Occupational hazard for pathologists: microscope use and musculoskeletal disorders

The dark side of being a pathologist: Unravelling the health hazards

Background

Pathologists are indispensable to the practice of medicine. Awareness of health hazards among pathologists is a crucial aspect of today's time. Numerous occupational health risks are prevalent which are mostly ignored; for example, the association of microscope use for prolonged durations leading to the development of chronic pain syndromes has been acknowledged for nearly three decades, yet most pathologists are unaware about this hazard until after it transforms into a chronic health issue. The purpose of this study is to learn its prevalence in working pathologists, make them aware of the risks, discuss and encourage them to proactively integrate strategies which are preventive in nature into their daily routine lives.

Objective

The aim of the study was to analyze the level of risk, knowledge, awareness and biosafety measures taken by the pathologists in their routine daily work life.

Materials and Methods

The study was conducted in a developing country, Northern India, using a standard online 50-item questionnaire enquiring about routine practices. 450 participants were enrolled consisting of 360 pathologists and 90 residents of pathology.

Results

Among the 450 enrolled study participants, 84.8% complained of musculoskeletal disorders (MSD), with the neck being the commonest location of pain. Furthermore, 74.8% reported visual refractive errors, among which myopia took the highest place. Work injuries were reported in 60% of participants. Intolerance reactions to chemicals especially formaldehyde was observed in 63.1%. Depression and burnout were reported in 42%.

Conclusions

Although knowledge seems to be near adequate, there is a lack of implementation and a noticeable risk of health hazards namely musculoskeletal problems, injuries, visual disorders, and ergonomic issues in routine daily activities of pathologists.

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.

Towards Inclusive Diagnostics for Neglected Tropical Diseases: User Experience of a New Digital Diagnostic Device in Low-Income Settings

Designing new and inclusive diagnostic tools to detect Neglected Tropical Diseases (NTDs) to achieve rational disease control requires a co-design process where end-users’ input is important. Failure to involve all potential end-users in new diagnostics for NTDs can result in low use and adoption failure, leading to persistent infection hot spots and ineffective disease control. There are different categories of potential end-users of new diagnostic tools for NTD control, and it is unclear if there are differences between the user efficiency, effectiveness, perception, and acceptability across these end-user categories. This study evaluated the usability, user perception, contextual factors affecting the user’s experience, and acceptability of a new digital optical diagnostic device for NTDs across three types of potential end users. A total of 21 participants were tested. Laboratory scientists, technicians, and Community Health Extension Workers (CHEWs) in training achieved similar scores on the usability and user perception questionnaires with no statistically significant difference between end-user categories. All participants also have high scores for the user perception domains which strongly correlate with the acceptability of the AiDx NTDx Assist device. This study indicates that, by providing digital diagnostic tools in combination with minimal training and support, CHEWs undergoing training and, by extension, CHEWs post-training, can be involved in the diagnoses of NTDs, potentially enhancing a community’s capabilities to diagnose, treat, and control NTDs.

Intraoperative Neck Angles in Endoscopic and Microscopic Otologic Surgeries

OBJECTIVE

To quantitatively compare the ergonomic risk of otologic surgeries performed with endoscopes and microscopes.

STUDY DESIGN

Observational cross-sectional study.

SETTING

Operating room of a tertiary academic medical center.

METHODS

Intraoperative neck angles of otolaryngology attendings, fellows, and residents were assessed during 17 otologic surgeries using inertial measurement unit sensors. Sensors were attached midline between the shoulder blades and on the posterior scalp of participants and were calibrated just prior to beginning each case. Quaternion data were used to calculate neck angles during periods of active surgery.

RESULTS

Endoscopic and microscopic cases included similar percentages of time in high-risk neck positions, 75% and 73%, respectively, according to a validated ergonomic risk assessment tool, the Rapid Upper Limb Assessment. However, microscopic cases included a higher percentage of time spent in extension (25%) compared to endoscopic cases (12%) (p < .001). When examining the magnitude of average flexion and extension angles, endoscopic and microscopic cases were not significantly different.

