Work-related musculoskeletal disorders and ergonomics among gynecologists

Yıl 2023, , 427 - 435, 30.09.2023

Hasan Turan , Suna Aşkın Turan , Nazlı Aylin Vural Melih Gaffar Gözükara , Nilüfer Çetinkaya

https://doi.org/10.18663/tjcl.1307864

Öz

Aim: Work-related musculoskeletal disorders (WMSD) have been a prevalent health issue among gynecologists. The current nationwide survey aimed to establish the prevalence and predictors of pain and WMSD among gynecologists in Turkey, as well as their influence on family, social, and professional life.
Material and Methods: The current prospective descriptive study was conducted as a national survey including gynecologists operating as a specialist for at least two years in a tertiary hospital with more than 500 beds.
Results: The survey was completed by 286 (131 female) respondents out of a total of 390 participants. The locations of pain were as follows: neck (49.3%), upper back (49.3%), lower back (44.4%), shoulder (43.49%), hand/fingers (34.8%), thumb (11.2%), wrist (21.9%), hip (17.3%), knee (26.8%), and foot (17.8%). 58.7% of the gynecologists discovered at least one diagnosis of WRMD. Female surgeons were at threefold risk of upper back pain (: 3.546 (%95 confidence interval (CI), 1.304-9.645; p=0.013), and at least two regions of pain (: 3.847; CI:1.241-11.928; p=0.020). Left dominant hand increased risk of pain in the elbow (:11.360, CI: 2.721-47.422; p=0.001), hip (:1.155, CI: 1.004-1.283; p=0.045), and pain in the more than two regions (:6.786, CI: 1.246-36.967, p=0.027). Exercise hours per week were found a protective factor for upper back pain and pain in more than two regions (:1.198, CI:1.005-1.355, p=0.013; :1.286, CI: 1.088-1.441, p=0.007).
Conclusion: WMSD are potentially affecting the gynecologist’s quality of life, income and professional life. Future research can be conducted to increase awareness and prevention from WMSD among gynecologists.

Anahtar Kelimeler

work related musuloskeletal disorders, pain, gynecologist, ergonomics, operation

Jinekologlarda işe bağlı kas-iskelet hastalıkları ve ergonomi

Öz

Amaç: İşe bağlı kas-iskelet hastalıkları (İBKİH), jinekologlarda sık görülen halk sağlığı sorunudur. Ulusal anket çalışmasında Turkiye’deki jinekologlarda İBKİH ve ağrı sıklığı ve prediktif faktörleri araştırılarak bunun jinekologların aile, sosyal ve iş hayatı üzerine etkisini belirlemek amaçlanmıştır.
Gereç ve Yöntemler: Prospektif tanımlayıcı anket çalışmasına Turkiye’de 500 yataktan fazla kapasitesi olan üçüncü basamak hastanelerinde çalışan ve en az 2 yıllık uzman olan jinekologlar çalışmaya dahil edilmiştir.
Bulgular: Çalışmaya katılan 390 jinekoloji uzmanının 286’sı (131 kadın) çalışmayı tamamladı.Ağrı lokalizasyon sıklıkları sırasıyla şöyledir: %49,3 boyun, %49,3 % sırt, %44,4 bel, %43,49 omuz, %34,8 el/ el parmakları, %26,8 diz, %21,9 el bileği, %17,3 kalça, %17,8 ayak ve %11,2 başparmak. %11,2 başparmak. Katılımcıların %58,7’sinde en az bir İBKİH tanısı mevcuttu. Kadın cinsiyeti sırt ağrısı (: 3.546 (%95 confidence interval (CI), 1.304-9.645; p=0.013) ve en az iki bölgede ağrı riskini (: 3.847; CI:1.241-11.928; p=0.020) üç kat arttırmakta idi. Sol el hakimiyeti olan jinekologlarda dirsek (:11.360, CI: 2.721-47.422; p=0.001), kalça (:1.155, CI: 1.004-1.283; p=0.045)ve en az iki bölgede ağrı riski (:6.786, CI: 1.246-36.967, p=0.027) artmaktaydı. Haftalık egzersiz saati arttıkça sırt ağrısı ve en az iki bölgede ağrı sıklığı azalmaktaydı. (:1.198, CI:1.005-1.355, p=0.013; :1.286, CI: 1.088-1.441, p=0.007).
Sonuç: Jinekologların yaşam kalitesi, iş hayatı ve geliri iş hayatına bağlı kas iskelet hastalıklarından etkilenmektedir. Bu konuda farkındalık ve korunmak için yeni çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

