Work-related Musculoskeletal Disorders Among Sonographers

Objective: Sonography has been used extensively in clinical diagnosis. Reports on sonographers' musculoskeletal disorders gave rise to concern about their well-being, the search for risk factors, and the measures to improve the situation. In Taiwan this issue has received little attention. The purpose of the study was to investigate this problem and to raise awareness in relevant medical community. Material and Methods: Nordic Musculoskeletal Questionnaire (NMQ) was filled out by 36 sonographers in 11 sonographic rooms of various departments. On-site visits were conducted to evaluate ergonomic, psychological, and managerial risk factors, coupled with Key Indicator Method (KIM) for the assessment of physical workloads. Results: Sixty-nine percent of sonographers suffered from moderate pain in at least one body part. The most affected parts comprised dominant wrists, shoulders, elbows, and neck back region. Work analysis revealed average examination loads often of more than 20 patients per shift, more than 30 in some, and exceeding 40 in busiest departments. These figures indicated an amount and work pace 2-3 times those reported from the other countries. There existed a myriad of ergonomic risk factors including repetitive movements, excessive reaching of arms, static postures, awkward positions, forceful exertion, and lack of break time. KIM distinguished between 5 moderate and 6 increased load sonographic operations, primarily determined by daily working time. NMQ scores and daily examination loads, however, were not associated significantly (P = 0.136). Conclusions: Work-related musculoskeletal complaints were prevalent among sonographers on account of unusually high daily workloads as well as ergonomic, psychological, and managerial risk factors. Safety culture need be nurtured at health care workplaces where little emphasis has been laid upon.

關鍵字

Sonographers ； Sonography ； Ergonomics ； Work-relatedness ； Musculoskeletal disorder

並列摘要

目的：診斷性超音波在臨床上廣泛使用，但關於操作人員骨骼肌肉症狀的報告日益增多，引人重視工作者的健康狀況，超音波作業的人因危害因子，以及改善措施。此議題在我國鮮少被提及，因此本研究的目的在探討這個問題，瞭解情況，以喚起醫界的重視。方法：針對北部某醫學中心的11處超音波室進行調查，讓36位工作人員填答北歐肌肉骨骼問卷。臨場訪視各超音波室，瞭解作業情形、人因危害因子、心理壓力、以及管理層面問題。除了質性訪查之外，對超音波作業進行關鍵指標法人因危害風險評估。結果：百分之六十九的超音波操作人員抱怨至少一處身體部位的中度疼痛。最常受影響的部位包括慣用側的手腕、肩部、肘部，以及頸背區域。工作情況調查顯示每個工作班的受檢人次經常超過20，部分超過30，而較忙碌的部門可超過40人次。這些工作量與作業速度是國外文獻報導的2-3倍之多。質性觀察顯示人員操作時存在多項人因危害因子，包括重複性動作、過度伸展上肢、長時間靜態姿勢、不自然的肢體位置、過度施力、以及缺少喘息時間。關鍵指標法分析區分出5處中度人因危害負荷與6處中高度人因危害負荷的超音波室，其中差異主要取決於每日工作總時間。北歐肌肉骨骼問卷分數與每日檢查數量並無顯著統計相關性（P = 0.136）。結論：工作相關骨骼肌肉系統症狀在超音波操作人員當中盛行，主要導因於高量的檢查負荷，以及人因性、心理性、與管理層面的危害因子。由於此問題並未受到足夠的重視，宜在醫療工作場域推動安全文化，針對相關危害因子進行改善。

並列關鍵字

超音波操作人員；超音波；人因危害；工作相關疾病

國際替代計量

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