ناراحتی و آسیب محیط کار : مطالعه بررسی ارگونومیک جامعه آمریکا از کاربران گوش و حلق و بینی اطفال

Background Workplace-related musculoskeletal pain has been studied in various occupations, but it is rarely reported in the surgical literature. Objective The aim of this study was to examine work-related discomfort and injury among pediatric otolaryngologists and to assess their knowledge of workplace ergonomic principles. Methods We surveyed current North American members of the American Society of Pediatric Otolaryngology. Our main outcomes were whether the physician had ever experienced discomfort or physical symptoms that they attributed to their surgical practice. Results Response rate of 43.7% was attained, and 62.0% of respondents reported experiencing pain or discomfort that they attributed to their surgical practice. Women were significantly more likely to report experiencing pain or discomfort that they associated with their surgical practice (P = .033). There were no significant differences found among length of time in practice, academic vs community setting, or number of surgeries completed by the surgeon. Some of the surgeons (31.0%) were aware of ergonomic principles, and of those who were aware, 83.9% had implemented ergonomic principles into their surgical practice. Conclusion Almost two thirds of surgeons who responded to the survey reported experiencing pain or discomfort that they attributed to their surgical practice. Only a minority of respondents were aware of ergonomic principles. These findings may confirm that most physicians believe that their physical health is affected by their operative environment. Increased knowledge of surgical ergonomics may lead to strategies that improve workplace health and safety.

Ergonomics is a relatively new scientific discipline concerned with the understanding of interactions among humans and other elements of a system. It is the profession that applies theory, principles, data, and methods to design to optimize human well-being and overall system performance [1]. Ergonomic analyses are widely applied today in industry [2], the military [3], and sports training [4] to help people achieve optimum performance while lowering the risk of error and injury. Industrial ergonomics is applicable to surgical practice because it is well recognized that both static and dynamic postural stresses can lead to fatigue and disability [5] and [6]. The National Institute of Occupational Safety and Health (NIOSH) recommendations for workstation design include the following: avoiding static loads, reducing fixed work postures, avoiding postures that include leaning to the front or to the side, holding a limb in a bent or extended position, and neck forward positions of more than 15° [7]. Repetitive motion injuries have also been described as the most frequent and disabling injuries involving medical professionals [8]. These principles prove difficult to comply with in an operating room setting, leaving surgeons at risk for work-related injury, pain, and discomfort complaints. Generally, surgeons tend to adopt operative positions based on their training and personal preferences as opposed to ergonomically guided principles. Kant et al [9] studied the posture of physicians and nurses while performing surgical procedures and found that both groups experienced substantial stress to the musculoskeletal system due primarily to the frequent and prolonged static head-bent and back-bent postures assumed. More recently, Park et al [10] surveyed 317 surgeons who performed laparoscopic procedures and found 86.9% reported physical complaints or discomfort related to their practice. Musculoskeletal disorders have been studied throughout various health care occupations. The higher incidence of occupational cervicobrachial disorders among dentists has prompted improved designs of dental operative equipment and dentist positioning [11]. However, studies among surgeons, particularly otolaryngologists, are rare [12], [13], [14] and [15]. One study in the United Kingdom found that 72% of otolaryngologists surveyed had either back pain or neck pain [15]. There were no North American studies found in the literature that described the incidence of pain and discomfort associated with pediatric otolaryngology surgical practices. It is for this reason that we conducted an ergonomics survey study among the North American pediatric otolaryngologists, with the aim to investigate the prevalence of workplace-related discomfort and injury and to assess their knowledge of workplace ergonomics principles.

Almost two thirds of surgeons who responded to the survey reported experiencing pain or discomfort that they attributed to their surgical practice. Only a minority of respondents were aware of ergonomic principles. These findings may confirm that most physicians believe that their physical health is affected by their operative environment. Increased knowledge of surgical ergonomics may lead to strategies that improve workplace health and safety.