Pipetting Related Repetitive Strain Injury (RSI) - The Modern Laboratory Hazard
"Work-related muscloskeletal disorders...are the most prevalent, most expensive and most preventable workplace injuries in the country. The good news is that real solutions are available."1
Working in the laboratory can be a dangerous occupation with exposure to hazardous, corrosive chemicals, infectious microbes & radiation. Fortunately over the years various Health & Safety directives have greatly reduced or eliminated these dangers by designing safety legislation to protect workers. However, certain hazards to health, of a more physical rather than chemical nature, are still apparent in modern laboratories.
Pipettes are a fundamental tool used in multiple disciplines, and the number of applications that use pipettes is growing at a rapid pace. It is not surprising that laboratory personnel spend considerable amounts of time pipetting; an average of nearly 500 hours per year (roughly 2 hours a day) of pipetting activities are reported by Bjorksten.2
If you spend several hours a day pipetting, you know it can be a real pain... in the neck or the wrist or the elbow or the thumb or just about any other part of the anatomy you care to mention. In fact, Bjorksten concludes that laboratory personnel who pipette more than 300 hours per week (approx. 1.3 hours a day) are at an elevated risk of RSI.
So the bad news is the prolonged pipetting without taking important precautions, can lead to serious repetitive strain injuries. The good news is that there is a lot you can do to protect yourself.
You should aim to become informed and learn all you can about pipetting injuries, risk factors and how to prevent or reduce them. Not only will this information help you avoid injury, it will assist you in when choosing and using a pipette. More and more laboratory based scientists are becoming aware of the injuries that can result from repetitive pipetting. Most pipette manufacturers have responded with new designs that dramatically reduce end user exposure to RSI-related injuries.
Potential Injuries
Most injuries are temporary, although some, such as Carpal Tunnel Syndrome, may be permanent. While the onset of musculoskeletal disorder symptoms can be either gradual or sudden, they generally develop progressively.
Stage 1
Minor aches and pain are experienced while performing a task. The pain goes away given a break and at night. Generally, no reduction in productivity is noted. However, the accuracy & precision of a low volume pipette is dependant on technique. So even a minor change in technique because of a temporary pain may impact results. Ergonomic methods can be used to reverse stage 1.
Stage 2
Symptoms begin early and last well past cessation of the activity and may disturb sleep. The capacity to perform the repetitive activity is reduced. Conditions can persist over months and medical intervention is often needed.
Stage 3
Symptoms are experienced almost all the time, with even non-repetitive movements being painful. productivity is severely limited and frequently ceases completely. Long-term damage is possible and medical attention is necessary.
Pipetting Risk Factors
Some of the most common risk factors leading to musculoskeletal disorders include:
Repetition
Force
Posture
Vibration
Strong evidence exists that combinations of these factors increase the risk of injuries common to pipette users, specifically, the combination of awkward, repetitive and forceful activities.3
Examples of Possible Causes/Pipetting Action which could lead to RSI
Tip insertion and using wrist movements to manipulate pipette. Symptoms include pain and inflammation in the wrist and elbow resulting in Tendinitis (inflammation of the tendon).
Gripping the pipette tightly and performing repetitive and forceful plunger and tip ejection activities with your thumb. Symptoms include DeQuervain's- pain on the thumb side of the wrist; thumb may be tender to touch and a small knot may be felt; the thumb may lock in position when bent. Alternatively Trigger Finger/Pipettor's Thumb - pain where the finger or thumb joins the palm; swelling; finger or thumb lock in position while being extended. This can result in Tenosynovitis (Paratenonitis) or inflammation of the sheath that surrounds the tendon.
Flexing, extending and rotating the wrist while pipetting or inserting and ejecting tips. Symptoms include weakness in the hand, numbness or tingling in the thumb, index and middle fingers; numbness or tingling of the palm of the hand, wrist pain, reduced finger and thumb movement, sharp radiating pain from the hand to the elbow or neck. These symptoms can be a sign of carpel Tunnel Syndrome - compression of the median nerve and vessels running through the carpel tunnel in the wrist.
Prevention
Both the pain and cost of workplace injuries can be reduced through preventative measures. More than 90 studies of ergonomic programs showed a 70% decrease in musculoskeletal disorders when integration of ergonomic education, working environments, techniques and tools were employed.4 These can reduce and even remove the risk of progressing through the stages of a disorder.
The poster pin points some key techniques that can be employed every day to reduce the risks.
Good posture
Not over reaching
Working at a comfortable height
Prevent twisting motions
vary pipetting activities
Alternate with other tasks
Try using either hand
Stretch frequently
Grip the pipette lightly
take regular short breaks
Pipetting Ergonomics Research Papers
Anachem runs a series of seminars for all levels from pHD students to experienced scientists.
The programme includes:-
Pipetting Techniques
Ergonomics of Pipetting
Service & Maintenance of Pipettes
So if you are worried about RSI or want to improve your pipetting technique contact Anachem for more details. The seminars can be tailored to your institutes individual requirements.
References
Alexis M Herman, US Secretary of labour (1999) "One Size Does Not Fit All" Approach. Unisted States Occupational Safety and Health Administration.
Bjorksten M G, Almby B and Jansson E S (1994) Hand and shoulder ailments amoung laboratory technicians using modern plunger-operated pipettes. Applied Ergonomics. 25, 88-94.
Kroemer K H E (1989) Cumlative trauma Disorders: Their recognition and ergonomics measures to avoid them. Applied Ergonomics. 20 274-280.
(1999) Ergonomics program. United States Occupational Safety and Health Administration.
