A Survey of Work-Related Musculoskeletal Disorders Among Otolaryngologists

Abstract

There are increased reports of prevalence of work-related musculoskeletal disorders (WRMSDs) in surgeons performing minimal access surgeries. Due to the nature of the speciality, otolaryngologists spend their work days in performing markedly precise procedures in small workspaces i.e. the patients' ear, nose and throat. Due to this, they frequently adopt awkward neck, back and shoulder postures while using devices like otoscope, endoscope and microscope. The field of otolaryngology has barely received any attention with respect to ergonomic assessment. Thus, the aim of this study was to find out the prevalence of WRMSDs in otolaryngologists in Mumbai and Navi Mumbai. A pre-validated, structured questionnaire was distributed to 150 otolaryngologists. Seventy-three otolaryngologists responded to the questionnaire. The questionnaire comprised of demographic and workload data, report of musculoskeletal symptoms and otolaryngologists' interpretation of casual and preventive factors of symptoms at workplace. Response rate of the survey was 48.6%. The total prevalence of WRMSDs in the otolaryngologists was 87.67%. Majority of those surveyed reported that they suffered from musculoskeletal problems which they attributed to the ergonomic flaws encountered during surgery (60.27%) and OPD (69.86%) respectively. Pain and discomfort during surgery experienced by the surgeons were most frequently attributed to the awkward and sustained postures adopted during surgery. Effective time management, ergonomically apt postures, intermittent change of posture, using back rest and availing skilled assistance during OPD and surgery, were the self-assessed corrective measures suggested by the respondents. The otolaryngologists' job profile puts them at high risk for WRMSDs.

Ergonomic hazards in otolaryngology

“…First, this study had a small sample size and was from a single institution, which may limit its generalizability. However, we had an excellent response rate of 68.6%, which compares very favorably to the literature . Additionally, assessment of the REBA score can be subjective, as most postural positions are scored based on both an angular and a time factor.…”

“…In our cohort, the standing position was significantly associated with cervical pain ( P = .034). Several other surveys of otolaryngology surgeons reported on neck pain as being most common MSK strain area during the surgery . Secondly, standing for extended periods of time (>30 minutes) almost always elevated the REBA risk score into the high‐risk category.…”

“…Several other surveys of otolaryngology surgeons reported on neck pain as being most common MSK strain area during the surgery. 1,[8][9][10]19,20 Secondly, standing for extended periods of time (>30 minutes) almost always elevated the REBA risk score into the high-risk category. Thus, our study has identified a potential target for intervention to mitigate ergonomic risk.…”

“…However, we had an excellent response rate of 68.6%, which compares very favorably to the literature. 1,[8][9][10]19,20,[22][23][24] Additionally, assessment of the REBA score can be subjective, as most postural positions are scored based on both an angular and a time factor. A static picture can be used to accurately measure an angle, but does not capture the length of time a position is maintained or how many repetitions per minute occurred.…”

“…9 In India, 87.7% of surveyed otolaryngologists reported work-related MSK symptoms, and 60% attributed these to poor ergonomics in the OR. 10 Although the prevalence of work-related MSK symptoms is consistent across practicing otolaryngologists globally, it is troubling that this rate is significantly higher than the rates reported in the general adult population. 11 These studies demonstrate that poor workplace ergonomics is a significant hazard in the field of otolaryngology.…”