Prevalence of musculoskeletal pain among gynecologic surgeons and assessment of ergonomic risk factors in the operating room environment
Quality Improvement & Outcomes
We have completed a meta-analysis and national survey examining the prevalence of work related musculoskeletal disorders (MSK) amongst gynecologic surgeons. We found a very significant burden of MSK disorders, leading to disability, time off work, and impact on surgeon well-being. Multiple contributors have been identified, including: ergonomic set up in the OR, lack of education, and work culture.
We are currently working to translate our findings to create a safer OR environment for surgeons, leading to improved health, career longevity, and workplace satisfaction of surgical team members. We aim to develop an educational platform and effective intervention strategies that can be adopted by any institution to improve the ergonomics in their OR, and decrease work related MSK disorders.
Objective: (1) To systematically review the global prevalence of MSK symptoms among gynecologic surgeons. (2) To determine the prevalence and burden of MSK symptoms among gynecologic surgeons in Canada, and identify risk factors for developing these symptoms.
Methods: (1)Sources included Embase, MEDLINE, PubMed, CINAHL, Web of Science Core Collection, Cochrane Central Register of Controlled Clinical Trials, and Google Scholar, between 1980 and 2022. (2) A cross sectional survey was administered to practicing gynecologic surgeons in Canada. The primary outcome was MSK pain prevalence. Multivariable logistics regression was performed to identify factors associated with severe symptom burden.
Results: (1) In a pooled sample of 1619 surgeons, from 12 studies, the estimated prevalence of musculoskeletal symptoms was 82% (95% confidence interval [CI], 70%-89%; I2 , 92%). Female sex was a risk factor, as identified by a pooled odds ratio of 4.64 (95% CI, 2.63-8.19; I2 , 0%) compared with male surgeons. Among surgeons who reported musculoskeletal symptoms, 30% (95% CI, 14%-52%; I2 , 95%) sought treatment and 3% (95% CI, 2%-6%; I2 , 0%) required work hour modifications.
(2) The survey received 254 complete responses. The prevalence of work-related MSK symptoms among survey participants was 92.1% (234/254). The most common symptoms experienced were pain, stiffness, muscle fatigue, and numbness/tingling, respectively. The most common body regions affected were the neck, lower back, and right shoulder. Overall, 48% of survey participants had a severe burden of MSK symptoms and 44% a mild or moderate burden. The odds of female surgeons experiencing severe symptom burden were significantly greater than male surgeons (aOR)2.62, 95% CI 1.26, 5.43). Age > 40 years (aOR0.44, 95% CI 0.25, 0.78) and greater perceived fitness level (aOR 0.70, 95% CI 0.53, 0.93) significantly reduced one’s odds of severe symptom burden.
Conclusion: This study underlines the high prevalence and burden of MSK symptoms among Canadian gynecologic surgeons, as well as globally. Risk and protective factors for severe symptom burden were identified. Our current work is focused on real life ergonomic performance in surgeons in order to develop effective interventional strategies to mitigate this risk.
Wu L, Liu S, Lommen J, Pudwell J, Pelland L, Bougie O. Prevalence of musculoskeletal pain among gynecologic surgeons performing laparoscopic procedures: A systematic review and meta-analysis. Int J Gynaecol Obstet. 2023;161(1):151-158. doi:10.1002/ijgo.14518