Assessment of ergonomic strain and positioning during bronchoscopic procedures

Christopher R. Gilbert, Jeffrey Thiboutot, Christopher Mallow, Alexander Chen, Nicholas J. Pastis, A. Christine Argento, Jennifer Millar, Robert A. Lavin, Andrew D. Lerner, Diana H. Yu, Ben Salwen, Daniel Lunz, Hans J. Lee, Lonny B. Yarmus

Research output: Contribution to journalArticle

Abstract

Background: Poor ergonomics place health care workers at risk for work-related overuse injuries. Repetitive and prolonged hand maneuvers, such as those performed during endoscopic procedures, may lead to musculoskeletal complaints and work-related injuries. However, the prevalence of health care-related work injuries among physicians is thought to be underreported and there is a paucity of literature investigating the impact of ergonomic strain on bronchoscopy. We designed a feasibility study to explore the differences in ergonomic strain and muscle activity of bronchoscopists. Materials and Methods: A prospective study of bronchoscopic procedures was performed in a simulated environment. Preselected target areas were identified and airway sampling was performed with real-time ergonomic assessment utilizing electromyogram (EMG), grip strength, and musculoskeletal use and motion analysis. Results: Procedural data was obtained for all procedures (78 bronchoscopies by 13 subjects) for both ergonomic and EMG scores. Experienced bronchoscopists demonstrated less EMG burden (P=0.007) and improved ergonomic positioning (P=0.007) during bronchoscopy when compared with less experienced bronchoscopists. Procedures performed with rotational-head bronchoscopes trended toward improved ergonomics (P=0.15) and lower EMG scores (P=0.88). A significant improvement in ergonomic scores was seen with the rotational-head bronchoscope when targeting the left upper lobe (P=0.036). Conclusion: Poor ergonomic positioning and excessive muscle strain appear present within bronchoscopy procedures but may be improved in those with more bronchoscopy experience. Technological advances in bronchoscope design may also have the potential to improve procedural ergonomics. Additional prospective studies are warranted to define the long-term impact on bronchoscopic ergonomics.

Original languageEnglish (US)
JournalJournal of Bronchology and Interventional Pulmonology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Human Engineering
Bronchoscopy
Electromyography
Bronchoscopes
Head
Prospective Studies
Cumulative Trauma Disorders
Delivery of Health Care
Muscles
Wounds and Injuries
Feasibility Studies
Hand Strength
Hand
Physicians

Keywords

  • bronchoscopy
  • ergonomics
  • rotational-head bronchoscope

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Assessment of ergonomic strain and positioning during bronchoscopic procedures. / Gilbert, Christopher R.; Thiboutot, Jeffrey; Mallow, Christopher; Chen, Alexander; Pastis, Nicholas J.; Argento, A. Christine; Millar, Jennifer; Lavin, Robert A.; Lerner, Andrew D.; Yu, Diana H.; Salwen, Ben; Lunz, Daniel; Lee, Hans J.; Yarmus, Lonny B.

In: Journal of Bronchology and Interventional Pulmonology, 01.01.2019.

Research output: Contribution to journalArticle

Gilbert, Christopher R. ; Thiboutot, Jeffrey ; Mallow, Christopher ; Chen, Alexander ; Pastis, Nicholas J. ; Argento, A. Christine ; Millar, Jennifer ; Lavin, Robert A. ; Lerner, Andrew D. ; Yu, Diana H. ; Salwen, Ben ; Lunz, Daniel ; Lee, Hans J. ; Yarmus, Lonny B. / Assessment of ergonomic strain and positioning during bronchoscopic procedures. In: Journal of Bronchology and Interventional Pulmonology. 2019.
@article{4c137805a8144cfc853e422836ba6d80,
title = "Assessment of ergonomic strain and positioning during bronchoscopic procedures",
abstract = "Background: Poor ergonomics place health care workers at risk for work-related overuse injuries. Repetitive and prolonged hand maneuvers, such as those performed during endoscopic procedures, may lead to musculoskeletal complaints and work-related injuries. However, the prevalence of health care-related work injuries among physicians is thought to be underreported and there is a paucity of literature investigating the impact of ergonomic strain on bronchoscopy. We designed a feasibility study to explore the differences in ergonomic strain and muscle activity of bronchoscopists. Materials and Methods: A prospective study of bronchoscopic procedures was performed in a simulated environment. Preselected target areas were identified and airway sampling was performed with real-time ergonomic assessment utilizing electromyogram (EMG), grip strength, and musculoskeletal use and motion analysis. Results: Procedural data was obtained for all procedures (78 bronchoscopies by 13 subjects) for both ergonomic and EMG scores. Experienced bronchoscopists demonstrated less EMG burden (P=0.007) and improved ergonomic positioning (P=0.007) during bronchoscopy when compared with less experienced bronchoscopists. Procedures performed with rotational-head bronchoscopes trended toward improved ergonomics (P=0.15) and lower EMG scores (P=0.88). A significant improvement in ergonomic scores was seen with the rotational-head bronchoscope when targeting the left upper lobe (P=0.036). Conclusion: Poor ergonomic positioning and excessive muscle strain appear present within bronchoscopy procedures but may be improved in those with more bronchoscopy experience. Technological advances in bronchoscope design may also have the potential to improve procedural ergonomics. Additional prospective studies are warranted to define the long-term impact on bronchoscopic ergonomics.",
keywords = "bronchoscopy, ergonomics, rotational-head bronchoscope",
author = "Gilbert, {Christopher R.} and Jeffrey Thiboutot and Christopher Mallow and Alexander Chen and Pastis, {Nicholas J.} and Argento, {A. Christine} and Jennifer Millar and Lavin, {Robert A.} and Lerner, {Andrew D.} and Yu, {Diana H.} and Ben Salwen and Daniel Lunz and Lee, {Hans J.} and Yarmus, {Lonny B.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1097/LBR.0000000000000615",
language = "English (US)",
journal = "Journal of Bronchology and Interventional Pulmonology",
issn = "1944-6586",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Assessment of ergonomic strain and positioning during bronchoscopic procedures