CONCLUSION

Utilizing intraoperative sensor data, we found that both endoscopic and microscopic approaches in otologic surgery were associated with high-risk neck angles, which can result in sustained neck strain. These results suggest that optimal ergonomics may be better achieved by the consistent application of basic ergonomic principles than by changing the technology in the operating room.

[Ergonomic parameters of the pathologist's workplace as important factors in the prevention of occupational musculoskeletal diseases]

BACKGROUND

More than 80% of pathologists suffer from various manifestations of disorders of the musculoskeletal system. The daily duties of pathologists include several hours of work at a microscope and a computer. Microscopes are often not optimized for ergonomics and do not allow the doctor to take the correct sitting position, most often working with a microscope requires leaning forward.

OBJECTIVE

To study the ergonomic properties of the workplace of a pathologist and develop specific practical recommendations for long-term work at a microscope.

MATERIAL AND METHODS

The study included microscopes with an adjustable and non-adjustable angle of inclination of the tube and height-adjustable chairs. We identify following ergonomic parameters: pathologist height; angle of inclination of the back of the chair; angle of inclination of the microscope tube; angle of inclination of the neck; chair height. The study included 21 participants. Statistical processing and analysis were made using single-factor and multifactorial correlation analysis.

RESULTS

A strong positive linear correlation was identified (r=0.80; p<0.05) between the height of test person and angle of inclination of the microscope tube. A strong positive linear correlation was established (r=0.91; p<0.05) between the test person height and the angle of inclination of the neck for microscopes with non-adjustable 31°-angle of inclination of the tube. For microscopes with non-adjustable 45°-angle of inclination of the tube a strong polynomial correlation of the second degree (r=0.85; p<0.05) was found. A moderate negative linear correlation was found between the height of the pathologist and his tilt angle neck with both adjustable and non-adjustable tube angle of the microscope.

CONCLUSION

In this study for the first-time exact correlation dependencies between key ergonomic parameters of pathologist's workplace were evaluated. This study showed that only microscopes with an adjustable angle of inclination of the tube allow to achieve an optimal body position.

Comparison of muscle activity while using different input devices in digital pathology

INTRODUCTION

The high prevalence of musculoskeletal disorders in pathologists, together with the current trend towards the digitization of pathology, prompted us to study the different types of input devices employed during the revision of whole slide images, in order to investigate the pattern and extent of muscle activity involved in their use.

MATERIAL AND METHODS

A comparative study was made of 10 input devices (conventional and vertical mouse, three trackballs, the Ergopointer™, the Rollermouse™, an optical pen mouse, a touchpad, and the Leap Motion™). Six medical students performed a standardized circuit using a Fitts' Law based tissue array, digitized. The electrical activity of seven upper limb muscles (adductor pollicis, extensor pollicis longus, extensor digitorum, flexor digitorum, middle deltoid, upper trapezius, and middle trapezius) was measured using surface electromyography.

RESULTS

Statistically significant differences in the overall electrical activity among the different input devices, both absolute values in mV as well as normalized values to the upper limb at rest, were observed (p<0.001); the Rollermouse™ (0.1027mV; 139%), Logitech M570 trackball (0.1053mV; 145%), Ergopointer™ (0.1151mV; 167%), conventional mouse (0.1251mV; 191%), and vertical mouse (0.1312mV; 205%) required less activity, while the optical pen mouse (0.1717mV; 299%), Leap Motion™ (0.1803mV; 319%), Expert Mouse trackball (0.1845mV; 329%), EIGIIS trackball (0.2442mV; 468%) and the touchpad (0.2560mV; 496%) required greater muscle mobilization.

CONCLUSION

We designed a system based on Fitts' Law to compare input devices in digital pathology. Variability between compared devices and muscle activity was found. Long-term use could result in different muscular fatigue patterns. Even though the selection of an input device is a matter of personal preference, its impact on ergonomics should be considered.

A study on musculoskeletal complaints and working postures in pathology specialists in Iran

Background

Musculoskeletal disorders (MSDs) are one of the most common causes of occupational injuries and disabilities among health care workers. This study investigates the relationship between musculoskeletal complaints and pathologist postures in laboratories.

