title: Work-related injuries of doctors of chiropractic in the United States.
abstract: OBJECTIVE
  This study was undertaken to determine the prevalence and types of work-related injuries among a nationwide sample of chiropractors and to identify factors associated with these injuries.
  
  
  METHODS
  Using a survey, 1000 randomly selected doctors of chiropractic in the United States were asked to record their 3 most serious injuries. Details were obtained about the type of injury, area of the body affected, activity performed at that time, year of practice when the injury had occurred, if the doctor had needed to take time off from work, and what they had changed as a result of the injury.
  
  
  RESULTS
  A total of 422 responses were obtained (42.2%), yielding 397 usable surveys. One hundred fifty-nine chiropractors (40.1%) reported experiencing a total of 252 injuries while working. Most injuries were classified as soft tissue injuries and occurred while either performing (66.7%) or positioning (11.1%) a patient for manipulation. Body parts most commonly injured were the wrist/hand/finger (42.9%), shoulder (25.8%), and low back (24.6%). The anatomic areas of the patient being manipulated in which the doctor was injured were the lumbosacral (37.1%) and thoracic spine (21.6%). Shoulder (P < .001) and low back (P < .001) injuries were significantly more likely to have been caused by adjustments of the lumbosacral spine with the patient in the side-lying position. Most commonly, injuries occurred in the first to fifth year of practice (37.3%). Of note, 5.4% of injuries reported occurred while attending chiropractic college.
  
  
  CONCLUSIONS
  A high prevalence of upper extremity injuries was reported in the group surveyed. These injuries were most often related to side-posture manipulation to the lumbar spine. Because most injuries occurred early on in the career and required a change in technique, greater efforts toward injury prevention education should be aimed toward chiropractic students.
authors.affiliation: Los Angeles College of Chiropractic, Southern California University of Health Sciences, 16200 E. Amber Valley Drive, Whittier, Calif, USA. susanholm@scuhs.edu
authors.forename: Susan M
authors.initials: SM
authors.lastname: Holm
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Rose
mesh_terms: D019567:Back Injuries / Q000453:epidemiology; D001827:Body Height; D001835:Body Weight; D002684:Chiropractic / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009141:Musculoskeletal System / Q000293:injuries*; D009784:Occupational Diseases / Q000453:epidemiology*; D010820:Physicians / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D034941:Upper Extremity / Q000293:injuries; D014947:Wounds and Injuries / Q000453:epidemiology*