Incidence de troubles musculosquelettiques chez le personnel en échographie

Les troubles musculosquelettiques sont une préoccupation de longue date dans le milieu de l’imagerie médicale. C’est un phénomène répandu, qui est particulièrement bien documenté en échographie. Ce billet regroupe des publications importantes à ce sujet, dont une nouvelle norme, un livre blanc et une revue de la littérature scientifique récente.

Accès aux documents : La plupart des documents présentés dans ce billet sont en accès libre. Lorsqu’un cadenas s’affiche devant le titre d’un document, il est en accès restreint et peut s’obtenir auprès de l’éditeur ou par prêt entre bibliothèques.

Bibliographie

Norme et livre blanc

Industry Standards for the Prevention of Work Related Musculoskeletal Disorders in Sonography
En 2017, une conférence de consensus réunissant associations professionnelles, gestionnaires du milieu de la santé, fabricants et autres acteurs du milieu a rédigé une version mise à jour des Industry Standards for the Prevention of Work Related Musculoskeletal Disorders in Sonography. Cette nouvelle norme a été appuyé par de nombreux acteurs du milieu, notamment au Canada.
Source : Industry Standards for the Prevention of Work Related Musculoskeletal Disorders in Sonography. (2017). Journal of Diagnostic Medical Sonography, 33(5), 370‑391. https://doi.org/10.1177/8756479317725531

Work Related Musculoskeletal Disorders in Sonography

Pour accompagner la norme, la Society of diagnostic medical sonography a publié ce livre blanc. Il se destine aux technologues en échographie, aux éducateurs, employeurs et fabricants qui souhaitent mieux comprendre les troubles musculosqulettiques reliés au travail et l’impact de ces derniers.

Source : Murphey, S. (2017). Work Related Musculoskeletal Disorders in Sonography. Journal of Diagnostic Medical Sonography, 33(5), 354‑369. https://doi.org/10.1177/8756479317726767

Études quantitatives

(document à accès restreint)The prevalence of work-related musculoskeletal disorders among sonographers.

Background Work-related musculoskeletal disorders (WRMSDs) have a significant effect on the psychological and physical function of the sonographer.

Objective: This study is concerned about finding the prevalence of WRMSDs among sonographers in the Kingdom of Saudi Arabia and assessing how to improve future practices and develop guidelines for safe, pain-free ultrasound departments.

Methods: A survey was distributed to sonographers working in major hospitals in Riyadh, Saudi Arabia (n  = 100, 83% response rate). The questionnaire focused on workload and ergonomics, pain existence and history, and the level of the sonographers’ awareness of prevention measures and best practices. Ethical approval was obtained from a local Institutional Review Board.

Results: Eighty-four percent of respondents suffer from pain they associated with their ultrasound practice. The shoulder, back, neck and right hand were the main symptomatic body areas. Low levels of awareness about best practices and safety measures were revealed. There was a strong correlation between the degree of pain suffered and the years of practice, the number of patients scanned per day, and movements during the exam.

Conclusion: Implementing standards and guidelines for best ultrasound practices is needed to develop better and safer ultrasound departments in Saudi hospitals for every practitioner.

Source : AL-Rammah, T. Y., Aloufi, A. S., Algaeed, S. K., & Alogail, N. S. (2017). Work, 57(2), 211‑219. https://doi.org/10.3233/WOR-172558


(document à accès restreint)Survey of UK sonographers on the prevention of work related muscular-skeletal disorder.

Background  To establish whether the current training of student sonographers in both academic and clinical settings is sufficient for educating about the dangers of work-related musculoskeletal disorders (WRMSDs).

Methods  A dual method of data collection was undertaken. Initially, a focus group was set up, involving a small group of practicing sonographers from a hospital in the United Kingdom, with the results of that survey being used to design a postal survey questionnaire. The questionnaire focused on ergonomics, scanning technique, training in physical techniques, personal general health, risk, stress, and task management. It was sent to seven participating universities across the United Kingdom. Approvals were obtained from the local ethics committees, the hospital Trust, and the academic institution.

