Radiologists encounter repetitive stress injuries

June 3, 2006

The advent of PACS has put radiologists at high risk of developing repetitive stress injuries. They desperately need ergonomics training, according to a study from Massachusetts General Hospital in the U.S.

The advent of PACS has put radiologists at high risk of developing repetitive stress injuries. They desperately need ergonomics training, according to a study from Massachusetts General Hospital in the U.S.

"The computer burden on the radiologist today is comparable to or more than that of the average person working on an office desktop," said Dr. Mansi Saksena, a radiologist at MGH.

She presented results of a "mouse count" study at the American Roentgen Ray Society meeting in Vancouver, Canada.

The same ergonomic rules used in the wider occupational world should apply to radiologists, but they typically do not, according to Saksena.

"Radiologists need to pay attention to ergonomics when they are working, and most don't. We are at much higher risk of developing repetitive stress injuries than any other medical profession," Saksena said.

Using special software, researchers recorded radiologists' daily mouse counts (clicks per user) in an average department. They then compared these to mouse count rates for secretaries in the same department. High mouse count rates are associated with pain in the wrist and forearm.

Over a seven-day period, the mean daily mouse count of radiologists ranged from 460 to just over 1100, with a weekly mean of about 826. In comparison, the secretaries clocked up a mean of 1150 counts per day, with a range of 882 to 1460 per day. Radiologists who were reading and dictating CT exams scored the highest physician rates.

Saksena points out that, unlike secretaries and other office workers, radiologists don't typically have individualized desks or chairs. One-size workstations do not fit every size.

The incidence of repetitive strain injury among radiologists has not been documented, though there is some evidence of problems with eye strain. RSI can be difficult to assess. Common symptoms include back pain, which is common in the general population.

MGH did a survey of its own radiologists and found signs of RSI-type damage. Most radiologists with more than 10 years' experience had some symptoms of strain, Saksena said.

RSI is the biggest, but certainly not the only, worry associated with poor ergonomics.

"Radiologists may not have a demonstrable injury. If you get an MR, it may be normal. But at the end of the work day, you may have pain in your back, shoulders, neck, and wrists. That can seriously compromise your productivity at work and at home," Saksena said.

The pain caused by sitting in the wrong position may prompt radiologists to take more breaks, she said.

Radiologists can cut down on the risks in many ways. First and foremost, it's important to be aware that sitting in the wrong position will cause harm. Radiologists can change their equipment by getting a better chair or desk and add foot and arm rests. Ergonomic training will help them assess their work environment, Saksena said.