VDT work, oculomotor strain, and subjective complaints: an experimental and clinical study

Effects of Astaxanthin, Lutein, and Zeaxanthin on Eye-Hand Coordination and Smooth-Pursuit Eye Movement after Visual Display Terminal Operation in Healthy Subjects: A Randomized, Double-Blind Placebo-Controlled Intergroup Trial

(1) Background: The impairment of eye-hand coordination and smooth-pursuit eye movement caused by visual display terminal (VDT) operation is thought to impair daily living activities, for which no effective methods are currently known. On the other hand, various food ingredients, including astaxanthin, lutein, and zeaxanthin, are known to help improve the eye health of VDT operators. This study aimed to test the hypothesis that the combination of astaxanthin, lutein, and zeaxanthin can prevent the impairment of eye-hand coordination and smooth-pursuit eye movement caused by VDT operation. (2) Methods: We conducted a randomized, placebo-controlled, parallel-group clinical trial. Healthy subjects who regularly worked with VDTs were randomly assigned to the active and placebo groups. All of the subjects took soft capsules containing 6 mg of astaxanthin, 10 mg of lutein, and 2 mg of zeaxanthin or placebo soft capsules once daily for eight weeks. We evaluated the eye-hand coordination, smooth-pursuit eye movements, and macular pigment optical density (MPOD) at 0, two, four, and eight weeks after soft-capsule intake. (3) Results: The active group showed significantly improved eye-hand coordination after VDT operation at eight weeks. However, there was no clear improvement in the effect of the supplementation on smooth-pursuit eye movements. The active group also showed a significant increase in MPOD levels. (4) Conclusions: Consumption of a supplement containing astaxanthin, lutein, and zeaxanthin mitigates the decline of eye-hand coordination after VDT operation.

Impact of the use of digital devices on eyes during the lockdown period of COVID-19 pandemic

Purpose:

The purpose of this study is to observe pattern of digital device use and the various ocular, visual and systemic symptoms associated with them during the lockdown period of the novel coronavirus disease (COVID-19) pandemic.

Methods:

Two hundred and thirty-three volunteers were included in web-based open e-survey. The survey was designed on the ‘Survey Monkey’ website and distributed through social media platform. The information was collected regarding hours and numbers of digital devices along with numbers of digital activities carried out during the pandemic. A pretested symptom questionnaire was also included regarding ocular, visual and systemic symptoms before and during lockdown. The statistical analysis was carried out using Statistical Package of Social Science software.

Results:

During the pandemic, most of the respondents were engaged in more than two digital activities (73.81%) over more than two digital devices (48.50%) for more than six days (65.66%). Maximum respondents were mobile users (97.85%) spending major time on social media (89.70%). Symptoms including watering eyes (P = 0.000), dry eyes (P = 0.000), shoulder pain (P = 0.020), back pain (P = 0.003) and headache (P = 0.043) showed positive correlation with hours of digital device use per day during lockdown, while itching eyes (P = 0.036) and pain behind eyes (P = 0.025) were the major symptoms in those engaged in a greater number of digital activities. Moreover, red eyes (P = 0.040) were more prominent in respondents using multiple devices for a greater number of hours.

Conclusion:

A big jump in digital activities on multiple digital devices was seen during lockdown which are more prone to ocular symptoms. Acceleration of ocular and systemic symptoms was particular with rise in time spending on digital devices.

Discomfort glare and psychological stress during computer work: subjective responses and associations between neck pain and trapezius muscle blood flow

PURPOSE

Exposure to additional environmental stress during computer work, such as visual and psychological demands, is associated with increased eye and neck discomfort, altered moods, and reduced well-being. The aim of this study is to elucidate further how subjective responses in healthy, young females with normal binocular vision are affected by glare and psychological stress during computer work, and to investigate possible associations between trapezius muscle blood flow and neck pain development.

