Work-related musculoskeletal injuries (MSI) are common among Mohs microsurgeons and histology technicians because they constantly tilt their head forward, flex their hips, and often slouch their upper back. In a poster session presented at his 2023 American College of Morse Surgery Conference in Seattle, Washington, the researcher explores ways to improve ergonomics and improve ergonomics while serving patients at the bedside, microscope, and cryostat. I explored ways to reduce MSI.1
The poster presenters examined a recently conducted study on common positions performed during Mohs surgery. Nearly 90% of his Mohs histotechs surveyed reported musculoskeletal problems in two or more of his body parts assessed in the previous 12 months. “Standing during specimen processing correlated with neck pain and upper back pain, whereas sitting was protective against lower back pain,” the investigators shared. .2
Providing bedside care
Improper positioning is very common while treating patients at the bedside. The head is often tilted forward, the hips are bent, and the back is slouched. Proper positioning requires muscle memory and self-awareness, keeping your head above your shodder, your shoulders back, your hips forward, and your chin tucked in.
looking into the microscope
Constant microscopists should consider bending their necks less than 20 degrees to view the eyepieces. A path distance of 45-55 cm is recommended. When sitting on a chair or stool, keep your shoulders in line with your hips.3
Utilization of cryostat
Arms should be kept close to the torso to avoid “winging”. Researchers recommend avoiding resting the forearm in the cryostat. They also encourage Morse experts to reduce neck and track flexion to less than 20 degrees.
In conclusion, the researchers behind this poster stated that it is important in all Morse roles to keep the chin tucked, shoulders back, hips forward, and head above shoulders. If possible, the patient and work surface should be positioned at “piano player height” to avoid injury.Four
References
1. Grushchak S, Yale K, Sklover L, Lee P. Ergonomics, microscopy, and cryostat in bedside Mohs surgery. The poster was presented at the 2023 American Mohs Surgical Society. May 4-7, 2023. Seattle, Washington. https://acms.planion.com/Web.User/AbstractDet?ACCOUNT=ACMS&ABSID=119464&CONF=AM2023&ssoOverride=OFF&CKEY=8A7Y39186
2. Shah, K., Maruthur, M., Phillips, W. et al. Ergonomic and psychosocial risk factors associated with work-related musculoskeletal disorders in the Morse histotech. Arch Dermatol Res 315, 917–923 (2023). https://doi.org/10.1007/s00403-022-02428-x
3. George E. Occupational hazards for pathologists: microscope use and musculoskeletal disorders. American Journal of Clinical Pathology. Volume 133. No. 4. April 2010. Pages 543-548, https://doi.org/10.1309/AJCPUXDS5KJKRFVW
4. Carley SK, Strauss JD, Vidal NY. An ergonomic solution for dermatologists. International Journal of Women’s Dermatology. 2021;7(5):863-866.doi:10.1016/j.ijwd.2021.08.006