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Rad Changes

Rad Changes: Improved ergonomics can help rad techs stay injury-free in the workplace.

Radiologic technologists’ work often revolves around PACS and digital imaging, which can lead to repetitive strain injuries, many of which are exacerbated by specific features of a radiology practice. Ergonomic approaches can help to decrease the frequency and severity of repetitive strain injuries and improve productivity; however, they are complex, include all aspects of the radiology environment, and are best implemented along with proper training of imaging personnel.

Kevin D. Evans, PhD, RT(R), a professor and the division director of radiologic sciences and respiratory therapy at The Ohio State School of Health and Rehabilitation Sciences, says the term ergonomics in the rad tech space is defined as “the understanding of interactions among humans and other elements of a system.

“It means to design in order to optimize human well-being and overall system performance,” he says. “It is important to take this definition literally, as it connotes the importance of a radiographer interacting within a department and with a variety of work systems.”

Some work system examples are X-ray equipment, patient handling/care, and computer workstations. Depending on the task, the technologist’s interface may have elevated risk for injury if proper precautions are not in place. In the example of a lateral transfer of a patient from a cart to an X-ray table, patient handling devices/tools are essential to minimize the risk for injury of the technologist and the patient.

Evans’ current research is devoted to not only understanding the risk but also mitigating it. He recently conducted a survey with the help of the American Registry of Radiologic Technologists and demonstrated that 80% of responding technologists are working in pain—only elevating the risk for further injury to the employee and the patient.

“The highest frequency was low back, shoulder, and neck,” Evans says. “When you know where the area of injury is located, then you can examine the occupational interactions that might have led to these work-related musculoskeletal injuries (WRMSI). It is our job to scrutinize the workplace for ways to optimize technologists’ well-being and also increase overall system performance.”

Direct Causes Gordon Sze, MD, chief of neuroradiology and professor of radiology and biomedical imaging at Yale School of Medicine, says imaging personnel work under conditions that precipitate repetitive strain injuries in multiple ways. First, use of the computer mouse can result in tenosynovitis, carpal tunnel, and cubital tunnel syndromes. Second, the prolonged positions at the computer terminals can result in neck and low back pain. Third, certain specialties are associated with particular problems.

“For example, ultrasonographers, in particular, are prone to develop shoulder symptoms due to the forces exerted by pressing the ultrasound probe on the area of interest on the patient’s body with an extended arm,” he says. “Neck, elbow, and low back pain are also common.”

The new digital workplace in radiology presents many challenges, according to Sze. Although the shift away from hard copy to PACS and digital imaging has become almost universal in this country, radiology departments have lagged in realizing that these changes also create conditions that mandate changes in workplace environments. Therefore, ergonomic issues cover a broad range of concerns, including the structure of radiology suites, background lighting, chair and monitor positioning, and mouse and keyboard design and placement.

Melody Pierson, RT(R), CRA, manager of imaging services at UCHealth Greeley Hospital in Colorado, says the main workplace ergonomics issues for techs are the work/control tables and the seating. Additionally, hand/arm ergonomics are an issue due to the use of multiple pieces of equipment such as keyboards, mouse, control panels for the equipment, and touch screens, often to operate one modality and/or send images and finalize an exam. Pierson also believes there is a need for adjustable-height tables and seating, which would allow technologists to customize the height of the work table to their needs allowing them to sit/stand as they prefer.

“Work table height is an issue, as not all techs are the same height or size. If the table is too high, the shorter-stature techs are required to climb onto a standing height stool to sit, when needed, and there is a chance of falling off when getting on or getting off the stool,” she says. “When the table is too low, the tall-stature techs have to sit in a low chair and are constantly using their knees to get up and down. For the mouse, keyboard, etc, these are vendor specific and are not designed in an ergonomic way for wrist support. I’d like to see staff provided with ergonomic wrist support, etc, when available.”