According to the latest statistics published by the Society of Diagnostic Medical Sonography (SDMS of Plano, Tex), more than 80% of sonographers experience some degree of work-related injury during their professional careers. Ultimately, 20% of these professionals must retire due to injury directly related to the profession’s ergonomics issues. Furthermore, on average, within 5 years of entering the profession, sonographers experience pain while scanning.1 Performing countless ultrasound scans, each taking 15?45 minutes, sonographers are among the highest risk groups in the medical profession for work-related musculoskeletal disorders (WRMSD) and career-ending injuries.
Today’s diagnostic medical sonography includes the clinical specialty areas of vascular sonography, cardiac sonography, and general diagnostic medical sonography-all of which are essential for diagnosing some of today’s most life-threatening diseases. Vascular sonography involves the use of ultrasound to evaluate the anatomy and hemodynamics of cerebral, peripheral, and abdominal blood vessels for the evaluation of vascular diseases. Recent advances in echocardiography procedures using ultrasound have dramatically improved cardiac sonography specialty areas. General diagnostic sonography refers to numerous specific medical specialties for the evaluation of specific organs and systems, including the abdomen, breast, female and male reproductive systems, brain, spinal cord, and eyes.
With such broad clinical applications for ultrasound technology, coupled with the decline in the number of trained sonographers due to WRMSD, the need to sustain this vital workforce has become a top concern for the diagnostic imaging industry.
Additionally, current economic data also supports the need to reform industry standards and practices in ultrasound equipment. Typically, it is estimated that an ultrasound workstation, including the cost of an ergonomically designed state-of-the-art system, a table, chair, and accessories, can be purchased for about $188,200. In contrast, failure to address ergonomics in the workplace can result in $580,000 in revenue loss, medical bills, workers’ compensation claims, and new staff recruitment. Temporary staffing from an agency can cost an additional $80,000.2
To address these concerns, professional associations-such as the SDMS and Sound Ergonomics LLC (Kenmore, Wash)-are speaking out to raise awareness and establish preventive measures. These associations also are taking steps with the US Department of Labor Occupational Safety & Health Administration (OSHA of Washington) in an effort to introduce ergonomic modifications/redesign standards for ultrasound imaging equipment as well as propose new workload procedure mandates.
In addition to industry organizations and legislative efforts, the diagnostic imaging equipment providers also are responding with innovative technologies and designs to alleviate some of the key ergonomic concerns. Equipment vendors are developing not only clinically relevant technology to improve diagnostic capabilities, but also ergonomically sound equipment with the needs of the sonographers in mind.
One important approach to ergonomic design is the introduction of wireless remote technology to provide operator comfort. Using the latest technology, a wireless remote controller provides command of all of the ultrasound system’s functions while allowing for improved body positioning to reduce musculoskeletal injuries. Remote operation also alleviates the physical strain associated with examinations that require sonographers to twist their heads and necks while leaning across the patient’s body in order to view the monitor.
Additionally, an ultrasound system equipped with a wireless remote enables the sonographer to engage the controls from several feet away and switch imaging modes and parameters without line-of-sight limitations, which can be particularly useful for routine and vascular studies.
Other equipment features that are beneficial to sonographers include new ultrasound panel designs, which group major functions around the central palm controller to further enhance user-friendliness. Newly designed panels offer customization according to personal preferences and clinical needs with programmable key functions, key tops that can be exchanged and relocated, and a panel design tailored for both right- and left-handed use.
Furthermore, a number of today’s ultrasound panel designs are movable in three directions and can be swiveled or adjusted in height to suit the position of the operator. Some systems offer touch-screen commands that can be programmed with preset adjustments that are accessed by a push of a single button.
Depending on the type of ultrasound procedure, a sonographer must repeatedly exert between 4 and 40 lbs of force during examinations using awkward transducers and heavy cords. To offer relief, the latest ergonomic transducer and lightweight cords are designed better, smaller, and lighter to further reduce operator fatigue. Despite their size and weight, the latest ergonomic transducers available today feature extremely wide bandwidth and enhanced sensitivity for the best spatial resolution, which translates to user-friendliness without sacrificing clinical performance.
In addition to transducers and cords, entire systems are now designed to be more portable and lightweight. Older ultrasound equipment designs, which can weigh between 300 and 600 lbs, were difficult to manage and transport for the sonographer. The new ultrasound systems now are designed for mobility; they weigh as little as 30 lbs and average about 200 lbs.
Although industry organizations continue to petition OSHA to pass legislation for certain ergonomic modifications of ultrasound equipment, the shortage and continued loss of experienced sonographers due to WRMSD are becoming more prevalent nationwide.
It is clear for the medical imaging industry, as well as the US healthcare industry, that the field of diagnostic medical sonography cannot afford to lose more sonographers if it is to continue. Therefore, the industry must make operational changes and take advantage of new innovations that effectively address the profession’s ergonomics issues.
For diagnostic imaging equipment providers, it is important to make ergonomics a top priority in designing new equipment and to continue to innovate new technologies and designs. The efforts by equipment providers to design more ergonomic ultrasound systems is a practical first step to preventing the number of WRMSD cases among sonographers, but it is ultimately dependent upon the buyers to make ergonomics a key purchasing decision for improving both the work environment and diagnostic ultrasound services.
Gordon Parhar is the director of the ultrasound business unit for Toshiba America Medical Systems Inc (Tustin, Calif).
References
- Society of Diagnostic Medical Sonography. Sonography Benchmark Survey. October 6, 2000.
- Sound Ergonomics. Manpower Shortages Are Costly. Available at: http://www.soundergonomics.com/Pages/Admin_Risk/ergoeconomics.htm. Accessed October 27, 2004.
