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Musculoskeletal pain common among health care workers participating in interventional procedures
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In a new study of occupational hazards in interventional laboratories, musculoskeletal pain was common among health care workers who participate in fluoroscopically guided interventional procedures.
However, rates of cancer, hypothyroidism or cataracts were not higher among physicians and staff who work in interventional laboratories compared with employees who do not.
Researchers sent an electronic study to Mayo Clinic employees working in affiliated hospitals with interventional cardiology or interventional radiology laboratories to investigate rates of musculoskeletal pain, cancer and other comorbid conditions associated with the workplace. Overall, 1,543 employees responded (cardiology, n = 554; radiology, n = 989). Of those, 1,042 (67.5%) were involved with procedures that utilized radiation. The mean age of the respondents was 43 years, and 33% were men.
Work-related pain was reported by 54.7% of employees involved with procedures utilizing radiation requiring lead apron use compared with 44.7% of other employees (P < .001). This association persisted after adjustment for sex, age, BMI, pre-existing musculoskeletal conditions, experience and job description (OR = 1.67; 95% CI, 1.32-2.11). These employees were more likely to seek care for their musculoskeletal pain compared with other employees (30.4% vs. 24.4%; P = .02).
Technicians (62%) and nurses (60%) reported the highest rates of musculoskeletal pain, followed by attending physicians (44%) and trainees (19%; P < .001).
Although employees involved with procedures utilizing radiation were more likely to report musculoskeletal pain, they did not differ from other employees in measures of objective pain, recent use of pain medication, missed workdays or disability.
Employees involved with procedures utilizing radiation who reported a history of pain were more likely to be women (71% vs. 56%), spend more time per week involved in such procedures (15 hours vs. 5 hours) and spend more time wearing a lead apron (4 hours vs. 1 hour; P < .001 for all) compared with other employees. In addition, employees who reported a history of work-related pain were more likely to engage in behaviors to improve musculoskeletal pain, such as prompt removal of lead apron, stretching and/or exercising before and after procedures, and wearing soft-soled shoes.
The researchers also reported no differences between employees exposed and not exposed to radiation in cancer (9% vs. 9%; P = .96), cataracts (4% vs. 4%; P = .98), kidney stones (10% vs. 9%; P = .87) and hypothyroidism (10% vs. 9%; P = .67). However, the researchers cautioned that “any conclusion regarding causality is limited by the cross-sectional nature of the study, as well as the low overall prevalence of malignancy in [the] study group.”
Employees involved with procedures utilizing radiation were more likely to be men and work in radiology, according to the results.
“More attention and effort needs to be directed toward improving the physical stresses that interventional lab employees endure. For all employees, continued efforts at limiting procedure times and regular ergonomic evaluations with associated training are advisable. Nonphysician employees also may benefit from periodic rotation out of the interventional lab suite,” the researchers wrote.
In an accompanying editorial, James A. Goldstein, MD, from the department of cardiovascular medicine at Beaumont Health System in Royal Oak, Michigan, said the results of this study are “consistent with, and extend observations from, prior studies over the past decade confirming that working in an interventional fluoroscopic environment poses significant risk for orthopedic injury.”
Disclosure: The researchers report no relevant financial disclosures. Goldstein reports owning equity in a company developing radiation shielding equipment.
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