Citation
Eachus, P. (2014), "Computer-induced health problems", Health Education, Vol. 114 No. 1. https://doi.org/10.1108/HE-09-2013-0045
Publisher
:Emerald Group Publishing Limited
Computer-induced health problems
Article Type: Internet review From: Health Education, Volume 114, Issue 1
September 2013
If you operate a pneumatic drill all day it perhaps would not be surprising if you developed health problems associated with this activity. Vibration White Finger (VWF) and hearing loss immediately come to mind. Fortunately most of us do not have to interact with equipment like this on a daily basis but in modern offices, hospitals or health centres we do come into daily contact with a machine that can also damage our health – the computer. For many people working with a computer is a necessity and therefore difficult to avoid. This does not alter the fact that daily use of computers may have a deleterious effect on our health for example eye strain, back neck and shoulder pain, caused by poor posture, and even chronic conditions such as arthritis in the fingers and repetitive strain injury (RSI). At least in the case of the person operating the pneumatic drill they do not take it home with them. But for many of us although we leave our computers at work when we get home we turn on our own personal computer! Ultimately all these conditions are caused by poor use or overuse of particular technologies. In this review we will examine web sites that can provide advice and information that may help prevent the development of these types of health problems. (The irony of using a computer to write a review to help with computer induced health problems has not escaped the reviewer!)
US Coastguard
www.uscg.mil/hq/cg1/cg113/docs/ergo_hfacs/computer_use.pdf
Not the most obvious place to start and rather than a web site what we have is a pdf document that can be found on the web site of the US coast guard. It really is a rather good summary of the nature of the problem and what can be done to help prevent the development of work-related musculoskeletal disorders (WMSDs) and related symptoms. The document starts by categorising the three main types of problem, i.e. muscle fatigue, cognitive and emotional fatigue and finally visual fatigue. For anyone who has used a computer for a prolonged period these will be familiar. Stiffness, physical discomfort and even pain are common symptoms of muscle fatigue. Cognitive fatigue is characterised by weariness, loss of concentration, irritability and even dizziness in some cases. Working close to a visual display unit for a significant period of time will lead to problems associated with visual fatigue, typically eye irritation, headache, and blurred or double vision. Besides the health implications, these problems will also lead to loss of proficiency and productivity and therefore need to be taken seriously.
The rest of this document presents a systems approach to the problem and starts by explaining that a computer workstation comprises three interacting components, the chair, the computer monitor, and the work surface. It is the way in which these interact that leads to either a comfortable and productive workstation or one that is pathological and will be detrimental to health and productivity. This systems approach is illustrated in the form of a chart with three-coloured columns. In the red column users will find examples of typical computer-induced health problems. The second yellow column suggests the probable cause of the condition, and the third green column suggests ways in which the computer workstation might be modified to deal with the likely cause of the condition.
The advice given is good and makes sense and although no mention is made of touch screen devices and the problems they may bring, for most purposes this will be adequate.
Princeton University Health Services
www.princeton.edu/uhs/healthy-living/hot-topics/ergonomics/
The title of this web site is “Ergonomics and computer use” and although the web site does not actually say much about ergonomics it does have a great deal of practical advice for computer users. The web site begins by acknowledging that many Princeton University students, like students all over the world, tend to use a laptop perched on an inappropriate table of the type typically found in institutional settings, and they are probably sat on an equally inappropriate simple wooden seat. This simple workstation set up is probably fine for a few hours work but for longer periods it would be better to make the sort of adaptations suggested in this web site.
The advice offered is very detailed for example a large section is devoted to just the positioning of the mouse and keyboard. It is suggested, amongst other things, that the keyboard should “be just above your lap so your elbows are bent at 90°”. The mouse should be close to the keyboard so you do not have to reach out for it and if troubled by wrist or forearm pain then an ergonomically designed mouse might be a good choice.
Is your monitor about an arm's length from your face and slightly below your eyeline? If not then you are likely to suffer from eye strain as well as pain in the neck and shoulders.
Now an ergonomically designed office chair might be ideal but they are also very expensive so what can be done to adapt the simple wooden chair? The web site explains why chair position is important to help maintain good posture which is necessary to avoid musculoskeletal problems. The web site suggests that the computer user's back should be upright and supported by the back rest. If it is not then a towel or cushion might be used to provide this support. Height of the chair is important but what if it cannot be adjusted? The advice given is that when sitting, feet should be flat on the floor with thighs roughly parallel to the floor. If the chair is too high then use a foot rest to provide support. If it is too low then a cushion might help. It is this type of detailed practical advice that makes this web site so useful.
