Workload as a pre-cursor to musculoskeletal strain among vaginal surgeons
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The results of previous studies indicate that the development of work-related musculoskeletal disorders (MSDs) is influenced by a number of risk factors that fall mainly into three categories: physical, cognitive, and psychosocial. There remains a lack of understanding of the role these risk factors play in the development of work-related MSDs and their value in the prediction of work-related MSD risk. A new conceptual model has been proposed to fill this gap in the research. Vaginal surgery was chosen as a case study to test a subset of the relationships proposed in this new model. The objectives of this research were to comprehensively characterize the physical, cognitive, and psychological requirements of direct vaginal surgical work, to evaluate the relationship between the work-related risk factors of this type of surgery and surgeons’ perceived workload and body discomfort, and to develop a method of systematically characterizing the postural loading experienced by surgeons in the operating room. Vaginal surgeons have been identified as exposed to a high risk of work-related MSDs, but very limited information is available about the physical, cognitive and psychological demands of their work. This study therefore employs vaginal surgery as a case study in order to comprehensively characterize the physical, cognitive, and psychological requirements of direct vaginal surgical work. To assist in real-time postural analysis in operating rooms, a new observational ergonomics job analysis method, Ergonomics Posture assessment in Real Time (ErgoPART), was developed prior to data collection. The results of the inter-observer reliability tests indicated that ErgoPART is a reliable tool for ergonomic posture assessment in vaginal surgeries. A total of thirteen real vaginal surgeries were observed at a teaching hospital in Washington D.C. The results of this study suggest that surgeons experience moderate to high workload during vaginal surgeries. Surgeons’ postural load was significantly different across different surgical tasks and increased with the cognitive demand of vaginal surgery. In addition, surgeons’ perceived workload and body discomfort differed between two groups of surgeons with different responsibilities. The findings of this study can be used to develop ergonomic interventions in order to reduce vaginal surgeons’ risk of work-related MSDs. Furthermore, the methodology of this study can be used in future studies to investigate surgeons’ postural loading and behavior, surgical tasks, and the physical setting of the operating room. The new tool, ErgoPART, can be used to assist in job analysis with a minimum of intrusion on the workers and the environment in field studies.