Effect of overuse injury and the importance of training on the use of adjustable workstations by keyboard operators

Assessment of Musculoskeletal Discomfort and Evaluation of Radiology Workstation Ergonomics in a National Radiology Workforce

RATIONALE AND OBJECTIVES

We assessed the presence of musculoskeletal discomfort and evaluated the ergonomics parameters of radiology workstations and the impact of poor radiology workstation ergonomics on musculoskeletal discomfort in a national radiology workforce.

METHODS

This was a cross-sectional, questionnaire-based study. All radiologist and radiology trainee members of the Canadian Association of Radiologists were eligible to participate. Radiology workstation ergonomics parameters and self-reported data on musculoskeletal discomfort were recorded. A binary logistic regression model was fitted to the data to ascertain the impact of participants' radiology workstation ergonomics parameters on the likelihood of experience of musculoskeletal discomfort while adjusting for demographic variables.

RESULTS

A total of 191 questionnaires were completed. The median (interquartile range) age of participants was 42.0 years (17.0 years) and 56.8% of participants were female. One hundred fifty participants (78.5%) self-reported the presence of musculoskeletal discomfort. Ergonomics parameters most commonly implemented included having monitors an arm's length away (82.6%) and hands being shoulder-width apart (77.1%). Binary logistic regression revealed participants either not having the top of the monitor screen at eye level when in a seated position or not having the wrists straight and relatively flat when using the mouse was associated with an increased likelihood of experience of musculoskeletal discomfort. The majority of participants (92.7%) self-reported their musculoskeletal discomfort to affect work productivity.

CONCLUSION

A high proportion of musculoskeletal discomfort, limited implementation of ergonomics parameters of radiology workstations, and an association of two of these ergonomics parameters with an increased likelihood of experience of musculoskeletal discomfort were observed in a national radiology workforce.

Controversies in the Science of Sedentary Behaviour and Health: Insights, Perspectives and Future directions from the 2018 Queensland Sedentary Behaviour Think Tank

The development in research concerning sedentary behaviour has been rapid over the past two decades. This has led to the development of evidence and views that have become more advanced, diverse and, possibly, contentious. These include the effects of standing, the breaking up of prolonged sitting and the role of moderate-to-vigorous physical activity (MVPA) in the association between sedentary behaviour and health outcomes. The present aim is to report the views of experts (n = 21) brought together (one-day face-to-face meeting in 2018) to consider these issues and provide conclusions and recommendations for future work. Each topic was reviewed and presented by one expert followed by full group discussion, which was recorded, transcribed and analysed. The experts concluded that (a). standing may bring benefits that accrue from postural shifts. Prolonged (mainly static) standing and prolonged sitting are both bad for health; (b). ‘the best posture is the next posture’. Regularly breaking up of sitting with postural shifts and movement is vital; (c). health effects of prolonged sitting are evident even after controlling for MVPA, but high levels of MVPA can attenuate the deleterious effects of prolonged sitting depending on the health outcome of interest. Expert discussion addressed measurement, messaging and future directions.

Sit-stand desks in call centres: associations of use and ergonomics awareness with sedentary behavior

OBJECTIVE

To investigate whether or not use of sit-stand desks and awareness of the importance of postural variation and breaks are associated with the pattern of sedentary behavior in office workers.

METHOD

The data came from a cross-sectional observation study of Swedish call centre workers. Inclinometers recorded 'seated' or 'standing/walking' episodes of 131 operators over a full work shift. Differences in sedentary behavior based on desk type and awareness of the importance of posture variation and breaks were assessed by non-parametric analyses.

RESULTS

90 (68.7%) operators worked at a sit-stand desk. Working at a sit-stand desk, as opposed to a sit desk, was associated with less time seated (78.5 vs 83.8%, p = 0.010), and less time taken to accumulate 5 min of standing/walking (36.2 vs 46.3 min, p = 0.022), but no significant difference to sitting episode length or the number of switches between sitting and standing/walking per hour. Ergonomics awareness was not associated with any sedentary pattern variable among those using a sit-stand desk.

CONCLUSION

Use of sit-stand desks was associated with better sedentary behavior in call centre workers, however ergonomics awareness did not enhance the effect.

Office ergonomics training and a sit-stand workstation: effects on musculoskeletal and visual symptoms and performance of office workers

Work Related Musculoskeletal Disorders (WMSDs) among office workers with intensive computer use is widespread and the prevalence of symptoms is growing. This randomized controlled trial investigated the effects of an office ergonomics training combined with a sit-stand workstation on musculoskeletal and visual discomfort, behaviors and performance. Participants performed a lab-based customer service job for 8 h per day, over 15 days and were assigned to: Ergonomics Trained (n = 11) or Minimally Trained (n = 11). The training consisted of: a 1.5-h interactive instruction, a sit/stand practice period, and ergonomic reminders. Ergonomics Trained participants experienced minimal musculoskeletal and visual discomfort across the 15 days, varied their postures, with significantly higher performance compared to the Minimally Trained group who had a significantly higher number of symptoms, suggesting that training plays a critical role. The ability to mitigate symptoms, change behaviors and enhance performance through training combined with a sit-stand workstation has implications for preventing discomforts in office workers.

The effects of an office ergonomics training and chair intervention on worker knowledge, behavior and musculoskeletal risk

A large-scale field intervention study was undertaken to examine the effects of office ergonomics training coupled with a highly adjustable chair on office workers' knowledge and musculoskeletal risks. Office workers were assigned to one of three study groups: a group receiving the training and adjustable chair (n=96), a training-only group (n=63), and a control group (n=57). The office ergonomics training program was created using an instructional systems design model. A pre/post-training knowledge test was administered to all those who attended the training. Body postures and workstation set-ups were observed before and after the intervention. Perceived control over the physical work environment was higher for both intervention groups as compared to workers in the control group. A significant increase in overall ergonomic knowledge was observed for the intervention groups. Both intervention groups exhibited higher level behavioral translation and had lower musculoskeletal risk than the control group.

