Prevalence and Gender Differences in Endoscopy-Related Injuries: A Comprehensive Systematic Review and Meta-Analysis

Abstract

Background and AimsGastroenterologists are at risk for endoscopy-related injury (ERI). The aim of this meta-analysis was to assess the prevalence, characteristics, and burden of ERI. MethodsWe searched PubMed/Embase/Web of Science databases for studies reporting ERI prevalence among gastrointestinal (GI) endoscopists. The primary outcome was to pool ERI prevalence. We also assessed ERI types and treatments. We compared ERI based on gender. Finally, we compared musculoskeletal injury (MSI) prevalence between GI endoscopists and non-endoscopists. The pooled rates were generated using a proportion meta-analysis with the random-effects model. Prevalence ratios (PR) with the corresponding confidence intervals (CI) were used for comparative data. ResultsWe included 26 studies with 6,246 endoscopists. Overall, ERI prevalence was 67.9% (60.7-74.4). ERI prevalence was 77.8% (55.1-90.9) in advanced endoscopists. A higher trend of ERI prevalence was observed in recent studies (after 2015), 71.7% (63.3-78.9). Neck pain (36.7%) was the most common ERI, followed by low back pain (35.6%) and thumb pain (33.1%). While females reported higher De Quervain tenosynovitis and carpal tunnel syndrome, wrist, thumb, shoulder, and neck pain, males reported higher elbow pain. GI endoscopists had a higher MSI prevalence than non-endoscopists, PR 1.56 (1.01-2.41). Female endoscopists reported higher ERI, PR 1.21 (1.10-1.32). Only 19.1% of endoscopists reported receiving prior ergonomic training. ConclusionsERI is increasingly prevalent in gastroenterology, particularly in female gastroenterologists with significant gender disparities in ERI types noted. These findings underscore the significance of incorporating ergonomic principles into gastroenterology practices to mitigate ERI risks, particularly considering the shortage of gastroenterologists.