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October is Ultrasound Awareness Month

ARDMS is celebrating Medical Ultrasound Awareness Month in October...

October 14 is World Standards Day

World Standards Day is celebrated each year on October 14th and pays tribute to the efforts of thousands of experts worldwide...

Headlines in the News:

Ergonomic Issues Continue to Plague Sonographers

Despite the use of ergonomically designed ultrasound equipment 96% of their female sonographers experienced some type of musculoskeletal symptom...

Ultrasound Densitometry Finds Beer Helps Women Keep Strong Bones

Ultrasound bone-density values were higher for women who drink beer...

October is Ultrasound Awareness Month

ARDMS is celebrating Medical Ultrasound Awareness Month in October...

ARDMS is celebrating Medical Ultrasound Awareness Month in October. This month and throughout the year, ARDMS encourages Registrants and ultrasound professionals to raise medical ultrasound awareness.

With ultrasound's increasing role in medicine, one of the main goals of Medical Ultrasound Awareness Month is to provide the public with a better understanding of ultrasound and its many uses in health care.

Here are some ways to educate the public, raise medical ultrasound awareness, and celebrate your profession during Medical Ultrasound Awareness Month:

1. Tell your patients you are certified: The mission of ARDMS is "quality care and patient safety through the certification and continuing competency of ultrasound professionals." Share with patients that you are certified by ARDMS, that you had to pass a series of rigorous examinations to earn the certification, and that as a result, your patients are receiving the highest level of care. To assist you in sharing information with your patients, ARDMS has developed a new brochure entitled, "Understanding Sonography...and the Importance of a Certified Sonographer." If you are interested in receiving this brochure, send an e-mail to communications@ardms.org and we will add your name to distribution efforts.

2. Educate Patients about the different terms of Sonography:

Sonography - using the reflections of high-frequency sound waves (ultrasound) to construct an image (a sonogram) of a body organ or to observe fetal growth or study bodily organs.

Ultrasound - the use of ultrasonic waves for diagnostic or therapeutic purposes, specifically to image an internal body structure, monitor a developing fetus, or generate localized deep heat to the tissues.

Transducer - a device that receives a signal in the form of one type of energy and converts it to a signal in another form.

Sound wave - a wave that transmits sound

Sonographer - a specialist in the use of Sonography; a person who performs the sonographic exam (ultrasound).

3. Celebrate your accomplishments: A recent study found that 97% of Registrants feel proud to have earned an ARDMS credential. Share your accomplishments with colleagues and patients by displaying your credential certificate at your facility, sporting the ARDMS Registrant patches on your scrubs or lab coat, or wearing the ARDMS lapel pin.

4. Encourage your colleagues to become credentialed: The reasons Sonographers become credentialed varies widely. According to a recent survey, many active Registrants sought certification as a personal career goal, to distinguish themselves as competent in the field, to elevate the profession of Sonography, to expand career opportunities, or because it was a condition of employment. Share your personal story about becoming certified with your colleagues and encourage them to join you in earning an ARDMS credential.

5. Be a Mentor: Offer to lend a supportive hand to students and those new to the profession of Sonography. Impart your clinical expertise through hands-on scanning, share the full scope of the day-to-day experience of a Sonographer, and encourage and celebrate efforts by others to become ARDMS certified.

6. Check-out the Medical Ultrasound Awareness Month resources offered by other sponsoring organizations.Cardiovascular Credentialing International (CCI) (www.cci-onine.org/)
Society of Diagnostic Medical Sonography (SDMS) (www.sdms.org/)

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October 14 is World Standards Day

World Standards Day is celebrated each year on October 14th and pays tribute to the efforts of thousands of experts worldwide...

In honor of World Standards Day, October 14th, ARDMS would like to thank our Registrants, colleagues, and all medical professionals for their continuous commitment to high-quality patient care.

World Standards Day pays tribute to the efforts of thousands of experts worldwide that collaborate with the International Electrotechnical Commission (IEC), International Organization for Standardization (ISO), and International Telecommunication Union (ITU) to develop voluntary international standards that facilitate trade, spread knowledge and disseminate technological advances.

The ISO and IEC work to develop international standards for certification processes worldwide and create a more cost-effective global standard for workers. The standard by which ARDMS is certified, is referred to as ISO/IEC 17024. The main role of ISO/IEC 17024, officially entitled General Requirements for Bodies Operating Certification Systems of Persons, is to oversee in facilitating global standardization of the certification community, increasing mobility of among countries, enhancing public safety, and protecting consumers.