METHODS

43 females participated in a laboratory experiment with a within-subject design. Four 10-min computer work conditions with exposure to different stressors were performed at an ergonomically optimal workstation, under the following series of conditions: no additional stress, visual stress (induced as direct glare from a large glare source), psychological stress, and combined visual and psychological stress. Before and immediately after each computer work condition, questionnaires regarding different visual and eye symptoms, neck and shoulder symptoms, positive and negative state moods, perceived task difficulty, and perceived ambient lighting were completed. Associations between neck pain and trapezius muscle blood flow were also investigated.

RESULTS

Exposure to direct glare induced greater development of visual/eye symptoms and discomfort, while psychological stress exposure made participants feel more negative and stressed. The perception of work lighting during glare exposure was closely related to perceived stress, and associations between visual discomfort and eyestrain, and neck pain were observed in all conditions. Furthermore, participants with high trapezius muscle blood flow overall reported more neck pain, independent of exposure.

CONCLUSIONS

Exposure to visual and psychological stresses during computer work affects the development of symptoms and negative moods in healthy, young females with normal binocular vision, but in different ways. The results also demonstrate the complex interactions involved in symptom development and lighting appraisal during computer work. When optimizing computer workstations, the complexity of the field must be taken into account, and several factors, including visual conditions, must be considered carefully.

Visual and psychological stress during computer work in healthy, young females-physiological responses

Purpose

Among computer workers, visual complaints, and neck pain are highly prevalent. This study explores how occupational simulated stressors during computer work, like glare and psychosocial stress, affect physiological responses in young females with normal vision.

Methods

The study was a within-subject laboratory experiment with a counterbalanced, repeated design. Forty-three females performed four 10-min computer-work sessions with different stress exposures: (1) minimal stress; (2) visual stress (direct glare); (3) psychological stress; and (4) combined visual and psychological stress. Muscle activity and muscle blood flow in trapezius, muscle blood flow in orbicularis oculi, heart rate, blood pressure, blink rate and postural angles were continuously recorded. Immediately after each computer-work session, fixation disparity was measured and a questionnaire regarding perceived workstation lighting and stress was completed.

Results

Exposure to direct glare resulted in increased trapezius muscle blood flow, increased blink rate, and forward bending of the head. Psychological stress induced a transient increase in trapezius muscle activity and a more forward-bent posture. Bending forward towards the computer screen was correlated with higher productivity (reading speed), indicating a concentration or stress response. Forward bent posture was also associated with changes in fixation disparity. Furthermore, during computer work per se, trapezius muscle activity and blood flow, orbicularis oculi muscle blood flow, and heart rate were increased compared to rest.

Conclusions

Exposure to glare and psychological stress during computer work were shown to influence the trapezius muscle, posture, and blink rate in young, healthy females with normal binocular vision, but in different ways. Accordingly, both visual and psychological factors must be taken into account when optimizing computer workstations to reduce physiological responses that may cause excessive eyestrain and musculoskeletal load.

Optical correction of refractive error for preventing and treating eye symptoms in computer users

BACKGROUND

Computer users frequently complain about problems with seeing and functioning of the eyes. Asthenopia is a term generally used to describe symptoms related to (prolonged) use of the eyes like ocular fatigue, headache, pain or aching around the eyes, and burning and itchiness of the eyelids. The prevalence of asthenopia during or after work on a computer ranges from 46.3% to 68.5%. Uncorrected or under-corrected refractive error can contribute to the development of asthenopia. A refractive error is an error in the focusing of light by the eye and can lead to reduced visual acuity. There are various possibilities for optical correction of refractive errors including eyeglasses, contact lenses and refractive surgery.

OBJECTIVES

To examine the evidence on the effectiveness, safety and applicability of optical correction of refractive error for reducing and preventing eye symptoms in computer users.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; Embase; Web of Science; and OSH update, all to 20 December 2017. Additionally, we searched trial registries and checked references of included studies.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) and quasi-randomised trials of interventions evaluating optical correction for computer workers with refractive error for preventing or treating asthenopia and their effect on health related quality of life.

