The Prevalence, Patterns and Factors Associated With Work-related Musculoskeletal Symptoms Among Surgical Residents at Kenyatta National Hospital

Abstract

Background: Workers all over the world are faced with work-related musculoskeletal disorders (WRMSDs) and symptoms, which have a large cost on both employers and employees. Within the medical sector, surgeons work in an environment that is not ergonomically ideal, and many suffer work-related musculoskeletal symptoms. The effects are significant, with some practitioners having reported early retirement due to work-related symptomatology. While a lot of data exists on musculoskeletal symptoms in practising surgeons, this is not the case for trainee surgeons. No published local data exists on work-related musculoskeletal symptoms among trainees in surgery. Study Objective: To determine the prevalence, patterns and factors associated with work-related musculoskeletal symptoms among surgical residents working in Kenyatta National Hospital. Study Design: This was a cross-sectional survey. Study setting: The study was carried out in Kenyatta National Hospital. Participants and methods: An electronic questionnaire prepared based on the Nordic Musculoskeletal Questionnaire (NMQ) was sent to all participants via electronic messaging across various online residents’ groups. The questionnaire captured data on demographics and musculoskeletal symptoms experienced. Data Analysis: Data was cleaned and analysed using the statistical software R. Both demographic and comparative analysis such as logistic regression was carried out. The results were then presented as tables and charts. Results: 217 responses were received from residents across various thematic units working in Kenyatta National Hospital. The female-to-male ratio was 1:2.4. The overall prevalence of work-related musculoskeletal symptoms was 93%. The most commonly affected anatomic region was the lower back (68%) followed by the neck (47%). Residents from the thematic units of urology, paediatric surgery and general surgery had a 100% prevalence rate of work-related musculoskeletal symptoms. Residents from plastic surgery and ophthalmology units had the lowest prevalence rates (83% and 84% respectively). Neck symptoms were associated with the use of loupes (OR, 2.9, p=0.02) and microscopes (OR, 2.2, p=0.05). Female gender was associated with presence of wrist/hand symptoms (OR, 3.84, p=0.01). Age was associated with symptoms in the neck (OR, 1.22 p=0.002) and lower back (OR, 1.15 p=0.03). No association was found between overall prevalence and thematic unit (p=0.13), year of study (p=0.903) or hours in theatre (p=0.97). Conclusion and recommendations: Surgical residents experience a significantly high prevalence of work-related musculoskeletal symptoms. Plastic surgery and ophthalmology residents had the lowest overall prevalence of work-related musculoskeletal symptoms. Further studies should be conducted assessing work-related musculoskeletal symptoms’ impact on trainee surgeons