Abstract
Background
Low-back pain (LBP) is the most common musculoskeletal disorder, which is considered one of the most debilitating chronic conditions worldwide. The operating room personnel are at higher risk of LBP due to the different working environment. Therefore, the aim of present study was to investigate the prevalence, dimensions and risk factors of LBP among operating room personnel of Hamedan hospitals.
Methods
This descriptive-cross-sectional study was conducted on 350 operating room personnel of teaching hospitals affiliated to Hamedan University of Medical Sciences in 2023. The sample size was estimated by census method. Data analysis was also carried out using descriptive statistics, frequency distribution, mean and standard deviation, chi-square test, t -test and ANOVA in SPSS ver. 22.
Results
Most of the participants (78.3 %) had LBP. Among the studied operating rooms, the highest and the lowest LBP rate belonged to the maxillofacial operating room and the plastic and reconstructive surgery operating rooms, respectively. The most prevalent LBP included acute LBP (40.6 %) and the regional type in which the pain did not radiate into the legs. Most people with LBP in this study complained of sharp pain (28.3 %) and mild transient pain that subsided without painkillers or rest. The results also revealed a significant relationship between age, years of work experience and type of hospital with LBP prevalence.
Conclusions
The results of the present study showed high prevalence for LBP among operating room personnel, and unfortunately, many of these people develop this condition within the first few years of their work. Therefore, it is recommended that operating room personnel are regularly screened and evaluated for musculoskeletal disorders (MSDs) and LBP, and adequate information about this complication is given to them.
1
Introduction
Musculoskeletal disorders (MSDs) are injuries that involve muscles, vertebrae, bones, joints and blood vessels. The most common MSD is low-back pain (LBP), which is the second cause of referral to medical centers in the world and is also the third cause for surgery. ,
LBP is a common chronic or acute MSD that involves the lower part of the vertebrae and is defined as pain or discomfort in the space between the 12th rib and the lower gluteal folds. , Currently, LBP is considered as one of the most debilitating chronic conditions worldwide, , which can affect individual, physical, social, and psychological aspects and increase government and social expenses. According to statistics, these expenses account for more than 1.13 % of the total public expenses in Iran. LBP is a public health problem worldwide and is a common cause of work-related disorders among health care workers (HCWs), especially nurses. HCWs are one of the most important health care providers who are highly exposed to MSDs due to occupational conditions. A study on Taiwanese HCWs found that 72 % of them had LBP. It is estimated that each year 12 % of British nursing staff consider a career change to reduce their LBP, and 12–18 % actually leave the nursing profession due to chronic LBP. It is worth noting that the prevalence of LBP is increasing among HCWs, nurses, and operating room personnel with a prevalence of 40–50 % per year.
Among the risk factors of MSDs are ergonomic risk factors that are directly related to LBP-induced MSDs. Workplace and individual activities play an important role in the prevalence of LBP. The hospital environment, especially the operating room, is full of all kinds of occupational hazards and injuries that threaten the people working in these departments. Due to the different working space and mechanisms of the operating room compared to other hospital wards, the activities perfumed in this ward can threaten the health of the surgical ward personnel, , so that they are affected by MSDs by 58 to 90 % after one year of clinical work experience.
Surgical technicians (operating room personnel) are the main members of the surgical team and are responsible for the safety and care of patients. Therefore, these problems may affect their efficiency and effectiveness and threaten the health and safety of patients. In a study, Al-Jish et al. reported LBP in 70.6 % of operating room personnel. These people suffer from the pressure of dynamic and high forces caused by pushing, pulling, and lifting heavy equipment and surgical equipment and the pressure of static forces due to standing for a long time, poor posture during surgery, limited movement during surgery, and doing repetitive and monotonous tasks for a long time. Considering the aforementioned cases and the importance of the role of the operating room personnel in the surgical team, the present study was conducted to investigate and evaluate the prevalence, dimensions, and risk factors of LBP among the operating room personnel.
2
Materials and methods
2.1
Study design
This cross-sectional study was conducted on 350 operating room personnel working at five teaching hospitals of Hamedan University of Medical Sciences in 2023.
2.2
Setting
This study was conducted on operating room personnel working at teaching hospitals of Hamedan University of Medical Sciences in 2023. Then the researcher referred to the operating rooms of these hospitals at the beginning of different shifts. Written informed consent was obtained from all participants involved in this study. After receiving the people’s written consent and willingness to participate in the study, the questionnaire was provided to them and collected at the end of the same work shift.
2.3
Participants
Inclusion criteria included having an associate degree, bachelor’s degree or higher in operating room or nursing and at least two years of work experience. Exclusion criteria also included unwillingness to participate or continue the study, having a history of MSDs, osteoporosis, and use of corticosteroids. In this study, participants were selected through the census.