Results  The focus group highlighted several areas in which improvements could be made in educating sonographers on the reduction of WRMSDs. The questionnaire results indicated that students are being taught about certain aspects of WRMSD prevention by both their university and clinical mentors. Respondents received training on the prevention of WRMSDs: 97% in the university setting and 81% from clinical mentors.

Conclusions  Improvements need to be made in terms of educating students to perform muscle-strengthening exercises during the workday; to have a system of reporting injury; to consider personal health, well-being, and stress management in the workplace; and to evaluate the ergonomics of computer workstations.

Source : Bolton, G. C., & Cox, D. L. (2015). Journal of Clinical Ultrasound, 43(3), 145‑152. https://doi.org/doi:10.1002/jcu.22216


Work-related musculoskeletal disorders in sonographers: A review of causes and types of injury and best practices for reducing injury risk.

Work-related musculoskeletal disorders in sonography professionals have a reported incidence of 90%. These disorders are defined as conditions that are either caused by or aggravated by tasks performed in the workplace. These injuries have a financial and emotional impact on the worker and affect workplace productivity and quality patient care. The causes for these injuries are multifactorial and therefore require a variety of solutions for mitigating injury risk. Sonographer work postures, work schedules, task rotation, administrative support, and ergonomic workplace equipment all enter into the formula for reducing the incidence of these disorders.

Source : Coffin, C. (2014). Reports in Medical Imaging, 7, 15. https://doi.org/10.2147/RMI.S34724


The Prevalence of and Risk Factors Associated with Musculoskeletal Disorders among Sonographers in Central China: A Cross-Sectional Study.

Objective Studies from industrialized countries show that musculoskeletal disorders (MSD) occur commonly in sonographers. However, little is known about sonographers in China, where the awareness of ergonomics and MSD, workload, and available equipment/facilities may differ. We aimed to investigate the prevalence of MSD and associated risk factors in sonographers in central China.

Methods A cross-sectional survey was conducted with 381 sonographers from 14 randomly selected tertiary hospitals in Hubei province, central China. Musculoskeletal symptoms (using the Nordic Questionnaire) and risk factors (mostly derived from the Health Benefit Trust survey instrument and the Dutch Musculoskeletal Questionnaire) were recorded. Multivariate logistic regression was used to quantify associations between risk factors and MSD.

Results The 12-month period prevalence of MSD was 98.3%, being highest in the neck (93.5%) and shoulder (92.2%), followed by the lower back (83.2%), wrist/hand, upper back, and elbow. Factors contributing to neck pain were psychological fatigue, shoulder abduction and trunk bend-and-twist posture. Height-adjustable tables and chairs were protective factors. Shoulder pain was associated with female sex, health status, mental stress, shoulder abduction, and trunk bend-and-twist posture. Height-adjustable chairs and the awareness of adjusting the workstation before scanning were protective factors. Elbow pain was associated with health status and height-adjustable tables. Wrist/hand pain was associated with female sex, bending the wrist, and working with obese patients. Upper back pain was associated with shoulder abduction, height-adjustable chairs, and device location. Lower back pain was associated with the number of scans performed per day, awkward postures, bending the trunk, twisting or bending the neck forward, and using a footrest.  Conclusions This study suggests a high prevalence of MSD in sonographers in central China. Hence, it is necessary to improve the awareness of MSD by training, and the ergonomics of their current work environment by addressing physical workload, and psychological and equipment/facility-related factors.

Source : Feng, Q., Liu, S., Yang, L., Xie, M., & Zhang, Q. (2016). PLOS ONE, 11(10), e0163903. https://doi.org/10.1371/journal.pone.0163903


(document à accès restreint)Occupational musculoskeletal pain in cardiac sonographers compared to peer employees: a multisite cross-sectional study.

Objectives The purpose of this study was to compare the prevalence and impact of work-related musculoskeletal pain in cardiac sonographers to a large control group of peer employees with similar demographics.

