Computer and VDU Related Injuries and How to Avoid Them

Introduction

In today's working environment the number of people working on PCs has increased rapidly. A recent TUC survey found that there are 5.5 million display screen equipment operators working in the UK - one quarter of the work force. Computer related Health and Safety is therefore of prime importance.

Computer power allows workers to increase productivity. However, this also tends to increase monotony, muscle strain and fatigue. In addition, computers make it possible to cut the work breaks and increase the pace of work. This leads to injuries associated with computer use become more pronounced. We still do not know the full, long term consequences of a working lifetime on computers because computer technology has not yet been around long enough. What we do know is that users are suffering from a range of injuries associated with computer use and that they are all preventable.

What are Computer Related Injuries?

Computer related injuries cover a wide variety of health problems caused by or contributed to by computer usage. These can be broadly divided in to three groups.

1) Repetitive Strain Injury (RSI)
2) Back Problems
3) Eye Strain & Discomfort

1) Repetitive Strain Injury (RSI)

Also known as Work Related Upper Limb Disorders (WRULD) this is a non medical term used to describe the many types of disorders associated with performing the same repetitive task, especially in an awkward posture, over a prolonged period of time.

RSI is not a modern problem. In 1713 the Italian physician Bernardino Ramazzini recorded that the incessant hand movements of clerks caused “maladies”. In the 1840’s there was an epidemic of writers cramp among service clerks in London.

The term RSI was introduced in Australia in the 1970’s with the introduction of VDU’s in to the workplace.

The two most common forms of RSI are Carpal Tunnel Syndrome and Tendon Injuries

i) Carpal Tunnel Syndrome

Carpal tunnel syndrome is caused by irritation and compression of the median nerve at the wrist. Constant flexing and compression of the wrist causes compression of the median nerve, eventually transforming into fibrosis (tough inflexible tissue). This can lead to constant pain in the wrist, numbness and pins and needles which may prevent full mobility in the hand.

ii) Tendon Injuries

Tendon injuries come in two forms:

Tendonitis:

Inflammation of tendons. Repeated tensing of a tendon causes inflammation. Eventually, the fibres of the tendon start separating, and can even break, leaving behind debris which induces more friction, more swelling, and more pain. "Sub-acute" tendonitis is more common, which entails a dull ache over the wrist and forearm, some tenderness, which gets worse with repetitive activity.

Tenosynovitis:

An inflammation of the tendon sheath. Chronic tenosynovitis occurs when the repetitive activity is mild or intermittent: not enough to cause acute inflammation, but enough to exceed the tendon sheath's ability to lubricate the tendon. As a result, the tendon sheath thickens, gets inflamed, and causes pain.

Both of the above cause pain with movement of the fingers. Pain is also felt over the top of the hands and knuckles as the condition worsens, possibly even leading to a burning sensation in the forearm.

The effects of RSI can be debilitating. The following experiences are not uncommon amongst chronic sufferers.

“After 8 years in programming and 2 as a manager, I was diagnosed in 1991 with early stage bilateral carpal tunnel after numbness and heaviness in my left hand and loss of strength in my right. Therapy increased my strength and allowed me to functions somewhat, but it increased the pain tenfold. I continued working the entire time, with light duty and a lot of frustration and pain. My pain was in my forearms, it was a burning ache and constant pain. I couldn't write much at work or home, my house was a constant mess, squeezing out shampoo or cutting my meat was extremely difficult, I couldn't even clap my hands, coming to work each day in pain was a chore in itself, and my kids had to learn to live with my many limitations.” - an RSI sufferer

The incidence of RSI is increasing rapidly. A 1998 TUC survey states that RSI has increased by 22% in the last two years. Over 100,000 computer operators are affected by RSI every year and one in three workplaces are affected. These are startling statistics leading to claims that RSI will be the industrial plague of the 21st century.

RSI is very easy to prevent. Unfortunately it is very hard to cure. Preventative measures are more cost effective and work. Curative measures are unreliable and extremely expensive.

2) Back Problems

Musculoskeletal back problems are the largest cause of disability amongst people of working age. 30% of adults become chronic sufferers. The highest incidences of back pain are found in workers whose jobs are entirely sedentary or entirely manual.

The human body is not designed to remain in a sedentary position for long periods of time. Unfortunately most VDU users do occupy sedentary positions for the majority of their working day. The sedentary position occupied whilst using a computer is not good for a users back and many office workers suffer from back pain. The problem is exacerbated if the user has a low general level of fitness.

There is a common misconception that it is only secretary’s and data entry clerks that suffer from back pain through sitting at their desk for too long. Back pain does not discriminate and there are sufferers throughout the office hierarchy.