Method

In this cross-sectional study, 40 pathologists were evaluated. MSDs in different body segments of the participants were evaluated by Nordic questionnaire. For postural analysis, 20 min film was recorded while using a microscope by subjects. Posture analysis was done by the Rapid Upper Limb Assessment (RULA) method and their repetitive movements were scored. The data was analyzed by SPSS Version 11.5.

Results

The mean age and duration of employment of subjects was 36.57 ± 7.54 years and 6.50 ± 6.30 years, respectively. Most MSDs were found in neck (65%), wrist (57.5%), upper back (50%) and lower back (47.5%). The mean RULA grand score was higher in participants with upper back and shoulder pain. A statistically significant relationship was found between the mean RULA grand, the upper back pain (P = 0.02) and the wrist pain (P = 0.003), as well as between the mean RULA B, the neck pain (P = 0.02) and the lower back pain (P = 0.05). The results showed a significant relationship between mean weekly working hours and tight (P < 0.001), wrist (p = 0.01) and ankle (P = 0.008).

Conclusion

This study revealed high prevalence of MSDs among the pathologists. Therefore, performing ergonomic corrective actions is essential in order to improve their physical conditions at work.

Pebrine diagnosis using quantitative phase imaging and machine learning

Pebrine is the most dreaded infectious disease of the silkworm and has devastated sericulture in Europe during the 18th century. Thereafter, if it is detected, the crop is burned to prevent further dissemination. The conventional microscopic examination of moth's body fluid is erroneous and it exacerbates on Metarhizium anisopliae (MA) contaminated test samples. This is due to the resemblance of pebrine and MA spores in the microscopic examination. Therefore, this study aims to demonstrate an efficient pebrine detection technique. In the proposed method, a motorised brightfield microscope is custom-made to acquire focused and defocused images of test spores. These images are used to produce quantitative phase images of the spores by the transport of intensity equation method. The phase images' histogram of oriented gradients feature is used by a machine learning classifier to categorise the spores. This system classified 92 pebrine and 185 MA spores with an accuracy of 97% at 0.04 seconds/spore. The duration taken for image acquisition is 2.5 minutes per sample (10 fields of view covering an area of 302 × 260 μm² ). The proposed method shows reliable results in pebrine diagnosis and would be an efficient alternative for current approaches.

A systematic review of biomechanical risk factors for the development of work-related musculoskeletal disorders in surgeons of the head and neck

BACKGROUND

Previous studies have shown high rates (47-72%) of self-reported work-related musculoskeletal disorders (WRMDs) in surgeons of the head and neck. Physical requirements in the workplace, individual factors (e.g. poor posture, obesity) and psychosocial factors have been identified as risk factors. Establishing biomechanical risk factors may help prevent further development of WRMDs in this population.

OBJECTIVE

The purpose of this critical review was to source studies that identified the biomechanical risk factors for WRMDs in this surgical sub-specialty.

METHODS

Searches were conducted of Medline, CINAHL, and AMED databases from 1980 until September 2018.

RESULTS

A total of 182 article were identified. Exclusion criteria lead to 163 full-text articles being screened, generating a total of 6 articles for review. The aims of the included studies varied significantly. Surgeons spend the majority of operating time in static, asymmetrical positions. Surgical loupes/headlamps significantly increased cervical spine loading. Articulated surgical arm supports provided optimal ergonomic conditions. Performing surgical operations with the surgeon in standing or sitting had no effect on task performance or demand. Physical fatigue was also measured in both positions.

CONCLUSIONS

A combination of equipment-based and patient/surgeon position-based factors predispose surgeons to biomechanical risk factors. Studies of greater methodological quality are required.

Exploring staff turnover, burnout, and resilience in cytology reference laboratories: A workforce qualitative study

OBJECTIVES

The aims of the study were to investigate cytology laboratory staff turnover in the context of workplace stressors and burnout and to explore qualities associated with long career tenure, in order to facilitate the development of future workplace intervention programs.

METHODS

Using an interpretive qualitative approach, semi-structured interviews were conducted and analysed using a directed and conventional content analysis. Seven participants who had left large cytology reference laboratories were purposively sampled to interview about their experience of leaving their former laboratories. Conventional content analysis was used to inductively generate themes and deductive content analysis was conducted with categories from the Transactional Model of Stress and Coping (ie, stress appraisal and coping style).

