Mammography equipment design: impact on radiographers’ practice

Abstract

Objectives Identify radiographers' postures during frequent mammography procedures related to the mammography equipment and patient characteristics. Methods A postural task analysis was performed using images acquired during the simulation of mammography positioning procedures. Simulations included craniocaudal/(CC) and mediolateral-oblique/(MLO) positioning in three different settings: radiographers and patients with similar statures, radiographers smaller than the patients and radiographers taller than the patients. Measurements of postural angles were performed by two raters using adequate software and classified according to the European Standard EN1005-4:2005 + A1:2008. Results The simulations revealed that the most awkward posture in mammography is during the positioning of MLO projection in short-stature patients. Postures identified as causing work-related musculoskeletal disorder (WRMSD) risk were neck extension, arms elevated and the back stooped, presenting angles of 87.2, 118.6 and 63.6, respectively. If radiographers were taller than patients, then the trunk and arm postures were not acceptable. Conclusions Working in a mammography room leads to awkward postures that can have an impact on radiographers' health, namely WRMSDs. The results in this study showed that there are non-acceptable postures associated with frequent working procedures in mammography. MLO is the most demanding procedure for radiographer postures and may be related to WRMSDs. Mammography devices should be redesigned considering adjustability for radiographers. Main Messages• Mammography constraints for radiographers in mammography procedures have not been well studied.• Performing mammography leads to awkward postures that can impact radiographers' health.• MLO, the most demanding procedure for radiographers, is possibly related to WRMSDs.

Collaborating with mammographers to address their work-related musculoskeletal discomfort

“…In a practice analysis survey by The American Registry of Radiology Technologists (2008), 54% of respondents performed 6–15 exams per day and another 26% performed 16–25 exams per day. Similarly awkward postures adopted by mammographers during patient positioning were depicted in Gale et al (2007), Costa et al (2014), and the current study (Figures 2b and c). Height differential between patient and mammographer was reported by mammographers in the current study and in other studies (Costa et al, 2014; Hearn & Reeves, 2003) to be an important factor contributing to the adoption of these awkward postures.…”

“…Similarly awkward postures adopted by mammographers during patient positioning were depicted in Gale et al (2007), Costa et al (2014), and the current study (Figures 2b and c). Height differential between patient and mammographer was reported by mammographers in the current study and in other studies (Costa et al, 2014; Hearn & Reeves, 2003) to be an important factor contributing to the adoption of these awkward postures. These postures can be exacerbated by view, particularly MLO, and machine design (rigid tube head location) (Costa et al, 2014; Gale et al, 2007; Hearn & Reeves, 2003), as well as repetition.…”

“…Height differential between patient and mammographer was reported by mammographers in the current study and in other studies (Costa et al, 2014; Hearn & Reeves, 2003) to be an important factor contributing to the adoption of these awkward postures. These postures can be exacerbated by view, particularly MLO, and machine design (rigid tube head location) (Costa et al, 2014; Gale et al, 2007; Hearn & Reeves, 2003), as well as repetition. Per Hearn and Reeves (2003), the awkward postures with the MLO view are particularly problematic because they occur “twice for every woman screened” and are held for several seconds.…”

“…However, few reports appear in the literature on work-related MSK discomfort in mammographers, (Costa, Oliveira, Reis, Viegas, & Serranheira, 2014; Gale, Hunter, Lawton, & Purdy, 2007; Hearn & Reeves, 2003; Lavell & Burkitt, 2008), imaging technologists who perform mammograms (radiographic examinations of breast tissue). Yet MSK symptoms appear to be as prevalent in mammographers as in other types of imaging technologists (Figure 1).…”

“…Mammographers often assume awkward work postures, such as illustrated in Figures 2b and c, in order to visually verify that all areas of the breast are correctly positioned before acquiring an image (Costa et al, 2014; Gale et al, 2007). This visual verification increases the likelihood that the image will contain all the tissue of interest to the radiologist and thus reduce the need to repeat an image, which would expose the patient to an additional radiation dose.…”