The Prevalence of and Risk Factors Associated with Musculoskeletal Disorders among Sonographers in Central China: A Cross-Sectional Study.
OBJECTIVE
Studies from industrialized countries show that musculoskeletal disorders (MSD) occur commonly in sonographers. However, little is known about sonographers in China, where the awareness of ergonomics and MSD, workload, and available equipment/facilities may differ. We aimed to investigate the prevalence of MSD and associated risk factors in sonographers in central China.


METHODS
A cross-sectional survey was conducted with 381 sonographers from 14 randomly selected tertiary hospitals in Hubei province, central China. Musculoskeletal symptoms (using the Nordic Questionnaire) and risk factors (mostly derived from the Health Benefit Trust survey instrument and the Dutch Musculoskeletal Questionnaire) were recorded. Multivariate logistic regression was used to quantify associations between risk factors and MSD.


RESULTS
The 12-month period prevalence of MSD was 98.3%, being highest in the neck (93.5%) and shoulder (92.2%), followed by the lower back (83.2%), wrist/hand, upper back, and elbow. Factors contributing to neck pain were psychological fatigue, shoulder abduction and trunk bend-and-twist posture. Height-adjustable tables and chairs were protective factors. Shoulder pain was associated with female sex, health status, mental stress, shoulder abduction, and trunk bend-and-twist posture. Height-adjustable chairs and the awareness of adjusting the workstation before scanning were protective factors. Elbow pain was associated with health status and height-adjustable tables. Wrist/hand pain was associated with female sex, bending the wrist, and working with obese patients. Upper back pain was associated with shoulder abduction, height-adjustable chairs, and device location. Lower back pain was associated with the number of scans performed per day, awkward postures, bending the trunk, twisting or bending the neck forward, and using a footrest.


CONCLUSIONS
This study suggests a high prevalence of MSD in sonographers in central China. Hence, it is necessary to improve the awareness of MSD by training, and the ergonomics of their current work environment by addressing physical workload, and psychological and equipment/facility-related factors.
Department of Medical Engineering, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China.|Healthcare Ergonomics Lab, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China.
Qingmin
Q
Feng
Department of Medical Engineering, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China.|Healthcare Ergonomics Lab, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China.
Shenglin
S
Liu
Department of Occupational and Environmental Health, Tongji Medical College, Huazhong University of Science and Technology, 13 HangKong Road, Wuhan, 430030, China.
Lei
L
Yang
Department of Medical Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China.
Mingxing
M
Xie
Department of Medical Engineering, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China.|Healthcare Ergonomics Lab, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, China.
Qiang
http://orcid.org/0000-0001-6549-437X
Q
Zhang
D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D016273:Occupational Exposure; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014463:Ultrasonography / Q000009:adverse effects; D017132:Workplace; D055815:Young Adult
Environ Res. 2000 May;83(1):23-32
10845778
Hum Factors. 2015 Mar;57(2):238-45
25850155
Work. 2012;42(3):355-65
22523028
Br J Ind Med. 1986 Nov;43(11):779-84
3790459
J Am Soc Echocardiogr. 1997 May;10(4):357-62
9168358
J Occup Environ Med. 1995 Apr;37(4):479-85
7670905
Arch Gynecol Obstet. 2012 Aug;286(2):353-6
22467149
Appl Ergon. 2012 May;43(3):554-63
21944295
Am J Ind Med. 2012 Mar;55(3):281-93
22125090
J Manipulative Physiol Ther. 2012 Sep;35(7):534-40
22951267
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2011 Mar;29(3):180-3
21619814
Eur Spine J. 2007 May;16(5):679-86
17160393
Ultrasound Med Biol. 2015 Mar;41(3):724-33
25638319
Aust Fam Physician. 1988 Feb;17(2):81-3
3282503
J Ultrasound Med. 2013 Aug;32(8):1363-75
23887945
Occup Med (Lond). 2004 Dec;54(8):579-82
15576874
Eur J Ultrasound. 1999 Sep;10(1):41-5
10502638
Work. 2009;33(2):181-9
19713628
J Clin Ultrasound. 2015 Mar;43(3):145-52
25042992
BMJ Open. 2014 Dec 19;4(12):e006451
25526795
PLoS One. 2015 Mar 25;10(3):e0121159
25806808
Biomed Environ Sci. 2002 Mar;15(1):83-96
12046553
J Med Ultrason (2001). 2013 Jul;40(3):189-95
27277235
J Rehabil Med. 2001 Jul;33(4):156-61
11506213
Occup Environ Med. 2005 Feb;62(2):105-12
15657192
Arch Phys Med Rehabil. 1997 Jan;78(1):26-32
9014953
Ergonomics. 2001 Oct 10;44(12):1038-55
11780727
J Occup Rehabil. 2009 Jun;19(2):175-84
19381790
G Ital Med Lav Ergon. 2010 Jul-Sep;32(3):223-6
21061698
J Phys Ther Sci. 2014 Sep;26(9):1423-8
25276028
AAOHN J. 1994 Jun;42(6):270-6
8037829
Appl Ergon. 1987 Sep;18(3):233-7
15676628
J Occup Med. 1993 Jun;35(6):604-10
8331442
J Ultrasound Med. 2013 Jan;32(1):157-64
23269721
Occup Med (Lond). 2014 Apr;64(3):211-6
24604101
J Hand Surg Am. 1987 Sep;12(5 Pt 2):830-7
3655257
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2012 May;30(5):335-8
22804984
Int Arch Occup Environ Health. 2015 Nov;88(8):1031-42
25677207
PLoS One. 2013 Jul 31;8(7):e70423
23936202
Biomed Environ Sci. 2012 Aug;25(4):421-9
23026522
JAMA. 1992 Feb 12;267(6):838-42
1732657
J Prof Nurs. 2004 Nov-Dec;20(6):390-5
15599873
Appl Ergon. 2002 Sep;33(5):385-93
12236647
Cochrane Database Syst Rev. 2012 Aug 15;(8):CD008570
22895977