Abstract Musculoskeletal Symptoms and Related Factors for Nurses and Radiological Technologists Wearing a Lead Apron for Radiation Pro t e c t i o n Jung-Im Yoo, Jung-Wan Koo 1 ) Angio Unit, Team of Radiology, Asan Medical Center, Dept. of Preventive Medicine, Industrial Medical Center, The Catholic University of Korea 1) Objectives: To determine the complaint rates of musculoskeletal symptoms and understand the related factors of musculoskeletal symptoms in nurses and radiological technologists wearing a lead apron for radiation protection. Method: The study subjects were 192 nurses and radiological technologists who work at the cardiac catheterization room or angioroom in the department of radiology. A self-recording questionnaire was used to investigate the general characteristics, occupational characteristics, characteristics related to wearing a lead apron, and subjective musculoskeletal symptoms designed by the National Institute for Occupational Safety and Health (NIOSH). Results: Complaint rates of musculoskeletal symptoms by NOISH were 51.0% in the upper /lower back, 49.0% in the shoulder, and 47.9% in the leg/knee/ankle. From multiple logistic regression analysis, musculoskeletal symptoms of the shoulder were influenced by two-piece type apron and long time wearing an apron, symptoms of upper/lower back by long time wearing an apron, sex, higher average working hours per a day and short resting time, symptoms of leg/knee/ankle by long time wearing an apron, working career at the present department (cardiac catheterization room or angioroom) and short resting time. Conclusion: The complaint rates of the musculoskeletal symptoms were affected by the characteristics of wearing a lead apron for radiation protection such as wearing time and apron type. Therefore, it is suggested that the workers who are wearing an apron need the proper wearing time and resting time, and suitable apron type and size for the body. Key Words: Musculoskeletal symptoms, Nurses and radiological technologists, Lead apron.

Fig. 1. One-piece type apron(left) and Two-piece type apron(right). Fig. 2. Back belt.

Table 1. General and occupational characteristics of the subjects. Characteristics N % Age (yr) 34 044 22.9 35 39 022 11.5 40 44 087 45.3 45 039 20.3 Sex Male 147 76.6 Female 045 23.4 Nurse 044 22.9 Occupation Radiological Technologist 148 77.1 Total job career (yr) 10 034 17.7 10 15 034 17.7 15 20 085 44.3 20 039 20.3 Career at the 5 052 27.1 present position (yr) 5 10 094 49.0 10 046 24.0 Working hours per day 8 039 20.3 8 153 79.7 Resting time (min) 30 080 41.7 31 60 048 25.0 61 064 33.3 Table 2. Characteristics of the subjects wearing a lead apron. Characteristics N % Wearing hours 6 96 50.0 6 96 50.0 Apron design One-piece type 99 51.6 Two-piece type 93 48.4 Apron weight (kg) 5 19 9.9 5 173 90.1 Back belt Use 50 26.0 Unuse 142 74.0

Table 3. Complaint rate of musculoskeletal symptoms. Body region Complaint rate N % Shoulder 94 49.0 Upper back/lower back 98 51.0 Leg/Knee/Ankle 92 47.9 Table 4. Complaint rate in musculoskeletal symptoms by general and occupational characteristcs Characteristics Characteristics Upper back/ Shoulder Leg/knee/ankle lower back N (%) N (%) N (%) Age (yr) 34 11 (25.0) 109.7** 16 (36.4) 93.4** 09 (20.5) 102.4** 35 39 04 (18.2) 05 (22.7) 06 (27.3) 40 44 78 (89.7) 76 (87.4) 76 (87.4) 45 01 (02.6) 01 (02.6) 01 (02.6) Sex Male 81 (55.1) 009.5** 80 (54.4) 002.9** 79 (53.7) 008.5** Female 13 (28.9) 18 (40.0) 13 (28.9) Occupation Nurse 13 (29.5) 008.6** 17 (38.6) 003.5** 13 (29.5) 007.7** Radiological Technologist 81 (54.7) 81 (54.7) 79 (53.4) Total job career (yr) 10 6 (17.6) 110.3** 10 (29.4) 109.8** 04 (11.8) 123.8** 10 15 10 (29.4) 10 (29.4) 10 (29.4) 15 20 78 (91.8) 78 (91.8) 78 (91.8) Career at the present position (yr) 5 10 (19.2) 110.1** 14 (26.9) 101.5** 08 (15.4) 115.3** 5 10 82 (87.2) 82 (87.2) 82 (87.2) 10 02 (04.3) 02 (04.3) 02 (04.3) Working hours per day 8 04 (10.3) 029.3** 06 (15.4) 024.9** 04 (10.3) 027.8** 8 90 (59.8) 92 (60.1) 88 (57.5) Resting time (min) 30 76 (95.0) 119.0** 76 (95.0) 107.9** 76 (95.0) 123.3** 31 60 12 (25.0) 13 (27.1) 10 (20.8) 61 06 (09.4) 09 (14.1) 06 (09.4) **p<0.01

Table 5. Complaint rate of musculoskeletal symptoms by characteristics related to wearing a lead apron. Characteristics with lead apron Upper back/ Shoulder Leg/knee/ankle lower back N(%) N(%) N(%) Wearing hours 6 09 (09.4) 120.4** 13 (13.5) 108.0** *8 (*8.3) 120.5** 6< 85 (88.5) 85 (88.5) 84 (87.5) Apron design One-piece type 12 (12.1) 111.0** 18 (18.2) 88.3** 12 (12.1) 104.9** Two-piece type 82 (88.2) 80 (86.0) 80 (86.0) Apron weight (kg)5 04 (21.1) 006.6** 07 (36.8) 01.7** 5 (26.6) 03.9** 5 90 (52.0) 91 (52.6) 87 (50.3) Back belt Use 04 (08.0) 45.4** 04 (*8.0) 50.1** *2 (*4.0) 52.2** Unuse 90 (63.4) 94 (66.2) 90 (63.4)

Table 6. Multiple logistic regression of musculoskeletal complaint rate. Characteristics (Indicator) Odds ratio and 95% confidence interval Shoulder Upper back/ Leg/knee/ankle lower back Age (<39 yr) 1.55 3.16 2.82 0.28 8.69 0.57 17.39 0.43 18.54 Sex (female) 1.63 5.28* 5.33 0.34 7.83 1.01 27.63 0.70 40.72 Career at the 1.94 2.70 8.50* present position (<5 yr) 0.45 8.41 0.65 11.28 1.32 54.74 Working hours 4.18 4.36* 4.40 per day (8 hr) 0.98 17.84 1.11 17.09 0.89 21.73 Resting times 0.18 0.03** 0.05** per day (30 min) 0.03 1.25 0.00 0.24 0.00 0.36 Apron design 6.86* 1.38 2.36 (one-piece) 1.46 32.33 0.28 6.81 0.40 13.81 Apron weight 1.55 1.87 2.14 (5 kg) 0.32 7.64 0.45 7.76 0.39 11.78 Wearing hours 8.59** 6.86** 7.70** per day (6 hr) 2.38 31.05 1.92 24.50 1.94 30.52 Back belt 0.39 0.42 0.15 (unuse) 0.08 1.86 0.09 1.98 0.02 1.09 *p<0.05, **p<0.01.