Ergonomics in Interventional Radiology: Awareness Is Mandatory

Abstract

Ergonomics in interventional radiology has not been thoroughly evaluated. Like any operators, interventional radiologists are exposed to the risk of work-related musculoskeletal disorders. The use of lead shielding to radiation exposure and the lack of ergonomic principles developed so far contribute to these disorders, which may potentially affect their livelihoods, quality of life, and productivity. The objectives of this review were to describe the different situations encountered in interventional radiology and to compile the strategies both available to date and in development to improve ergonomics.

Keywords: computed tomography; ergonomics; interventional radiology; musculoskeletal disorders; radiation exposure.

Figure 1

Percutaneous procedures performed under image guidance often require grip strength with instruments, bending for adequate needle positioning, and cervical rotation to visualize the screens: (A) vertebroplasty performed under cone-beam computed tomography; (B) cryoablation performed under computed tomography guidance. The resulting body contortion potentially leads to discomfort and musculoskeletal disorders.

Figure 2

The lead apron is a heavy piece of radiation protection that should be worn by all staff working in the angio suite but it increases the risk of musculoskeletal disorders (A). A lighter two-part coat (arrows) helps to distribute the weight across the shoulders and waist and must fit properly to improve radiation protection (B).

Figure 3

During procedures performed under ultrasound (A), X-rays (B), or under computed tomography scan (C), the screens should be placed in front of the operator to allow a downward viewing angle of 10–15°, which improves the position of the operator’s cervical spine during the whole procedure. Ceiling-mounted monitors can be placed in a wide variety of positions while gathering all the information needed by the operator, including the electromagnetic navigation system, and reducing the congestion of space (D, arrow). Head and body movements used to navigate and search among the screens of all the systems required are therefore limited (to the right, as shown by the dashed line).