Importance Physicians in procedural specialties are at high risk for work-related musculoskeletal disorders (MSDs). This has been called “an impending epidemic” in the context of the looming workforce shortage; however, prevalence estimates vary by study.

Objectives To estimate the prevalence of work-related MSDs among at-risk physicians and to evaluate the scope of preventive efforts.

Data Sources and Study Selection Systematic search in MEDLINE (Ovid), Embase (Elsevier), Web of Science, PubMed (National Center for Biotechnology Information), and 2 clinical trial registries, without language restriction, for studies reporting on the prevalence and prevention of work-related MSDs among at-risk physicians published until December 2016. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines for meta-analyses and systematic reviews of observational studies were used. At-risk physicians were defined as surgeons and medical interventionalists. Studies reporting on specific disorders or pain assessed with validated instruments were included.

Data Extraction and Synthesis Study characteristics; disease prevalence for the neck, shoulder, back, and upper extremity; and measures of resulting disability were recorded. Study estimates were pooled using random-effects meta-analytic models.

Main Outcomes and Measures Career prevalence of injuries and 12-month prevalence of pain.

Results Among 21 articles (5828 physicians [mean age, 46.0 years; 78.5% male; 12.8 years in practice; 14.4 hours performing procedures per week]) included in this systematic review and meta-analysis, pooled crude prevalence estimates of the most common work-related MSDs were degenerative cervical spine disease in 17% (457 of 2406 physicians) (95% CI, 12%-25%), rotator cuff pathology in 18% (300 of 1513 physicians) (95% CI, 13%-25%), degenerative lumbar spine disease in 19% (544 of 2449 physicians) (95% CI, 5%-16%), and carpal tunnel syndrome in 9% (256 of 2449 physicians) (95% CI, 5%-16%). From 1997 to 2015, the prevalence of degenerative cervical spine disease and degenerative lumbar spine disease increased by 18.3% and 27%, respectively. Pooled prevalence estimates for pain ranged from 35% to 60% and differed by assessment instrument. Of those with a work-related MSD, 12% (277 of 2319 physicians) (95% CI, 7%-18%) required a leave of absence, practice restriction or modification, or early retirement. Heterogeneity was considerable for all crude analyses (mean I² = 93.5%) but was lower for sensitivity analyses (mean I² = 72.3%). Interventions focused on products and behaviors. Twelve at-risk specialties described a gross lack of awareness and an unmet need for ergonomics education.

Conclusions and Relevance Prevalence estimates of work-related MSDs among at-risk physicians appear to be high. Further research is needed to develop and validate an evidence-based applied ergonomics program aimed at preventing these disorders in this population.

重要 的程序性特色医生们在与工作有关的肌肉骨骼疾患（MSDS）的高风险。在劳动力短缺迫在眉睫的情况下，这被称为“即将到来的流行病”；但是，患病率估计因研究而异。

目的 评估高风险医生中与工作相关的MSD患病率，并评估预防工作的范围。

数据来源和研究选择 在MEDLINE（Ovid），Embase（Elsevier），Web of Science，PubMed（国家生物技术信息中心）和2个无语言限制的临床试验注册中心中进行系统搜索，用于报告关于流行病的发生和预防的报告直到2016年12月为止，高风险医师中与工作相关的MSD均已发布。使用了流行病学观察性研究的荟萃分析（MOOSE）进行荟萃分析的荟萃分析和观察性研究的系统评价。风险医师被定义为外科医生和医学干预专家。包括报告有关使用经验证的仪器评估的特定疾病或疼痛的研究。

数据提取与综合 研究的特点；颈部，肩膀，背部和上肢的疾病患病率；并记录导致残疾的措施。使用随机效应荟萃分析模型汇总研究估计数。

主要结果和衡量指标 职业生涯中的患病率和12个月的疼痛率。

结果 在该系统评价和荟萃分析中，纳入21篇文章（5828名医师[平均年龄46.0岁；男性78.5％；实践12.8年；每周执行手术14.4小时]）中，汇总了以下最常见工作的粗略患病率估算值：相关MSD为变性颈椎疾病（17％）（2406位医师中的457名）（95％CI，12％-25％），18％（1513位医师中的300名）的肩袖病理（95％CI，13％-25％） ），19％（2449名医师中的544名）发生退行性腰椎疾病（95％CI，5％-16％）和9％（2449名医师中的256名）（95％CI，5％-16％）的腕管综合症）。从1997年到2015年，变性性颈椎疾病和变性性腰椎疾病的患病率分别增加了18.3％和27％。汇总的疼痛估计值范围为35％至60％，并且因评估工具而异。患有与工作有关的MSD的患者中，有12％（在2319位医师中有277位）（95％CI，7％-18％）需要请假，限制工作或进行调整或提前退休。对于所有原油分析而言，异质性都相当大（平均值I ²  = 93.5％），但敏感性分析则较低（平均I ²  = 72.3％）。干预措施着重于产品和行为。十二个高风险专业描述了人们对人机工程学教育的严重缺乏和未满足的需求。

结论与相关性 高风险医师中与工作相关的MSD患病率估计很高。需要开展进一步的研究，以开发和验证旨在预防该人群中这些疾病的循证应用人体工程学计划。