Year 2025 / Volume 117 / Number 6
Original
Musculoskeletal complaints among gastrointestinal endoscopists: prevalence, risk factors, and occupational impact. Insights from a Spanish national survey

313-318

DOI: 10.17235/reed.2024.10940/2024

Mónica Ayude Galego, Luisa de Castro Parga, Vicent Hernández Ramírez, José Ignacio Rodríguez Prada, Antonio Rodríguez D´Jesús,

Abstract
Background: the absence of proper ergonomics in digestive endoscopy, combined with an increasing workload, has contributed to a growing incidence of musculoskeletal complaints among endoscopists. This study aimed to assess the frequency of musculoskeletal complaints and their impact on clinical practice among Spanish endoscopists. Methods: an electronic survey was sent to active members of the Spanish Society of Digestive Endoscopy (SEED) in July 2019. The survey collected data on the endoscopist’s anthropometrics, workload, complaints prevalence, work impact, required treatments, and their relationship with endoscopic procedures. Results: the survey was completed by 287 endoscopists. Of these, 192 (66.9 %) reported musculoskeletal complaints that were clearly or possibly related to endoscopy practice. Factors associated with a higher incidence of complaints included female gender, moderate to vigorous physical activity, and shorter height. The most commonly affected areas were the neck and/or upper back (79.7 %), thumb (63.5 %), and wrist/hand (60.4 %). Seven endoscopists (3.6 %) reported temporary absence from work due to symptoms, while 17 (8.9 %) had to reduce the number of endoscopies performed per session. Treatments most frequently reported were physiotherapy (59.6 %), oral medications (55.7 %), and steroid injections (19.2 %). Our study has limitations, including recall bias from self-reported data, participation bias favoring injured physicians, and a low response rate, which may limit the generalizability of the findings. Conclusion: musculoskeletal complaints related to endoscopy are highly prevalent among Spanish endoscopists. Factors such as gender, workload, and physical activity levels were associated with a greater risk of complaints. Strategies to improve the work environment and manage workloads are urgently needed.
Lay Summary
Musculoskeletal complaints are common among endoscopists, as their work involves repetitive movements and uncomfortable body positions held for extended periods of time. This study assessed the frequency of these complaints and their impact on clinical practice among endoscopists in Spain. The results showed that 66.9% of Spanish endoscopists reported musculoskeletal complaints that were clearly or possibly related to endoscopy practice. Factors such as gender, workload, and physical activity levels were associated with a higher risk of injury. In some cases, these complaints resulted in absence from work and a reduction in the number of endoscopies performed per session. To prevent these complaints, it is essential to provide ergonomics training and implement strategies that improve the work environment in endoscopy practice.
New comment
Comments
No comments for this article
References
1. Centers for Disease Control and Prevention. CDC: Workplace Health Promotion [Internet]. 2020. Available from: https://www.cdc.gov/workplacehealthpromotion/health-strategies/musculoskeletal-disorders/index.html
2. Hansel SL, Crowell MD, Pardi DS, et al. Prevalence and impact of musculoskeletal injury among endoscopists: a controlled pilot study. J Clin Gastroenterol 2009;43(5):399–404. Doi: 10.1097/MCG.0b013e31817b0124.
3. Kuwabara T, Urabe Y, Hiyama T, et al. Prevalence and impact of musculoskeletal pain in Japanese gastrointestinal endoscopists: A controlled study. World J Gastroenterol 2011;17(11):1488–94. Doi: 10.3748/wjg.v17.i11.1488
4. Villa E, Attar B, Trick W, et al. Endoscopy-related musculoskeletal injuries in gastroenterology fellows. Endosc Int Open 2019;7(6):808-812. Doi: 10.1055/a-0811-5985
5. Byun YH, Lee JH, Park MK, et al. Procedure-related musculoskeletal symptoms in gastrointestinal endoscopists in Korea. World J Gastroenterol 2008;14(27):4359–64. Doi: 10.3748/wjg.14.4359
6. O’Sullivan S, Bridge G, Ponich T. Musculoskeletal injuries among ERCP endoscopists in Canada. Can J Gastroenterol 2002;16(6):369–74. Doi: 10.1155/2002/523125
