Resident, PGY-3 Walter Reed National Military Medical Center
Educational Objective: At the conclusion of this presentation, the participants should be able to discuss the large burden that ergonomic stressors may put on practicing otolaryngologists in regards to the development of chronic pain and the subsequent impact on productivity, longevity, and quality of life.
Objectives: To determine the proportion of otolaryngologists with work related musculoskeletal discomfort (WRMD) and to review objective ergonomic data that contribute to WRMD.
Study Design: Systematic review and meta-analysis.
Methods: A comprehensive search of the literature identified 1121 articles for initial review of which nineteen (3563 participants) met criteria for qualitative discussion and eight (2192 participants) met criteria for meta-analysis. Random effects meta-analyses were used to estimate the proportion of otolaryngologists reporting WRMD.
Results: The overall proportion (95% confidence intervals) of general otolaryngologists reporting WRMD was 0.78 (0.67, 0.86); 0.52 (0.42, 0.61) for neck symptoms; 0.29 (0.21, 0.39) for shoulder symptoms; and 0.44 (0.35, 0.53) for back symptoms. Qualitative analysis revealed that overall prevalence of WRMD from data restricted to specific subspecialties is lower than nonsubspecialty practice with the overall rate of WRMD ranging from 64% for endoscopic sinus surgery to 21% for laryngology. Due to WRMD, 57% of surveyed (785 of 1378) otolaryngologists underwent medical treatment, 43% (113 of 263) believed quality of life was negatively impacted, 6% (74 of 1235) required surgery, 16% (109 of 679) needed significant time away from work, and 2% (11 of 542) stopped operating or retired early. Objective measures of ergonomic posture indicate moderate to severe risk of injury during routine clinic and surgical procedures with none found to be low risk.
Conclusions: Ergonomic stressors among otolaryngologists contribute to a high rate of WRMD across all subspecialties with notable impact on productivity, longevity, and quality of life.