RESULTS

Three main themes were discerned from the interviews: concerns about the cytology workplace, reasons for choosing to leave, and strategies for coping with stress. Demand for productivity was the most commonly cited concern among cytotechnologists, followed by work-life balance, and musculoskeletal strain related to microscopic screening. The top reason given for people choosing to leave the commercial laboratories was the lack of work-life balance, and the second was the lack of professional challenges and growth opportunities. Participants with longer job tenure who experienced a promotion described coping with job stress as more optimistic and problem focused.

CONCLUSIONS

Opportunities exist within large commercial laboratories for improving the work environment to reduce workplace burnout and turnover.

The in vitro micronucleus assay using imaging flow cytometry and deep learning

The in vitro micronucleus (MN) assay is a well-established assay for quantification of DNA damage, and is required by regulatory bodies worldwide to screen chemicals for genetic toxicity. The MN assay is performed in two variations: scoring MN in cytokinesis-blocked binucleated cells or directly in unblocked mononucleated cells. Several methods have been developed to score the MN assay, including manual and automated microscopy, and conventional flow cytometry, each with advantages and limitations. Previously, we applied imaging flow cytometry (IFC) using the ImageStream® to develop a rapid and automated MN assay based on high throughput image capture and feature-based image analysis in the IDEAS® software. However, the analysis strategy required rigorous optimization across chemicals and cell lines. To overcome the complexity and rigidity of feature-based image analysis, in this study we used the Amnis® AI software to develop a deep-learning method based on convolutional neural networks to score IFC data in both the cytokinesis-blocked and unblocked versions of the MN assay. We show that the use of the Amnis AI software to score imagery acquired using the ImageStream® compares well to manual microscopy and outperforms IDEAS® feature-based analysis, facilitating full automation of the MN assay.

Work-related Hazards Among Pathologists and Residents of Pathology:Results of a Cross-sectional Study in Iran

BACKGROUND & OBJECTIVE

Pathologists as medical professionals involved in the diagnosis and planning of therapies in many diseases are exposed to occupational hazards in workplaces. Hence, we aimed to determine the occupational health problems among Iranian pathologists in this cross-sectional study.

METHODS

This cross-sectional study was conducted among the Iranian pathologists. The data required for this study was collected through a self-reported questionnaire containing 48 questions about major occupational health problems, including musculoskeletal problems, visual disorders, workplace characteristics, health behavior, and other medical conditions.

RESULTS

Among the study participants (N=350), 87.4% presented with musculoskeletal disorders in the past year, with the neck as the most common location of pain (71%). Musculoskeletal pain was significantly higher in those working with the computer for more than 5 hours per day (P=0.007). Furthermore, 273 (78%) participants reported visual refractive errors, and myopia was the most common error (53%). Acute injuries were reported in 263 (75%) participants, and the cutting injury had the highest frequency (56.6%). Depression was reported in 54 (15.4%) of the participants, followed by burnout (10.3%) and hypertension (4%). Intolerance reactions to formalin were reported by 222 (63.6%) and were significantly more frequent among the residents (P<0.001). The residents were more prone to musculoskeletal pain (P=0.002) and injury (P=0.026).

CONCLUSION

We observed a noticeable prevalence of health risks, including musculoskeletal problems, visual disturbances, injuries, and ergonomic problems among the Iranian pathologists. Solving these problems demands thorough prevention and personal protection, as well as educational programs with more attention toward optimization of ergonomics in the workplace and awareness about chemical and biological hazards.

