Ergonomic benefit using heads-up display compared to conventional surgical microscope in Japanese ophthalmologists

PURPOSE

Occupational musculoskeletal disorders are prevalent in ophthalmic surgeons and can impact surgeons' well-being and productivity. Heads-up displays may reduce ergonomic stress compared to conventional microscopes. This cross-sectional, non-interventional study compared ergonomic experience between heads-up display and conventional ocular microscopes.

METHODS

The study protocol was approved by the independent ethics committee and nonprofit organization MINS Institutional Review Board. An online questionnaire was distributed to a sample of ophthalmic surgeons in Japan with experience operating with heads-up display. The questionnaire captured surgeon-specific variables, the standardized Nordic Musculoskeletal Questionnaire, and custom questions to compare heads-up display and conventional microscope and understand long-term impacts of musculoskeletal disorders.

RESULTS

Analysis was conducted on responses from 67 surgeons with a mean 25 years of practice and 2.7 years using heads-up display. Many surgeons agreed or strongly agreed that heads-up display reduced the severity (40%) and frequency (40%) of pain and discomfort, improved posture (61%), and improved overall comfort (61%). Of respondents who experienced asthenopia (n = 59) or pain/discomfort during operation (n = 61), 54% reported improvement in asthenopia and 72% reported feeling less pain/discomfort since using heads-up display. Overall, 69% reported preference for heads-up display.

CONCLUSION

This study provides novel data on musculoskeletal disorders and the long-term impacts of ergonomic strain reported by ophthalmologists building on existing literature demonstrating ergonomic and other advantages of heads-up display. Future studies with objective ergonomic assessment are warranted to validate these findings.

Visualisation ergonomics and robotic surgery

Stereopsis may be an advantage of robotic surgery. Perceived robotic ergonomic advantages in visualisation include better exposure, three-dimensional vision, surgeon camera control, and line of sight screen location. Other ergonomic factors relating to visualisation include stereo-acuity, vergence-accommodation mismatch, visual-perception mismatch, visual-vestibular mismatch, visuospatial ability, visual fatigue, and visual feedback to compensate for lack of haptic feedback. Visual fatigue symptoms may be related to dry eye or accommodative/binocular vision stress. Digital eye strain can be measured by questionnaires and objective tests. Management options include treatment of dry eye, correction of refractive error, and management of accommodation and vergence anomalies. Experienced robotic surgeons can use visual cues like tissue deformation and surgical tool information as surrogates for haptic feedback.

Anti-Fatigue Glasses Based on Microprisms for Preventing Eyestrain

Although microprisms have become an important medical means of strabismus treatment, related research concerning the design, fabrication, and testing of microprismatic glasses for preventing eyestrain has rarely been reported. In this study, the structure of microprismatic glasses for preventing eyestrain related to using electronic monitors, including computers and mobile phones, is introduced. A designing theory of anti-fatigue glasses with microprisms is developed. The fabrication technique and the process are described, and the performances of the fabricated microprisms are characterized. Finally, a compact testing system for the measurement of prismatic diopter is designed and constructed. This measuring system can be used not only for Fresnel microprisms, but also for other types of prisms. The measured results agree with our calculations. Although this study is focused on optimizing the objective prismatic diopter for anti-fatigue microprismatic glasses, 2.0–3.0 prismatic diopters (Δ) for each eye in the anti-fatigue glasses are suggested according to our experience on strabismus treatments. The clinical research for patients using the developed anti-fatigue glasses will be fully implemented in our further research to confirm the optimal subjective prismatic value.

Do Blue-blocking Lenses Reduce Eye Strain From Extended Screen Time? A Double-Masked Randomized Controlled Trial

PURPOSE

To investigate if blue-blocking lenses are effective in reducing the ocular signs and symptoms of eye strain associated with computer use.

DESIGN

Double-masked, randomized controlled trial.

METHODS

A total of 120 symptomatic computer users were randomly assigned (1:1) into a "positive" or "negative" advocacy arm (ie, a clinician either advocating or not advocating for the intervention via a prerecorded video). Participants were further sub-randomized (1:1) to receive either clear (placebo) or blue-blocking spectacles. All participants were led to believe they had received an active intervention. Participants performed a 2-hour computer task while wearing their assigned spectacle intervention. The prespecified primary outcome measures were the mean change (post- minus pre-computer task) in eye strain symptom score and critical flicker-fusion frequency (CFF, an objective measure of eye strain). The study also investigated whether clinician advocacy of the intervention (in a positive or negative light) modulated clinical outcomes.

RESULTS

All participants completed the study. In the primary analysis, for CFF, no significant effect was found for advocacy type (positive or negative, p = .164) and spectacle intervention type (blue-blocking or clear lens, p = .304). Likewise, for eye strain symptom score, no differences were found for advocacy (p = .410) or spectacle lens types (p = .394). No adverse events were documented.

