Musculoskeletal disorders: personnel monitoring and use of Romeo^® handling aid

Introduction
The increased activity of our chemotherapy production unit (CPU) has consequences: musculoskeletal disorders (MSDs). After a first study on MSDs in our cancer institute in 2021, preventive measures have been put in place: shift rotation per half day and Romeo^® handling aid (HA) acquisition.
What is the impact of these measures on MSDs evolution in our pharmaceutical technicians (PTs) team?

Material and Method
A descriptive observational study was conducted from January to March 2023.
14 PTs of our CPU answered two questionnaires:
* Nordic Questionnaire: allowing to make an inventory of pains and discomforts felt by location.
* Borg CR10 scale: evaluating the risk of MSDs occurring according to three workstations: control station, without Drugcam^® and with Drugcam^®.
A PTs subgroup which responded to the questionnaires in 2021 was extracted and the 2021 results were compared with the 2023 results by non-parametric statistical test (Fischer’s exact test and Wilcoxon test). A questionnaire on ROMEO^® use was created and submitted to PTs.

Results/discussion
Compared to the 2021 results, 3 more PTs had shoulder and wrist/hand pains in the past 12 months. Nevertheless, the increase is not statistically significant for any location. The evaluation by Borg’s scale reveals an increase in pain after half a day of production for all locations and for all workstations in 2023. Unlike 2021, more areas were significantly more painful after production: for Drugcam^® station left arm, for control station lower back and legs as in 2021 and for all three stations shoulders and right arm. As for ROMEO^® use only 2 out 14 PTs use it regularly, for large volume preparations. A relief in pain has been noted since ROMEO^® use for the 2 PTs. The main reasons of non-use are loss of time (45.4%) and poor ergonomics of the device: heavy and bulky (72.7%).

Conclusion
The 2021 measures appear insufficient in coping with MSDs. However, non-parametric tests have low power and require large differences to be significant. In view of a low ROMEO^® use, an awareness action on MSDs and a training on ROMEO^® will take place. After discussion with other user centers and the supplier, an optimization of our dose banding production is planned with slots reserved for ROMEO®^®use for large volume preparations. Finally, a follow-up using the prevalence and CR10 indicators will be set up to monitor the trend of MSDs.

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