The ISO 17024 certification gives ARDMS a clear advantage in being the model for setting high standards in credentialing and within the sonography community. It creates domestic and global networking opportunities, since most countries recognize the ISO standard as the model for successful management. It assures a level playing field for standards and conformity assessment programs. ISO 17024 gives ARDMS information on new requirements and new market directions. By keeping up with the ISO standards, ARDMS is able to maintain its high quality credentials to the public and international sonography community.

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Ergonomic Issues Continue to Plague Sonographers

Despite the use of ergonomically designed ultrasound equipment 96% of their female sonographers experienced some type of musculoskeletal symptom...

Despite the use of ergonomically designed ultrasound equipment, researchers at Yale University in New Haven, CT, have found that 96% of their female sonographers experienced some type of musculoskeletal symptom within a 12-month time frame.

The study, conducted through the school's Occupational and Environmental Medicine Program, found that shoulder (73%) and lower back (69%) symptoms were the most common ailments, followed by wrist and hand issues (54%).

"All of these people are experiencing some discomfort, some in multiple areas, some in one specific area," said Dr. James J. Hill, assistant professor of medicine at Yale and lead study author. "Unless something changes, this group is going to move on to have career-ending injuries."

Ergonomic equipment

The researchers noted that ultrasound equipment manufacturers have made a concerted effort in recent years to make sonographer workstations more ergonomically friendly, with height-adjustable keyboards, monitors, and control panels; lightweight transducers that facilitate a palmar grip; and voice-activated controls. But musculoskeletal problems persist.

"Even with newer machines, ergonomically designed carts, and different transducers, we are still seeing very high rates of symptoms in our population," Hill said. "At face value, it is shocking, but as we got into it, we were overestimating the impact just changing the equipment would make in the work experience."

Twenty-six Yale sonographers completed a survey and interviews in April and May 2006. The female sonographers had a mean age of 36.9 years, with a mean career duration of 9.2 years and mean job duration of 6.4 years. Six sonographers worked between 24 and 32 hours per week, 14 sonographers worked between 36 and 40 hours weekly, and four sonographers worked more than 40 hours per week. (Two male sonographers at Yale were excluded from the study, because of their small number and the differences between males and females in terms of grip strength and anthropometric measurements.)

Four-part questionnaire

The research included a four-part written questionnaire on the sonographers' demographic information, such as age, gender, and hand dominance. Researchers also collected anthropometric measurements, such as hand length and span, forward reach, height, weight, and body mass index, along with grip strength. There also was a review of occupational health records for previous treatment or more serious musculoskeletal injury.

The survey also asked questions about both physical and psychological job demands and the sonographers' work pace, the importance of avoiding mistakes, the presence of conflicting work demands, and the degree of control over how and when a task is completed.

"Those things also are ergonomic, but they are things that can't be manufactured; they are how your organization runs," Hill said. "We were finding that it was difficult for the practitioner to change their day-to-day job. In some workplaces, if you are having a bad day or something hurts, you can shift the responsibilities to someone else and the team takes care of the problem. In this population, there isn't a break on some levels."

Abdominal girth

The researchers also measured abdominal girth of the sonographers to determine how close they could get to a keyboard or a patient. The current advice for sonographers is to angle one's shoulder 10° to 60° toward the patient to avoid any undue stress on the joint while scanning. If that angle cannot be maintained due to abdominal girth, Hill said, the sonographer could develop shoulder symptoms.

"It looked like people who had a larger abdominal girth were more at risk in general for some musculoskeletal symptoms," Hill said. "Why that is, we can hypothesize all day. With our measures of forward reach and how close we can position to patients, that may be one factor, but it is hard to say."

The results found that 25 of the 26 female sonographers reported at least one musculoskeletal symptom, with shoulders, lower back, wrist and hand, and neck conditions among the most common complaints. Only one sonographer reported no symptoms.

As for the causes of musculoskeletal problems, the study cited job strain, time on the job, work pace and variability, and time spent standing as several variables for the musculoskeletal symptoms.

One dilemma the study uncovered is that by reducing the risk factors for one anatomic location, a sonographer likely is increasing the risk of pain in another area. For example, if a sonographer changes his or her hand and wrist position to alleviate discomfort, the adjustment will add pressure to the neck or back, causing another symptom.

"We can tell them to maintain a certain position of the wrist, but they still have to do that same motion," Hill said. "They will simply shift the burden to the shoulder or to the back."

So what can sonographers do to minimize their risk of injury? Periodic breaks and stretching exercises are a start, Hill said, but there is no magic bullet. "Unless you get to the root or nature of the problem, these are technically demanding studies with a lot on the line," he said.

