# Systematic Review and Meta-Analysis of Work-Related Musculoskeletal Disorder Prevalence Among European Surgeons: Effect of Demographic, Economic, and Quality-of-Life Indicators

## TL;DR

This study finds that 75.8% of European surgeons suffer from work-related musculoskeletal disorders, with the lower back and neck most affected, and suggests that health policies should consider economic and demographic factors.

## Contribution

The study introduces HDI and SBS as new risk factors for WMSDs among surgeons and provides prevalence data by body area.

## Key findings

- 75.8% of European surgeons experience work-related musculoskeletal disorders.
- Lower back and neck are the most commonly affected body areas.
- Higher WMSD prevalence is linked to surgeons over 45 and in countries with high surgery-by-surgeon ratios.

## Abstract

Public health relevance—How does this work relate to a public health issue?
WMSDs are ubiquitous among healthcare professionals.Knowledge of prevalence and the factors that cause them is essential for good health at work and maintaining the effectiveness of interventions by surgeons.

WMSDs are ubiquitous among healthcare professionals.

Knowledge of prevalence and the factors that cause them is essential for good health at work and maintaining the effectiveness of interventions by surgeons.

Public health significance—Why is this work of significance to public health?
To have data on the general prevalence and by body area among surgeons in Europe for the development of new health policies (recommendations and education).This study investigates new parameters such as HDI and SBS as risk factors underlying WMSD.

To have data on the general prevalence and by body area among surgeons in Europe for the development of new health policies (recommendations and education).

This study investigates new parameters such as HDI and SBS as risk factors underlying WMSD.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
For practitioners: to carry out their activities in the best working conditions while protecting their health.Improved quality of life for surgeons.

For practitioners: to carry out their activities in the best working conditions while protecting their health.

Improved quality of life for surgeons.

Background: Work-related musculoskeletal disorders (WMSDs) are common among surgeons. The objective was to study how economic, demographic, and quality-of-life indicators influence the WMSD prevalence among European surgeons. Methods: A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three open databases were scanned without a date limit to extract the overall WMSD prevalence and by body area. Results: Among the 11,814 articles, 25 were included, with a total of 5174 surgeons. The overall prevalence was pooled at 75.8% (95% CI: 68.6–83.1%). The most affected areas were lower back (52.1%, 95% CI: 43.1–61.0%), neck (51.2%, 95% CI: 43.7–58.9%), shoulder (43.1%, 95% CI: 36.4–49.8%) and upper back (34.2%, 95% CI: 24.2–44.1%). Surgeons aged over 45 with more than 10 years’ experience had a higher prevalence of WMSDs in the neck, hip, upper and lower back. The overall and lower back prevalence was higher among surgeons in countries where the surgery-by-surgeon ratio was greater than 125. A negative correlation was observed between the Human Development Index and the lower back prevalence. Conclusions: Further research is needed to strengthen ergonomics programs, knowledge, and organizational work strategies to effectively reduce WMSD prevalence among European surgeons.