DATA COLLECTION AND ANALYSIS

Two authors independently assessed study eligibility and risk of bias, and extracted data. Where appropriate, we combined studies in a meta-analysis.

MAIN RESULTS

We included eight studies with 381 participants. Three were parallel group RCTs, three were cross-over RCTs and two were quasi-randomised cross-over trials. All studies evaluated eyeglasses, there were no studies that evaluated contact lenses or surgery. Seven studies evaluated computer glasses with at least one focal area for the distance of the computer screen with or without additional focal areas in presbyopic persons. Six studies compared computer glasses to other types of glasses; and one study compared them to an ergonomic workplace assessment. The eighth study compared optimal correction of refractive error with the actual spectacle correction in use. Two studies evaluated computer glasses in persons with asthenopia but for the others the glasses were offered to all workers regardless of symptoms. The risk of bias was unclear in five, high in two and low in one study. Asthenopia was measured as eyestrain or a summary score of symptoms but there were no studies on health-related quality of life. Adverse events were measured as headache, nausea or dizziness. Median asthenopia scores at baseline were about 30% of the maximum possible score.Progressive computer glasses versus monofocal glassesOne study found no considerable difference in asthenopia between various progressive computer glasses and monofocal computer glasses after one-year follow-up (mean difference (MD) change scores 0.23, 95% confidence interval (CI) -5.0 to 5.4 on a 100 mm VAS scale, low quality evidence). For headache the results were in favour of progressive glasses.Progressive computer glasses with an intermediate focus in the upper part of the glasses versus other glassesIn two studies progressive computer glasses with intermediate focus led to a small decrease in asthenopia symptoms (SMD -0.49, 95% CI -0.75 to -0.23, low-quality evidence) but not in headache score in the short-term compared to general purpose progressive glasses. There were similar small decreases in dizziness. At medium term follow-up, in one study the effect size was not statistically significant (SMD -0.64, 95% CI -1.40 to 0.12). The study did not assess adverse events.Another study found no considerable difference in asthenopia between progressive computer glasses and monofocal computer glasses after one-year follow-up (MD change scores 1.44, 95% CI -6.95 to 9.83 on a 100 mm VAS scale, very low quality evidence). For headache the results were inconsistent.Progressive computer glasses with far-distance focus in the upper part of the glasses versus other glassesOne study found no considerable difference in number of persons with asthenopia between progressive computer glasses with far-distance focus and bifocal computer glasses after four weeks' follow-up (OR 1.00, 95% CI 0.40 to 2.50, very low quality evidence). The number of persons with headache, nausea and dizziness was also not different between groups.Another study found no considerable difference in asthenopia between progressive computer glasses with far-distance focus and monofocal computer glasses after one-year follow-up (MD change scores -1.79, 95% CI -11.60 to 8.02 on a 100 mm VAS scale, very low quality evidence). The effects on headaches were inconsistent.One study found no difference between progressive far-distance focus computer glasses and trifocal glasses in effect on eyestrain severity (MD -0.50, 95% CI -1.07 to 0.07, very low quality evidence) or on eyestrain frequency (MD -0.75, 95% CI -1.61 to 0.11, very low quality evidence).Progressive computer glasses versus ergonomic assessment with habitual (computer) glassesOne study found that computer glasses optimised for individual needs reduced asthenopia sum score more than an ergonomic assessment and habitual (computer) glasses (MD -8.9, 95% CI -16.47 to -1.33, scale 0 to 140, very low quality evidence) but there was no effect on the frequency of eyestrain (OR 1.08, 95% CI 0.38 to 3.11, very low quality evidence).We rated the quality of the evidence as low or very low due to risk of bias in the included studies, inconsistency in the results and imprecision.