A director of an international accountancy firm developed shoulder and neck pain two years ago from sitting at a computer all day. The pain started to cause loss of sleep and an inability to carry out normal household tasks or pick up her toddler. Changed working practices would have prevented this problem occurring. They are now helping reduce the pain experienced.

3) Eye Strain & Discomfort

People who use VDUs for extended periods of time can suffer from tired eyes, discomfort and head aches. “70% of display screen operators complain at some stage in their working lives of discomfort around the eye region.” (Dr Janet Voke, The Safety and Health Practitioner July 1998) Staring at a screen can lead to a drop in blink rate causing dry eye. Undertaking more demanding tasks with your eyes can cause headaches and users may become aware of an eyesight problem they had not noticed before. There is no evidence that using VDUs causes permanent damage to eyes. The impact of any serious injury caused at work creates a dramatically negative effect on the overall performance of the company itself. Pain experienced at work immediately affects both the morale and the productivity of employees. Loss of morale on the part of the injured employee in the workplace linked to working practices often creates a ripple effect throughout the company resulting in a discontented work force. Productivity decreases.

The Legislation

Legislation has been put in place to protect computer operators from the risks inherent in computer use.

The UK 1992 Display Screen Equipment Regulations set out the legal requirements of employers with regard to their computer operators. Employers also have a general duty of care under the 1974 Health and Safety at Work Act.

All the regulations derive from the common Health and Safety principle of eliminating the source of an identified risk. Where risk is unavoidable it must be evaluated and measures taken to reduce it to an acceptable level.

The 1992 DSE Regulations lay down the following areas of responsibility.

1. All computers must fit a minimum specification for healthy use.
2. All workstations must be assessed for risk.
3. Computer equipment must be fit for the job to avoid strains and discomfort.
4. All users must be made to take regular breaks from computer work.
5. Eye tests and special glasses must be provided if requested.
6. Training on computer safety must be provided to all computer users.
7. Users must be given relevant information relating to their health and safety.

For exact details contact HSE Books on 01787 881165 and ask for the "Health & Safety (Display Screen Equipment) 1992" regulations.

The onus of responsibility lies squarely with the employer to provide a safe working environment for users and to inform the users of measures they should undertake to protect themselves from injury.

The HSE has the power to enforce fines of up to £20,000 on employers who are not fully implementing the directive. They also have the power to bring criminal charges.

However a greater financial threat comes from injured employees claiming compensation from the employer for injuries sustained at work, the loss in productivity through absence or reduced work rate and the loss of morale throughout the company caused by the injured employee.

The Costs of Computer Related Injury

Computer related injury compensation claims are dominated by Repetitive Strain Injury which is now one of the top five occupational diseases. Over £3 million was paid out to victims of RSI in compensation claims in 1997 and as we aspire to a more litigious culture this figure will increase. In the US in 1993 $20 Billion were paid in compensation claims for RSI. Indirect costs were estimated at up to $100 Billion. (US Occupational Health and Safety Administration)

In a breakthrough ruling recently, the Midland Bank had to pay £550,000 in compensation and costs in a case brought by five women who suffered Repetitive Strain Injury (RSI). Judge Byrt ruled that the bank had breached its duty of care to staff by not allowing adequate breaks away from their computers. This is the first time that a court has accepted diffuse RSI as an injury caused by work.

There is no test for diffuse RSI, the symptoms consist of multiple aches and tender spots which migrate around the arm and shoulder and this is the first court ruling in the UK where a judge has awarded compensation for diffuse RSI.

Hundreds of similar cases are now expected from computer operators suffering pain in their necks, shoulders and arms. This case was backed by the Banking Insurance and Finance Union who have 9 other cases pending. Other unions have followed the case closely and employers in the public and private sectors are bracing themselves for the onslaught.

The costs of RSI are not confined to compensation claims. The TUC have estimated the cost to British industry of RSI alone as over £1 billion every year:

Lost Income £96 million Time Off £278 million Lost production as efficiency is affected £135 million Welfare costs, adaptations and treatments £343 million Benefits to sufferers unable to work £65 million Insurance and cost of coping with absences £88 million

What Can we do to Prevent These Problems Occurring?

Good ergonomic design of workplaces and behavioural practices can create a working environment which will protect employees against many of the debilitating effects of computer related injury.

Ergonomic Workplace Design

Good workplace ergonomic design is essential to prevent the onset of computer related injuries. The areas which must be covered include:

i) General Workplace Design
ii) The Display or Computer Screen
iii) The Chair
iv) The Keyboard and Mouse

The 1992 Display Screen Equipment Regulations set out minimum requirements for workstations. More information on workstation ergonomics can be found from in the ScreamSaver help file.