Background Cardiac sonographers are known to have high levels of occupational musculoskeletal pain. Comparative studies with other employees within cardiology/radiology departments have never been performed.  Methods An electronic survey was administered to Mayo Clinic employees at six major patient care facilities in four different states.

Results There were 2682 employees within the departments of cardiology and radiology who were contacted, and 1532 (57%) completed the survey. After excluding those who wore protective lead aprons, 517 employees comprised the control group and 66 cardiac sonographers made up the study group. Cardiac sonographers reported work-related musculoskeletal pain more frequently than the control group (88% vs 40%; P<.001). This association persisted after multivariable adjustment for age, sex, body mass index, length of current employment, and history of preexisting musculoskeletal pain (OR 11.6; [95% CI 5.32, 25.5]; P<.001). Cardiac sonographers sought medical care for their work-related pain more often (55% vs 21%; P<.001) and missed more work due to pain (35% vs 12%, P<.001). In a secondary analysis, cardiac sonographers also experienced more work-related musculoskeletal pain than nurses, technicians, and physicians working in the interventional laboratory who regularly wear a protective lead apron (P<.001).

Conclusions In this multisite cross-sectional study, cardiac sonographers experienced significantly more work-related pain and missed more work due to pain than peer employees within cardiology/radiology departments.

Source : Orme, N. M., Geske, J. B., Pislaru, S. V., Askew, J. W., Lennon, R. J., Lewis, B. R., … Singh, M. (2016). Echocardiography, 33(11), 1642‑1647. https://doi.org/10.1111/echo.13344


Musculoskeletal pain and injury in sonographers, causes and solutions.

Introduction Scanning a patient involves pushing a heavy transducer and a heavy cord while simultaneously leaning over a patient, using the keyboard and viewing the screen. Even with good patient and machine position, a sonographer’s upper limbs can be abducted up to 90o from the body that can place the body under stress. International statistics indicate that 80–95% of sonographers experience work-related pain, 90% experience this pain for more than half their career and one in five sonographers sustain a career ending work-related injury.

Methods The sonographer safety initiative is a collaborative effort between sonographers, biomedical engineers in SA Health, Flinders Biomedical Enterprises and GE Healthcare; with the goal to investigate sonographer work-place injuries. A 6-month study was conducted that reviewed literature, compensation claims, injury reports, and surveyed sonographers and relevant stakeholders.

Results Information regarding the social/cultural, physiological/environmental and technological issues in current practices was collected along with the causes and rates of sonographer injuries.  Discussion Musculoskeletal disorders are a significant concern for sonographers with detrimental effects on the individual and the employer. Sonographers are reluctant to report or claim these injuries, which mask the problem and prevent it from getting the traction it requires.

Source : Pallotta, O. J., & Roberts, A. (2017). Sonography, 4(1), 5–12. https://doi.org/10.1002/sono.12093


(document à accès restreint)Barriers to Performing Ergonomic Scanning Techniques for Sonographers. 

This study aimed to identify the barriers that prevent currently practicing credentialed sonographers from using industry standard ergonomic scanning techniques. A quantitative descriptive design was used with data collected through an anonymous online survey of members of the Society of Diagnostic Medical Sonography. A total of 1234 members participated in the survey. The results confirmed previous reports that a high percentage (85.5%) of sonographers scan in pain, with the shoulder most commonly affected. Four barriers to ergonomic scanning practice were identified by more than 25% of the respondents, including being too busy, patient obesity, portable exams, and patients who are unable to cooperate. Some barriers are not within the control of the sonographer, such as patient obesity and patient condition, while other barriers are within moderate control, such as scheduling and lack of equipment. The focus should be placed on correcting and improving those barriers that can be controlled, thereby reducing the risk of work-related musculoskeletal injuries in sonographers.