AUTHORS' CONCLUSIONS

There is low to very low quality evidence that providing computer users with progressive computer glasses does not lead to a considerable decrease in problems with the eyes or headaches compared to other computer glasses. Progressive computer glasses might be slightly better than progressive glasses for daily use in the short term but not in the intermediate term and there is no data on long-term follow-up. The quality of the evidence is low or very low and therefore we are uncertain about this conclusion. Larger studies with several hundreds of participants are needed with proper randomisation, validated outcome measurement methods, and longer follow-up of at least one year to improve the quality of the evidence.

Effects of Dual Monitor Computer Work Versus Laptop Work on Cervical Muscular and Proprioceptive Characteristics of Males and Females

OBJECTIVE

The effects of performing a 90-minute computer task with a laptop versus a dual monitor desktop workstation were investigated in healthy young male and female adults.

BACKGROUND

Work-related musculoskeletal disorders are common among computer (especially female) users. Laptops have surpassed desktop computer sales, and working with multiple monitors has also become popular. However, few studies have provided objective evidence on how they affect the musculoskeletal system in both genders.

METHODS

Twenty-seven healthy participants (mean age = 24.6 years; 13 males) completed a 90-minute computer task while using a laptop or dual monitor (DualMon) desktop. Electromyography (EMG) from eight upper body muscles and visual strain were measured throughout the task. Neck proprioception was tested before and after the computer task using a head-repositioning test. EMG amplitude (root mean square [RMS]), variability (coefficients of variation [CV]), and normalized mutual information (NMI) were computed.

RESULTS

Visual strain ( p < .01) and right upper trapezius RMS ( p = .03) increased significantly over time regardless of workstation. Right cervical erector spinae RMS and cervical NMI were smaller, while degrees of overshoot (mean = 4.15°) and end position error (mean = 1.26°) were larger in DualMon regardless of time. Effects on muscle activity were more pronounced in males, whereas effects on proprioception were more pronounced in females.

CONCLUSION

Results suggest that compared to laptop, DualMon work is effective in reducing cervical muscle activity, dissociating cervical connectivity, and maintaining more typical neck repositioning patterns, suggesting some health-protective effects.

APPLICATION

This evidence could be considered when deciding on computer workstation designs.

Real-Time Non-Intrusive Assessment of Viewing Distance during Computer Use

PURPOSE

To develop and test the sensitivity of an ultrasound-based sensor to assess the viewing distance of visual display terminals operators in real-time conditions.

METHODS

A modified ultrasound sensor was attached to a computer display to assess viewing distance in real time. Sensor functionality was tested on a sample of 20 healthy participants while they conducted four 10-minute randomly presented typical computer tasks (a match-three puzzle game, a video documentary, a task requiring participants to complete a series of sentences, and a predefined internet search).

RESULTS

The ultrasound sensor offered good measurement repeatability. Game, text completion, and web search tasks were conducted at shorter viewing distances (54.4 cm [95% CI 51.3-57.5 cm], 54.5 cm [95% CI 51.1-58.0 cm], and 54.5 cm [95% CI 51.4-57.7 cm], respectively) than the video task (62.3 cm [95% CI 58.9-65.7 cm]). Statistically significant differences were found between the video task and the other three tasks (all p < 0.05). Range of viewing distances (from 22 to 27 cm) was similar for all tasks (F = 0.996; p = 0.413).

CONCLUSIONS

Real-time assessment of the viewing distance of computer users with a non-intrusive ultrasonic device disclosed a task-dependent pattern.

Work-related health disorders among Saudi computer users

The present study was conducted to investigate the prevalence of musculoskeletal disorders and eye and vision complaints among the computer users of King Abdulaziz University (KAU), Saudi Arabian Airlines (SAUDIA), and Saudi Telecom Company (STC). Stratified random samples of the work stations and operators at each of the studied institutions were selected and the ergonomics of the work stations were assessed and the operators' health complaints were investigated. The average ergonomic score of the studied work station at STC, KAU, and SAUDIA was 81.5%, 73.3%, and 70.3, respectively. Most of the examined operators use computers daily for ≤ 7 hours, yet they had some average incidences of general complaints (e.g., headache, body fatigue, and lack of concentration) and relatively high level of incidences of eye and vision complaints and musculoskeletal complaints. The incidences of the complaints have been found to increase with the (a) decrease in work station ergonomic score, (b) progress of age and duration of employment, (c) smoking, (d) use of computers, (e) lack of work satisfaction, and (f) history of operators' previous ailments. It has been recommended to improve the ergonomics of the work stations, set up training programs, and conduct preplacement and periodical examinations for operators.

