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Endoscopy‐related musculoskeletal injuries: a systematic review and meta‐analysis on prevalence, risk factors and prevention

2025-05-19Journal article Open access
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dc.contributor.authorde Oliveira, Raquel
dc.contributor.authorRoseira, Joana
dc.contributor.authorEstevinho, Maria Manuela
dc.contributor.authorSousa, Helena Tavares
dc.contributor.authorRolanda, Carla
dc.contributor.authorMeining, Alexander
dc.contributor.authorWalter, Benjamin
dc.date.accessioned2025-06-23T11:51:07Z
dc.date.available2025-06-23T11:51:07Z
dc.date.issued2025-05-19
dc.description.abstractBackgroundEndoscopy-related musculoskeletal injuries (ERIs) are a major occupational hazard, impacting career longevity and personal well-being.ObjectiveThis systematic review and meta-analysis aimed to update and expand on previous findings by assessing prevalence, risk factors and management of ERIs among endoscopists.MethodsFollowing PRISMA guidelines, we systematically searched MEDLINE, Web of Science and Scopus for relevant studies published since the last comprehensive review. A manual search of the references of relevant manuscripts was also performed. Outcomes of interest included the prevalence of ERIs, common pain syndromes, risk factors, and preventive or treatment strategies. Studies' quality was assessed using the National Institutes of Health (NIH) Quality Assessment Tool.ResultsThirty studies were included, incorporating data from 7646 gastrointestinal endoscopists. The pooled career-long prevalence of overall ERI was 62.5% (CI 52.6-71.8, I2 = 98%), including pain (67.5%; CI 46.4%-85.6%; I2 = 98%) and numbness (12.4%; 95% CI 6.6%-19.7%; I2 = 98%) syndromes. Among pain syndromes, the most affected areas were the hand (28.2%; CI 19.2%-38.2%; I2 = 99%), lower back (27.3%; CI 20.1%-35.2%; I2 = 97%), thumb (27.1%; CI 18.9%-37.7%; I2 = 99%) and neck (25.7%; CI 19.3%-32.7%; I2 = 98%). Higher procedural volume, years in practice and female gender were consistently reported as risk factors for ERIs. Concerning therapy, 41.8% of endoscopists used medications (CI 31.2%-52.8%; I2 = 94%), while 28.2% engaged in physical therapy (CI 18.2%-39.5%; I2 = 96%). Sick leave was reported by 13.8% of endoscopists (CI 7.9%-20.9%; I2 = 94%). Practice modifications to manage ERIs included adjusting monitor (45.5%, CI 22.2%-69.9%; I2 = 96%) and table (32.4%, CI 14.5%-53.5%; I2 = 97%) height, but also reducing the number of cases per endoscopy session (14.6%; CI 10.4%-19.4%; I2 = 72%).ResultsThirty studies were included, incorporating data from 7646 gastrointestinal endoscopists. The pooled career-long prevalence of overall ERI was 62.5% (CI 52.6-71.8, I2 = 98%), including pain (67.5%; CI 46.4%-85.6%; I2 = 98%) and numbness (12.4%; 95% CI 6.6%-19.7%; I2 = 98%) syndromes. Among pain syndromes, the most affected areas were the hand (28.2%; CI 19.2%-38.2%; I2 = 99%), lower back (27.3%; CI 20.1%-35.2%; I2 = 97%), thumb (27.1%; CI 18.9%-37.7%; I2 = 99%) and neck (25.7%; CI 19.3%-32.7%; I2 = 98%). Higher procedural volume, years in practice and female gender were consistently reported as risk factors for ERIs. Concerning therapy, 41.8% of endoscopists used medications (CI 31.2%-52.8%; I2 = 94%), while 28.2% engaged in physical therapy (CI 18.2%-39.5%; I2 = 96%). Sick leave was reported by 13.8% of endoscopists (CI 7.9%-20.9%; I2 = 94%). Practice modifications to manage ERIs included adjusting monitor (45.5%, CI 22.2%-69.9%; I2 = 96%) and table (32.4%, CI 14.5%-53.5%; I2 = 97%) height, but also reducing the number of cases per endoscopy session (14.6%; CI 10.4%-19.4%; I2 = 72%).ConclusionERIs are highly prevalent among international gastrointestinal endoscopists, and are linked to procedural volume, years in practice, and gender. Ergonomic training and workplace adaptations are essential to mitigate risks and support career sustainability.Trial RegistrationPROSPERO Registration: CRD42024534349eng
dc.identifier.doi10.1002/ueg2.70042
dc.identifier.eissn2050-6414
dc.identifier.issn2050-6406
dc.identifier.urihttp://hdl.handle.net/10400.1/27259
dc.language.isoeng
dc.peerreviewedyes
dc.publisherWiley
dc.relation.ispartofUnited European Gastroenterology Journal
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectChronic pain syndromes
dc.subjectEndoscopy
dc.subjectEndoscopy‐related injuries
dc.subjectErgonomics
dc.subjectMusculoskeletal injuries
dc.subjectOveruse injuries
dc.subjectRisk factors
dc.subjectWork‐related injuries
dc.titleEndoscopy‐related musculoskeletal injuries: a systematic review and meta‐analysis on prevalence, risk factors and preventioneng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage19
oaire.citation.startPage1
oaire.citation.titleUnited European Gastroenterology Journal
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNamede Oliveira
person.familyNameRoseira
person.familyNameSousa
person.givenNameRaquel
person.givenNameJoana
person.givenNameHelena Tavares
person.identifier.ciencia-idCF1F-1163-1C4A
person.identifier.orcid0000-0002-3818-981X
person.identifier.orcid0000-0002-5098-8729
person.identifier.orcid0000-0002-6626-205X
relation.isAuthorOfPublication6342394b-9f17-4e83-bacd-5e7f45bb958e
relation.isAuthorOfPublication077331f1-402e-455f-8e16-e475d62bc73a
relation.isAuthorOfPublication6b1d11dd-486f-4fb3-b41f-02e1cf6a5c2e
relation.isAuthorOfPublication.latestForDiscovery6342394b-9f17-4e83-bacd-5e7f45bb958e

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