By Kate Madden Yee, AuntMinnie.com staff writer

September 26, 2014 -- Almost 60% of breast imaging radiologists experience repetitive strain injury (RSI), and their symptoms are exacerbated by the use of PACS, longer work hours, higher imaging volumes, and pressure to submit reports quickly, according to a study in the Journal of the American College of Radiology.

"Repetitive strain injury is the kind of work-related injury [that is] often overlooked because it develops from multiple minor movements that lead to accumulated injury over the course of years," lead author Dr. Atalie Thompson from Stanford University told AuntMinnie.com via email. "From the public health perspective, these RSIs are more insidious and often more prevalent than expected."

Work-related repetitive strain injury has been recognized in other professions in which work is largely carried out on a computer, but little has been published on how well breast imagers adhere to ergonomic recommendations, or how they are affected by computer workstations, according to Thompson. She and her colleagues investigated the prevalence of RSI among breast imagers and whether any particular ergonomic interventions are helpful in reducing or preventing it.

Dr. Atalie Thompson
Dr. Atalie Thompson from Stanford University.

For the study, the group emailed an anonymous survey to 2,618 physician members of the Society of Breast Imaging (SBI) in 2012. They received 727 responses, for a rate of 27.8% (JACR, August 22, 2014).

The survey asked participants to rank their pain levels before and after digital imaging was implemented in their workplace, and it included questions about departmental position, current use of digital or analog mammography, hours spent per day at a computer or PACS workstation, hours spent per day in an awkward position (e.g., wrists bent, leaning forward, or stooping or squatting), and previous diagnoses of repetitive strain or overuse syndrome.

In all, 438 (60.2%) of the 727 survey participants reported RSI symptoms; 242 (33.3%) reported prior diagnosis and treatment of repetitive strain syndrome. Unsurprisingly, RSI symptoms increased with the number of work hours, and respondents said they experienced greater pain levels after PACS was implemented in their department.

The survey participants also reported a decrease in pain after beginning to use ergonomic devices or receiving ergonomic training, although only 17.7% said they used an ergonomic mouse and 13.3% had attended ergonomic training.

"We expected to find reports of RSI, but it was more prevalent than we anticipated," Thompson told AuntMinnie.com. "And we were surprised that such a low percentage of respondents reported using an ergonomic mouse or adjustable tables at work. Even fewer had ever received any ergonomic training, though a majority of respondents expressed interest in participating in this kind of training if it were available."

Another unexpected finding was that RSI rates were higher among radiologists 49 years of age or younger, Thompson said.

"We were initially surprised that there was a trend for RSI to be reported among younger radiologists, since RSI is an injury pattern that accumulates over time," she told AuntMinnie.com. "But younger radiologists also reported longer work hours. As these younger radiologists age and accumulate more years of injury, the typical pattern for RSI and age may develop."

Regarding different types of ergonomic interventions, respondents rated their pain before and after implementation on a scale of 0 to 10, with 10 being the most pain.

Median pain level after changes in work environment
  Before After
Ergonomic mouse 6.1 2
Adjustable chair 5 2.9
Adjustable table 5 2.1
Ergonomic training 5.7 3.1

Computers have negatively affected workers in numerous professions, the authors wrote. Businesses have a framework for spending money on ergonomic training and devices; however, healthcare does not -- and it's time for that to change.

"Instituting ergonomic workstations takes planning and, of course, will cost money," Thompson said. "Some of these changes may be expensive in the short term, but they're a worthwhile investment in the health of radiologists. If we can prevent radiologists from having diminished work productivity due to painful RSI symptoms, ergonomic workstations will be more than cost-effective in the long run."

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