|Year : 2014 | Volume
| Issue : 3 | Page : 204-207
Prevalence of musculoskeletal disorders among doctors in Mangalore: A cross-sectional survey
Srikanth Lahoti1, Amitesh Narayan2, Zulfeequer CVP Ottayil2, Unnikrishnan Bhaskaran3
1 Vaagdevi College of Physiotherapy, Hanamkonda, Warangal, Andhra Pradesh, India
2 Department of Physiotherapy, Kasturba Medical College (Manipal University, Manipal), Bejai, Mangalore, Karnataka, India
3 Department of Community Medicine, Kasturba Medical College (Manipal University, Manipal), Bejai, Mangalore, Karnataka, India
|Date of Web Publication||13-Aug-2014|
Department of Physiotherapy, Kasturba Medical College, Bejai, Mangalore - 575 004, Karnataka
Source of Support: None, Conflict of Interest: None
Context: Musculoskeletal disorders (MSDs) are a significant concern for health care professionals due to the nature of work that exposes them to injuries. Aims: The aim was to assess the prevalence of MSDs among doctors. Settings and Design: Cross-sectional survey among doctors working in Mangalore. Materials and Methods: Self-administered questionnaires distributed among medical specialties professionals of two major hospitals (Government Wenlock Hospital and Kasturba Medical College Hospital) of Mangalore. Statistical Analysis Used: Descriptive analysis and Chi-square test (P < 0.05 with 95% confidence interval). Results: Lower back (25%), neck (20.21%), and knees (14.36%) were the common MSDs among doctors in different specialties. MSDs association with respect to age, gender, and work experiences were nonsignificant, except physical activity (P = 0.042). Conclusions: About 58.5% doctors reported MSDs and lower back disorders were most common.
Keywords: Doctors, healthcare professionals, low back pain, musculoskeletal disorders
|How to cite this article:|
Lahoti S, Narayan A, Ottayil ZC, Bhaskaran U. Prevalence of musculoskeletal disorders among doctors in Mangalore: A cross-sectional survey. Int J Health Allied Sci 2014;3:204-7
|How to cite this URL:|
Lahoti S, Narayan A, Ottayil ZC, Bhaskaran U. Prevalence of musculoskeletal disorders among doctors in Mangalore: A cross-sectional survey. Int J Health Allied Sci [serial online] 2014 [cited 2020 Feb 25];3:204-7. Available from: http://www.ijhas.in/text.asp?2014/3/3/204/138609
| Introduction|| |
Work-related musculoskeletal disorders (WMSDs) are defined as "regional impairments of the muscles, tendons, nerves and joints that are associated with work-related mechanical trauma".  The common WMSDs among medical professionals are pain in low back, ................... neck, ,,,,,,,,,,,, shoulder, ,,,,, hand, ,,,,,, wrist, ,,,,,,,, elbow, ,,, and upper back. ,,
A medical practice involves repetitive tasks, high force manual techniques, awkward joint position during certain maneuvers and prolonged constrained postures.  These may induce pain or discomfort, loss of motor or sensory function, sickness behaviors, and depression or anxiety; causing effect on tissue reorganization (pathological or adaptive) and facilitating inflammations; depending on exposure duration. 
Literatures reported for prevalence of WMSDs among physicians,  ophthalmologists, , physiotherapists, ,,, surgeons,  gynecologists, , radiologists, , and nurses.  In India, low back pain prevalence was 53% among obstetricians and gynecologists. 
Even though doctors (medical professionals) have knowledge about prevention strategies against musculoskeletal injuries, they do develop work-related musculoskeletal injuries.  Therefore, need felt to study the prevalence of MSDs among doctors in Mangalore.
The main objective of this study was to find, (a) common MSDs, (b) common site of disorder present across the medical specialty, and (c) relationships between age, gender, work experiences, and physical activity level with regards to the MSDs among doctors.
| Materials and methods|| |
Study settings and sample selection criteria
Time bound research Ethics Committee (TREC/KMC/05/2011-2012) of Kasturba Medical College Mangalore, approved the study and meet the criteria of Helsinki Declaration on human experimentation. Sample size (n = 188) was estimated using formula 4pq/d2 (p [proportion of event in the population] = 50%, q = 1 – p, d [relative precision] = 15%). A self-generated and content validated "Mangalore questionnaire for identification of musculoskeletal disorders (MQI-MSDs) among healthcare professionals" were distributed among interested doctors of Government Wenlock Hospital and Kasturba Medical College Hospital, after obtaining their consent. Duly filled questionnaire recollected in a sealed cover.
