title: Factors associated with repetitive strain, and strategies to reduce injury among breast-imaging radiologists.
abstract: OBJECTIVE
  To investigate the prevalence of repetitive strain injury (RSI) among breast-imaging radiologists, the factors associated with such symptoms, and strategies to reduce injury.
  
  
  METHODS
  In 2012, an anonymous survey regarding RSI and work habits was administered to 2,618 physician members of the Society of Breast Imaging via e-mail. Analysis of 727 (27.8%) de-identified responses was completed using STATA 12.1. Pain levels before and after implementation of digital imaging were compared with the Wilcoxon signed-rank test. The associations between RSI symptoms and work habits were assessed with logistic regression and test for trend.
  
  
  RESULTS
  In the survey 438 of 727 (60.2%) respondents reported RSI symptoms, and 242 of 727 (33.3%) reported prior diagnosis/treatment. Results showed a statistically significant trend for the odds of RSI symptoms to increase with decreasing age (P = .0004) or increasing number of daily hours spent working (P = .0006), especially in an awkward position (P < .0001). Respondents recalled a significant increase in pain level after implementation of PACS, and a decrease in pain after ergonomic training or initiating use of an ergonomic mouse, adjustable chair, or adjustable table (P < .001, all comparisons). Only 17.7% (129 of 727) used an ergonomic mouse and 13.3% (97 of 727) had attended ergonomic training. Those with RSI symptoms or prior diagnosis of a Repetitive Strain Syndrome (RSS) were more likely to desire future ergonomic training compared with those without symptoms or injury (odds ratio 5.36, P < .001; odds ratio 2.63, P = .001, respectively).
  
  
  CONCLUSIONS
  RSI is highly prevalent among breast-imaging radiologists nationwide and may worsen after implementation of PACS or with longer work hours. Ergonomic training and ergonomic devices may diminish or prevent painful RSI among radiologists.
authors.affiliation: Stanford University School of Medicine, Stanford, California; University of California, Berkeley, Berkeley, California. Electronic address: ataliethompson@gmail.com.
authors.forename: Atalie C
authors.initials: AC
authors.lastname: Thompson
authors.affiliation: Department of Radiology, Stanford University Hospital, Stanford, California.
authors.forename: Marnie J
authors.initials: MJ
authors.lastname: Kremer Prill
authors.affiliation: Department of Radiology, Stanford University Hospital, Stanford, California.
authors.forename: Sandip
authors.initials: S
authors.lastname: Biswal
authors.affiliation: Department of Radiology, Beaumont Hospital, Royal Oak, Michigan.
authors.forename: Murray
authors.initials: M
authors.lastname: Rebner
authors.affiliation: Department of Physical Therapy, Simmons College, Boston, Massachusetts.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Rebner
authors.affiliation: Department of Radiology, Stanford University Hospital, Stanford, California; Department of Radiology, San Antonio Military Medical Center, San Antonio, Texas.
authors.forename: William R
authors.initials: WR
authors.lastname: Thomas
authors.affiliation: Department of Radiology, Stanford University Hospital, Stanford, California; Department of Radiology, Kaiser Permanente, Greater Southern Alameda Area, Hayward, California.
authors.forename: Sonya D
authors.initials: SD
authors.lastname: Edwards
authors.affiliation: Stanford University School of Medicine, Stanford, California; Department of Internal Medicine, Highland Hospital, Oakland, California.
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Thompson
authors.affiliation: Department of Radiology, Stanford University Hospital, Stanford, California.
authors.forename: Debra M
authors.initials: DM
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D012090:Cumulative Trauma Disorders / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D006804:Ergonomics; D005260:Female; D006801:Humans; D008297:Male; D008327:Mammography; D008875:Middle Aged; D060051:Occupational Injuries / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013180:Sprains and Strains / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D011795:Surveys and Questionnaires
keywords: Repetitive strain injury; breast-imaging radiology; ergonomics