Eyestrain in working children of footwear making units of Agra, India

Children of footwear making units are working in the soling process. The process includes fixing of upper part with the sole of the footwear. The adhesives contain a mix of organic solvents, which are released in the working environment and cause irritation and lacrimation of eyes. In addition poor illumination and ventilation further aggravates the eyestrain. The present study was carried out to find out the prevalence and the associated factors of eyestrain in working children of footwear making units. The study included 139 exposed and 160 comparison group subjects. Self-reported eyestrain was recorded through personal interview. The prevalence of eyestrain in child laborers was 25.9%, which was significantly more than the 12.4% prevalence in comparison group subjects (P=0.01). Working children of footwear making units were at 2.4 times higher risk of developing eyestrain as compared to comparison group subjects, though statistically non significant. Significantly higher proportion of eyestrain was reported in those aged >12 years, males and those working daily for >4 hours. The higher prevalence of eyestrain in the working children of footwear units may be attributed to exposure to workplace factors.

A visual ergonomics intervention in mail sorting facilities: effects on eyes, muscles and productivity

Visual requirements are high when sorting mail. The purpose of this visual ergonomics intervention study was to evaluate the visual environment in mail sorting facilities and to explore opportunities for improving the work situation by reducing visual strain, improving the visual work environment and reducing mail sorting time. Twenty-seven postmen/women participated in a pre-intervention study, which included questionnaires on their experiences of light, visual ergonomics, health, and musculoskeletal symptoms. Measurements of lighting conditions and productivity were also performed along with eye examinations of the postmen/women. The results from the pre-intervention study showed that the postmen/women who suffered from eyestrain had a higher prevalence of musculoskeletal disorders (MSD) and sorted slower, than those without eyestrain. Illuminance and illuminance uniformity improved as a result of the intervention. The two post-intervention follow-ups showed a higher prevalence of MSD among the postmen/women with eyestrain than among those without. The previous differences in sorting time for employees with and without eyestrain disappeared. After the intervention, the postmen/women felt better in general, experienced less work induced stress, and considered that the total general lighting had improved. The most pronounced decreases in eyestrain, MSD, and mail sorting time were seen among the younger participants of the group.

Asthenopia (eyestrain) in working children of gem-polishing industries

Working children of gem-polishing units are exposed to poor illumination and improper workstations. Also processes require lot of visual and mental concentration for precision. This may result in eyestrain. The study included 432 exposed and 569 comparison group subjects. Self-reported eyestrain was recorded through personal interview. Eyestrain included symptoms like itching, burning, or irritated eyes; tired or heavy eyes; difficulty seeing clearly (including blurred or double vision); and headache. The study variables included age, gender, daily working hours, and duration of exposure. The prevalence of eyestrain in child labourers was 32.2%, which was significantly more than the comparison group subjects. Also, the working children of gem-polishing units were at 1.4 times higher risk of developing eyestrain. Age (3)14 years and female gender were significantly associated with the eyestrain. The prevalence of eyestrain in child labourers was 32.2% and was associated with age (3)14 years and female gender.