Detection of Intestinal Protozoa in Trichrome-Stained Stool Specimens by Use of a Deep Convolutional Neural Network

Intestinal protozoa are responsible for relatively few infections in the developed world, but the testing volume is disproportionately high. Manual light microscopy of stool remains the gold standard but can be insensitive, time-consuming, and difficult to maintain competency. Artificial intelligence and digital slide scanning show promise for revolutionizing the clinical parasitology laboratory by augmenting the detection of parasites and slide interpretation using a convolutional neural network (CNN) model. The goal of this study was to develop a sensitive model that could screen out negative trichrome slides, while flagging potential parasites for manual confirmation. Conventional protozoa were trained as "classes" in a deep CNN. Between 1,394 and 23,566 exemplars per class were used for training, based on specimen availability, from a minimum of 10 unique slides per class. Scanning was performed using a 40× dry lens objective automated slide scanner. Data labeling was performed using a proprietary Web interface. Clinical validation of the model was performed using 10 unique positive slides per class and 125 negative slides. Accuracy was calculated as slide-level agreement (e.g., parasite present or absent) with microscopy. Positive agreement was 98.88% (95% confidence interval [CI], 93.76% to 99.98%), and negative agreement was 98.11% (95% CI, 93.35% to 99.77%). The model showed excellent reproducibility using slides containing multiple classes, a single class, or no parasites. The limit of detection of the model and scanner using serially diluted stool was 5-fold more sensitive than manual examinations by multiple parasitologists using 4 unique slide sets. Digital slide scanning and a CNN model are robust tools for augmenting the conventional detection of intestinal protozoa.

[Pathologist occupational hazards: Results of a survey for the French case]

INTRODUCTION

The profession of pathologist exposes to various risks, notably infectious, physical and chemical. The objective of this study was to make an inventory of these occupational risks to which pathologists are subjected and to evaluate the pathologies that they presented. A particular attention was given to microscopic and screen work as they can induce musculoskeletal or ophthalmic disorders, and stress-related psychological disorders.

METHOD

An anonymous online questionnaire containing 54 questions had been sent by mail to pathologists via the French Society of Pathology and the Syndicate of French Pathologists.

RESULTS

Five hundred and twelve pathologists responded to the survey. Thirty-eight percent reported musculoskeletal disorders in the last 6 months. Visual disturbances concerned 73.4% of respondents. In the last 12 months, 33.3% of pathologists had been injured or had had mucosal projections during macroscopic or autopsy specimens. The frequency of infectious diseases was low (6.2%) as well as that of cancers (3.9%). Psychological disorders such as depression or burnout were reported by 16.7% of respondents. Pathologists seemed happy at work and had a good overall lifestyle. Few doctors had medical follow-up and few had benefited from ergonomic advice and training on the risks of chemicals.

CONCLUSION

The results of this study showed the interest of a medical surveillance adapted to the pathologies presented by the pathologists. Educational and preventive measures should be introduced early in the career, focusing on ergonomics and learning about chemical and biological hazards.

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

BACKGROUND

As the practice of dermatology becomes increasingly procedurally based, there is a concordant rise in musculoskeletal injury (MSI) risk. Dermatologic surgeons are most susceptible and, although the majority suffer from MSI, few have received any formal ergonomics training. This stems from a lack of awareness of this troubling trend and a paucity of research and education on the ergonomics of dermatologic surgery.

OBJECTIVE

To highlight pertinent ergonomics principles and strategies from other specialties that could be translated into dermatology, and to synthesize general recommendations aimed at reducing MSI among dermatologic surgeons.

MATERIALS AND METHODS

A comprehensive search of the PubMed and Cochrane Reviews databases from 1975 to 2019 was conducted, using a combination of ergonomics-related search terms, generating 6 publications from the dermatology literature and 58 from the fields of dentistry, medicine, and select surgical subspecialties.

RESULTS

This multidisciplinary approach yielded multiple interventions that could be applied directly (i.e., adequate lighting, adjustable operating tables, and surgical seat heights) or indirectly pending further investigation into their feasibility (i.e., video displays of the surgical field to allow neutral head and neck postures).

CONCLUSION

Although much can be learned from decades of prior ergonomics research from other specialties, considerations that are unique to dermatology remain and must be addressed with specialty-specific research.

