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MUSCULOSKELETAL INJURIES AMONG PHYSICIANS WHO PERFORM ERCP: A CANADIAN SURVEY
SP O’Sullivan, TP Ponich
Division of Gastroenterology, University of Western Ontario, London, Ontario
OBJECTIVE: There are a few reports in the literature describing musculoskeletal (MSK) injuries among endoscopists, but none specific to ERCP. ERCPs are lengthy and involve wearing heavy lead aprons, which has been associated with back injury elsewhere. Since ERCPs are usually performed in Radiology facilities that have not been designed for ERCP, poor ergonomic room design is another potential concern. The purpose of this study is to examine the current practices of ERCP endoscopists and the prevalence of MSK injuries.
METHOD: A self-reported survey was sent to physicians practicing ERCP across Canada. Physicians practicing in Ontario were identified from an existing database. Physicians practicing outside of Ontario were identified through colleagues at a nearby academic GI division. A second mailing was sent six weeks later to all non-respondents.
RESULTS: A total of 162 surveys were sent and of these, 117 responded with 109 (n=109) choosing to participate, a response rate of 71%. Sixty-six percent reported at least one MSK injury, 60% of which incurred two or more injuries. Seventy-five percent attributed their injuries to endoscopy/ERCP. A total of 80.4% had their condition aggravated while performing ERCP, of these 39% have their condition aggravated only while performing ERCP. The most frequently reported injuries include: back, 57%, neck, 46% and hand pain, 33.3%, all of which are consistent with the physical risk factors involved in ERCP. The most frequently chosen potential risks while performing ERCP were: lengthy procedures; 32.1%, lead apron, 28.3% and poor ergonomics, 13.1%. Only 52.3% take regular breaks and only 25.7% have fluoroscopy tables that are height adjustable. Sixty-five percent are interested in preventative strategies related to performing ERCP.
CONCLUSION: Physicians who perform ERCP develop significant MSK injuries. The majority are interested and may benefit from an ergonomic assessment and information regarding risk-factor modification.