Source : Scholl, C., & Salisbury, H. (2017).  Journal of Diagnostic Medical Sonography, 33(5), 406–411.
http://journals.sagepub.com/doi/abs/10.1177/8756479317726768


Prévention des TMS

Swedish Sonographers’ perceptions of ergonomic problems at work and their suggestions for improvement.

Sonographers’ perceptions of ergonomic and work-related pain problems at work have so far mostly been researched in quantitative studies by questionnaires. There is a need of experience-based research to deepen the knowledge about how sonographers perceive ergonomic problems at work. Therefore, the aim of this qualitative study was to describe sonographers’ perceptions of ergonomic problems at work, and their suggestions for improvement strategies.

Source : Gemark Simonsen, J., & Gard, G. (2016). BMC Musculoskeletal Disorders, 17(1), 391. https://doi.org/10.1186/s12891-016-1245-y


Work-related musculoskeletal disorders in ultrasound: Can you reduce risk?

Work-related musculoskeletal disorders are a common cause of pain and sickness absence for ultrasound practitioners. This article aims to provide background information about factors increasing the chance of developing work-related musculoskeletal disorders and potential ways to reduce risk. Factors influencing ultrasound professionals’ likelihood of developing work-related musculoskeletal disorders include poor posture, repetitive movements, transducer pressure and poor grip, stress, workload, limited support or sense of control and other psychosocial factors. The impact of these risk factors on the health and well being of ultrasound practitioners can be reduced by following recommendations published by professional bodies and the Health and Safety Executive. Ultrasound practitioners should remember that optimising the examination should not be at the detriment of their health. Some hints and tips to reduce the chance of developing work-related musculoskeletal disorders are provided.

Harrison, G., & Harris, A. (2015). Ultrasound, 23(4), 224‑230. https://doi.org/10.1177/1742271X15593575


Sonographer Ergonomics: Assessment and workplace redesign. 

Work  related  risk  associated  with  Medical  personnel  reported  in  previous  studies several  times.  A  large  no  of sonographers were reported suffering work related musculoskeletal disorder (WRMSD).  Awkward postures for performing scans, High work load, less frequent relaxation times, ignorance and lack of initiatives from both management and individuals add in the problems substantially. This paper provides a comprehensive study of sonographer’s ergonomics, first accessing the workplace using Digital  Human  Modelling  (DHM)  then  proposing  a  noble  methodology  to  optimally  redesign  workplace,  fusing  qualitative  and quantitative  ergonomic  fitness  criteria.    Fusion  of  Microsoft  Kinect  and  Inertial  sensor  performed  for  obtaining  workplace parameters and DHM simulation were utilized for determining the optimal value of workplace parameters.

Source : Patil, A., & Rao, P. V. M. (2016). Dans Proceedings of the 2016 International Conference on Industrial Engineering and Operations Management. Kuala Lumpur, Malaysia: IEOM Society International.
http://ieomsociety.org/ieom_2016/pdfs/599.pdf


(document à accès restreint)Musculoskeletal Pain Relief in Sonographers: A Systematic Review of the Effects of Therapeutic Techniques

Musculoskeletal pain and resulting injury is a growing concern for sonographers. Statistics substantiate the rising trend of sonographers in pain, but prevention methods are not currently established as part of the education process or in the clinical environment. A systematic review of the literature was performed to determine whether sonographers taught to use proper body mechanics, stretching, and/or therapeutic techniques experience less pain. The results suggest that education workshops and stretching techniques have the potential to benefit sonographers. Sonographers who incorporate stretching into the work day may experience a reduction in pain. Education workshops may improve the long-term outcomes for sonographers. Additional research is necessary to determine the outcomes of the various therapeutic methods. Those methods that are proven valuable should be adopted into the sonography profession by educators and clinical sites. Managers, supervisors, physicians, and sonographers should be provided information regarding research outcomes in order to advocate for evidence-based practice changes.

Source : Tator, C. F., & Truluck, C. (2017). Journal of Diagnostic Medical Sonography, 33(5), 420‑426. https://doi.org/10.1177/8756479317721673

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