Abstract
The Society of Diagnostic Medical Sonography’s (SDMS) commitment to addressing work-related musculoskeletal disorders (WRMSDs) in sonography is unwavering. Since the issue was identified, the SDMS has been at the forefront in driving research and increasing awareness of this complex and pervasive issue. The SDMS also continues to be a vocal champion of both the vital role sonographers play in health care and the importance of ensuring their safety and well-being while scanning. In support of this focus, the SDMS has made addressing WRMSDs a part of its strategic plan and is an active participant in initiatives designed to both protect sonographers and provide real-world solutions that sonographers can implement in their daily activities.
In 1985, the Journal of Diagnostic Medical Sonography (JDMS), which is the official peer-reviewed journal of the SDMS, published the first report on ergonomic issues in sonography. 1 Since then, the JDMS has taken the lead in publishing articles on WRMSD research and ergonomics in sonography. Today, Kevin D. Evans, PhD, RT(R)(M)(BD), RDMS, RVT, FSDMS, FAIUM, the JDMS Editor-in-Chief, is the lead investigator for exciting new longitudinal research titled “Documenting the progression of work-related musculoskeletal injuries and well-being in sonography: A longitudinal survey of ultrasound users.” Phase 1 of the longitudinal study was recently completed and produced the following preliminary findings:
Eighty-six percent of respondents reported experiencing musculoskeletal discomfort during or following their work shift that was directly attributed to work activities.
More than half of the respondents reported experiencing discomfort in the neck, shoulders, and hands/wrists with an average rating of discomfort between 4 and 5 on a 10-point scale.
Only half of the respondents reported engaging in ergonomic training at some point in their careers and one-third of those individuals reported the last training was more than 5 years ago.
The findings were obtained from 3660 completed surveys. The profile of respondents was 88% female, the median age was 48.6 years old, and most had at least one sonography credential (two-thirds were RDMS, half were RVT, and one-third were RDCS). The respondent cohort also included physicians who use ultrasound in their practice and represents one of the largest physician cohort of WRMSD responses to date in sonography literature. Approximate frequencies by areas of work reported across respondents included 55% in vascular, 54% in obstetrics/gynecology, 48% in abdominal, 34% in cardiac (adult), and 26% in breast. Pediatric sonography was slightly less than 20%. Slightly fewer than 10% reported being in musculoskeletal, fetal cardiac, or pediatric cardiac settings as a primary area of practice. Integrative data analyses are underway to examine reports of discomfort, workplace policies and support systems, work hours, and other factors within and across all areas of practice. 2
In addition to supporting WRMSD research, the SDMS has also championed a variety of profession-wide initiatives focused on addressing WRMSDs in sonography. In 2003, the SDMS led an effort to create the first Industry Standards for the Prevention of Work-Related Musculoskeletal Disorders in Sonography. 3 The resulting standards were hailed as a concrete way to address the multifactorial problem of WRMSDs in sonography.
In 2004, the SDMS entered into an alliance with the Occupational Safety and Health Administration (OSHA) to establish a collaborative relationship for training and outreach on WRMSDs in sonography. 4 The alliance created the opportunity for a national dialogue on workplace safety and health for sonographers and raised the visibility of the issue of WRMSDs in sonography. Outcomes of the alliance included the creation of an OSHAcademy course on sonography safety and the publication of an eTool on the OSHA website designed to limit WRMSDs among sonographers. 5 In 2007, the SDMS renewed the alliance agreement with OSHA for an additional 2 years. 6
In 2016, the SDMS hosted a consensus conference dedicated to updating the Industry Standards for the Prevention of Work-Related Musculoskeletal Disorders in Sonography. Twenty-six sonography-related professional organizations, accreditation bodies, and manufacturers participated in the collaborative process of reviewing comments and suggested edits submitted by the sonography community, examining the existing standards, and revising the standards. The resulting updated standards acknowledged the realities of the current scanning environment and succinctly outlined the responsibilities of manufacturers, employers, and sonographers as it related to reducing the risk of WRMSDs in sonography. 7 The SDMS also published a white paper designed to act as a companion piece to the standards, advance knowledge, and facilitate discussion on this important matter. 8
Continuing its commitment to addressing WRMSDs in sonography, in 2017, the SDMS participated in a Community Engagement Group which was led by the American Registry for Diagnostic Medical Sonography (ARDMS). The group’s discussions resulted in the creation of a sonography Alliance. The Alliance chose as its focus the “Grand Challenge” of stopping WRMSDs resulting from the performance of diagnostic medical ultrasound. As a founding member and active participant in the WRMSD Alliance, the SDMS has been instrumental in working toward achieving the objectives of the Grand Challenge. Select accomplishments of the WRMSD Alliance include hosting a design summit, holding a hack-a-thon, and supporting the longitudinal research underway on WRMSDs in sonography.
The 2019 WRMSD Grand Challenge Design Summit focused on increasing awareness of WRMSDs in sonographers and those performing diagnostic medical ultrasound and engaging stakeholders who had not historically been involved in the efforts to address WRMSDs. The 2020 WRMSD Grand Challenge Virtual Student Solution Hack-a-Thon was a competition aimed at students with the goal of generating innovative ideas to reduce the risks of WRMSDs in sonography. The winning team presented a concept titled “The Air Buddy,” which was an assistive device that reduced the amount of force required by the sonographer while scanning. In 2020, the COVID-19 pandemic necessitated a short-term pivot of the WRMSD Alliance’s focus to supporting sonographers during the pandemic. Today, the WRMSD Alliance is refocused on its original mission and is currently supporting phase 2 of the WRMSD longitudinal research referenced earlier. 9
In addition to the outlined initiatives that focus on the sonography profession as a whole, the SDMS has also been influential in driving decisions that ensure sonographers are aware of the risks of WRMSDs and have access to resources to help reduce their exposure. The SDMS was instrumental in the Joint Review Committee on Education in Diagnostic Medical Sonography (JRC-DMS) adding an ergonomic component to the Commission on Accreditation of Allied Health Education Programs (CAAHEP) Standards which ensures that all students graduating from a JRC-DMS CAAHEP-accredited sonography program learn from the beginning how to scan ergonomically and protect their health. The SDMS also petitioned accreditation bodies, such as Intersocietal Accreditation Commission (IAC) and American Institute of Ultrasound in Medicine (AIUM), to include an ergonomics component in their accreditation standards and ARDMS and Cardiovascular Credentialing International (CCI) to include an ergonomics component in their credentialing exams.
The SDMS has also focused on educating sonographers by working with subject matter experts to publish multiple learning activities on WRMSDs in sonography. The learning activities include practical tips to stay healthy and reduce exposure to WRMSDs. Housed in the SDMS Learning Center, the learning activities also include SDMS CME credit upon successful completion of the associated post-tests. 10 The SDMS has also published and promoted a Sonographer Safety Alert that provides a quick overview of the risk factors behind WRMSDs in sonography, as well as an action plan for employers that covers scheduling, equipment and setup, prevention, and monitoring. 11
As sonographers, we are the eyes of the physicians. Our knowledge and skills enable us to find the answers our patients need so that they can be correctly diagnosed and treated. However, we cannot take care of our patients if our own health and well-being are suffering due to WRMSDs. The SDMS understands the issues facing sonographers and is working every day to support our members and the sonography community in the fight against WRMSDs. As the knowledge and understanding of WRMSDs in sonography continue to evolve, the SDMS is committed to advancing the awareness of this issue and supporting sonographers.