Estimation of surgeons' ergonomic dynamics with a structured light system during endoscopic surgery

Background: The purpose of this study was to use motion capture to collect body posture information during simulated endoscopic sinus surgery interventions performed by both specialists and residents in standing and sitting positions and to analyze that information with the validated Rapid Upper Limb Assessment (RULA) tool, which allows calculation of a risk index of musculoskeletal overload. Methods: Bilateral endoscopic sinus surgery was performed in 5 cadaver heads by 2 residents, and 4 practicing rhinologists. Musculoskeletal symptoms were evaluated before and after the dissection. Full?body postural data were collected with the help of Kinect and a .NET WPF (Windows Presentation Foundation) software application to record images of the surgical procedures, and then analyzed with the RULA tool to calculate a risk score indicative of the exposure of the individual surgeon to ergonomic risk factors associated with upper extremity musculoskeletal disorders. Results: All subjects reported physical discomfort after nasal endoscopic procedures. An overall similar RULA score was obtained by the residents and the practicing rhinologists. The RULA score was slightly lower for the sitting position than for the standing position, mostly due to a lower score in group B (neck, trunk, and leg); however, the RULA score for group A (arm and wrist analysis) was higher, denoting a higher risk for the upper back and arms. Conclusion: Significant musculoskeletal symptoms were reported after an endoscopic operation by both the resident and the practicing otolaryngologists. All surgeons obtained a high RULA score, meaning that urgent changes are required in the task.This project has been developed thanks to the Innovation Support Program "InnVal" of the Marques de Valdecilla Research Institute (IDIVAL

Nasosinusal adenocarcinoma in Cantabria

RESUMEN: Objetivo: El adenocarcinoma nasosinusal (ADCNS) es una neoplasia infrecuente con una fuerte asociación a exposición ocupacional a polvo de madera que se encuentra recogida en el cuadro de enfermedades profesionales del RD 1299/2006. El propósito de este trabajo es conocer la incidencia, las características clínicas y su declaración como enfermedad profesional en la Comunidad de Cantabria. Material y Método: Estudio clínico-epidemiológico retrospectivo de los pacientes diagnosticados de ADCNS en la comunidad autónoma de Cantabria entre los años 1990-2014. Resultados: En el periodo de estudio se registraron 36 casos de ADCNS. Todos los casos fueron varones, con una mediana de edad de 69 años. La localización más frecuente fue el etmoides. Los síntomas principales que motivaron la consulta fueron la obstrucción nasal y epistaxis, con una mediana de tiempo hasta la primera consulta con el especialista de 6 meses. La supervivencia estimada a los 5 años fue del 52%; Intervalo de Confianza al 95% (IC): 36-68%. En 31 pacientes (86%) se objetivó historia laboral de ocupaciones relacionadas con la exposición a polvo de madera, siendo ebanistas y carpinteros las más frecuentes. Sin embargo, ningún caso se declaró como contingencia laboral, y en especial como enfermedad profesional tras la aprobación en 2006 de la normativa vigente. Conclusiones: Los síntomas clínicos como la obstrucción nasal o la epistaxis deben alertarnos en trabajadores que tengan el antecedente de haber trabajado con la madera. La mayoría de los adenocarcinomas son diagnosticados en estadios avanzados lo que empeora el pronóstico. Debe proporcionarse la formación y sensibilización adecuada sobre cáncer laboral en facultativos para una mejor notificación de la sospecha de un origen laboral.ABSTRACT: Objective: Nasosinusal adenocarcinoma (NSADC) is an infrequent neoplasm with a strong association to occupational exposure to wood dust that is listed in the RD 1299/ 2006 occupational disease list. The purpose of this work is to know the incidence, the clinical characteristics and its declaration as an occupational disease in the Autonomous Community of Cantabria of Spain. Material and Method: Retrospective clinical-epidemiological study of patients diagnosed with NSADC in the autonomous community of Cantabria between the years 1990-2014. Results: During the study period, 36 cases of ADCNS were recorded. All cases were male, with a median age of 69 years. The most frequent location was the ethmoid. The main symptoms that motivated the specialist visit were nasal obstruction and epistaxis, with a median time until the first specialist visit of 6 months. Estimated survival at 5 years was 52%; 95% confidence interval (IC): 36-68%. In 31 patients (86%) there was an occupational history of occupations related to exposure to wood dust, with cabinetmakers and carpenters being the most frequent. However, no case was declared as an occupational contingency, and especially not as an occupational disease after the approval in 2006 of the current regulations. Conclusions: Clinical symptoms such as nasal obstruction or epistaxis should alert us in workers who have a history of working with wood. Most adenocarcinomas are diagnosed in advanced stages which worsens the prognosis. Adequate training and awareness of occupational cancer should be provided to physicians for better reporting of suspected occupational origin