The web site also has a very useful checklist on how to avoid RSI. This takes the form of a description of behaviour, for example “Excessive bend or extension of the wrists”, followed by the correction in behaviour required, in this case, “Wrists in a neutral position not resting on anything, unless one is not actively typing. Fingers in a straight line with the forearm, and the back edge of the keyboard tilted down”. There are five more examples of the behaviours that might lead to RSI and of course the corrections required to minimise this are also provided.
The final section deals with eyestrain and although there are many contributory factors that users cannot do much about, for example office lighting, there are other simple steps that can help. The piece of advice I liked the best was also the simplest…. in order to cut down the likelihood of eyestrain all you need to do is blink! It seems that most of us blink less when sat in front of a computer monitor and this is bad for our eyes. The other suggestion I also liked was to get up at least every two hours and do something that does not involve looking at a computer screen. One suggestion is to eat a banana since the potassium in bananas is also good for our eyes!
This is a very simple web site, wholly text based, no images, few links, and no downloads. What is good about this web site, however, is that it translates what could be very theoretical advice into practical doable tasks that anyone can perform, particularly useful for students who may not be able to afford the ergonomically designed workstation that might be more desirable.
The Shreeji Hospital
www.shreejihospital.com/computer.html
This is a specialist orthopaedic hospital based in Ahmedabad, Gujarat, India and I particularly like this web site because, as well as the more general advice on health problems associated with computer use, it also focuses on two areas that are likely to become increasingly important in future years, namely computer use by children and the increase in the use of lap tops notepads and mobile devices.
The web site opens with quite a good diagram of a skeleton sat at a workstation and surrounding it are boxes containing information on the different types of problems that could be encountered. For example there is a box pointing to the wrist and explaining that 26 per cent of workers suffer from inflamed tendons. Advice is also given that wrist should be level and not rest on anything while typing. Other boxes deal with the forearm, neck, eyes and so on. The diagram is actually a very good summary of computer-induced health problems.
Most children will be using computers in school and in the home and for the most part these will be machines that have been designed for adults rather than children. Adult sized keyboards may not be appropriate for little hands though child-sized keyboards are not very common. It is, however, possible to buy a smaller mouse and the web site suggests that this is probably a good idea for small children. Perhaps the best advice that is given as far as children are concerned is that parents should monitor and limit computer use by their children. Simple and effective but how easy to implement?
Laptops and notepads bring their own hazards. The screen is often difficult to move in a way that prevents glare. Keyboards may be small and cramped and difficult to use for prolonged periods. Unfortunately laptops and even smaller tablets are here to stay and only by minimising use can the user reduce the health hazards associated with these technologies.
RSI Awareness
Although repetitive strain injuries only form a subset of all the health problems that can be induced by computer use, RSIs are some of the more common. RSI Awareness describes itself as a resource for people who have to live and work with repetitive strain injuries. The information provided is extensive and mainly in the form of factsheets that can be freely downloaded making them very useful for health education professionals.
The web site begins by pointing out that RSI is not a new condition and was first noted as long ago as 300 years. But it was during the 1970s with the replacement of typewriters by computers that we saw a dramatic rise in the prevalence of the condition. Nowadays as many as 45 per cent of people complain of pain resulting from problems with posture at work and it is estimated to cost the UK economy £3billion per annum, so it is not a small problem.
The web site goes into a great deal of detail describing the different forms of RSI before explaining the variety of treatments that are available. These include the conventional, for example physiotherapy and anti-inflammatory drugs and even surgery for severe cases. Complementary therapies also get a mention and these include the Alexander technique, acupuncture and magnetic therapy. What the web site does not do is attempt any sort of evaluation of comparison of the therapies, conventional or complementary and this limits the usefulness of the information provided.
There is a section headed “Advice and Research” but the only advice offered is a list of health and safety legislation leaflets that may be of use to human resource managers but of little interest to lay users. Unfortunately the link to research was not working at the time of this review.
Probably the most useful section of this web site is labelled “RSI Hazards” and here users will find a very good factsheet showing how to set up a workstation to minimise the likelihood of causing RSI's. This factsheet can be downloaded and printed off and could very usefully be pinned next to every workstation to remind people what they should and should not be doing at their workstation to reduce the risk of computer-induced health problems.
Not the most interesting of web sites nor particularly attractive, but there is useful information to be found if users are prepared to spend a little time digging.
Peter Eachus
School of Community Health Sciences & Social Care, University of Salford, Salford, UK