CONCLUSIONS

Blue-blocking lenses did not alter signs or symptoms of eye strain with computer use relative to standard clear lenses. Clinician advocacy type had no bearing on clinical outcomes.

A Randomized, Placebo-Controlled Study on the Safety and Efficacy of Daily Ingestion of Green Tea (Camellia sinensis L.) cv. "Yabukita" and "Sunrouge" on Eyestrain and Blood Pressure in Healthy Adults

The green tea (Camellia sinensis L.) cultivar “Sunrouge” contains anthocyanins, catechins and flavonols. To determine whether ingesting green tea containing anthocyanins improves visual function and blood pressure (BP) in healthy adults, a randomized, double-blind, placebo-controlled study was performed. A total of 120 healthy subjects, aged between 20 and 60 years and with a systolic BP (SBP) value of ≤125 and <155 and a diastolic BP (DBP) value <95, or a DBP of ≤75 mmHg and <95 mmHg and a SBP <155 mmHg, were randomly assigned to one of three groups. For 12 weeks, the placebo group received barley extract without catechin; another group received “Sunrouge” extract containing 11.2 mg anthocyanin and 323.6 mg epigallocatechin-3-O-gallate (EGCG); and a third group received “Yabukita” extract containing 322.2 mg EGCG. Home BP, accommodation ability, visual analog scale questionnaires for eyestrain, and metabolic-associated markers were analyzed at weeks 0, 4, 8, and 12 of the intake period. The ingestion of “Sunrouge” tea significantly improved accommodation ability and eyestrain in subjects younger than 45 years and in subjects who operated visual display terminals every day. It also elevated BP. “Yabukita” tea ingestion significantly increased serum adiponectin levels. No adverse effects were observed. We conclude that long-term intake of “Sunrouge” tea containing anthocyanins and flavonols might improve visual function.

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.

A systematic review of controlled trials on visual stress using Intuitive Overlays or the Intuitive Colorimeter

Claims that coloured filters aid reading date back 200 years and remain controversial. Some claims, for example, that more than 10% of the general population and 50% of people with dyslexia would benefit from coloured filters lack sound evidence and face validity. Publications with such claims typically cite research using methods that have not been described in the scientific literature and lack a sound aetiological framework. Notwithstanding these criticisms, some researchers have used more rigorous selection criteria and methods of prescribing coloured filters that were developed at a UK Medical Research Council unit and which have been fully described in the scientific literature. We review this research and disconfirm many of the more extreme claims surrounding this topic. This literature indicates that a minority subset of dyslexics (circa 20%) may have a condition described as visual stress which most likely results from a hyperexcitability of the visual cortex. Visual stress is characterised by symptoms of visual perceptual distortions, headaches, and eyestrain when viewing repetitive patterns, including lines of text. This review indicates that visual stress is distinct from, although sometimes co-occurs with, dyslexia. Individually prescribed coloured filters have been shown to improve reading performance in people with visual stress, but are unlikely to influence the phonological and memory deficits associated with dyslexia and therefore are not a treatment for dyslexia. This review concludes that larger and rigorous randomised controlled trials of interventions for visual stress are required. Improvements in the diagnosis of the condition are also a priority.

Viewing 3D TV over two months produces no discernible effects on balance, coordination or eyesight

With the rise in stereoscopic 3D media, there has been concern that viewing stereoscopic 3D (S3D) content could have long-term adverse effects, but little data are available. In the first study to address this, 28 households who did not currently own a 3D TV were given a new TV set, either S3D or 2D. The 116 members of these households all underwent tests of balance, coordination and eyesight, both before they received their new TV set, and after they had owned it for 2 months. We did not detect any changes which appeared to be associated with viewing 3D TV. We conclude that viewing 3D TV does not produce detectable effects on balance, coordination or eyesight over the timescale studied. Practitioner Summary: Concern has been expressed over possible long-term effects of stereoscopic 3D (S3D). We looked for any changes in vision, balance and coordination associated with normal home S3D TV viewing in the 2 months after first acquiring a 3D TV. We find no evidence of any changes over this timescale.

[Focal Point “Reading Animal”. Hermann Cohn and the Emergence of the Fin de Siècle Hygiene of Reading]

From the 1860s onward, ‘eye experts’ increasingly fretted the alleged surge of myopia attributed to an increase of reading matter circulating in schools. In order to avert the inauspicious prospects, revised school desks designed to prevent children from becoming myopic were introduced. During the 1880s, said experts turned to printed matter, maintaining that books must become more reader friendly. Along with the turn to books, a peculiar shift within the hygiene discourse occurred: While the ill addressed by school desk-revisions was myopia, the goal of revising book design was to make reading less tiring. This paper explores both the shift from the hygiene of the eye to the hygiene of reading as well as the materialization of the stipulations and claims made by reading hygienists. In doing so, the paper demonstrates that optimizing the reading process was closely linked to a fear of overburdening and fatigue which expressed itself in the psychopathological discourse of the time.

