Beware of injurious culprits in the reading room

“Oh, my aching back!” How often do you hear colleagues complaining about musculoskeletal discomfort in the reading room? Do you ever find yourself massaging an aching neck or wrist while slogging through a seemingly endless list of cases? You are not alone!

Fatigue, stress and burnout are hot topics among physicians, especially radiologists. The causes are multifactorial, likely attributable to a combination of systemic and individual factors. Often overlooked, but potentially significant, is the contribution of physical wear and tear. Can the workplace environment—chairs, desks, computer peripherals—induce or, at the very least, exacerbate physical discomfort or injury? Evidence is slowly accumulating to suggest that the answer is yes.

We recently surveyed radiologists at Emory University to determine the extent, severity and impact of musculoskeletal discomfort on work. Luckily, we were not the first ones to be interested in quantitatively assessing discomfort in a computer-based work environment. The Cornell Musculoskeletal Discomfort Questionnaire was developed and validated years ago by Alan Hedge, PhD, director of the Cornell Human Factors and Ergonomics Research Group. It is a 54-item questionnaire about the prevalence of musculoskeletal symptoms in 18 regions of the body during the previous week. It assesses the frequency, degree and extent to which musculoskeletal discomfort interferes with work. Our response rate was a notably robust 39 percent. This could reflect a high level of interest in the topic among radiologists. 

Not surprisingly, radiologists named the neck, back, shoulder and wrist as the most common sites of discomfort in the seven days prior to the survey. (The irritation largely involved the right side for the shoulder and wrist. This was not surprising, as only 10 percent of the population is left-handed). Across all 18 body regions, most reports of discomfort tended to be characterized as slightly uncomfortable. However, closer to 40 percent of respondents characterized their discomfort in these areas as very uncomfortable. At least 40 percent said the discomfort slightly or substantially interfered with their ability to work.

We combined all three discomfort scores into a weighted average and examined them as a function of how long the respondents typically spent at their workstations. This confirmed what one would expect: More  workstation hours were associated with higher discomfort scores. It was interesting to note that the weighted overall discomfort scores were higher for women than men.

These data support the idea that radiologists are experiencing a significant amount of physical discomfort in their day-to-day work. Some of the reasons are clearer than others—they spend a lot of time seated, looking back and forth between multiple displays to access data and generate reports, while using a mouse and microphone. Our respondents also pointed to some other considerations that are not so obvious. For example, work environments are, for the most part, one-size-fits-all and not readily tailored to the individual. This could account, in large part, for the differences we observed between males and females. Chairs, desks and so on may be more tailored to suit the male than female body, increasing the likelihood that females could experience more discomfort. 

Much thought went into the digital reading room in the early days of the digital transition. Planners thoroughly considered lighting, soundproofing and display configurations. At the same time, perhaps understandably given the lack of data, they gave only minimal recommendations for such key workplace components as desks, mice and chairs (e.g., “Find a chair with good lumbar support”). 

Perhaps we need to think outside the box as we design reading spaces for the future. Rather than architectural design, consider ecotectural design. The latter, according to the influential architect Jorg-Dietram Ostrowski, is “grounded on natural dynamics, healthy materials, biological principles, human ergonomics, cultural respect and compassionate understanding for the planet and all living creatures.” 

Sounds rather lofty, but the key aspects to consider are natural dynamics and human ergonomics—and simply considering the idea that we need to start viewing the work environment as something that we need to adapt to the user rather than the other way around. Whether each workspace can be tailored to the individual user is obviously something that would take time and resources, but if the goal is to protect our future workforce and reduce fatigue, stress and burnout, it seems like a worthy and rational endeavor.  

Krupinski and Seidel work in the department of radiology and imaging sciences at Emory University in Atlanta.