Incidence of work-related musculoskeletal disorders in medical dosimetry.

I. Abstract
II. Introduction
A. PI: Musculoskeletal disorders and risk factors, such as poor ergonomics, are well
documented among computer users and healthcare workers. (References: CDC1,
NSC2, WHO3, Mehrparvar4, Putz-Anderson5, Borhany6, Gerr7)
B. PII: As healthcare workers and computer users, medical dosimetrists meet several
of the documented risk factors. (References: Borhany6, Oha8, Roll9, Ayden10)
Problem Statement: Medical dosimetrists are at increased risk of
developing diagnosed work-related musculoskeletal disorders (WRMD)
due to poor ergonomics, repetitive motion, and length of time spent
working at a computer.
C. PIII: Potential hours of awkward postures and poor ergonomics suggest medical
dosimetrist are susceptible to MSDs. (References: Rehman11)
D. PIV: Repetitive motion, duration of computer use and inability to take
recommended breaks increases risk of developing MSDs. (References: Putz-
Anderson5, Borhany6, Rehman11, Tiric-Campara12)
E. PV: Musculoskeletal disorders may result in work time loss. Improving
ergonomics can reduce musculoskeletal disorders thus reducing medical care
costs and work time loss. (References: WHO3, BLS13, Liberty Mutual14)
Summarize introduction points
1. Purpose: To determine the incidence and variables of workstation
ergonomics that contribute to the increased risk of work-related
musculoskeletal disorders seen in medical dosimetrists.
2. Research Questions: Research questions used to guide the study were
(Q1) what work related musculoskeletal disorders are seen amongst
medical dosimetrists, (Q2) what alterations or adaptations have
medical dosimetrists done to create an individualized ergonomic
workspace, (Q3) since implementing ergonomic alterations or
adaptations have medical dosimetrist musculoskeletal disorders
improved?
III. Materials and Methods
A. PI: Survey Selection
1. Modified musculoskeletal questionnaire
a. Standardized Nordic questionnaire
b. Cornell Musculoskeletal discomfort questionnaire
B. PII: Study Population
1. Respondent population
a. Medical dosimetrists
b. Active CMDs only
C. PIII: Study Design
1. Three survey question types: what work-related musculoskeletal
disorders have been experienced by professionals, what adaptations
have been or should be made to workspaces/areas, what improvements
were seen in musculoskeletal disorders in response to adaptations
made.
2. 5 minutes
D. PIV: Data Collection
1. Online survey distributed through AAMD membership database
2. Data extracted from Qualtrics
E. PV: Statistical Analysis
1. Qualtrics used for data storage and calculations
2. Descriptive statistics only
IV. Results
A. PI: General result information
1. Number of responses
2. Response rate
B. PII: Demographics of respondent population
1. Gender (Table 1)
2. Age range (Table 1)
3. Years of experience (Table 1)
4. Average hours worked (Table 1)
 5. Work setting (Table 1)
6. Daily breaks taken
C. PIII: (Research Question 1)What work-related musculoskeletal disorders are seen
amongst medical dosimetrists?
1. Number of respondents experiencing MSDs
2. Most commonly experienced MSDs (Figure 1)
3. Work interference from MSDs (Figure 2)
D. PIV: (Research Question 2) What alterations or adaptations have medical
dosimetrists done to create an individualized ergonomic workspace? (Research
Question 3) Since implementing adjustments, have MSDs improved?
1. Training on ergonomics
2. Ergonomic workstation
3. Individual workstation
4. Most frequently implemented equipment (Figure 3)
5. Purchase of equipment
6. Improvements of MSDs
V. Discussion
A. PI: Survey summarization of participants population and demographics
B. PII: Survey summarization of results of work-related musculoskeletal disorders
amongst medical dosimetrist.
C. PIII: Summarization of alterations/adaptations and implementation seen in
medical dosimetrist from results of survey.
VI. Conclusion
A. PI: Summary of Incidence of work-related musculoskeltal disorders in medical
dosimetry
1. Problem: Medical dosimetrist are at increased risk of developing
diagnosed work-related musculoskeletal disorders (WRMD) due to
poor ergonomics, repetitive motions, and length of time spent working
at a computer.
 2. Purpose: To determine the incidence and variables of workstation
