Introduction
Sonographers are vital in providing quality ultrasound services and in this respect, they are vital in improving patient care. In the past, the sonography community has mainly dwelt on finding new scanning techniques, clinical application, and in improving image resolution. However, in recent years, research findings in the field of sonography have revealed that long-term scanning might in fact prove quite harmful to sonographers’ health. Craig (2006) has noted that one of the key objectives of sonographers “has been that of creating a safe working environment for sonographers” (p. 56). However, with time, an increasingly higher number of sonographers reported experiencing varying levels of pain while undertaking scanning.
Causes of musculoskeletal injuries
A poor working condition was identified as a leading cause for these injuries. Morton and Delf (2008) argues that musculoskeletal injuries (MSIs) may be caused by “thousands of repetitive, forceful or awkward movements “ (p. 1). The initial symptoms of musculoskeletal injury resemble those of muscle fatigue and as such, there is the risk of one confusing the two. One difference though is that musculoskeletal-related injuries do not heal easily. On the other hand, when one stop doing a particular task, muscle fatigue symptoms will often fade. Lack of sufficient rest periods also contributes towards MSIs. In their study, Morton and Delf (2012) report that more than two-thirds of the respondents who took part in the study received below 3 minutes of break every day. This coupled with advances in technology and prolonged working hours means that that the sonography have little time to relax their muscles.
Prevalence of MSIs
In a study that the Society of Radiographers had commissioned in 1997, the research findings identified the prevalence of MSIs among sonographers. The study reported that 71 percent of the radiographers taking part in the study experienced discomfort and pain linked to their work. In 2000, another larger study was conducted in the same field and according to its research findings, 77 percent of sonographers and 71 percent of the radiographers reported experiencing MSI-related problems (Morton & Delf 2008, p. 196). Below is a table of prevalence of discomfort and pain among sonographers as presented by Morton and Delf (2008):
Table 1: The prevalence of pain and discomfort among sonographers.
(Source: Morton & Delf 2008)
These findings point at a sonographer’s working environment as a key factor in the causation of musculoskeletal injuries. The apparent increase in the prevalence of MSIs among sonographers is because they are now under a lot of pressure to perform at the workplace. Recent studies indicate that sonographers need to work in efficient, relaxed and safe working environment; otherwise their productivity is likely to suffer and their risk of developing available work-related injuries increases (Craig 2006, p. 56).
A report by the Society of Diagnostic Medical Sonography (2003) indicates that over 80 percent of sonographers undertake their scanning activities in pain. The report further indicates that musculoskeletal injuries have led to a decline in the number of sonographers in the workplace. Owing to the high cost of putting up a sonography workstation, it becomes important to address the economics of ergonomics as it appertains to the field of sonography. Failure to do so may result in a health care provider incurring more costs that the actual cost of putting up the facility. For example, in case a sonographer suffers from musculoskeletal injuries, the hospital will have to cater for his/her Worker’s Compensation claim, cater for medical bills, and hire temporary staff.
Types of MSIs injuries
Some of the most common injuries that sonographers are likely to report at the workplace are tenndonsynovitis and tendonitis of the neck, wrist, shoulder, and back, according to Craig (2006, p. 57). There is a direct link between the aforementioned injuries on the one hand, and prolonged muscle and arm abduction loading, on the other hand. These injuries are also related to constant transducer pressure that sonographers may be exposed to while scanning. Morton and Delf (2008) have identified biochemical factors (for example poor equipment design, sonographer’s posture), individual physical factors (for instance age, gender, and height), types of work activities, and work organisation as some of the major causes of MSIs.
With regard to individual physical factors, weight and health can predispose an individual at risk of developing musculoskeletal injuries. Female sonographers are reportedly more prone musculoskeletal injuries than male sonographers (Morton & Delf 2008, p. 1917). The authors further note that “inefficient scanning postures, frequent repetitive motions, exertions of excess force whilst performing these motions, wrist flexion, or deviation, faulty workplace and equipment design are all biochemical factors” (Morton & Delf 2008, p. 197).
Recommendations
Because musculoskeletal injuries have been identified as a leading complaint by sonographers, it is important to explore ways of eliminating this risk. Hospital administrators, instructors, majority of sonographers and equipment manufacturers all need educating on the high-risks attached to sonography as an occupation. Because this will take time, the onus is on sonographers to take a key role in not only protecting themselves, but their career potential as well (Craig 2006).
Separately, Morton and Delf (2008) contend that the only way fight MSIs in the workplace is to make sure that they do not happen in the first place. The adoption of different job design control measures will prevent MSIs. Examples of useful job design measures that can be adopted include encouraging repetitive examination, reducing overtime, letting staff to rotate their sessions, and encouraging sonographers to go no mini-breaks as a way of allowing muscle recovery and reducing muscle fatigue as well.
The standards by The Society of Diagnostic Medical Sonography report (2003) include equipment control measures. Guidelines have also been provided on the use of monitors and transducers. The report also provides administrative control measures for the employer, including workload and scheduling. The suggested best practices include relaxing of muscles periodically and adjusting all equipment. Sonographers are also encouraged to attend education and training sessions aimed at helping to lower musculoskeletal disorders development.
Critique
Whereas the three sources chosen in writing this paper have addressed the issue of MSIs among sonographers, they differ in terms of context. For example, the journal article by Morton and Delf (2008) mainly addressed the elements of causes and prevalence among sonographers. On the other hand, the Society of Diagnostic Medical Sonography Report (2003) has sought to address the industrial standards available for sonograhers to follow in order to prevent musculoskeletal disorders in the workplace.
In his book, Craig (2006) has undertaken an in-depth analysis of the causes, risk factors, prevalence and safety issues affecting sonography. Therefore, he has addressed the issues of both the article by Morton and Delf (2008), as well as the Society of Diagnostic Medical Sonography Report (2003). As a sonographer trainee, I have observed that the pain and musculoskeletal discomfort usually experienced by sonographers in the workplace is due to a combination of a number of ergonomic risk factors. These risk factors have to do with the organization, the individual, work environment, and job design. As such, I think that any strategy to minimize these risk factors should encompass the implementation of control at each of the individual levels.
Conclusion
An increasingly higher number of sonographers are reporting rising cases of work-related musculoskeletal problems. This is primarily attributed to biochemical factors, individual physical factors, types of work activities, and work organization, with most of these injuries mainly affecting muscles and tendons. Changes in the modification in equipment design, as well as the frequency and duration with regard to sonographic examinations are crucial in significantly reducing or preventing MSIs. It is important for sonographers to become acquainted with the various ways trough which they can protect themselves, such as by avoiding situations that could result in MSIs. There is also the need to incorporate sonography training instructions and information about prevention and injury in safe scanning techniques.
Reference List
Craig, M 2006, Essential of Sonography and patient care, Saunders-Elsevier, St Louis, Missouri.
Morton, B & Delf, P 2008 , ‘The prevalence and causes of MSI amongst sonographers’, Radiography, Vol. 14, No. 3, pp. 195-200.
Society of Diagnostic Medical Sonography Report 2003. Industry Standards for the Prevention of Work-Related Musculoskeletal Disorders in Sonography. [Online]. Web.