The role of artificial intelligence and machine learning in harmonization of high-resolution post-mortem MRI (virtopsy) with respect to brain microstructure

Enhanced resolution of 7 T magnetic resonance imaging (MRI) scanners has considerably advanced our knowledge of structure and function in human and animal brains. Post-industrialized countries are particularly prone to an ever-increasing number of ageing individuals and ageing-associated neurodegenerative diseases. Neurodegenerative diseases are associated with volume loss in the affected brain. MRI diagnoses and monitoring of subtle volume changes in the ageing/diseased brains have the potential to become standard diagnostic tools. Even with the superior resolution of 7 T MRI scanners, the microstructural changes comprising cell types, cell numbers, and cellular processes, are still undetectable. Knowledge of origin, nature, and progression for microstructural changes are necessary to understand pathogenetic stages in the relentless neurodegenerative diseases, as well as to develop therapeutic tools that delay or stop neurodegenerative processes at their earliest stage. We illustrate the gap in resolution by comparing the identical regions of the post-mortem in situ 7 T MR images (virtual autopsy or virtopsy) with the histological observations in serial sections through the same brain. We also described the protocols and limitations associated with these comparisons, as well as the necessity of supercomputers and data management for "Big data". Analysis of neuron and/or glial number by using a body of mathematical tools and guidelines (stereology) is time-consuming, cumbersome, and still restricted to trained human investigators. Development of tools based on machine learning (ML) and artificial intelligence (AI) could considerably accelerate studies on localization, onset, and progression of neuron loss. Finally, these observations could disentangle the mechanisms of volume loss into stages of reversible atrophy and/or irreversible fatal cell death. This AI- and ML-based cooperation between virtopsy and histology could bridge the present gap between virtual reality and neuropathology. It could also culminate in the creation of an imaging-associated comprehensive database. This database would include genetic, clinical, epidemiological, and technical aspects that could help to alleviate or even stop the adverse effects of neurodegenerative diseases on affected individuals, their families, and society.

Interventions commonly used to prevent work-related musculoskeletal disorders among healthcare workers

Purpose

The purpose of this paper is to review the prevalence and risk factors of work-related musculoskeletal disorders (WMSDs) among healthcare workers (HCWs) in order to ascertain the occupation with the highest susceptibility to WMSD in the health sector. This paper will also review the effective interventions which have been used to prevent WMSDs among HCWs.

Design/methodology/approach

This study is a literature review of 11 papers related to the prevalence and risk factors of WMSDs and 12 papers about the interventions being used to prevent WMSDs among HCWs. The papers were retrieved from respectable databases such as PubMed, Science Direct, Google Scholar and E-Thesis.

Findings

Nurses belong to the major group of HCWs who had the highest prevalence of WMSDs compared with other health professionals and other hospital workers. Although there are several interventions being commonly used to prevent WMSD risk factors, some interventions were unsuccessful in the prevention of WMSDs in healthcare tasks. Therefore, it is necessary that future research focuses on the tasks of HCWs that are WMSD risk factors and tries to innovate or redesign ergonomic workstations to prevent those risk factors.

Originality/value

The expected benefit of this study is to motivate ergonomists to provide appropriate and innovative interventions to ensure health and safety for nurses and other HCWs.

Histopathology: ditch the slides, because digital and 3D are on show

Due to the growing field of digital pathology, more and more digital histology slides are becoming available. This improves the accessibility, allows teleconsultations from specialized pathologists, improves education, and might give urologist the possibility to review the slides in patient management systems. Moreover, by stacking multiple two-dimensional (2D) digital slides, three-dimensional volumes can be created, allowing improved insight in the growth pattern of a tumor. With the addition of computer-aided diagnosis systems, pathologist can be guided to regions of interest, potentially reducing the workload and interobserver variation. Digital (3D) pathology has the potential to improve dialog between the pathologist and urologist, and, therefore, results in a better treatment selection for urologic patients.

Future-proofing pathology part 2: building a business case for digital pathology

Diagnostic histopathology departments are experiencing unprecedented economic and service pressures, and many institutions are now considering digital pathology as part of the solution. In this document, a follow on to our case for adoption report, we provide information and advice to help departments create their own clear, succinct, individualised business case for the clinical deployment of digital pathology.

Carpal tunnel syndrome among laboratory technicians in relation to personal and ergonomic factors at work

OBJECTIVES

Work-related carpal tunnel syndrome (CTS) has been reported in different occupations, including laboratory technicians, so this study was carried out to determine the prevalence and the associated personal and ergonomic factors for CTS among laboratory technicians.

