Musculoskeletal injuries in gastrointestinal endoscopists: a systematic review.

INTRODUCTION: Gastrointestinal(GI) endoscopy forms a significant proportion of clinicians' workloads. However, little attention is given to the ergonomic aspects of endoscopy. This systematic review of musculoskeletal pain and/or injuries in GI endoscopists aims to better understand the types of occupational injuries resulting from endoscopic procedures and associated risk factors. Areas covered: Systematic literature search conducted for articles evaluating prevalence, risk factors and mechanism of musculoskeletal pain and/or injuries related to GI endoscopy. In 13 included studies, 39-89% of surveyed endoscopists reported pain and/or injuries related to endoscopy. Common areas of pain were the back(15-57%), neck(9-46%), shoulders(9-19%), elbows(8-15%) and hands/fingers(14-82%). Risk factors included procedure volume, time spent doing endoscopy, cumulative time in practice and endoscopist age. Experimental studies showed that forces and loads placed on endoscopists' bodies during procedures place them at risk of occupational injury. Areas of pain differed between novice and experienced endoscopists implying separate mechanisms of injury. Expert commentary: Comprehensive investigation into the prevalence, types, pathophysiology and methods to minimise endoscopy-related musculoskeletal injuries is vital to ensure the continued efficient provision of endoscopy services in the face of rising demands worldwide. A paradigm shift is required in endoscopic devices and techniques to improve safety and comfort.