Working Practices

Even with the best ergonomic workstation design a user with bad working practices will develop injuries associated with computer use. Good working practices are at least as important as workstation design to prevent injury. This is often overlooked by employers who spend money improving the workstations their staff are using but ignore their working practices.

Slight changes in working practices can have a dramatic effect in reducing risks and aches and pains associated with computer use.

i) Active posture

Good posture is NOT just about sitting up straight.

Our bodies are not designed to sit in one position for prolonged periods of time. It is just as important to change your posture frequently as it is to sit with a good posture.

What is good posture?

A good posture is one which most naturally suits your body. This means that your back should be in a slight S-shape with your shoulders up and your head straight. You should not be hunched over nor have your head tilting down at a sharp angle.

Your arms and fingertips should be horizontal and level with your desk top.

The back rest of your chair should support your lower back and you should sit with your back against it.

Your eyes should point slightly downwards to the middle of your computer screen. Adjust the height of the screen accordingly.

Your legs should be horizontal on the seat of your chair, or should point slightly downwards at the knees to encourage a good posture (try tucking your legs under your chair).

If your feet do not touch the floor, a foot rest should be used to support your legs.

Try to become more aware of your posture and keep reminding yourself to sit properly. You will soon learn to do it naturally and you will benefit forever.

Changing your body position regularly keeps your back, neck and body mobile and free from stiffness.

ii) Taking regular breaks

The way you work affects your health and in turn affects your work. Taking regular breaks is essential to relieve the body:

• from the strains imposed by the continuous repetitive movements of using a keyboard and mouse.
• from the sedentary position we all occupy when working at our computer.

Even with the best possible posture and a perfect ergonomic workstation we will still harm our bodies if regular breaks are not taken.

This has been recognised in law and UK regulations state that “all employers must ensure that work on computers is periodically interrupted by breaks or changes in activity.” It is important to recognise that a break from computer related work does not necessarily mean taking a break from all work.

UK and European legislation which enforces the need for regular breaks does not recommend length or frequency of breaks because it varies so much depending on the nature of the tasks undertaken. However the Japanese Ministry of Labour issued guidelines for keyboard operators which suggested a 10 minute break every hour and in Australia unions negotiate for a 5 minute break for operators every hour.

A change is as good as a rest and the break does not just refresh the body physically it also refreshes the body mentally.

For good health, you should develop a routine which involves taking regular breaks from computer work. Frequent short breaks are much better than longer breaks at less frequent intervals. During a break it is important to relax your eyes by looking away from the screen and relieve the stress on your body by relaxing your hands, arm and shoulders. Ideally you should move from your seat.

Regular stretching exercises will stimulate blood flow and help prevent the build up of aches and pains. It will also stimulate the mind! A range of suggested exercises are suggested in ScreamSaver. Remember that you should not look at the screen whilst undertaking the exercises.

How Can ScreamSaver Help You?

The real costs of computer related injury is starting to be realised and employers are now taking a much more proactive approach to preventing them. Computer related injuries are very hard to cure. The good news is that they are easily preventable.

The benefits of ScreamSaver:

A perfect ergonomic workstation alone can't prevent RSI. To avoid injury, computer users must maintain good posture, get appropriate exercise and take frequent, regular breaks from keyboard and mouse. ScreamSaver provides the reminder to the user, without which he or she is unlikely to take these breaks.

There are risks inherent with using computers at work. The ScreamSaver Computer Safety Training educates users of these risks and how to avoid them. Just training users of the need to take breaks has very limited effectiveness. The training material is soon relegated to the bottom drawer and the training forgotten after a month or so. ScreamSaver cannot be relegated to the bottom drawer. It is a proactive reminder to users.

It is not just about prompting users of the need to take breaks but of the need to look after themselves whilst using their computers. It is a reminder to attain the correct posture and vary tasks.

ScreamSaver provides an informative suggested exercise screen for users. ScreamSaver is promoting a healthier working environment and work force.

ScreamSaver computer safety training contains all the information users need to undertake computer work safely easily accessible to all users.

ScreamSaver can be used to log the breaks of individual users. The powerful search engine can then be used by the network administrator to target those users who are not taking adequate breaks. The information contained within these log files provide an important tool should the employer have to defend against compensation claims.

ScreamSaver is essential for best practice computer use. It is an inexpensive, fully automatic software solution to the fastest growing workplace health risk.

More and more employers are recognising the risks of computers. Many are discovering these risks through a costly compensation claim. Don’t let this happen to you. A minimal investment of time and money now will protect your staff from injury.

Ask any back pain or RSI sufferer if ScreamSaver would have helped to prevent their condition. You and your staff deserve the opportunity to protect yourselves from such potentially debilitating afflictions.

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