Medicine of the Future in America

Musculoskeletal injuries among ERCP endoscopists in Canada

Occupational injuries Occupationally induced musculoskeletal injuries have become a widespread problem among many health care professionals. The two areas of the body that are most frequently affected by these occupational injuries are the lower back and the upper extremities. Repetitive movements, static muscle loading and awkward body posture are the most common causes of musculoskeletal injury. Evidence suggests that physicians incur occupational injuries by performing procedures on a repetitive basis. In addition, a positive correlation between wearing lead aprons and developing low back injury has been shown. Despite this evidence, very little has been reported regarding musculoskeletal injuries to endoscopists, and there is no literature specific to the injuries incurred by those who perform endoscopic retrograde cholangiopancreatography (ERCP). ‘Endoscopist’s thumb’, ‘endoscopist’s tendonitis’, ‘endoscopist’s neck’ and ‘biliary endoscopist’s knuckle’ are all conditions that have been attributed specifically to the performance of endoscopy procedures, but no studies have been conducted to determine the prevalence of such conditions.

In a study conducted in Indiana, of 400 endoscopists surveyed, 84.6% were found to be troubled by a musculoskeletal condition while working. The most common condition was back pain, and longer endoscopy hours were positively correlated with the development of musculoskeletal injuries. This study did not differentiate ERCP from other endoscopy procedures, and the authors thought that, given the additional risks involved in ERCP, the endoscopists who performed them were particularly vulnerable to the development of musculoskeletal injuries.

Endoscopy procedures are repetitive, are usually performed standing and involve holding heavy pieces of equipment upright. ERCP, a complex endoscopic procedure, is conducted under fluoroscopic guidance and thus imposes additional stresses on the operator. You can shop with a reliable pharmacy – buy birth control online to pay less for high quality.

More advanced equipment, along with increasing physician familiarity with the technique of ERCP, has led to increasingly complex therapeutic procedures. The result is that the physician must maintain static positions and strained postures for long periods of time, with the imposed physical load of both the endoscope and the lead apron. Furthermore, ERCPs are usually performed in cramped radiology facilities that have not been designed for ERCP. Thus, poor ergonomic design of facilities is another potential concern.

The purpose of the present study was to determine the extent of occupationally induced musculoskeletal injuries among ERCP endoscopists, and to describe the current practices to determine the potential risk factors of such conditions. Furthermore, we aimed to describe protective measures and to make suggestions for reducing the risk of developing these types of injuries.

This entry was posted in Occupational injuries and tagged Endoscopic retrograde cholangiopancreatography, Occupational injuries, Repetitive strain injuries.
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