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耳鼻喉科中的工效学:系统评价和荟萃分析。

Ergonomics in Otolaryngology: A Systematic Review and Meta-analysis.

机构信息

Department of Otolaryngology Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, U.S.A.

School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, U.S.A.

出版信息

Laryngoscope. 2023 Mar;133(3):467-475. doi: 10.1002/lary.30216. Epub 2022 May 16.

Abstract

OBJECTIVES

To determine the proportion of otolaryngologists with work-related musculoskeletal discomfort (WRMD) and to review objective ergonomic data that contribute to WRMD.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

A comprehensive search of the literature identified 1121 articles for initial review of which 19 (3563 participants) met criteria for qualitative discussion and eight (2192 participants) met criteria for meta-analysis. Random effects meta-analyses were used to estimate the proportion of otolaryngologists reporting WRMD.

RESULTS

The overall proportion (95% confidence intervals [CI]) of general otolaryngologists reporting WRMD was 0.79 (0.66, 0.88) for any symptoms; 0.54 (0.40, 0.67) for neck symptoms; 0.33 (0.20, 0.49) for shoulder symptoms; and 0.49 (0.40, 0.59) for back symptoms. Surgeons performing primarily subspecialty cases had a lower estimated overall prevalence of WRMD versus those performing general ENT cases, however the odds ratio (OR) was not statistically significant (OR [95% confidence interval] 0.53 [0.22, 1.25]). 23%-84% of otolaryngologists underwent medical treatment for WRMD. 5%-23% took time off work and 1%-6% stopped operating completely as a result of WRMD. 23%-62.5% of otolaryngologists believed WRMD negatively impacted their quality of life. Objective measures of ergonomic posture indicate moderate to severe risk of injury during the routine clinic and surgical procedures with none found to be low risk.

CONCLUSIONS

Ergonomic stressors among otolaryngologists contribute to a high rate of WRMD across all subspecialties with notable impact on productivity, longevity, and quality of life. Laryngoscope, 133:467-475, 2023.

摘要

目的

确定患有与工作相关的肌肉骨骼疾病(WRMD)的耳鼻喉科医生的比例,并回顾导致 WRMD 的客观人体工程学数据。

研究设计

系统回顾和荟萃分析。

方法

对文献进行全面检索,共检索到 1121 篇文章,对其中 19 篇(3563 名参与者)进行了定性讨论标准的初步审查,8 篇(2192 名参与者)符合荟萃分析标准。使用随机效应荟萃分析来估计报告 WRMD 的耳鼻喉科医生的比例。

结果

报告任何症状的耳鼻喉科医生的总体比例(95%置信区间[CI])为 0.79(0.66,0.88);颈部症状为 0.54(0.40,0.67);肩部症状为 0.33(0.20,0.49);背部症状为 0.49(0.40,0.59)。主要进行专业病例手术的外科医生与进行一般耳鼻喉科病例手术的外科医生相比,估计总体 WRMD 患病率较低,但比值比(OR)无统计学意义(OR [95%CI] 0.53 [0.22, 1.25])。23%-84%的耳鼻喉科医生因 WRMD 接受过治疗。5%-23%的人因 WRMD 请假,1%-6%的人完全停止手术。23%-62.5%的耳鼻喉科医生认为 WRMD 对他们的生活质量产生负面影响。人体工程学姿势的客观测量指标表明,在常规诊所和手术过程中存在中度至重度受伤风险,没有发现低风险。

结论

耳鼻喉科医生的人体工程学压力因素导致所有专业的 WRMD 发生率较高,对生产力、寿命和生活质量有显著影响。喉镜,133:467-475,2023。

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