The Occupational Injuries of Oncologic Surgeons

Albert B. Lowenfels, MD


January 27, 2017

Do No Harm, Except to Ourselves? A Survey of Symptoms and Injuries in Oncologic Surgeons and Pilot Study of an Intraoperative Ergonomic Intervention

Voss RK, Chiang YJ, Cromwell KD, et al
J Am Coll Surg. 2017;224:16-25


How frequent are occupational musculoskeletal disorders in surgeons who perform long operations? The authors surveyed 127 oncologic surgeons from a single center, of whom 81% had practiced for more than 5 years. Nearly all (94%) had experienced one occupational symptom within the past 6 weeks, and 28% reported having an occupational injury at some time during their career. Some of the symptoms were nonspecific, such as fatigue and "general physical discomfort." Cervical spine pain (38%) was the most frequent complaint.


One of the characteristics of oncologic procedures is that their duration tends to be longer than other operations. In this survey, 40% of surgeons reported an average patient operation length of greater than 4 hours. Are there acceptable methods for injury prevention? Foot pads have been noted to reduce stress, but in this report, the use or non-use of cushioning floor pads did not seem to have a preventive effect for any type of symptom (P > .26), except for generalized discomfort (P = .03). One drawback to the study is that 42% of the surgeons in this center failed to respond to the survey, limiting our ability to estimate the true injury rate for surgeons who perform prolonged procedures. The frequency of symptoms associated with prolonged operations emphasizes the need to improve human engineering in the operating room as an important strategy for reducing occupational injury.


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