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Ergonomics, in the context of endoscopy, refers to the study and optimisation of an endoscopist’s interaction with their endoscopy environment, to reduce the rate of endoscopy-related injury (ERI). 1 While the risk and prevalence of ERI has been established in adult gastroenterology,2–4 and paediatric gastroenterologists in the USA,5 there are no available data on this subject amongst UK paediatric gastroenterologists. Considering increasing awareness of this issue, the American Society for Gastrointestinal Endoscopy developed guidelines for prevention of ERI, and a core curriculum presenting best practice recommendations for ergonomics in endoscopy, highlighting the importance of optimisation of factors such as posture, room set up, and appropriate equipment handling in paediatric endoscopy.1 6 However, ESGE/ESPGHAN joint guidelines on paediatric endoscopy do not mention ergonomics and there exists no similar guidance for the European audience.7 Aim To ascertain attitudes towards ergonomics in endoscopy and the prevalence, nature, and risk factors for endoscopy-related injury in the UK paediatric endoscopist population.Methods A 26-point questionnaire survey focusing on three sections: demographics and clinical experience in endoscopy; history of injury related to endoscopy; previous experience with ergonomic modification in endoscopy was distributed to all members of BSPGHAN via email and social media.Results 65 respondents. 50.8% (n=33) female. 52.3% (n=34) aged 35–44 years, 24.6% (n=16) aged 45–54 years). 53.8% (n=35) consultant grade, the remainder were registrar, clinical fellow, or SAS. 76.9% (n=50) performed 1–4 hours of endoscopy weekly, 18.5% (n=12) practiced 5–10 hours weekly. 53.8% (n=35) stated they had previously experienced injury or pain related to endoscopy. Of those who had experienced injury/pain, the most common experiences were hand/digit pain (62.2%, n=23); backache (35.1%, n=13); arm pain (24.3%, n=9); neck ache (16.2%, n=6). 29.2% (n=19) had experienced pain during endoscopy monthly, while only 18.5% (n=12) had taken analgesia for endoscopy related pain. 86.2% (n=56) had never had any training focused on ergonomics and/or reducing ERI. Only 6.2% (n=4) reported that ergonomics formed part of their theatre brief. There were significant differences in rates of endoscopy-related injury in females vs males (69.7% vs 37.5%, p=0.013), as well as in respondents who reported performing weight/resistance exercises vs not (39.4% vs 68.8%, p=0.025). There was no significant difference between rates of injury between consultants vs non-consultants (54.3% vs 55.5%); those using water-assisted colonoscopy vs not (36.9% vs 60.1%, p=0.103); age <45 years vs >45 years (56.1% vs 50%, p=0.79); and those performing cardiovascular exercise vs not (63.6% vs 51.9%, p=0.52).Conclusion This is the first UK nationwide study of ergonomics and ERI amongst paediatric endoscopists. Over half of paediatric endoscopists surveyed experienced ERI, most commonly hand/digit pain, backache, arm pain, and neckache. The vast majority of endoscopists had never had training in ergonomics. We found that women and endoscopists not performing resistance exercises were significantly more likely to experience ERI. These findings provide impetus for the development and delivery of training and guidelines in ergonomics to reduce the risk of occupational injury amongst UK-based paediatric endoscopists.References Walsh CM, Qayed E, Aihara H, et al. Core curriculum for ergonomics in endoscopy. Gastrointest Endosc. 2021 Jun;93(6):1222–7.Yung DE, Banfi T, Ciuti G, et al. Musculoskeletal injuries in gastrointestinal endoscopists: a systematic review. Expert Rev Gastroenterol Hepatol. 2017 Oct 3;11(10):939–47.Austin K, Schoenberger H, Sesto M, et al. Musculoskeletal injuries are commonly reported among gastroenterology trainees: results of a national survey. Dig Dis Sci. 2019 Jun 25;64(6):1439–47.Pawa S, Banerjee P, Kothari S, et al. Are all endoscopy-related musculoskeletal injuries created equal? Results of a national gender-based survey. American Journal of Gastroenterology 2021 Mar;116(3):530–8.Ruan W, Walsh CM, Pawa S, et al. Musculoskeletal injury and ergonomics in pediatric gastrointestinal endoscopic practice. Surg Endosc. 2023 Jan 3;37(1):248–54.Pawa S, Kwon RS, Fishman DS, et al. ASGE guideline on the role of ergonomics for prevention of endoscopy-related injury: summary and recommendations. Gastrointest Endosc. 2023 Oct;98(4):482–91.Tringali A, Thomson M, Dumonceau JM, et al. Pediatric gastrointestinal endoscopy: ESGE and ESPGHAN guideline executive summary. Endoscopy 2016 Sep 12;49(01):83–91.