564 Prevalence, Risk Factors, and Global Impact of Musculoskeletal Injuries Among Endoscopists in Portugal

Abstract

INTRODUCTION: The performance of endoscopy is characterized by frequent and repetitive activities. Endoscopists often report musculoskeletal injuries (MI). The widespread use of endoscopy and the execution of more technically challenging procedures may lead to higher rates of repetitive stress injuries. Despite previous American and Asian reports, little evidence has come from Europe. We aimed to determine the prevalence, risk factors and impact of MI among Portuguese endoscopists. METHODS: A 48-question electronic survey was developed by a multidisciplinary group. The electronic survey was sent to all members of Portuguese Society of Gastroenterology (SPG, n = 705) during May 2019. Study data were collected and managed using REDCap electronic data capture tools hosted at SPG–CEREGA. RESULTS: The survey was completed by 171 endoscopists (response rate of 24.3%), 55.0% female, with a median age of 36 years (31-50). The majority of the respondents were consultants (77.8%; trainees 22.2%), with 97.7% currently performing endoscopy. The median time of endoscopic practice was 9 years (5-22). Regarding practice setting, 52.0% worked in academic centers, 41.5% in community centers and 63.9% in private practice. The median weekly-working time was 50 hours (45-60), 50% (37.5-62.5%) performing endoscopy. The prevalence of reported MI was 69.6% (n = 119). The median time for MI development was 6 years (3-16). The most common sites of injury were neck (42.9%) and thumb (42.0%). In 45.4%, the pain was evident both in work and daily activities and 22.7% referred pain even at rest. In the respondents with MI, 34.5% changed practice and/or reduced working activity and 33.6% reduced work-unrelated physical activity. Missing work was reported by 10.1% [median 30 days (4-45)]. The most common treatments were NSAIDs (57.1%) and physiotherapy (30.3%) but surgery was required in 1.7%. In the multivariate logistic regression, endoscopic practice >15 years (OR 3.514, P = 0.004), female gender (OR 2.443, P = 0.018) and higher percentage of time performing upper endoscopy (OR 0.974, P = 0.026) were independently associated with MI. CONCLUSION: Musculoskeletal injuries were reported by over two thirds of the portuguese endoscopists that completed our survey. These injuries had a significant impact on regular and professional activities. Female endoscopists and those with a minimum of 15 years of practice are at higher risk. The identification of these risk factors may result in practice changes to reduce the burden of the injuries.

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

“…3) [10,16,17,21,22]. Hand injury or numbness was present in 10.1% (95%CI 3.5%-16.7%) [7,19,20,21,22]. ▶ Co-primary outcome: prevalence of endoscopy-related pain…”

“…Due to ERI, 171/1562 (10.9%) respondents reported reducing their daily number of procedures. [7,14,15,18,20,23] The pooled prevalence of respondents that reduced their number of procedures per day was 12.7% (95% CI: 7.8, 17.6; I 2 : 89.4%).…”

“…Unauthorized distribution is strictly prohibited. 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.…”

“…[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.…”

“…Eleven studies assessed the impact of ERI on the clinical practice of endoscopists [7,10,[14][15][16][18][19][20][21][22][23]. Of the 4782 respondents, 601 (12.6%) respondents reported missing work due to injuries while the number of missed workdays ranged from 1 to 90 days.…”