Abstract
Lack of ergonomic training and poor ergonomic habits during the operation leads to musculoskeletal pain and affects the surgeon's life outside of work. The objective of the study was to evaluate the severity of ergonomic hazards in the surgical profession across a wide range of surgical subspecialties. We conducted intraoperative observations using Rapid Entire Body Assessment (REBA) score system to identify ergonomic hazards. Additionally, each of the ten surgical subspecialty departments were sent an optional 14 question survey which evaluated ergonomic practice, environmental infrastructure, and prior ergonomic training or education. A total of 91 surgeons received intraoperative observation and were evaluated on the REBA scale with a minimum score of 0 (low ergonomic risk <3) and a maximum score of 10 (high ergonomic risk 8-10). And a total of 389 surgeons received the survey and 167 (43%) surgeons responded. Of the respondents, 69.7% reported suffering from musculoskeletal pain. Furthermore, 54.9% of the surgeons reported suffering from the highest level of pain when standing during surgery, while only 14.4% experienced pain when sitting. Importantly, 47.7% stated the pain impacted their work, while 59.5% reported pain affecting quality of life outside of work. Only 23.8% of surgeons had any prior ergonomic education. Both our subjective and objective data suggest that pain and disability induced by poor ergonomics are widespread among the surgical community and confirm that surgeons rarely receive ergonomic training. Intraoperative observational findings identified that the majority of observed surgeons displayed poor posture, particularly a poor cervical angle and use of ergonomic setups, both of which increase ergonomic risk hazards. This data supports the need for a comprehensive ergonomic interventional program for the surgical team and offers potential targets for future intervention.
Highlights
The operative tasks, which surgeons undertake every day, require mental sharpness, concentration, hand-eye coordination and precise execution of movement, and minutes to hours of sustained posture with prolonged static exertion [1, 2]
This study aimed to explore the occupational risk to surgeons across multiple surgical subspecialties by comparing objective and subjective measures of ergonomic hazard
The ergonomic hazards for surgeons this study, 389 surgeons were invited to participate in the study from ten surgical programs, including: Cardiovascular, General, Neurosurgery, Obstetrics and Gynecology, Ophthalmology, Orthopedic, Otolaryngology, Plastics, and Vascular
Summary
The operative tasks, which surgeons undertake every day, require mental sharpness, concentration, hand-eye coordination and precise execution of movement, and minutes to hours of sustained posture with prolonged static exertion [1, 2]. While surgery is an inherently dynamic environment, where conditions change in a split-second, a surgeon, more often than not, assumes a poor, ergonomically limited postural position in order to ensure that the surgical area of interest is optimally exposed and accessed. Between 23– 100% of surgeons across various subspecialties, report some degree of musculoskeletal (MSK) discomfort stemming from poor ergonomics during work [6]. Lack of ergonomic training and subsequent ergonomic practice during the operation leads to discomfort and pain and results in fatigue, and can affect surgical speed and stamina, as well as concentration [4, 7]. Outside of work, surgeons report that occupationally-induced MSK pain leads to disturbance in sleep, relationships, and has a negative effect on quality of life [7, 8]
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