Ergonomics in Dermatologic Surgery: Lessons Learned Across Related Specialties and Opportunities for Improvement

Factors Associated With Musculoskeletal Pain Among Hair Transplant Surgeons: Analyses of Survey Data and Review of the Literature

BACKGROUND

The prevalence of work-related musculoskeletal disorders (WRMD) is increasing among all surgical specialties.

OBJECTIVE

Results of a cross-sectional survey of hair transplant surgeons were analyzed, with the aims to (1) determine the prevalence of WRMD, (2) assess risk factors associated with musculoskeletal (MSK) symptoms, and (3) identify mitigation measures.

MATERIALS AND METHODS

A survey pertaining to demographics, MSK-related symptoms and its impacts, and pain mitigation measures taken, if any, were distributed to 834 hair transplant surgeons. Risk factors associated with pain severity were assessed using linear regression.

RESULTS

Overall, 78.5% (73 of 93) respondents had experienced pain when performing surgery. Musculoskeletal symptoms were most severe in the neck, followed by upper/lower back, and extremities. Number of grafts performed per session of follicular unit extraction positively correlated with pain severity; female surgeons and surgeons aged >71 years were at higher risk. A majority expressed concern that WRMD may limit their career and agreed to a need for improved workplace education. Strength training and ergonomic improvements of surgical procedure were not commonly adopted.

CONCLUSION

In sum, WRMD can be debilitating in health care professionals. Workplace ergonomic adjustments and physical exercise programs may be warranted to better mitigate MSK symptoms.

Ergonomic and psychosocial risk factors associated with work-related musculoskeletal disorders in Mohs histotechs

Mohs histotechs are at high risk for work-related musculoskeletal disorders (WRMSDs) due to repetitive motions, forceful exertions, and fixed postures required for their work. Psychosocial factors such as perceptions of pressure to achieve deadlines may exacerbate risk of occupational injury. To assess the prevalence of and risk factors for WRMSD in Mohs histotechs, an online survey was created using literature review, expert opinion, and two validated instruments (the Nordic Musculoskeletal Questionnaire and the Oldenburg Burnout Inventory) and distributed to Mohs histotechs. 88% of respondents reported musculoskeletal problems in 2 or more of the 9 body sites assessed in the past year. Standing during specimen processing was correlated with having neck pain and upper back pain, while sitting was protective against lower back pain. Individuals that felt that they could not take breaks or slow their pace of work were more likely to report pain at multiple body sites. Total pain scores were significantly lower in those reporting extensive ergonomic training. There is a high prevalence of WRMSD in Mohs histotechs. Addressing poor posture as well as psychosocial risk factors could further reduce injury.