ergonomics that contribute to the increased risk of work-related
musculoskeletal disorders seen in medical dosimetrist.
B. PII: Future research
1. Respondent population
2. WRMSDs/medical dosimetrist correlation
3. Employer awareness
B. PIII: Limitations
1. Email distribution
2. Survey Timeline
 Acknowledgements
The authors would like to thank Dr. David Reineke and the UW-La Crosse Statistical Consulting
Center for their guidance with data analysis and display of statistical results for the study. Any
errors in statistics or interpretation of data are the sole responsibility of the authors.
 References
1. Work-Related Musculoskeletal Disorders & Ergonomics. Centers for Disease Control and
Prevention. Published 2020. Accessed March 28, 2020.
https://www.cdc.gov/workplacehealthpromotion/health-strategies/musculoskeletal-
disorders/index.html
2. Top Work-Related Injury Causes. National Safety Council. Accessed March 28, 2020.
https://injuryfacts.nsc.org/work/work-overview/top-work-related-injury-causes
3. Putz-Anderson V, Bernard B, Burt S. Musculoskeletal disorders and workplace factors: A
critical review of epidemiologic evidence for work-related musculoskeletal disorders of the
neck, upper extremity, and low back. National Institute for Occupational Safety and Health.
1997:97-141.
4. Musculoskeletal conditions. World Health Organization. Published 2019. Accessed April 5,
2020. https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions
5. Mehrparvar A, Heydari M, Mirmohammadi S, Mostaghaci M, Davari M, Taheri M.
Ergonomic interventions, workplace exercies, and musculoskeletal complaints: A
comparative study. Med J Islam Repub Iran. 2014;28(69).
6. Borhany T, Shahid E, Siddique W, Ali H. Musculoskeletal problems in frequent computer
and internet users. J Fam Med Prim Care. 2018;7(2):337-339.
https://doi.org/10.4103/jfmpc.jfmpc_326_17
7. Rehman R, Khan R, Surti A, Khan H. An ounce of discretion is worth a pound of wit:
Ergonomics is a healthy choice. PLoS One. 2013;8(10):e71891.
https://doi.org/10.1371/journal.pone.0071891
8. Oha K, Animagi L, Paasuke M, Coggon D, Merisalu E. Individual and work-related risk
factors for musculoskeletal pain: A cross-sectional study among Estonian computer users.
BMC Musculoskelet Disord. 2014;15(181). https://doi.org/10.1186/1471-2474-15-181
9. Roll S, Evans K, Hutmire C, JP B. An analysis of occupational factors related to shoulder
discomfort in diagnostic medical sonographers and vascular technologists. Work.
2012;42(3):355-365. https://doi.org/10.4103/jfmpc.jfmpc_326_17
10. Ayden A, Gursoy Z. Upper extremity musculoskeletal disorders among computer users. Turk
J Med Sci. Published 2008. Accessed March 28, 2020.
http://journals.tubitak.gov.tr/medical/issues/sag-08-38-3/sag-38-3-8-0708-7.pdf
11. Tiric-Campara M, Krupic F, Biscevic M. et al. Occupational overuse syndrome
(technological diseases): Carpal tunnel syndrome, a mouse shoulder, cervical pain syndrome.
Acad Med Sci Bosnia Herzegovina. 2014;22(5):333-340.
https://doi.org/10.5455/aim.2014.22.333-340
12. U.S. Bureau of Labor and Statistics. Case and Demographic Characteristics for Work-
Related Injuries and Illnesses Involving Days Away from Work: Number and Rate of Cases
of Musculoskeletal Disorder.; 2020. https://www.bls.gov/iif/oshcdnew.htm
13. Liberty Mutual Risk Control Services. Liberty Mutual Workplace Safety Index. Published
2019. Accessed June 8, 2020. www.libertymutualgroup.com/riskcontrolservices
14. Kuorinka I, Jonsson B, Kilborn A, et al. Standardised Nordic questionnaires for the analysis
of musculoskeletal symptoms. 1987;18(3):233-237. https://doi.org/10.1016/0003-
6870(87)90010-X
15. Human Factors and Ergonomics Laboratory at Cornell University, Hedge A, Morimoto S,
McCrobie D. Effects of keyboard tray geometry on upper body posture and comfort.
Ergonomics. 1999;42(10):1333-1349. https://doi.org/10.1080/001401399184983
16. Crawford JO. The Nordic Musculoskeletal Questionnaire. Occup Med. 2007;57(4):300-301.
https://doi.org/10.1093/occmed/kqm036
17. Sultan-Taïeb H, Parent-Lamarche A, Gaillard A, et al. Economic evaluations of ergonomic
interventions preventing work-related musculoskeletal disorders: A systematic review of
organizational-level interventions. BMC Public Health. 2017;17(935).
https://doi.org/10.1186/s12889-017-4935-y
 Figures