7. Cappell MS. Colonoscopist’s thumb: DeQuervain’s syndrome (tenosynovitis of the left thumb) associated with overuse during endoscopy. Gastrointest Endosc 2006;64(5):841–3. Doi: 10.1016/j.gie.2006.04.014
8. Siegel JH. Risk of repetitive-use syndromes and musculoskeletal injuries. Tech Gastrointest Endosc 2007;9(4):200–4. Doi: 10.1016/j.tgie.2007.08.010
9. Ridtitid W, Coté GA, Leung W, et al. Prevalence and risk factors for musculoskeletal injuries related to endoscopy. Gastrointest Endosc 2015;81(2):294-302.e4. Doi: 10.1016/j.gie.2014.06.036
10. Pawa S, Kwon RS, Fishman DS, et al. American Society for Gastrointestinal Endoscopy guideline on the role of ergonomics for prevention of endoscopy-related injury: summary and recommendations. Gastrointest Endosc 2023;98(4):482–91. Doi: 10.1016/j.gie.2023.05.056
11. Singh AD, Aggarwal N, Mohan BP, et al. Prevalence of endoscopy-related injuries and their impact on clinical practice: a systematic review and meta-analysis. Endoscopy 2024; 56(8):612-619. Doi: 10.1055/a-2270-4174
12. Miller AT, Herberts MB, Hansel SL, et al. Procedural and anthropometric factors associated with musculoskeletal injuries among gastroenterology endoscopists. Appl Ergon 2022;104. Doi: 10.1016/j.apergo.2022.103805
13. Morais R, Vilas-Boas F, Pereira P, et al. Prevalence, risk factors and global impact of musculoskeletal injuries among endoscopists: a nationwide European study. Endosc Int Open 2020;8(4)–80. Doi: 10.1055/a-1038-4343
14. Instituto Nacional de Estadística. Encuesta de Población Activa, EPA 2017 [Internet]. [cited 2020 May 10]. Available from: https://www.ine.es/prensa/epsc_2017.pdf
15. Sturm N, Leukert J, Perkhofer L, et al. The impact of endoscopic activity on musculoskeletal disorders of high-volume endoscopists in Germany. Sci Rep 2022;12(1). Doi: 10.1038/s41598-022-12400-4.
16. Yung DE, Banfi T, Ciuti G, et al. Musculoskeletal injuries in gastrointestinal endoscopists: a systematic review. Expert Rev Gastroenterol Hepatol 2017 ;11(10):939–47. Doi: 10.1080/17474124.2017.1356225.
17. Shergill AK, Asundi KR, Barr A, et al. Pinch force and forearm-muscle load during routine colonoscopy: a pilot study. Gastrointest Endosc 2009 Jan;69(1):142–6. Doi: 10.1016/j.gie.2008.09.030.
18. Sutton E, Irvin M, Zeigler C, et al. The ergonomics of women in surgery. Surg Endosc 2014;28(4):1051–5. Doi: 10.1007/s00464-013-3281-0.
19. Geschwind H, Durič T, Cibulkova I, et al. Prevention of musculoskeletal injuries in gastrointestinal endoscopists. Gastroenterology Insights 2024;15(2):285–302. Doi: 10.3390/gastroent15020021.
20. Hootman JM, Macera CA, Ainsworth BE, et al. Epidemiology of musculoskeletal injuries among sedentary and physically active adults. Med Sci Sports Exerc 2002;34(5):838–44. Doi: 10.1097/00005768-200205000-00017.
21. Singla M, Kwok RM, Deriban G, et al. Training the Endo-Athlete: An Update in Ergonomics in Endoscopy. Clin Gastroenterol Hepatol 2018;16(7):1003–6. Doi: 10.1016/j.cgh.2018.04.019.
22. Siau K, Anderson JT. Ergonomics in endoscopy: Should the endoscopist be considered and trained like an athlete? Endosc Int Open 2019 Jun;7(6)–5. Doi: 10.1055/a-0838-5534.
Related articles

Digestive Diseases Image

A case of duodenal-type follicular lymphoma

DOI: 10.17235/reed.2021.8233/2021

Letter

Basic training in gastrointestinal endoscopy: recording images

DOI: 10.17235/reed.2020.7385/2020

Digestive Diseases Image

Dysphagia and hematemesis caused by an intramural esophageal dissection

DOI: 10.17235/reed.2018.5471/2018

Citation tools
Ayude Galego M, de Castro Parga L, Hernández Ramírez V, Rodríguez Prada J, Rodríguez D´Jesús A. Musculoskeletal complaints among gastrointestinal endoscopists: prevalence, risk factors, and occupational impact. Insights from a Spanish national survey. 10940/2024


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 113 visits.
This article has been downloaded 15 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 11/11/2024

Accepted: 11/12/2024

Online First: 09/01/2025

Published: 10/06/2025

Article Online First time: 59 days

Article editing time: 211 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2025 y Creative Commons. The Spanish Journal of Gastroenterology