METHODS

A cross-sectional study was conducted among 279 laboratory technicians at King Fahd Hospital, Saudi Arabia, who filled in a self-administered questionnaire, including questions regarding their demographic criteria, occupational history, job tasks, workplace tools, ergonomic factors at work, and symptoms suggestive of CTS. Physical examinations and electrodiagnostic studies were carried out for those who had symptoms suggestive of CTS to confirm the diagnosis. Univariate and multivariate analysis were performed for both personal and physical factors in association with confirmed CTS among laboratory technicians.

RESULTS

The prevalence of CTS among the laboratory technicians was 9.7% (27/279). The following were the statistically significant risk factors for CTS among them: gender (all cases of CTS were female, P=0.00), arm/hand exertion (OR: 7.96; 95% CI: 1.84-34.33), pipetting (OR: 7.27; 95% CI: 3.15-16.78), repetitive tasks (OR: 4.60; 95% CI: 1.39-15.70), using unadjustable chairs or desks (OR: 3.35; 95% CI: 1.23-9.15), and working with a biosafety cabinet (OR: 2.49; 95% CI: 1.11-5.59). CTS cases had significant longer work duration (17.9 ± 5.6 years) than CTS non-case (11.5 ± 7.4 yeas) with low OR (1.108).

CONCLUSION

This study demonstrates some personal and ergonomic factors associated with CTS among the laboratory technicians, including female gender, arm/hand exertion, pipetting, repetitive tasks, working with a biosafety cabinet, and an unadjusted workstation.

Future-proofing pathology: the case for clinical adoption of digital pathology

This document clarifies the strategic context of digital pathology adoption, defines the different use cases a healthcare provider may wish to consider as part of a digital adoption and summarises existing reasons for digital adoption and its potential benefits. The reader is provided with references to the relevant literature, and illustrative case studies. The authors hope this report will be of interest to healthcare providers, pathology managers, departmental heads, pathologists and biomedical scientists that are considering digital pathology, deployments or preparing business cases for digital pathology adoption in clinical settings. The information contained in this document can be shared and used in any documentation the reader wishes to present for their own institutional case for adoption report or business case.

Awareness and Knowledge of Ergonomics Among Medical Laboratory Scientists in Nigeria

Background:

Ergonomics awareness helps in its right application and contributes significantly to general wellbeing and safety of worker at workplace.

Aim:

This cross-sectional descriptive study aimed at assessing the level of awareness and knowledge of the science of ergonomics among Medical Laboratory Scientists in Benin City, Nigeria.

Subjects and Methods:

A total of 106 medical laboratory scientists comprising 64 and 42 in public and private laboratories, respectively, were recruited for this study using systematic random sampling technique. Data were obtained from the study participants using a questionnaire and subsequently analyzed with the statistical software INSTAT^®.

Results:

Out of 106 study participants, 27 (25.5%) were reported to have heard of the term ergonomics. Awareness was significantly associated with gender (male vs. female: 38.5% [15/39] vs. 17.9% [12/67]; odds ratio = 2.9; 95% confidence interval = 1.2, 7.1;P = 0.02). Awareness of ergonomics was not significantly affected by affiliation (P = 0.18), area of specialization (P = 0.78), post-qualification experience (P = 0.43), and educational qualification (P = 0.23) of the study participants. Irrespective of the affiliation of the participant, only 6 of 27 (22.2%) participants who were aware of ergonomics knew at least a benefit of right application of ergonomics in the laboratory. Knowledge of risk factors for the development of musculoskeletal disorders was reported by 8 of 27 (29.6%) persons who claimed to be aware of ergonomics.

Conclusions:

Awareness of ergonomics and knowledge of gains of its right application was poor among the study participants. Regular ergonomic education of medical laboratory scientists in Nigeria is advocated.

Ergonomic Microscope: Need of the Hour

BACKGROUND

Prolonged use of conventional microscope develops musculo-skeletal injuries like chronic pain syndrome, including shoulder, neck, back aches & fatigue. Since the problems go unnoticed, the injuries can lead to some serious permanent damages. This further leads to a compromise in the health and welfare of the person and the institute. Hence, an understanding about the ergonomics is the need of the hour in this postmodern era. Inspite of few studies and surveys about ergonomics, there is still a steep rise in the musculoskeletal disorders.