80

70
71 69
60 63
58
Number of Participants experiencing MSD

50
50
40
36 35
30
31
20
19 17 16
10
7
0
s n isc isc e e .. ue s e
iti
s e
he io ag m t. iti m m
a c x at
d
d
d
d
am d r o en atig on d ro e ur d ro
d i e e m /f d
ea /f at ur /d sy
n
ga in n yn lN yn
H in ni pt ain /li ra Te ls ita ss
pa er u p c k n s t e g n '
k H R ve ne ai e un
n i
va
i
N
ec er n str Ey lt
D
er
N is o n a u
n do rp eQ
Te ten Ca D
o r
s cle
u
MMusculoskeltal Disorder (MSD)
Figure 1. Distribution of musculoskeletal disorders (MSDs) experienced in survey respondents
who answered that they have suffered from work-related musculoskeletal disorders (WRMDs).
 Slight Moderate Severe
35

30

25

20

15
Number of Participants

10

0
es on sc sc ag
e e in ue tis e
rit
is e
ach ati di di m r om p ra tig o ni r om u rom
d x d d a d s a d d e d
ea /fi ate ur
e /d sy
n
en
t
in
/f n yn lN sy
n
H in ni pt ain tra Te ls ita
pa er u p c k am s e g 's
ec
k H R ve ne /li
g e nn D
i ain
N er is o
n ain Ey al tu e rv
N u
n str rp eQ
Te on Ca D
n d
te
or
lc e
us
M

Musculoskeletal Disorder (MSD)

Figure 2. Reported level of work interference due to specific Musculoskeletal disorders (MSDs).

70

60 62
56
Number of implemented adjustment

50
47
40
38
30 32
26
20 22

10

0
Stand/sit desk Ergonomic Ergonomic Specialized Ergonomic Ergonomoic Footrest
chair wrist pad computer keyboard mouse
screen

Ergonomic Adjustment

Figure 3. Distribution of ergonomic adjustments implemented by medical dosimetrists.

 Tables
Table 1. Survey Demographic Results and Office Setting Question Results (n = 164)

Characteristic Mode Number

Age Range 51-60 years 47
Gender Female 112
Years of experience >15 years 89
Hours worked per week >40 104
Question Response Percentagea
Home
21%
Free-standing
What is your office setting? 32%
clinic
47%
Hospital
a
Parenthical information reflects percentage of 191 responses as 27
individuals worked at multiple office settings
 Appendix A
Survey Introduction

Dear medical dosimetry professional,

As medical dosimetry graduate students at the University of Wisconsin La Crosse, we invite

you to complete this survey regarding musculoskeletal disorders within the medical
dosimetry profession. Medical dosimetrists are at increased risk of developing diagnosed
work-related musculoskeletal disorders (WRMD) due to poor ergonomics, repetitive motion,
and length of time spent working at a computer. The purpose of our study is to determine the
incidence and variables of workstation ergonomics that contribute to the increased risk of
WRMD seen in medical dosimetrists.

Participation in this survey is voluntary. However, consent is implied when you begin the
survey. Your identity will remain anonymous, and your privacy and confidentiality will not
be compromised.

The survey should take approximately 5 minutes to complete. As you respond to each survey
question, please answer honestly while considering your experience with musculoskeletal
disorders prior to the COVID-19 quarantine period.

We would greatly appreciate your participation. If you have any questions or concerns,
please contact our research advisor, Nishele Lenards, at nlenards@uwlax.edu.

This survey is best suited for completion on a desktop, as some of the questions may not be
mobile friendly. Please click here; or copy and paste this URL into your internet browser:
https://uwlax.ca1.qualtrics.com/jfe/form/SV_1Tyx0fSEoCLmEEB

The survey deadline is Friday October 2, 2020, we ask that you please submit your response
by this date.

Respectfully,

Alicia Wilson (wilson1599@uwlax.edu)

Hanaan Habibulla (habibulla6931@uwlax.edu)
John Keefe (keefe8954@uwlax.edu)
 Appendix B
Questions and Answers to Musculoskeletal Disorders Survey
We greatly appreciate your participation in this survey regarding musculoskeletal disorders in the
medical dosimetry profession. This survey should take approximately 5 minutes to complete.
 