AU - Gilbert, Christopher R.

AU - Thiboutot, Jeffrey

AU - Mallow, Christopher

AU - Chen, Alexander

AU - Pastis, Nicholas J.

AU - Argento, A. Christine

AU - Millar, Jennifer

AU - Lavin, Robert A.

AU - Lerner, Andrew D.

AU - Yu, Diana H.

AU - Salwen, Ben

AU - Lunz, Daniel

AU - Lee, Hans J.

AU - Yarmus, Lonny B.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Poor ergonomics place health care workers at risk for work-related overuse injuries. Repetitive and prolonged hand maneuvers, such as those performed during endoscopic procedures, may lead to musculoskeletal complaints and work-related injuries. However, the prevalence of health care-related work injuries among physicians is thought to be underreported and there is a paucity of literature investigating the impact of ergonomic strain on bronchoscopy. We designed a feasibility study to explore the differences in ergonomic strain and muscle activity of bronchoscopists. Materials and Methods: A prospective study of bronchoscopic procedures was performed in a simulated environment. Preselected target areas were identified and airway sampling was performed with real-time ergonomic assessment utilizing electromyogram (EMG), grip strength, and musculoskeletal use and motion analysis. Results: Procedural data was obtained for all procedures (78 bronchoscopies by 13 subjects) for both ergonomic and EMG scores. Experienced bronchoscopists demonstrated less EMG burden (P=0.007) and improved ergonomic positioning (P=0.007) during bronchoscopy when compared with less experienced bronchoscopists. Procedures performed with rotational-head bronchoscopes trended toward improved ergonomics (P=0.15) and lower EMG scores (P=0.88). A significant improvement in ergonomic scores was seen with the rotational-head bronchoscope when targeting the left upper lobe (P=0.036). Conclusion: Poor ergonomic positioning and excessive muscle strain appear present within bronchoscopy procedures but may be improved in those with more bronchoscopy experience. Technological advances in bronchoscope design may also have the potential to improve procedural ergonomics. Additional prospective studies are warranted to define the long-term impact on bronchoscopic ergonomics.

AB - Background: Poor ergonomics place health care workers at risk for work-related overuse injuries. Repetitive and prolonged hand maneuvers, such as those performed during endoscopic procedures, may lead to musculoskeletal complaints and work-related injuries. However, the prevalence of health care-related work injuries among physicians is thought to be underreported and there is a paucity of literature investigating the impact of ergonomic strain on bronchoscopy. We designed a feasibility study to explore the differences in ergonomic strain and muscle activity of bronchoscopists. Materials and Methods: A prospective study of bronchoscopic procedures was performed in a simulated environment. Preselected target areas were identified and airway sampling was performed with real-time ergonomic assessment utilizing electromyogram (EMG), grip strength, and musculoskeletal use and motion analysis. Results: Procedural data was obtained for all procedures (78 bronchoscopies by 13 subjects) for both ergonomic and EMG scores. Experienced bronchoscopists demonstrated less EMG burden (P=0.007) and improved ergonomic positioning (P=0.007) during bronchoscopy when compared with less experienced bronchoscopists. Procedures performed with rotational-head bronchoscopes trended toward improved ergonomics (P=0.15) and lower EMG scores (P=0.88). A significant improvement in ergonomic scores was seen with the rotational-head bronchoscope when targeting the left upper lobe (P=0.036). Conclusion: Poor ergonomic positioning and excessive muscle strain appear present within bronchoscopy procedures but may be improved in those with more bronchoscopy experience. Technological advances in bronchoscope design may also have the potential to improve procedural ergonomics. Additional prospective studies are warranted to define the long-term impact on bronchoscopic ergonomics.

KW - bronchoscopy

KW - ergonomics

KW - rotational-head bronchoscope

UR - http://www.scopus.com/inward/record.url?scp=85072318190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072318190&partnerID=8YFLogxK

U2 - 10.1097/LBR.0000000000000615

DO - 10.1097/LBR.0000000000000615

M3 - Article

C2 - 31524654

AN - SCOPUS:85072318190

JO - Journal of Bronchology and Interventional Pulmonology

JF - Journal of Bronchology and Interventional Pulmonology

SN - 1944-6586

ER -