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Evaluation of the preventive impact of surgical ergonomics training and surgical magnification
1150-20 U1996
(97FS-28)
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Issue: |
Musculoskeletal health of BC dentists and dental hygienists and the factors that contribute to that health. |
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Agency: |
Department of Oral Health Sciences, University of British Columbia |
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Representative: |
Lance Rucker |
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Funding: |
$53,979 |
Context: A better understanding of musculoskeletal health of BC dentists and dental hygienists was required to help identify those at risk of experiencing work-related injuries. Also the impact of "Performance Logic" training and surgical magnification on improving musculoskeletal health had not been systematically evaluated.
Objective: To determine the effect of "Performance Logic" education and surgical magnification on the musculoskeletal health of BC dentists and dental hygienists and assess other factors related to musculoskeletal health of this subject group.
Design: There were two sections to this study. The first involved an analysis of claims information from insurance companies. Although insurance plan managers had assured the feasibility of the study, the data received was sparse and fragmented, which resulted in this aspect of the study being discontinued.
The second section of the study involved a survey questionnaire being sent to 975 dentists and 433 dental hygienists, requesting information regarding their practice ergonomics, practice management issues and lifestyle, perceived control of the work environment, and musculoskeletal symptoms (MSSs). The questionnaire data were analyzed through descriptive and inferential statistics. The analysis included comparisons of groups (and subgroups) with respect to several variables such as symptoms, practice patterns, equipment characteristics and psychosocial factors.
Setting: British Columbia, Canada
Subjects: The study group included dental graduates from the University of British Columbia and Vancouver Community College. The control groups consisted of dental graduates from other programs who were practicing in BC as well as graduates from the dental hygiene programs at the College of New Caledonia and Camosun College.
Main Outcome Measures: Approximately 1400 comparisons were made in the study. The most prominent associations identified clinical equipment usage factors, "Posture and Position Profile" factors, and miscellaneous factors associated with increased or decreased risk of MSSs for both dentists and dental hygienists.
Results: The clinical usage factors and "Posture and Positioning Profile" factors that were associated with increased risk of MSSs included: torso twist, tipped shoulders, elbow raised during operation, light positioning, operating with hands close to face, increased time practicing in the 7:00 – 8:30 and 3:30 to 5:00 positions, increased use of ultrasonic scalers. Ten clinical equipment usage and "Posture and Positioning Profile" elements were strongly associated with decreased risk of MSSs. These included the use of surgical magnification as well as many positioning characteristics. The miscellaneous factors associated with increased risk of MSSs were increasing age, smoking and diagnosis of spinal curvature or eye problems. Those miscellaneous factors associated with decreased risk of MSSs were increased frequency of both physical activity and strengthening exercise. The study confirmed that certain psychosocial and environmental factors and associated with increased risk of MSSs.
Appropriate educational measures, undertaken as part of the initial basic training programs of dentists and dental hygienists can help reduce the high-risk clinical equipment usage factors and "Posture and Positioning Profile" factors that are strongly associated with risks of MSSs for dentists and dental hygienists.
Conclusion: Recommendations are made for logical steps toward ergonomic awareness and change within the dental professional community. They are: development of an assessment tool to promote self-awareness for dental professionals use, disbursing the assessment tool and study findings to dental professional educational program across Canada, and encouraging private corporate disability insurance carriers to include relevant risk factors in their rate category analysis reviews and educational materials.