As you respond to each survey question, please answer honestly considering your experience
with musculoskeletal disorders. More importantly, please consider your typical
workstation prior to the COVID-19 quarantine period.
21-30
31-40
1. What is your age
41-50
range?
51-60
>60
2. What is your Male
gender? Female
<1 year
3. How many years
1-5 years
have you been a
6-10 years
medical
11-15 years
dosimetrist?
>15 years
Home
4. What is your office
Free-standing Clinic
setting?
Hospital
0-20
5. On average how 21-30
many hours do you 31-40
work per week? >40
6. Do you consciously
stand up from your
Yes
chair at least once
No
per hour during the
work day?
7. Do you consciously Yes
look away from No
your computer
screen at least
every 20 minutes
 during the work
day?
Musculoskeletal disorders (MSDs) are injuries and disorders that affect the human body’s movement or
musculoskeletal system (i.e. muscles, tendons, ligaments, nerves, discs, blood vessels etc.
8. As a medical
dosimetrist have
Yes
you experienced
No
work related
(if No please skip questions 9-10)
musculoskeletal
injuries?
9. If you have been Years
diagnosed with or affected
experience specific by Work
musculoskeletal Pain specific Interference due
injuries related to Injury Frequency Scale injury to discomfort
Slight
work posture Have
(0-3)
and/or environment experienced 0-5 Slight
Moderate
please select all 1-3x/week 6-10 Moderate
Headaches (4-6)
that apply 4-7x/week >10 Severe
Severe
Never N/A N/A
(7-10)
N/A
Slight
Have (0-3)
0-5 Slight
experienced Moderate
Neck 6-10 Moderate
1-3x/week (4-6)
pain/fixation >10 Severe
4-7x/week Severe
N/A N/A
Never (7-10)
N/A
Herniated disc Have Slight 0-5 Slight
experienced (0-3) 6-10 Moderate
1-3x/week Moderate >10 Severe
4-7x/week (4-6) N/A N/A
Never Severe
(7-10)
N/A
 Slight
Have
(0-3)
experienced 0-5 Slight
Moderate
1-3x/week 6-10 Moderate
Ruptured disc (4-6)
4-7x/week >10 Severe
Severe
Never N/A N/A
(7-10)
N/A
Slight
Have (0-3)
0-5 Slight
Nerve experienced Moderate
6-10 Moderate
pain/damage (i.e. 1-3x/week (4-6)
>10 Severe
Sciatica) 4-7x/week Severe
N/A N/A
Never (7-10)
N/A
Slight
Have (0-3)
0-5 Slight
experienced Moderate
Tension neck 6-10 Moderate
1-3x/week (4-6)
syndrome >10 Severe
4-7x/week Severe
N/A N/A
Never (7-10)
N/A
Slight
Have (0-3)
0-5 Slight
Muscle or tendon experienced Moderate
6-10 Moderate
strain/ 1-3x/week (4-6)
>10 Severe
ligament sprain 4-7x/week Severe
N/A N/A
Never (7-10)
N/A
Slight
Have (0-3)
0-5 Slight
experienced Moderate
6-10 Moderate
Eye strain/fatigue 1-3x/week (4-6)
>10 Severe
4-7x/week Severe
N/A N/A
Never (7-10)
N/A
Tendonitis Have Slight 0-5 Slight
 (0-3)
experienced Moderate
6-10 Moderate
1-3x/week (4-6)
>10 Severe
4-7x/week Severe
N/A N/A
Never (7-10)
N/A
Slight
Have (0-3)
0-5 Slight
experienced Moderate
Carpal tunnel 6-10 Moderate
1-3x/week (4-6)
syndrome >10 Severe
4-7x/week Severe
N/A N/A
Never (7-10)
N/A
Slight
Have (0-3)
0-5 Slight
experienced Moderate
6-10 Moderate
Digital Neuritis 1-3x/week (4-6)
>10 Severe
4-7x/week Severe
N/A N/A
Never (7-10)
N/A
Slight
Have (0-3)
DeQuervain’s 0-5 Slight
experienced Moderate
syndrome 6-10 Moderate
1-3x/week (4-6)
(Tendonitis of the >10 Severe
4-7x/week Severe
radial wrist) N/A N/A
Never (7-10)
N/A
10. Have you sought
medical care for
these injuries (i.e. Yes
physician, No
chiropractic,
therapy, etc.)?
11. Have you received Yes
training on the No
recommendations
 for an
ergonomically
designed
workstation?
12. Do you believe
your employer has
Yes (please explain)
designed your
No
workstation and/or
work area
ergonomically?
13. Do you believe that
your employer has
Yes (please explain)
designed your
No
workstation to fit
your individual
needs?
14. Have you made
Yes
adaptations to your
No
workstation?

Equipment Purchased by?

15. If adjustments have Stand/sit desk Employer/Employee/Not Implemented
been made please Chair Employer/Employee/Not Implemented
check all that Wrist pad Employer/Employee/Not Implemented
apply. Computer Screen Employer/Employee/Not Implemented
Keyboard Employer/Employee/Not Implemented
Mouse Employer/Employee/Not Implemented
Footrest Employer/Employee/Not Implemented
Stand/sit desk Yes/No/NA
Chair Yes/No/NA
16. Did implementing Wrist pad Yes/No/NA
adjustment improve Computer Screen Yes/No/NA
MSD Keyboard Yes/No/NA
Mouse Yes/No/NA
Footrest Yes/No/NA
17. Would you like to
see new or further Yes (please explain)
adjustments made No
to your workspace?