Old habits—whether good or bad—die hard. Studies are mounting, showing that as radiologists diagnose patients’ injuries, many are incurring their own, with poor workstation design, harmful repetitive motions and prolonged postures as key culprits.

“The ergonomic design of any radiology facility … is extremely important to optimizing work performance, comfort and health,” says Alan Hedge, director of the Human Factors and Ergonomics teaching and research program at Cornell University in Ithaca, N.Y.

With the new year upon us, Health Imaging & IT offers a top 10 list of ergonomic musts to help protect radiologists’ health and improve efficiency.

1. What’s the diagnosis? “There is much good ergonomic information on the web,” notes Hedge. A self-survey designed for radiology reading rooms is a start, but hiring a Certified Public Ergonomist to evaluate your department “face-to-face is best.” In Ruess’ and Hedge’s study, an industrial hygienist discovered 93 ergonomic issues, including many hazardous conditions, in 38 radiology workspaces.
2. Adjust from head to toe. Everything should be adjustable and adjusted by each radiologist, from armrests to desk height, lighting and heating, ventilation and air conditioning to seat height. “Radiologist comfort is key to success. You don’t want the radiologist thinking about comfort [or lack thereof], you want him concentrated on the exam at hand,” Dinwiddie notes.
3. Avoid repetitive motion: Any motion with an ailment named after it, à la repetitive motion disorders (including carpal tunnel, tendonitis and other musculoskeletal disorders) is a tipoff. Typing, scrolling, clicking and staring at the screen, without rest, contribute to these disorders, while prolonged posture was partly to blame for back, neck and wrist pain in 81 percent of radiologists in one study, according to Anand Prabhakar, MD, a radiologist at Massachusetts General Hospital in Boston.
4. Monitor the monitor: Desktop luminance should be kept at 400 cd/m2, explains David Hirschorn, MD, a radiologist at Massachusetts General Hospital in Boston. Krupinski adds, “Optimized displays mean radiologists take less time overall to interpret the cases, find the relevant lesions faster and spend less time trying to decide what type of lesion it is.”
5. Talk is cheap: Voice recognition software significantly shortens report turnaround and makes injury-associated motions like typing, clicking and leaning unnecessary.
6. Take a break! “Studies show that frequent microbreaks from using the keys and mouse (30 seconds to 2 minutes every 20 to 30 minutes) reduce complaints of musculoskeletal discomfort and have no adverse effects on work performance and productivity,” Ruess and colleagues emphasize.
7. Radical redesign: Many radiology departments report cost-benefits and strong satisfaction with hefty ergonomic overhauls.
8. Rest your feet: Whether a physician prefers to sit, stand or both, foot support is critical. Steve Dinwiddie, MD, a 6’3” radiologist and director of imaging services at Memorial Hermann Katy Hospital in Katy, Tex. prefers a nightclub-style workstation with bar-style footrest.
9. Split, lower and negatively tilt the keyboard. Split keyboards help users avoid ulnar deviation. Most keyboards come with legs allowing for positive tilt, which, according to Lynne Ruess, MD, of the department of radiology at Tripler Army Medical Center in Honolulu, are the opposite of what’s needed to avoid injury.
10. “If you’re feeling strain and pain, consider buying a different mouse,” advises Elizabeth Krupinski, PhD, professor of radiology at the University of Arizona in Tucson. Researchers have associated mouse usage, especially the scrolling wheel, with carpal tunnel syndrome. Hedge recommends alternatives like the trackball, wireless mouse and pointing pads, making sure to minimize wrist dorsiflexion.