Musculoskeletal Pain Symptoms and Injuries Among Endoscopists Who Perform ERCP Presidential Poster Award

Abstract

Introduction: The leaded protective gear worn, patient and endoscopist positioning, and longer average procedural time places endoscopists who perform endoscopic retrograde cholangiopancreatography (ERCP) at an increased risk for injuries as compared to other endoscopists. While multiple studies have investigated the prevalence of various pain symptoms and injuries among endoscopists, only one has been carried out in endoscopists who perform ERCP, and none have investigated potential predisposing risk factors. Methods: An anonymous electronic survey containing 23 questions was sent to 3,276 gastroenterologists. Only providers that performed ERCPs were asked to respond. Participants were only allowed to select one musculoskeletal pain symptom and one musculoskeletal injury thus enabling us to evaluate the predominant symptom and or injury in each participant. Results: A total of 203 surveys were completed. Variables that were assessed included sex, glove size, average number of ERCPs performed per year, types of lead gowns worn, time period ERCPs were performed prior to symptom onset, patient positioning, and the presence or absence of fluoroscopy tables and monitors with adjustable heights, and anti-fatigue matting. Of the 203 respondents, 91% reported a musculoskeletal pain symptom. 42% attributed this pain to performing ERCPs. The most prevalent pain symptoms were neck pain (24%), and lower back pain (17%). 48% of respondents reported a musculoskeletal injury. 16% attributed these injuries to performing ERCPs. The most prevalent musculoskeletal injuries were De Quervain's Tenosynovitis (16%), and cervical radiculopathy (12%). Among the respondents, only 36% used anti-fatigue matting, 40% wore two-piece lead gowns and 74% weren't aware of the thickness of their lead gown. Only 25% of participants had received any education/training on ergonomics in endoscopy and 71% stated they are interested in learning more about preventative strategies regarding ERCP-related injuries. Conclusion: The majority of endoscopists who perform ERCPs suffer from a musculoskeletal pain symptom and almost half report a musculoskeletal injury. Further investigation regarding risk factors and preventative strategies is warranted. Only a small portion of advanced endoscopists report having received any training on ergonomics and the majority are interested in learning more. More information and education regarding ergonomics should be included during fellowship and postgraduate training.