back pain-related ERI. Significant gender differences were noted in the reported mechanisms attributed to ERI. Most respondents did not discuss ergonomic strategies in their current practice (63%). ERI was less likely to be reported in GI who took breaks during endoscopy (P = 0.002). DISCUSSION: ERI is highly prevalent in GI physicians. Significant gender differences regarding specific sites affected by ERI and the contributing mechanisms were observed. Results strongly support institution of training in ergonomics for all GI as a strategy to prevent its impact on providers of endoscopy. JOURNAL/ajgast/04.03/00000434-202103000-00021/inline-graphic1/v/2023-07-18T070745Z/r/image-tiff

Musculoskeletal Pains and Their Risk Factors in Endoscopists

“…In this issue of Clinical Endoscopy, Kamani et al [ 3 ] presented a study on the prevalence of endoscopy-related musculoskeletal pain (ERMP) in endoscopists, comparison of ERMP between endoscopists and non-endoscopists, and the risk factors associated with the pain in endoscopists. They reported that the prevalence of ERMP in endoscopists was higher than that in non-endoscopists (95.08% vs. 54.83%), which was higher than that reported in other studies [ 2 ]. This discrepancy might be due to the different study designs or different questionnaires used.…”

“…In particular, procedural physicians and surgeons are at a high risk of WRMDs that may be harmful to their lives and influence the quality and quantity of patient care [ 1 ]. Gastroenterologists performing endoscopy are also at a high risk of WRMDs, and the prevalence of endoscopy-related injuries has been reported as 75% in a previous study [ 2 ].…”

“…The most common injuries in surgeons and interventionalists are cervical spine disorder, followed by rotator cuff disorder, lumbar spine disorder, and carpal tunnel syndrome [ 1 ]. The sites commonly affected by ERMP are the thumb, followed by the neck, hand/fingers, lower back, shoulder, and wrist [ 2 ]. Interestingly, the most prevalent sites of ERMP were different between experienced endoscopists (shoulder) and beginners (fingers) [ 4 ].…”

“…Severe ERMP was reported with an increase in the time spent per week performing the procedure [ 5 ]. The time spent performing endoscopy per week and years were independently associated with ERMP [ 2 ]. Other factors that contributed to ERMP were manipulation of the endoscopic parts and prolonged standing [ 6 ].…”

“…Conservative treatments, including medications, massage, physical therapy, rest, splinting, steroid injection, and acupuncture/chiropractic, are commonly used for ERMP [ 2 ]. Kamani et al [ 3 ] reported that most endoscopists with musculoskeletal pain preferred conservative treatment, except for oral medication, physical therapy, and splinting.…”