Endoscopy‐Related Musculoskeletal Injuries: A Systematic Review and Meta‐Analysis on Prevalence, Risk Factors and Prevention

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Abstract
Background: Endoscopy‐related musculoskeletal injuries (ERIs) are a major occupational hazard, impacting career longevity and personal well‐being.Objective: This systematic review and meta‐analysis aimed to update and expand on previous findings by assessing prevalence, risk factors and management of ERIs among endoscopists.Methods: Following PRISMA guidelines, we systematically searched MEDLINE, Web of Science and Scopus for relevant studies published since the last comprehensive review. A manual search of the references of relevant manuscripts was also performed. Outcomes of interest included the prevalence of ERIs, common pain syndromes, risk factors, and preventive or treatment strategies. Studies' quality was assessed using the National Institutes of Health (NIH) Quality Assessment Tool.Results: Thirty studies were included, incorporating data from 7646 gastrointestinal endoscopists. The pooled career‐long prevalence of overall ERI was 62.5% (CI 52.6–71.8, I2 = 98%), including pain (67.5%; CI 46.4%–85.6%; I2 = 98%) and numbness (12.4%; 95% CI 6.6%–19.7%; I2 = 98%) syndromes. Among pain syndromes, the most affected areas were the hand (28.2%; CI 19.2%–38.2%; I2 = 99%), lower back (27.3%; CI 20.1%–35.2%; I2 = 97%), thumb (27.1%; CI 18.9%–37.7%; I2 = 99%) and neck (25.7%; CI 19.3%–32.7%; I2 = 98%). Higher procedural volume, years in practice and female gender were consistently reported as risk factors for ERIs.Concerning therapy, 41.8% of endoscopists used medications (CI 31.2%–52.8%; I2 = 94%), while 28.2% engaged in physical therapy (CI 18.2%–39.5%; I2 = 96%). Sick leave was reported by 13.8% of endoscopists (CI 7.9%–20.9%; I2 = 94%). Practice modifications to manage ERIs included adjusting monitor (45.5%, CI 22.2%–69.9%; I2 = 96%) and table (32.4%, CI 14.5%–53.5%; I2 = 97%) height, but also reducing the number of cases per endoscopy session (14.6%; CI 10.4%–19.4%; I2 = 72%).Conclusion: ERIs are highly prevalent among international gastrointestinal endoscopists, and are linked to procedural volume, years in practice, and gender. Ergonomic training and workplace adaptations are essential to mitigate risks and support career sustainability.Trial Registration: PROSPERO Registration: CRD42024534349

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