Effects of adjustable sit-stand VDT workstations on workers' musculoskeletal discomfort, alertness and performance

Adjustable sit-stand workstations, which are designed to allow workers to sit and stand autonomously while working, were examined to identify the effects on workers' musculoskeletal discomfort, alertness and performance. Twenty-four healthy subjects participated in the study. The subjects were required to do an English transcription task for 150 min under the following conditions: 1) sitting at standard workstations (Standard), 2) sitting on a chair with the work surface elevated to standing position (High-chair) and 3) a combination of 10-min sitting and 5-min standing with the same setting as that in the high-chair condition (Sit-stand). The subjective musculoskeletal discomfort scores indicated that High-chair and Sit-stand resulted in relatively higher discomfort levels than the Standard condition. Although the ratio between low-frequency (0.04-0.15 Hz) and high-frequency (0.15-0.4 Hz) components of heart rate variability (LF/HF ratio) in Sit-stand was higher than that in other conditions, there were no significant differences in subjective sleepiness among the three conditions. As for work performance, there was a tendency to be steadily high under the Sit-stand condition compared with other conditions, but not a significant difference. This study revealed that although the use of sit-stand workstations can contribute to keeping workers' arousal level steady, it has an adverse effect in light of musculoskeletal discomfort.

Flexible workspace design and ergonomics training: impacts on the psychosocial work environment, musculoskeletal health, and work effectiveness among knowledge workers

A macroergonomics intervention consisting of flexible workspace design and ergonomics training was conducted to examine the effects on psychosocial work environment, musculoskeletal health, and work effectiveness in a computer-based office setting. Knowledge workers were assigned to one of four conditions: flexible workspace (n=121), ergonomics training (n=92), flexible workspace+ergonomics training (n=31), and a no-intervention control (n=45). Outcome measures were collected 2 months prior to the intervention and 3 and 6 months post-intervention. Overall, the study results indicated positive, significant effects on the outcome variables for the two intervention groups compared to the control group, including work-related musculoskeletal discomfort, job control, environmental satisfaction, sense of community, ergonomic climate, communication and collaboration, and business process efficiency (time and costs). However, attrition of workers in the ergonomics training condition precluded an evaluation of the effects of this intervention. This study suggests that a macroergonomics intervention is effective among knowledge workers in office settings.

The introduction of sit-stand worktables; aspects of attitudes, compliance and satisfaction

The introduction of sit-stand worktables was examined in this study. Purchasers at four companies were interviewed regarding preparations prior to purchase, follow-up after installation, and if expectations had been fulfilled. Personnel at the four companies answered a questionnaire examining use of the worktables' sit-stand function, and the influence of some variables on this. Utilisation of the sit-stand function was less than what could be expected to relieve static musculoskeletal loading during VDU work. Pain experienced during the past year, and education on the use of the worktable gave rise to modest increases in utilisation. Investment in sit-stand worktables was satisfactory to purchasers, in terms of providing flexible furniture to suit modern organisational dynamics. Users were, in general, positive to the worktables, but showed poor compliance in using them. User and purchaser satisfaction with regard to improving individual health ergonomics was questionable in respect of the low level of usage.

Self-administered preventive programme for sedentary workers: reducing musculoskeletal symptoms or increasing awareness?

The objective of this study was to evaluate an auto-instructional preventive programme designed to allow the subjects to identify critical aspects related to their work and musculoskeletal comfort, and provide them with some simple alternatives for controlling the identified problems. The programme was evaluated by 36 secretaries and bank clerks through their symptom perception before and after the programme. The results showed that the symptoms increased in number and severity. The programme seemed to have helped the participants to become aware of the ergonomic problems present in their job and to link these problems to physical symptoms. Self-administered preventive programmes can lead to clearly negative results when applied as the only measure to control musculoskeletal symptoms.

Computer workstation adjustment: a novel process and large sample study

The use of computers in the US workforce is expected to grow throughout the 1990s. Prolonged computer use, repetitive keying, awkward postures and psychosocial issues have been associated with injuries described as cumulative trauma disorders (CTDs). The incidence and reporting of occupationally induced CTDs has increased dramatically since 1980. Proper adjustment of individual computer workstations requires time and technical knowledge. An automated process for computer workstation adjustment was developed using linked-segment anthropometry. Over 3300 employees in a large industrial complex voluntarily participated in this programme by completing a computer workstation questionnaire. Significant relationships were demonstrated comparing both hours and years of computer use with symptoms. A followup questionnaire was completed by 531 programme participants. Ninety percent indicated an improved understanding of proper computer adjustment. Eighty percent of those making recommended adjustments indicated benefits in reduced symptoms and greater work efficiency.

Factors related to working posture and its assessment among keyboard operators

Video analysis of 15 keyboard operators was conducted over two four-hour periods to determine the effects of symptoms of over-use injury, the adjustability of the workstation, the type of keyboard, time of day and sex on working posture. The only factor which significantly affected posture was the type of keyboard, with operators at typewriters adopting a more extended shoulder position, reduced elbow flexion and increased wrist flexion, than those working at a VDU terminal. Analysis of the components of variance associated with repeated observations revealed that to minimise the variance associated with recording the posture of these subjects, and therefore obtain a representative mean posture, required at least nine observations for wrist angle, four for elbow angle, six for shoulder angle and three for trunk incline. The mean posture adopted by this group of operators was similar to the 'right angles' posture, with the trunk reclined 4 degrees , shoulder extended 1 degrees , elbow 92 degrees and wrist extended 7 degrees .