işe bağlı kas iskelet hastalıkları, ağrı, jinekolog, ergonomi, cerrahi operasyon

Kaynakça

• Cardenas-Trowers O, Kjellsson K, Hatch K. Ergonomics: making the OR a comfortable place. Int Urogynecol J. 2018 Jul;29(7):1065-1066
• Catanzarite T, Tan-Kim J, Menefee SA. Ergonomics in gynecologic surgery. Curr Opin Obstet Gynecol. 2018 Dec;30(6):432-440.
• Szeto GPY, Cheng SWK, Poon JTC, et al. Surgeons’ static posture and movement repetitions in open and laparoscopic surgery. J Surg Res. 2012; 172(1): e19–e31
• Franasiak J, Ko EM, Kidd J, Secord AA, Bell M, Boggess JF, Gehrig PA (2012) Physical strain and urgent need for ergonomic training among gynecologic oncologists who perform minimally invasive surgery. Gynecol Oncol 126:437–442.
• Alleblas CC, Formanoy MA, Könemann R, Radder CM, Huirne JA, Nieboer TE. Ergonomics in gynecologists' daily practice: A nationwide survey in The Netherlands. Work. 2016;55(4):841-848.
• Dalager T, Søgaard K, Bech KT, Mogensen O, Jensen PT. Musculoskeletal pain among surgeons performing minimally invasive surgery: a systematic review. Surg Endosc. 2017 Feb;31(2):516-526.
• Wang J, Cui Y, He L, Xu X, Yuan Z, Jin X, Li Z. Work-Related Musculoskeletal Disorders and Risk Factors among Chinese Medical Staff of Obstetrics and Gynecology. Int J Environ Res Public Health. 2017 May 26;14(6):562.
• Wong JMK, Moore KJ, Lewis P, Reid M, Saul K, Carey ET. Ergonomic Assessment of Surgeon Characteristics and Laparoscopic Device Strain in Gynecologic Surgery. J Minim Invasive Gynecol. 2022 Sep 30:S1553-4650(22)00916-5
• Tamburacı E, Mülayim B. Awareness and practice of ergonomics by gynecological laparoscopists in Turkey. Ginekol Pol. 2020;91(4):175-180
• Kapoor S, Mahomed K, Kapoor V. Work-related musculoskeletal injuries among obstetricians and gynaecologists: A cross-sectional survey of Fellows of Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Aust N Z J Obstet Gynaecol. 2021 Oct;61(5):785-792. doi: 10.1111/ajo.13339. Epub 2021 Mar 25. PMID: 33763876.
• Dalager T, Søgaard K, Boyle E, Jensen PT, Mogensen O. Surgery Is Physically Demanding and Associated With Multisite Musculoskeletal Pain: A Cross-Sectional Study. J Surg Res. 2019 Aug;240:30-39. doi: 10.1016/j.jss.2019.02.048. Epub 2019 Mar 22. PMID: 30909063.
• Epstein S, Sparer EH, Tran BN, Ruan QZ, Dennerlein JT, Singhal D, Lee BT. Prevalence of work-related musculoskeletal disorders among surgeons and interventionalists: a systematic review and meta-analysis. JAMA surgery. 2018 Feb 1;153(2):e174947.
• Adams SR, Hacker MR, McKinney JL, Elkadry EA, Rosenblatt PL. Musculoskeletal pain in gynecologic surgeons. Journal of minimally invasive gynecology. 2013;20(5):656-60.
• Dean AG, Sullivan KM, Soe MM. OpenEpi: Open Source Epidemiologic Statistics for Public Health, Version. www.OpenEpi.com, updated 2013/04/06, accessed 2022/10/07
• Kahraman T, Genç A, Göz E. The Nordic Musculoskeletal Questionnaire: cross-cultural adaptation into Turkish assessing its psychometric properties. Disabil Rehabil. 2016 Oct;38(21):2153-60.
• Lee, J. Y., Mucksavage, P., & McDougall, E. M. (2013). Surgical skills acquisition among left-handed trainees-true inferiority or unfair assessment: A preliminary study. Journal of Surgical Education, 70(2), 237–242. doi:10.1016/j.jsurg.2012.09.007
• Sabharwal S, MacKenzie JS, Sterling RS, Ficke JR, LaPorte DM. Left-Handedness Among Orthopaedic Surgeons and Trainees. JB JS Open Access. 2020;5(2):e20.00019. Published 2020 Jun 9. doi:10.2106/JBJS.OA.20.00019