Descriptive statistics (frequency, mean, and standard deviation) analyzed. Chi-square test used to identify the association of age, gender, work experience, and physical activity with respect to MSDs. P < 0.05 considered as statistically significant with 95% confidence interval. Statistical Package for Social Sciences (SPSS) version 17.0 used for data analysis.
| Results|| |
A total of 188 responses obtained (202 questionnaires distributed); therefore, response rate was 93.06%. Participants were physician (13.3%), surgeon and orthopedist (each 12.8%), gynecologists (11.7%), physiotherapist (7.4%), otolaryngologist and pediatrician (each 6.4%), anesthetist (5.9%), dermatologists (4.8%), psychiatrist and radiologist (each 4.3%), cardiologist and ophthalmologist (each 3.7%), and oncologist (2.7%).
Mean age of subjects was 42.22 ± 10.23 (range 26-76 years; male: 75%, n = 141 and female: 25%, n = 47). The average years of experience were 14.68 ± 9.52 (1-38 years).
About 58% (n = 109) had MSDs, but only 25.5% (n = 48) believed that it was because of their nature of work. Many had MSDs, but 99.5% (n = 187) were not diagnosed with any disorders. Of 100% (n = 188) participants, 41% (n = 78) had no symptoms, 25% (n = 47) had symptoms in lower back, 20% (n = 37) in neck, and 14% (n = 26) in knees. Many had MSDs in lower back (dermatologist 55.5%, psychiatrist 50%, physiotherapist 42.6%, radiologist 37.5%, anesthetist 36.4%, surgeon 29.2%, ophthalmologist 28.6%, physician 24%, orthopedist 16.7%, and gynecologist 13.5%) and in neck (cardiologist 42.9%, pediatrician 41.5%, anesthetist 36.4%, physician 24%, and orthopedist 16.7%) [Table 1].
Doctors in age range of 26-40 years had more prevalence of MSDs (60.4%, n = 64) [Table 2]. Doctors in work experience range 10-15 years had more percentage of MSDs that is, 23.6% (n = 26) [Table 3]. Those involved in some kind of physical activity had less percentage of MSDs that is, 67.1% (n = 53; P = 0.042) compared to those who were not doing any physical activity [Table 2].
|Table 1: Percentage of medical professionals (specialty) with specific symptomatic areas of MSDs|
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|Table 2: Association between age, gender, and physical activity with MSDs among doctors|
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| Discussion|| |
Prevalence of MSDs among doctors in Mangalore was 58% (n = 109), that is less than the previously reported studies (73.1%) in other regions of the world.  Medical professionals in Mangalore have better health, because they (58%, n = 109) associate self with physical activity. Furthermore, 93.6% (n = 176) liked working with colleagues, indicating better psychosomatic perception; while in one study, only 53.7% medical professionals had satisfaction from their work. 
In this study, 25% (n = 47) doctors had lower back symptoms, followed by neck, knee, etc., Previous studies also reported a high prevalence of low back symptoms ,, suggesting that low back symptoms are most common site of MSDs among doctors. The reasons could be body weight, tiring posture, lifting, and mixed indices. 
Specialty wise analysis indicates that low back symptoms were maximally reported by dermatologists, psychiatrist, physiotherapist, and radiologist; neck symptoms more in cardiologists while equal number of orthopedist and surgeon had both neck and low back symptoms [Table 1]. The reason could be body postures adopted during work that is, head and back bent forward, bent to one side, or twisted,  static workload (sustained trunk posture), prolong sitting  and repetitive tasks;  contributing to fatigue and symptoms of MSDs.  It was interesting to note that gynecologist (58.5%),  ophthalmologist (54%),  orthopedist (50%),  physiotherapist (51.7%),  and surgeons (36.5%)  also reported high prevalence of low back symptoms in earlier studies [Table 1].
High prevalence of MSDs was found in 26-40 years age ranges, which was less in higher age professionals. Furthermore, MSDs among doctors were more in the experience range of <5 years to 10-15 years, but less in higher experience rage professionals that is, >15 years. The answer is higher age group professionals are well-trained, so they maintain efficient posture for activities and performs tasks ergonomically with less strain;  therefore better coping strategies;  as younger professionals are vulnerable to adopt suboptimal ergonomic job practices. 
Of 58% subjects who had MSDs, 67.1% were not participating in any physical activity, but they all had MSDs. In a study, sonologist had reported reduced prevalence of MSDs, because of regular physical activity practices (prophylactic effect). 
The main limitations of the study are small sample size.
We recommend following studies in the future: (a) multi-centered study in India to obtain statistics regarding MSDs among doctors; (b) specialty wise work analysis to identify etiology of specific MSDs and interventions to prevent the same, (c) association between physical activity and MSDs, and (d) psychometric properties of MQI-MSDs.
| Conclusion|| |
About 58% doctors have MSDs due to the job nature. Low back symptoms are most common among dermatologists, psychiatrist, physiotherapist, and radiologist. Doctors in age range of 26-40 years and work experience range of 10-15 years have a higher prevalence of MSDs. There is a significant association between physical activity and MSDs.
| Acknowledgments|| |
Author's s heartily acknowledges the support given by the faculties of departments of Kasturba Medical College, Mangalore and Heads of all the departments for their assistance in carrying out the study.
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[Table 1], [Table 2], [Table 3]