Surgical Ergonomics: Pain in HQHVSN vets

So… is there even a problem? Is ergonomics and pain something we need to spend time thinking about in spay-neuter veterinarians?

In order to figure this out, in 2011 I designed an online survey and collected responses from veterinarians who currently or previously perform spay and neuter surgeries at least 4 hours a week. I asked about hand and body pain, and whether that pain affected their work or activities, whether the pain was related to spay/neuter, and whether they had ever had to miss work because of the pain. I also asked about interventions that they had tried in their surgery day as well as outside of surgery, and about job stress and their satisfaction at work.

Here you can see the profile of the 219 people who responded to the survey.

As you can see, there is quite a range in experience and workload, but overall from what I have seen, this population is pretty representative of the population of people working in the spay neuter field.

When I looked at the prevalence of pain, I found that 99% of the vets in this survey had experienced some musculoskeletal discomfort in the past month.  98% had body pain, and just over ¾ had hand or wrist pain. While this sounds really alarming, other surveys of veterinarians in a variety of practice areas have shown nearly as high prevalence of discomfort.

There is a lot of variability in the severity of discomfort that people experience, and the number of body regions that were uncomfortable. Some veterinarians had worked full time for many years in spay neuter with relatively little discomfort, and others are uncomfortable with a much lighter workload.

This diagram shows the body regions where spay neuter veterinarians most commonly experience discomfort. As you can see, the low back, neck, and shoulders are the most likely to be uncomfortable.

Low back pain is common in humans, and so the high proportion of vets reporting low back pain in the past month is actually in line with other surveys of people.

However, the rate of neck, shoulder, and upper back pain is about 40% higher than what is reported in other surveys of veterinarians. The only surveys where I have seen these high rates of neck pain are in human surgeons.

This diagram shows the areas of the hands and wrists where spay neuter veterinarians most commonly experience discomfort.

The right thumb and wrist are the most commonly painful areas–  this was true of the lefties that answered as well as the right handed vets.

 

---

One big question this research was trying to answer was “what are the workplace factors that contribute to pain?”

Of the work factors, hours per week in surgery (TIME) had the greatest relative importance in predicting total pain score, followed by years in spay neuter (CAREER). Number of surgeries (LOAD) and surgeries per hour (SPEED) were the least important predictors of pain:

TIME > CAREER > SATISFACTION > LOAD > SPEED

However, these workplace factors only explained a small amount of the pain score.  Most of the differences would have to be explained by individual variability, genetics, activities outside of work, and other factors that we may not even think about.

Many studies in many fields have shown that people who have higher job stress or lower job satisfaction experience more work-related pain. In this study, nearly every measure of discomfort increased as people had higher stress and lower satisfaction.

We can’t say from this survey that this is a direct cause-and-effect process, although other studies have suggested that it can be. It may be best to think about pain, stress and low job satisfaction as a cycle that feeds on itself.

So as you’re trying to solve ergonomics problems in your workplace, take the time to consider that working on psychosocial issues may actually improve peoples’ physical comfort as well.

---

This is a basic summary of my study Prevalence and Risk Factors Associated with Musculoskeletal Discomfort in Spay and Neuter Veterinarians. If you are interested in more details and analysis, you can download and read the entire study here http://www.mdpi.com/2076-2615/3/1/85.

In my next post, I’ll talk about some basic things that spay neuter veterinarians can do to improve their physical ergonomics when they set up their surgical space.