Prevalence and impact of musculoskeletal pain in Japanese gastrointestinal endoscopists: A controlled study

Table 1 Non-endoscopist physicians who participated in this survey

	n (%)
Internist	65 (54)
Surgeon	17 (14)
Dermatologist	10 (8)
Psychiatrist	7 (6)
Radiologist	4 (3)
Resident	4 (3)
Pathologist	3 (3)
Pediatrician	1 (1)
Orthopedic surgeon	1 (1)
Gynecologist	1 (1)
Emergency physician	1 (1)
NI	6 (5)
Total	120 (100)

NI: Not informed.

Table 2 Subject characteristics

Characteristics	Endoscopists	Non-endoscopists	P value
	(n = 190)	(n = 120)
Age (yr, mean ± SD)	41.4 ± 6.7	40.1 ± 7.6	0.202
Years in practice (yr, mean ± SD)	16.2 ± 8.1	14.8 ± 9.4	0.083
Sex			0.197
Male/female	164/26	97/23
Dominant hand			0.077
Right/left/NI	179/9/2	108/12/0
Activity level			0.046
Mild	131 (69%)	70 (58%)
Moderate	50 (26%)	43 (36%)
Remarkable	5 (3%)	5 (4%)
NI	4 (2%)	4 (3%)
Height (cm)	168.6 ± 6.9	168.1 ± 7.0	0.202
Weight (kg)	66.3 ± 10.6	64.9 ± 11.3	0.287
Body mass index (kg/m2)	23.2 ± 2.2	22.8 ± 3.0	0.306

NI: Not informed.

Table 3 Number of endoscopic procedures completed per week (mean ± SD)

Procedure type	No. per week
Esophagogastroduodenoscopy (n = 190)	15.0 ± 8.7
Colonoscopy (n = 161)	6.7 ± 3.7
Endoscopic retrograde cholangiopancreatography (n = 63)	2.1 ± 1.8
Endoscopic ultrasonography (n = 48)	2.2± 1.9

Table 4 Environmental factors affecting endoscopic procedures

Factor	No. per week (n = 190)
Use of height-adjustable examination table (yes/no)	186 (98)/4 (2)
Position of monitor (directly in front of endoscopist, at eye level/other position)	133 (70)/57 (30)
Manufacturer of endoscope primarily used (Olympus/Fujifilm/NI)	138 (73)/47 (25)/5 (3)

NI: Not informed.

Table 5 Frequency of major types of musculoskeletal pain in Japanese endoscopists and non-endoscopists n (%)

Site of pain	Endoscopists (n = 190)	Non-endoscopists (n = 120)	P value
Neck (present/absent)	18 (9)/172 (91)	13 (11)/107 (89)	0.698
Right shoulder (present/absent)	18 (9)/172 (91)	14 (12)/106 (88)	0.536
Left shoulder (present/absent)	15 (8)/175 (92)	12 (10)/108 (90)	0.522
Right wrist (present/absent)	3 (2)/187 (98)	1 (1)/119 (99)	0.571
Left wrist (present/absent)	13 (7)/177 (93)	4 (3)/116 (97)	0.186
Right thumb (present/absent)	3 (2)/187 (98)	0 (0)/120 (100)	0.167
Left thumb (present/absent)	16 (8)/174 (92)	0 (0)/120 (100)	0.001
Right hand/fingers (present/absent)	5 (3)/185 (97)	1 (1)/119 (99)	0.263
Left hand/fingers (present/absent)	4 (2)/186 (98)	1 (1)/119 (99)	0.387
Lower back (present/absent)	50 (26)/140 (74)	24 (20)/96 (80)	0.204
Hand and wrist (present/absent)	32 (17)/158 (83)	7 (6)/113 (94)	0.004
Total (present/absent)	81 (43)/109 (57)	49 (41)/71 (59)	0.755

Table 6 Univariate analysis of factors associated with pain in the hand and wrist in endoscopists

Characteristics	P value
Age (> 40 yr vs < 40 yr)	0.011
Sex (male vs female)	0.378
Dominant hand (left vs right)	0.098
Activity level (moderate/remarkable vs mild)	0.338
Height (> 168 cm vs < 168 cm)	0.796
Weight (> 66 kg vs < 66 kg)	0.642
Body mass index (> 25 kg/m2vs < 25 kg/m2)	0.61
Mean number of esophagogastroduodenoscopies per wk (> 15 vs < 15)	0.215
Mean number of colonoscopies per wk (> 6.7 vs < 6.7)	0.091
Do ERCP (yes vs no)	0.871
Do EUS (yes vs no)	0.969
Mean time performing endoscopic procedures per week (> 12 h vs < 6.7 h)	0.636
Use of height-adjustable examination table (no vs yes)	0.836
Position of monitor (other position vs directly in front of endoscopist, at eye level)	0.8
Manufacturer of endoscope primarily used (fujifilm vs olympus)	0.28

ERCP: Endoscopic retrograde cholangiopancreatography; EUS: Endoscopic ultrasonography.

Table 7 Modifications to prevent musculoskeletal pain

Modification	Endoscopists(n = 190)	Non-endoscopists(n = 120)	P value
No modifications	167 (88)	80 (67)	< 0.0001
Stretching exercises	11 (6)	26 (22)	< 0.0001
Taking breaks	11 (6)	8 (7)	0.754
Wearing athletic shoes	8 (4)	6 (5)	0.744
Less work	5 (3)	1 (1)	0.263

Table 8 Requests to improve endoscopic design from endoscopists n (%)

Request	No. of endoscopists (n = 190)
Make the operating part heavier/lighter	0 (0)/85 (45)
Make the operating part larger/smaller	1 (1)/41 (22)
Make the angulation controller larger/smaller	15 (8)/27 (14)
Make the resistance of the angulation controller heavier/lighter	0 (0)/36 (19)