Abstract
Background and Aim: Although musculoskeletal injury appears to be common among endoscopists, there is no evidence from controlled studies to support this belief. Furthermore, the impact of injury among endoscopists is unknown. It was our aim, therefore, to identify the frequency and significance of musculoskeletal injury among gastroenterologists (GI group) compared to a similar group of non-procedure-oriented internal medicine specialists and subspecialists (non-GI group). Methods: A survey was developed and administered via e-mail with the help of the Mayo Clinic Survey Research Group to all gastroenterologists and hepatologists and a sampling of non-procedure-oriented internal medicine specialists and subspecialists across the three Mayo Clinic sites. The questionnaire consisted of 45-items that assessed time spent performing procedures, current or past pain or injury associated with performing endoscopy, location and description of pain or injury, impact of the pain or injury on the subject, type of treatment needed for pain or injury, prevention strategies and demographic information including age, gender, BMI, handedness, type of current practice, and level of physical activity. A modified survey was sent to the control group. Results: The response rate was 63% (72/115) in the GI group and 45% (104/230) in the non-GI group. The two groups were of similar age and level of physical activity. The average years in practice were higher in the non-GI group. The frequency of any musculoskeletal injury was higher in the GI group (74% vs. 35%). The most common sites of injury among the GI group were the thumb (19%), hand (17%), back (12%) and neck (10%). There was no significant association between volume of endoscopy or years performing endoscopy and injury. There were no significant differences in medical care seeking or short- or long-term disability between the GI and non-GI groups despite the increased prevalence of injury in the GI group; however, more in the GI group lost days of work compared to the non-GI group as a result of the injury (7/53 vs. 3/36). Most of the GI group (50/72) had made at least one modification in their endoscopic practice to reduce injury risk. Conclusions: Musculoskeletal injury occurs more commonly among gastroenterologists than non-procedure-oriented internal medicine specialists despite similar age and levels of physical activity and fewer years in practice. While the impact of the injury appears to be minor for the majority, the GI group tended to have more members with severe repercussions relating to ability to work. More attention to injury prevention is needed among gastroenterologists.
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