AIM OF THE STUDY

The aim of our study was to gauge the general awareness of pathologists, microbiologists and oral pathologists towards ergonomics in their profession.

MATERIALS AND METHODS

A cross-sectional survey based study was de-signed, which included a questionnaire. The questionnaire included multiple choice questions with four alternatives. Professionals (pathologists, microbiologists and oral pathologists) were included in the survey. Teaching faculty (Professors, Associate Professors and Lecturers) and Post graduate students formed the study group.

RESULTS AND OBSERVATIONS

The response to the questionnaire was 100%. Less than 50% of oral pathologists were aware of the importance of ergonomics in their profession. The most common site affected was neck and back. One of the drastic observations was that, Oral Pathologists suffered from a combination of problems affecting neck, back, eyes, headache, shoulders, arms and wrists.

CONCLUSION

Increase in our understanding regarding ergonomic-ally designed microscopes can increase our efficiency and in turn improve our general well-being. With improvements in ergonomics, professionals would be able to modify and optimize their working conditions. Certain guidelines need to be followed by the profes-sionals to reduce chances of musculoskeletal disorders.

Occupational concerns associated with regular use of microscope

OBJECTIVES

Microscope work can be strenuous both to the visual system and the musculoskeletal system. Lack of awareness or indifference towards health issues may result in microscope users becoming victim to many occupational hazards. Our objective was to understand the occupational problems associated with regular use of microscope, awareness regarding the hazards, attitude and practice of microscope users towards the problems and preventive strategies.

MATERIAL AND METHODS

a questionnaire based survey done on 50 professionals and technicians who used microscope regularly in pathology, microbiology, hematology and cytology laboratories.

RESULTS

Sixty two percent of subjects declared that they were suffering from musculoskeletal problems, most common locations being neck and back. Maximum prevalence of musculoskeletal problems was noted in those using microscope for 11-15 years and for more than 30 h/week. Sixty two percent of subjects were aware of workplace ergonomics. Fifty six percent of microscope users took regular short breaks for stretching exercises and 58% took visual breaks every 15-30 min in between microscope use sessions. As many as 94% subjects reported some form of visual problem. Fourty four percent of microscope users felt stressed with long working hours on microscope.

CONCLUSIONS

The most common occupational concerns of microscope users were musculoskeletal problems of neck and back regions, eye fatigue, aggravation of ametropia, headache, stress due to long working hours and anxiety during or after microscope use. There is an immediate need for increasing awareness about the various occupational hazards and their irreversible effects to prevent them.

Occupational health risks of pathologists--results from a nationwide online questionnaire in Switzerland

BACKGROUND

Pathologists are highly trained medical professionals who play an essential part in the diagnosis and therapy planning of malignancies and inflammatory diseases. Their work is associated with potential health hazards including injuries involving infectious human tissue, chemicals which are assumed to be carcinogenic or long periods of microscope and computer work. This study aimed to provide the first comprehensive assessment of the health situation of pathologists in Switzerland.

METHODS

Pathologists in Switzerland were contacted via the Swiss Society of Pathologists and asked to answer an ethically approved, online anonymous questionnaire comprising 48 questions on occupational health problems, workplace characteristics and health behaviour.

RESULTS

163 pathologists participated in the study. Forty percent of pathologists reported musculoskeletal problems in the previous month. The overall prevalence was 76%. Almost 90% of pathologists had visual refraction errors, mainly myopia. 83% of pathologists had experienced occupational injuries, mostly cutting injuries, in their professional career; more than one fifth of participants reported cutting injuries in the last year. However, long lasting injuries and infectious diseases were rare. Depression and burnout affected every eighth pathologist. The prevalence of smoking was substantially below that of the general Swiss population.

CONCLUSIONS

The results of this study suggest that more care should be taken in technical and personal protective measures, ergonomic workplace optimisation and reduction of work overload and work inefficiencies. Despite the described health risks, Swiss pathologists were optimistic about their future and their working situation. The high rate of ametropia and psychological problems warrants further study.