Isolation of the ocular surface to treat dysfunctional tear syndrome associated with computer use

Dysfunctional tear syndrome (DTS) associated with computer use is characterized by mild irritation, itching, redness, and intermittent tearing after extended staring. It frequently involves foreign body or sandy sensation, blurring of vision, and fatigue, worsening especially at the end of the day. We undertook a study to determine the effectiveness of periocular isolation using microenvironment glasses (MEGS) alone and in combination with artificial tears in alleviating the symptoms and signs of dry eye related to computer use. At the same time, we evaluated the relative ability of a battery of clinical tests for dry eye to distinguish dry eyes from normal eyes in heavy computer users. Forty adult subjects who used computers 3 hours or more per day were divided into dry eye sufferers and controls based on their scores on the Ocular Surface Disease Index (OSDI). Baseline scores were recorded and ocular surface assessments were made. On four subsequent visits, the subjects played a computer game for 30 minutes in a controlled environment, during which one of four treatment conditions were applied, in random order, to each subject: 1) no treatment, 2) artificial tears, 3) MEGS, and 4) artificial tears combined with MEGS. Immediately after each session, subjects were tested on: a subjective comfort questionnaire, tear breakup time (TBUT), fluorescein staining, lissamine green staining, and conjunctival injection. In this study, a significant correlation was found between cumulative lifetime computer use and ocular surface disorder, as measured by the standardized OSDI index. The experimental and control subjects were significantly different (P<0.05) in the meibomian gland assessment and TBUT; they were consistently different in fluorescein and lissamine green staining, but with P>0.05. Isolation of the ocular surface alone produced significant improvements in comfort scores and TBUT and a consistent trend of improvement in fluorescein staining and lissamine green staining. Isolation plus tears produced a significant improvement in lissamine green staining. The subjective comfort inventory and the TBUT test were most effective in distinguishing between the treatments used. Computer users with ocular surface complaints should have a detailed ocular surface examination and, if symptomatic, they can be effectively treated with isolation of the ocular surface, artificial tears therapy, and effective environmental manipulations.

Computer use, symptoms, and quality of life

PURPOSE

To model the effects of computer use on reported visual and physical symptoms and to measure the effects upon quality of life measures.

METHODS

A survey of 1000 university employees (70.5% adjusted response rate) assessed visual and physical symptoms, job, physical and mental demands, ability to control/influence work, amount of work at a computer, computer work environment, relations with others at work, life and job satisfaction, and quality of life. Data were analyzed to determine whether self-reported eye symptoms are associated with perceived quality of life. The study also explored the factors that are associated with eye symptoms. Structural equation modeling and multiple regression analyses were used to assess the hypotheses.

RESULTS

Seventy percent of the employees used some form of vision correction during computer use, 2.9% used glasses specifically prescribed for computer use, and 8% had had refractive surgery. Employees spent an average of 6 h per day at the computer. In a multiple regression framework, the latent variable eye symptoms was significantly associated with a composite quality of life variable (p = 0.02) after adjusting for job quality, job satisfaction, supervisor relations, co-worker relations, mental and physical load of the job, and job demand. Age and gender were not significantly associated with symptoms. After adjusting for age, gender, ergonomics, hours at the computer, and exercise, eye symptoms were significantly associated with physical symptoms (p < 0.001) accounting for 48% of the variance.

CONCLUSIONS

Environmental variability at work was associated with eye symptoms and eye symptoms demonstrated a significant impact on quality of life and physical symptoms.

Are there differences between ‘visual symptoms’ and specific ocular symptoms associated with video display terminal (VDT) use?

To assess the reliability of self-reported symptoms of asthenopia associated with VDT use (as characterized by general visual symptoms, headache and specific ocular symptoms) for both continuing soft contact lens (SCL) wearers and former SCL wearers who had undergone successful laser-in-situ-keratomileusis (LASIK) surgery.

METHODS

Forty generally healthy adults, aged between 24 and 44 years, were asked to complete a 13 page questionnaire that included requests for information on general visual symptoms, headache and specific ocular symptoms such as dry eye associated with VDT use. The adults were either long term successful soft contact lens wearers (n=20) or a similar group who had then undergone successful LASIK refractive surgery for myopia 2 years prior to the questionnaire being provided.

