The impact of endoscopic activity on musculoskeletal disorders of high-volume endoscopists in Germany

Abstract

Physical stress is common in GI endoscopists, leading to musculoskeletal disorders. Considering the increasing complexity of interventional GI endoscopy with prolonged examination time, work-related musculoskeletal disorders have come into focus. However, data on work-related health stress in German endoscopists are elusive. The aim of this study was therefore to investigate the prevalence and consequences of work-related musculoskeletal disorders in German endoscopists. A 24-item questionnaire on endoscopy-associated musculoskeletal disorders and standardized pain assessment was developed by an interdisciplinary team of endoscopists and sports medics. The survey was distributed online by the leading German societies for gastroenterology and endoscopy. Overall, 151 German practicing endoscopists took part in the study. Regarding the average number of endoscopic procedures per week, the study collective consisted mainly of high-volume endoscopists. The survey showed that most participants suffered from general musculoskeletal disorders (82.8%) and from work-related musculoskeletal disorders (76.8%). The most affected body parts were the neck, low back, thumb, and shoulder. Temporary absence from work due to symptoms was reported by 9.9% of the respondents. Over 30% of participating endoscopists stated the need for analgesics or physiotherapy due to musculoskeletal disorders. Age, professional experience and work time were identified as relevant risk factors for musculoskeletal health issues. A high number of German endoscopists are affected by musculoskeletal disorders due to specific working postures and repetitive movements with a large impact on personal health. Further interventional studies are mandatory to improve the risk prevention of endoscopic activity.

Prevalence of endoscopy-related injuries and their impact on clinical practice: a systematic review and meta-analysis

“…20 15 and 19 21 (exp animals/ or exp nonhuman/) not exp humans/ 22 ((alpaca or alpacas or amphibian or amphibians or animal or animals or antelope or armadillo or armadillos or avian or baboon or baboons or beagle or beagles or bee or bees or bird or birds or bison or bovine or buffalo or buffaloes or buffalos or "c elegans" or "Caenorhabditis elegans" or camel or camels or canine or canines or carp or cats or cattle or chick or chicken or chickens or chicks or chimp or chimpanze or chimpanzees or chimps or cow or cows or "D melanogaster" or "dairy calf" or "dairy calves" or deer or dog or dogs or donkey or donkeys or drosophila or "Drosophila melanogaster" or duck or duckling or ducklings or ducks or equid or equids or equine or equines or feline or felines or ferret or ferrets or finch or finches or fish or flatworm or flatworms or fox or foxes or frog or frogs or "fruit flies" or "fruit fly" or "G mellonella" or "Galleria mellonella" or geese or gerbil or gerbils or goat or goats or goose or gorilla or gorillas or hamster or hamsters or hare or hares or heifer or heifers or horse or horses or insect or insects or jellyfish or kangaroo or kangaroos or kitten or kittens or lagomorph or lagomorphs or lamb or lambs or lemur or lemurs or llama or llamas or macaque or macaques or macaw or macaws or marmoset or marmosets or mice or minipig or minipigs or mink or minks or monkey or monkeys or mouse or mule or mules or nematode or nematodes or octopus or octopuses or orangutan or "orang-utan" or orangutans or "orang-utans" or ostrich or ostriches or oxen or parrot or parrots or pig or pigeon or pigeons or piglet or piglets or pigs or porcine or primate or primates or quail or rabbit or rabbits or rat or rats or reptile or reptiles or rodent or rodents or ruminant or ruminants or salmon or sheep or shrimp or slug or slugs or swine or tamarin or tamarins or toad or toads or trout or urchin or urchins or vole or voles or waxworm or waxworms or wildlife or worm or worms or xenopus or "zebra fish" or zebrafish) not (human or humans or patient or patients)).ti,ab,hw,kf. 23 Endoscopy related musculoskeletal injuries (ERI) are commonly reported but its exact prevalence and clinical impact remains obscure. We conducted a systematic review and meta-analysis of the present literature to answer these questions.…”

“…[13] Characteristics of the included studies Data was extracted from 12 studies including 4563 respondents, 3172 were doctors while 22 were GI nurses and technicians. [7,10,[14][15][16][17][18][19][20][21][22][23] The surveys included gastroenterologist, general surgeons, colorectal surgeons performing colonoscopies, nurses, and endoscopy technicians. Of two studies performed from the same center, the paper with higher response rates was selected.…”

New Insight into Endoscopic Work-Related Musculoskeletal Disorders (WRMD): Why Repeated Motions Damage

“…Since Wolff and Shinya published the first description of a fiberoptic colonoscopy using a flexible endoscope in 1969, there have been significant advancements, most notably conversion to video from fiberoptic imaging. It is estimated that over 15 million colonoscopies are performed annually in the USA with the average gastroenterologist performing several hundred colonoscopies each year [2]. Due to the repetitive nature, large physical forces and non-neutral postures required to maneuver the endoscope, microtrauma to joints, tendons, and ligaments occurs, initiating a cascade of continual inflammation and injury.…”

“…This impact is manifest in the observation that approximately 15.9% of high-volume endoscopists surveyed had to reduce procedures and 9.9% took time off work as a result of WRMDs. Further, 35.8% of the respondents reported medical therapy for WRMDs including analgesic use, physiotherapy and surgical treatment [2]. The impact of WRMDs is not only limited to work-related activities but also affects physician quality-of-life outside of work with 36.4% of respondents reporting an impairment of leisure activities as a result of WRMDs [2].…”

“…Further, 35.8% of the respondents reported medical therapy for WRMDs including analgesic use, physiotherapy and surgical treatment [2]. The impact of WRMDs is not only limited to work-related activities but also affects physician quality-of-life outside of work with 36.4% of respondents reporting an impairment of leisure activities as a result of WRMDs [2].…”