Postural Assessment and the Prevalence of Musculoskeletal Disorders during Routine Clinical Examinations among Otolaryngologists in Isfahan City, Iran

  • Babak Vahdatpour Associate Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  • Saeid Sadeghi Joni Department of Radiology, Razi Hospital, School of Medicine, Gilan University of Medical Sciences, Rasht, Iran
Keywords: Ergonomics; Position; Otolaryngology; Quick Exposure Check (QEC); Loading on the upper body assessment (LUBA)


Background: Otolaryngologists are susceptible to various musculoskeletal disorders (MSDs) in the absence of suitable posture, because of working in various postures in offices and hospitals. The present study aimed to assess the risk of postures whilst either standing or sitting during routine examinations, estimate the prevalence of MSDs, and determine the relationship between these disorders and postures among otolaryngologists in Isfahan City, Iran.

Methods: In this study, photos were taken of the postures of 39 otolaryngologists in Isfahan City during patient examination and were analyzed using Quick Exposure Check (QEC) and loading on upper body assessment (LUBA) tools. Based on the risk of their postures, they were categorized into three groups of low-risk, medium-risk, and high-risk. Moreover, the Nordic Musculoskeletal Questionnaire (NMQ) was used for the assessment of the prevalence of MSDs.

Results: Based on the LUBA tool, otolaryngologists were at medium risk while examining patients' throats, and high risk during ears and nasal examinations; the QEC tool assessed this risk as low. Data resulting from the NMQ revealed that 31 participants (79.4%) had at least one MSD, which was a remarkable number. Based on data analysis, the relation between LUBA posture scores and the prevalence of MSDs was not statistically significant.

Conclusion: The prevalence of MSDs was remarkably high in some body regions, which might be due to inappropriate sitting or standing postures during common examinations. This can be prevented by educating practitioners about suitable postures.


1. Helmseresht P, Delpisheh A. Work-related healthcare. 3rd ed. Tehran, Iran: Chehr Publications; 2003. p. 44-8. [In Persian].
2. Chubine A, Amirzadeh F. General occupational health.1st ed. Shiraz, Iran: Kushamehr Publications; 1999. p. 53-9. [In Persian].
3. Nordin M, Andersson GBJ, Pope MH. Musculoskeletal disorders in the workplace: principles and practice. 2nd ed. Philadelphia, PA: Mosby; 2006.
4. Hart LG, Deyo RA, Cherkin DC. Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey. Spine (Phila Pa 1976) 1995; 20(1): 11-9.
5. Aghilinejad M, Farshad A, Mostafaee M, Ghafari M. Occupational medicine and occupational diseases.2nd ed. Tehran, Iran. Arjmand Publications; 2006. p. 31-9. [In Persian].
6. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 1987; 18(3): 233-7.
7. Mohammadfam I, Kianfar A, Afsartala B. Assessment of musculoskeletal disorders in a manufacturing company using QEC and LUBA methods and comparison of results. Iran Occup Health 2010; 7(1): 54-60. [In Persian].
8. Mehrdad R, Dennerlein JT, Morshedizadeh M. Musculoskeletal disorders and ergonomic hazards among Iranian physicians. Arch Iran Med 2012; 15(6): 370-4.
9. Rambabu T, Suneetha K. Prevalence of work related musculoskeletal disorders among physicians, surgeons and dentists: a comparative study. Ann Med Health Sci Res 2014; 4(4): 578-82.
10. Choobineh AR, Daneshmandi H, Aghabeigi M, Haghayegh A. Prevalence of musculoskeletal symptoms among employees of Iranian petrochemical industries: October 2009 to December 2012. Int J Occup Environ Med 2013; 4(4): 195-204.
11. Garcia PP, Presoto CD, Campos JA. Perception of risk of musculoskeletal disorders among Brazilian dental students. J Dent Educ 2013; 77(11): 1543-8.
12. Gomez MG, Castaneda R, Menduina PL, Garrido RU, Markowitz S. Estimating medical costs of work-related diseases in the Basque Country (2008). Med Lav 2013; 104(4): 267-76.
13. Freimann T, Coggon D, Merisalu E, Animagi L, Paasuke M. Risk factors for musculoskeletal pain amongst nurses in Estonia: a cross-sectional study. BMC Musculoskelet Disord 2013; 14: 334.
14. Vahdatpour B, Khosravi S, Rahimi A, Sattari S, Mogtaderi A, Dabiri F, et al. Work-related musculoskeletal disorders among radiologists in Isfahan: a cross-sectional study. Research Journal of Biological Sciences 2010; 5(10): 664-9.
15. Rahimi A, Vahdatpour B, Khosrawi S, Mogtaderi A, Sattari S, Dabiri F, et al. Work-related musculoskeletal disorders among pathologists in Isfahan: a cross-sectional study. Research Journal of Biological Sciences 2012; 5(12): 793-7.
16. Khosrawi S, Rahimi A, Vahdatpour B, Dabiri F, Mashrabi O. Work-related musculoskeletal disorders among cardiologists. Research Journal of Biological Sciences 2011; 6(4): 170-4.
17. Yasobant S, Rajkumar P. Work-related musculoskeletal disorders among health care professionals: A cross-sectional assessment of risk factors in a tertiary hospital, India. Indian J Occup Environ Med 2014; 18(2): 75-81.
18. Warren N, Dillon C, Morse T, Hall C, Warren A. Biomechanical, psychosocial, and organizational risk factors for WRMSD: population-based estimates from the Connecticut upper-extremity surveillance project (CUSP). J Occup Health Psychol 2000; 5(1): 164-81.
19. Szeto GP, Ho P, Ting AC, Poon JT, Cheng SW, Tsang RC. Work-related musculoskeletal symptoms in surgeons. J Occup Rehabil 2009; 19(2): 175-84.
20. Andersson BJ, Ortengren R, Nachemson AL, Elfstrom G, Broman H. The sitting posture: an electromyographic and discometric study. Orthop Clin North Am 1975; 6(1): 105-20.
21. MacDonald K, King D. Work-related musculoskeletal disorders in veterinary echocardiographers: a cross-sectional study on prevalence and risk factors. J Vet Cardiol 2014; 16(1): 27-37.
Original Article(s)