RESULTS

Most subjects (70%) reported experiencing some visual symptoms sometimes, 62.5% reported headaches sometimes, and 82.5 % reported specific ocular symptoms sometimes. There were no obvious differences between the two groups either in the reported frequency or severity (by visual analogue scale, VAS) of visual symptoms, headache or specific ocular symptoms. However, while the reporting of headache showed no obvious association with the number of specific ocular symptoms reported, the latter showed a clear correlation with the reporting of the severity of visual symptoms (p<0.001).

DISCUSSION

The results indicate that when an individual reports visual symptoms, they may actually be providing recall of specific ocular symptoms. Therefore, contrary to an often common practice, visual symptoms should be assessed separately to specific ocular symptoms such that the appropriate management can be selected. The results also indicate that previous contact lens wearers who have undergone successful LASIK are still likely to experience some visual and specific ocular symptoms when undertaking computer based work on a regular basis.

Effect of yoga on self-rated visual discomfort in computer users

BACKGROUND

'Dry eye' appears to be the main contributor to the symptoms of computer vision syndrome. Regular breaks and the use of artificial tears or certain eye drops are some of the options to reduce visual discomfort. A combination of yoga practices have been shown to reduce visual strain in persons with progressive myopia. The present randomized controlled trial was planned to evaluate the effect of a combination of yoga practices on self-rated symptoms of visual discomfort in professional computer users in Bangalore.

METHODS

Two hundred and ninety one professional computer users were randomly assigned to two groups, yoga (YG, n = 146) and wait list control (WL, n = 145). Both groups were assessed at baseline and after sixty days for self-rated visual discomfort using a standard questionnaire. During these 60 days the YG group practiced an hour of yoga daily for five days in a week and the WL group did their usual recreational activities also for an hour daily for the same duration. At 60 days there were 62 in the YG group and 55 in the WL group.

RESULTS

While the scores for visual discomfort of both groups were comparable at baseline, after 60 days there was a significantly decreased score in the YG group, whereas the WL group showed significantly increased scores.

CONCLUSION

The results suggest that the yoga practice appeared to reduce visual discomfort, while the group who had no yoga intervention (WL) showed an increase in discomfort at the end of sixty days.

Neuromuscular assessment in elderly workers with and without work related shoulder/neck trouble: the NEW-study design and physiological findings

Musculoskeletal disorders in the neck and shoulder area are a major occupational concern in the European countries especially among elderly females. The aim was to assess these disorders based on quantitative EMG indicators and functional tests. 252 female computer users (45-68 years) were recruited from four European countries in two contrast groups: (1) 88 neck/shoulder (NS) cases reporting trouble in the neck and/or shoulder region for more than 30 days during the last year, and (2) 164 NS-controls reporting such trouble for no more than 7 days. Questionnaires, functional/clinical tests, and physiological recordings were performed in workplace related field studies. The results showed no differences in anthropometrics but NS-cases reported more strained head positions and more eye problems than controls. The psychosocial working factors were similar, although, NS-controls had slightly better scores on working conditions, general health, and vitality compared to cases. The NS-cases had lower maximal voluntary contraction (MVC) during shoulder elevation (mean (SD) 310 (122) N) compared to the controls (364 (122) N). During 30% MVC electromyography (EMGrms) in the trapezius muscle was lower in NS-cases (194 (105) muV) than in controls (256 (169) muV), while no differences were found regarding endurance time. Estimated conduction velocity was not different between NS-cases and -controls. Four functional computer tests were performed equally well by NS-cases and -controls, and the corresponding EMG variables also did not differ. A major finding in this large-scale epidemiological study is the significantly lower MVC in NS-cases compared with NS-controls together with lower EMGrms value at 30% MVC, while computer tasks were performed at similar relative muscle activation. The study was unable to reveal quantitative EMG indicators and functional tests that could objectively assess disorders in NS-cases.

