Everyone has a role in maintaining a culture of safety and reducing the incidence of WRMSDs in sonographers. For those who are actively scanning, personal accountability for maintaining safe work practices and the ongoing pursuit of risk-reducing modifications to scanning techniques are a necessity. Sonographers should know what work postures cause pain and make the necessary changes in their work behaviors, such as avoiding scanning positions that require extreme wrist flexion, trunk bending or twisting, shoulder abduction greater than 30 degrees, and excess force to acquire an image, particularly when scanning patients with a Body Mass Index (BMI) greater than 30. Familiarization with the proper use of adjustable chairs and adjustable exam tables is also crucial to optimizing scanning position. Sonographers should take the time to adjust the patient close to the edge of the exam table and properly adjust the height of the exam table and chair used during the exam to reduce abduction and reach of the upper extremities.
Shared Sonographer-Employer Responsibility
Even in areas where the Occupational Safety and Health Administration (OSHA) has not set forth a standard addressing a specific hazard, there is employer and employee responsibility for complying with the Occupational Safety and Health Act of 1970 (OSH Act)12. The general duty clause (Section 5) of the OSH Act states that:
Each employer
- shall furnish to each of his[/her] employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his[/her] employees;
- shall comply with occupational safety and health standards promulgated under this Act.
Each employee
- shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act which are applicable to his[/ her] own actions and conduct.
Furthermore, the Occupational Safety and Health Act of 1970 gives employees and their representatives the right to confidentially file a complaint and request an OSHA inspection of their workplace if they believe there is a serious hazard or their employer is not following OSHA standards. Workers can file a complaint without fear of retaliation by calling 1-800-321-OSHA (6742), online via eComplaint Form, or by printing the complaint form and mailing or faxing it to the local OSHA area office.13
Excerpt from the Work Related Musculoskeletal Disorders in Sonography white paper.
6. Evans K, Roll S, Baker J. Work-Related Musculoskeletal Disorders (WRMSD) Among Registered Diagnostic Medical Sonographers and Vascular Technologists: A Representative Sample. Journal of Diagnostic Medical Sonography 2009;25(6):287-299.
12. OSHA Act of 1970. Occupational Safety and Health Administration 2016. Available at: https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=OSHACT&p_id=3359. Accessed July 15, 2016.
13. How to File a Safety and Health Complaint. Occupational Safety and Health Administration 2016. Available at: https://www.osha.gov/workers/file_complaint.html. Accessed July 15, 2016.