He added that the results "beg the question: Are we hitting the end of how well we can design the equipment? We may have made all the gains we can. Then the question becomes: What are we doing with the job task? The best ergonomic equipment in the world for someone doing 30 diagnostic studies a day is not going to help them."

Among the study's recommendations is teaching safer scanning positions, especially in initial training sessions, with increased emphasis on shoulder positions. The authors also advocated the possible redesign of transducers and improvements in the work environment.

Physicians beware

Musculoskeletal symptoms are not exclusive to sonographers and can occur among physicians, emergency medical responders, nurses, and firefighters, Hill said, as they "tend to neglect their own symptoms as they are helping everyone else."

He believes that physicians might be the next group to experience musculoskeletal symptoms because they increasingly use ultrasound for office diagnostics and joint injections. "Are they going into this field blind?" Hill queried. "And will we see an increase in physician injuries as they incorporate ultrasound in their daily practice?"

With an estimated 41,280 diagnostic medical sonographers working in the U.S., according to the U.S. Bureau of Labor Statistics, the Yale researchers plan to gather more anthropometric data to help vendors and engineers design future ultrasound equipment.

"You would rather engineer a solution and put in controls," Hill said. "If you depend on the individual to do things safely, that is usually where you have the most problems."

View the article online.

Article written by staff at auntminnie.com and adapted for the purposes of this newsletter.

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Ultrasound Densitometry Finds Beer Helps Women Keep Strong Bones

Ultrasound bone-density values were higher for women who drink beer...

While wine has long been cited for its health benefits, beer hasn't enjoyed nearly the same positive reputation. But a study published in the October issue of Nutrition found that ultrasound bone-density values were higher for women who drink beer, besting both wine drinkers and teetotalers.

The Spanish research team also found that beer drinkers had a lower body mass index (BMI) than those who didn't drink beer (Nutrition, October 2009, Vol. 25:10, pp. 1057-1063).

"The consumption of beer, apart from its alcohol content, favors greater bone mass in women independently of their gonadal status," wrote the group led by Dr. Juan Pedrera-Zamorano of the University of Extremadura in Caceres, Spain. "This might be a result of the phytoestrogen content of this alcoholic drink, which requires further investigation."

Seeking to study the effect of beer consumption on bone mass in healthy women, the researchers performed a cross-sectional study of 1,697 participants from the health district of the province of Caceres. These women had a mean age of 48.44 and BMI ranging between 19 and 32 kg/m2.

Of the study participants, 710 were premenopausal (mean age, 37), 176 were perimenopausal (mean age, 49.4), and 811 were postmenopausal (mean age, 58.1). All participants were recruited in a clinical convenience sample, having visited the health district's rheumatology department clinic for risk assessment of osteoporotic fracture.

After providing their complete medical history and receiving a physical examination, the participants completed a questionnaire that detailed their current cigarette, alcohol, caffeine, and nutrient consumption. The researchers calculated current alcohol intake according to international references, and the subjects were classified as moderate drinkers (110-280 g/week), light drinkers (< 110 g/week), and nondrinkers. They also classified women based on whether they consumed beer and/or wine.

All subjects received a bone ultrasound study of the second to fifth proximal phalanges of the non-dominant hand, noting the mean of all measurements. Exams were performed using a DBM Sonic Bone Profiler (Igea, Carpi, Italy), which was equipped with a caliper that closes tangentially on the phalanx; the caliper measures the amplitude-dependent speed of sound (Ad-SoS) through the phalanx, which is used to calculate bone density.

Beer does a body good?

The researchers found that women who drank beer had higher bone density than those who didn't, with the association directly correlated to alcohol consumption. Bone density as measured by the amplitude-dependent speed of sound was 2063.10 m/sec in nondrinkers, 2073.10 m/sec in light drinkers (p < 0.005 versus nondrinkers), and 2087.21 m/sec in moderate drinkers (p < 0.0001 versus nondrinkers and light drinkers).

In addition to beer intake as a factor related to improved bone density, the researchers found that gonadal status influenced Ad-SoS scores. Postmenopausal women tended to have lower bone densities, with Ad-SoS scores of 2020.95 m/sec, compared to scores of 2090.34 m/sec in perimenopausal women and 2117.21 m/sec in premenopausal women.

BMI also lead to higher Ad-SoS scores, while age led to lower scores. There was no association between bone density and wine intake or the number of cigarettes per day.

The lower bone density found in the non-alcohol and wine drinkers may indicate that other components found in beer besides alcohol influence bone mass, according to the authors. The researchers also noted a decline in bone-density values and beer intake with age.

View the article online.

Article written by staff at auntminnie.com and adapted for the purposes of this newsletter.

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