Computer vision syndrome: a review

As computers become part of our everyday life, more and more people are experiencing a variety of ocular symptoms related to computer use. These include eyestrain, tired eyes, irritation, redness, blurred vision, and double vision, collectively referred to as computer vision syndrome. This article describes both the characteristics and treatment modalities that are available at this time. Computer vision syndrome symptoms may be the cause of ocular (ocular-surface abnormalities or accommodative spasms) and/or extraocular (ergonomic) etiologies. However, the major contributor to computer vision syndrome symptoms by far appears to be dry eye. The visual effects of various display characteristics such as lighting, glare, display quality, refresh rates, and radiation are also discussed. Treatment requires a multidirectional approach combining ocular therapy with adjustment of the workstation. Proper lighting, anti-glare filters, ergonomic positioning of computer monitor and regular work breaks may help improve visual comfort. Lubricating eye drops and special computer glasses help relieve ocular surface-related symptoms. More work needs to be done to specifically define the processes that cause computer vision syndrome and to develop and improve effective treatments that successfully address these causes.

Prevalence of Eye Strain Among Radiologists: Influence of Viewing Variables on Symptoms

OBJECTIVE

To determine the prevalence of and factors contributing to eye strain among radiologists, we examined the influence of the viewing method (PACS vs hard-copy film), age, case volume, technique, work habits, and workstation design on symptoms.

MATERIALS AND METHODS

An Internet-based survey was sent to 2,700 radiologists randomly selected from the membership database of the Radiological Society of North America. Questions included demographic information, viewing method, work habits, and workstation design. Common eye strain symptoms were evaluated on a 5-point Likert scale. Chi-square analysis, analysis of variance, and step-wise and regression analyses were performed to evaluate codependence of the explanatory variables with eye strain.

RESULTS

The adjusted response rate was 14% (380 respondents). The largest age cohort was 36-50 years. The prevalence of eye strain was 36% and was not affected by the viewing method (PACS vs film). Increased symptoms could be independently predicted in radiologists who were women (p <0.001), had longer work days (p=0.009), took fewer breaks (p=0.03), reported screen flicker (p=0.0003), and performed CT screening (p=0.04). Working hours had the strongest influence on eye strain. Eye strain was increased in those who reported studies for longer than 6 hr per day (p=0.01) and decreased in those who took breaks every hour (p=0.04). Symptoms were independent of the length of the break taken and of other workstation and technique factors.

CONCLUSION

Eye strain was common among the radiologists in our study population, with no significant difference between PACS and hard-copy film users. Taking frequent short breaks, eliminating screen flicker, and limiting the number of CT screening studies interpreted may improve symptoms.

Applying epidemiological principles to ergonomics: a checklist for incorporating sound design and interpretation of studies

The primary purpose of this paper is to provide a checklist of scientific requirements necessary for the design of sound ergonomics studies. Ergonomics researchers will be able to use the checklist when designing a study and preparing it for publication. Practitioners can use the checklist to critically appraise study results, thereby having greater confidence when applying ergonomic recommendations to the workplace. A secondary purpose of the paper is to pilot the checklist on a sample of papers in the ergonomics literature and to assess its reliability. While there are checklists to assess the epidemiological rigour of studies, none have been adapted to address methodological issues in ergonomics. Two epidemiologists independently searched five ergonomics journals (Applied Ergonomics, Ergonomics, Human Factors, International Journal of Human-Computer Interaction and Journal of Human Ergology) for research studies on VDT use and visual function published between 1990 and 1995. Twenty-one articles were reviewed. Each paper was scored according to the checklist. Overall, the reviewers found that the articles did not consistently fulfill some of the checklist criteria. An insufficient sample size was the most serious omission. Inter-rater reliability of the checklist was excellent for 11 of 14 items on the checklist (Kappa > 0.74), good for two items (Kappa between 0.40 and 0.74) and poor for one item. As ergonomics is gaining acceptance as an integral part of occupational health and safety, individuals in this field must be cognizant of the fact that study results are being applied directly to workplace procedures and design. It is incumbent upon ergonomists to base their work on a solid research foundation. The checklist can be used as a tool to improve study designs and so ultimately has implications for improving the fit between the worker and the work environment.