Prevalence of Work-Associated Musculoskeletal Issues Amongst Surgeons and Interventionalists: A Systematic Evaluation and Meta-analysis.
JAMA Surg. 2017 Dec 27;:e174947
Authors: Epstein S, Sparer EH, Tran BN, Ruan QZ, Dennerlein JT, Singhal D, Lee BT
Significance: Physicians in procedural specialties are at excessive threat for work-related musculoskeletal problems (MSDs). This has been known as “an impending epidemic” within the context of the looming workforce scarcity; nevertheless, prevalence estimates fluctuate by examine.
Targets: To estimate the prevalence of work-related MSDs amongst at-risk physicians and to guage the scope of preventive efforts.
Knowledge Sources and Examine Choice: Systematic search in MEDLINE (Ovid), Embase (Elsevier), Net of Science, PubMed (Nationwide Heart for Biotechnology Data), and a couple of medical trial registries, with out language restriction, for research reporting on the prevalence and prevention of work-related MSDs amongst at-risk physicians revealed till December 2016. The Meta-analysis of Observational Research in Epidemiology (MOOSE) pointers for meta-analyses and systematic evaluations of observational research have been used. At-risk physicians have been outlined as surgeons and medical interventionalists. Research reporting on particular problems or ache assessed with validated devices have been included.
Knowledge Extraction and Synthesis: Examine traits; illness prevalence for the neck, shoulder, again, and higher extremity; and measures of ensuing incapacity have been recorded. Examine estimates have been pooled utilizing random-effects meta-analytic fashions.
Fundamental Outcomes and Measures: Profession prevalence of accidents and 12-month prevalence of ache.
Outcomes: Amongst 21 articles (5828 physicians [mean age, 46.0 years; 78.5% male; 12.8 years in practice; 14.4 hours performing procedures per week]) included on this systematic evaluation and meta-analysis, pooled crude prevalence estimates of the commonest work-related MSDs have been degenerative cervical backbone illness in 17% (457 of 2406 physicians) (95% CI, 12%-25%), rotator cuff pathology in 18% (300 of 1513 physicians) (95% CI, 13%-25%), degenerative lumbar backbone illness in 19% (544 of 2449 physicians) (95% CI, 5%-16%), and carpal tunnel syndrome in 9% (256 of 2449 physicians) (95% CI, 5%-16%). From 1997 to 2015, the prevalence of degenerative cervical backbone illness and degenerative lumbar backbone illness elevated by 18.three% and 27%, respectively. Pooled prevalence estimates for ache ranged from 35% to 60% and differed by evaluation instrument. Of these with a work-related MSD, 12% (277 of 2319 physicians) (95% CI, 7%-18%) required a depart of absence, apply restriction or modification, or early retirement. Heterogeneity was appreciable for all crude analyses (imply I2?=?93.5%) however was decrease for sensitivity analyses (imply I2?=?72.three%). Interventions centered on merchandise and behaviors. Twelve at-risk specialties described a gross lack of understanding and an unmet want for ergonomics schooling.
Conclusions and Relevance: Prevalence estimates of work-related MSDs amongst at-risk physicians seem like excessive. Additional analysis is required to develop and validate an evidence-based utilized ergonomics program geared toward stopping these problems on this inhabitants.
PMID: 29282463 [PubMed – as supplied by publisher]