2.4
Measurements
In this study, Low Back Pain questionnaire (Tavakkol et al.) was used. This questionnaire consists of two parts of demographic factors and low-back pain (including 11 multiple-choice questions) whose validity (CVR: 0.91 and CVI: 0.95) and reliability (using internal consistency (0.60) and test-retest (0.77) have been confirmed by Tavakkol et al. .
2.5
Study size
This cross-sectional study was conducted on 350 operating room personnel working at five teaching hospitals of Hamedan University of Medical Sciences in 2023. The sample size was estimated using the census method.
2.6
Statistical methods
Data analysis was carried out using SPSS ver. 22. Demographic information of the participants was calculated using descriptive statistics, frequency distribution, mean and standard deviation. Also, chi-square test, t -test and ANOVA were used to investigate the relationship between the prevalence of LBP, demographic information and risk factors of LBP.
2.7
Ethical statement
The present study has been approved by the Ethics Committee of Hamedan University of Medical Sciences with the ethics code IR.UMSHA.REC.1401.019. All information obtained from the study participants was kept confidential and the names of the participants were replaced by codes.
The authors wrote this manuscript according to the STROBE Guidelines for observational studies.
3
Results
3.1
Participants
A total of 350 operating room personnel working in five teaching hospitals of Hamedan University of Medical Sciences participated in this study. Table 1 shows the frequency of demographic characteristics of the participants. Most of the participants were women (61.4 %), single (62 %), aged under 30 years (52 %) and had bachelor degree (68 %).
| Variable | Frequency (%) | |
|---|---|---|
| Gender | Female | 215 (61.4) |
| Male | 135 (38.6) | |
| Age | 20–30 years | 182 (52) |
| 31–45 years | 112 (32) | |
| 46–60 years | 56 (16) | |
| Marital status | Single | 217 (62) |
| Married | 133 (38) | |
| Education level | Associate degree | 63 (18) |
| Bachelor degree | 238 (68) | |
| Master degree | 49 (14) | |
3.2
Descriptive data
Several factors contribute to LBP. Table 2 shows the frequency of a number of risk factors for LBP among operating room personnel. More than half of the study subjects had a normal BMI. Also, most of the participants had work experience of less than 5 years (42 %), rotating shifts (62 %) and standing posture (48 %) while working. Most participants expressed they had no history of immigration and smoking.
| Variable | Frequency (%) | |
|---|---|---|
| BMI | Less than 18.5 | – |
| 18.5- 24.9 | 190 (54.3) | |
| 25–29.9 | 160 (45.7) | |
| 30–34.9 | – | |
| Work experience | Less than 5 years | 147 (42) |
| 5–10 years | 105 (30) | |
| 11–15 years | 49 (14) | |
| 16–20 years | 21 (6) | |
| More than 21 years | 28 (8) | |
| Physical condition | Standing | 168 (48) |
| Sitting | 42 (12) | |
| Moving | 84 (24) | |
| A combination of different physical conditions | 56 (16) | |
| Shifts | Morning | 91 (26) |
| Evening | 14 (4) | |
| Night | 28 (8) | |
| Rotating shifts | 217 (62) | |
| Migration | Yes | 12 (3.4) |
| No | 338 (96.6) | |
| Smoking | Yes | 25 (7.1) |
| No | 325 (92.9) | |
3.3
Main results
One of the goals of this study was to investigate the prevalence of LBP among operating room personnel in different hospitals. A large number of participants (78.3 %) in this study had LBP. Among the studied operating rooms, the highest and the lowest prevalence of LBP was reported among the maxillofacial operating room and the plastic operating room, respectively ( Table 3 ).
| Hospital name | Number of personnel (%) | Type of operating room (Frequency) | The prevalence of low back pain Frequency (%) |
|---|---|---|---|
| Be’sat | 188 (53.7) | General (44) | 37 (84) |
| Orthopedics (35) | 30 (85.7) | ||
| ENT (44) | 35 (79.5) | ||
| Thorax (31) | 26 (83.8) | ||
| Maxillofacial (34) | 30 (88.2) | ||
| Fatemiyeh | 65 (18.6) | Gynecology (65) | 45 (69.2) |
| Sina | 40 (11.4) | Ophthalmic (26) | 21(80.7) |
| Plastic (14) | 8 (57.1) | ||
| Beheshti | 35 (10) | Urology (35) | 28 (80) |
| Farshchian | 22 (6.3) | Heart (22) | 14 (63.6) |
| Total | 350 | 350 | 274 (78.3) |
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