Bilberry extract supplementation for preventing eye fatigue in video display terminal workers

OBJECTIVES

To examine the effect of a dietary supplement containing bilberry extract (BE) on eye fatigue induced by acute video display terminal (VDT) loads.

DESIGN AND SETTING

A prospective, randomized, double-blind, placebo-controlled study was performed from August 2012 to February 2013 in the Medical Corporation Jico-kai Yagi Hospital, and the Shinyokohama Shinoharaguchi Orthopedic Surgery and Dermatology Clinic, in Japan.

PARTICIPANTS

Two hundred eighty-one office workers aged 20-40 years that used VDTs were screened by critical flicker fusion (CFF) and near point accommodation (NPA).

INTERVENTION

The participants were randomized to either a BE (480 mg/day) or placebo (vehicle) group, and took allocated capsule, daily, for 8 weeks.

MEASUREMENTS

The CFF, NPA, contrast visual acuity, functional visual acuity, keratoconjunctival epithelial damage, and fluorescein tear film break-up time were examined, and 18 subjective symptoms of eye fatigue were evaluated by questionnaire. Adverse events were reported via medical interviews. Data were collected both before and after VDT load at baseline, and 4, and 8 weeks after daily supplementation with either BE or placebo.

RESULTS

Of 281 participants screened, 88 having relatively lower levels of CFF and NPA were enrolled in the study. Of these, 37 control and 43 BE group subjects completed the study. The VDT load-induced reduction in CFF was alleviated after 8 weeks of BE supplementation (95% confidence interval, 0.10-1.60; p=0.023), in contrast to placebo supplementation, while NPA variation was not. Of the subjective symptoms of eye fatigue, VDT load-induced ocular fatigue sensation, ocular pain, eye heaviness, uncomfortable sensation, and foreign body sensation were mitigated more in the BE group than in the control group, at week 8 (p<0.05). There were no severe adverse events in either group.

CONCLUSIONS

BE supplementation improved some of the objective and subjective parameters of eye fatigue induced by VDT loads.

Effect of Blue Light-Reducing Eye Glasses on Critical Flicker Frequency

PURPOSE

This study aims to evaluate the effect of blocking short-wavelength light on critical flicker frequency (CFF).

DESIGN

This study is a prospective clinical study.

METHODS

Thirty-three participants (17 men and 16 women; age range, 28-39 years) were divided into 3 groups. Each group wore 1 of 3 types of lenses while performing an intensive computer task for 2 hours. To evaluate the effect of blocking short-wavelength light before and after the task, we measured the CFF and evaluated subjective questionnaires. We used the analysis of variance test to examine whether the type of lenses tested affected any of the visual fatigue-related parameters.

RESULTS

The type of lens worn significantly affected the CFF; however, answers to the subjective questionnaires did not differ significantly between the groups. Two of the 13 question items showed a statistical difference between lens transparency and increase in the CFF (lens 3 > lens 2 > lens 1).

CONCLUSIONS

The higher the blocking effect of the lens, the lower the reduction in the CFF, suggesting that blocking short-wavelength light can reduce eye fatigue.

An Attempt at Preventing Asthenopia Among VDT Workers

We report the results of 3 surveys of visual display terminal (VDT) users who took a minibreak during which they viewed a stereoscopic image of a repeating parallel pattern showing planets. The single image stereogram method employed is called Stretch Eye (TM), and we evaluated the effects of Stretch Eye (TM) on asthenopia. An accommodative relaxation of about 1 D was observed in participants while they were gazing at the image. The employees of 2 information technology companies were evaluated according to a visual analogue scale (VAS) for subjective symptoms of asthenopia and eyesight. The results showed that Stretch Eye (TM) was effective in easing visual fatigue due to VDT work and it improved eyesight under working conditions.

Visual Strain and Lighting Preferences of VDT Users Under Different Lighting Systems

Lighting influences users' visual strain and well-being. Therefore creating lighting that ensures visual work conditions do not result in visual fatigue is a preventive activity. The aim of the study was to model different lighting systems for visual display terminal (VDT) work and to determine their influence on users' visual strain and preferences. The results of the study showed that visual fatigue was lowest for indirect and compound lighting systems. On the other hand, in general, direct lighting realized by "dark-light" luminaires was the most preferred lighting system. Some interesting differences related to age, gender, and VDT work experience were found. On the basis of the obtained results lighting designers can be provided with some guidance.

[Psychophysiological research of changes of the functional condition of the neuro-psychic sphere of younger schoolchildren during the school day at luminescent and LED lighting in the classroom]

The purpose of the study is to test the hypothesis that the LED lighting (LL) in training class does not have a negative impact on the change in the functional state of the neuro-psychiatric sphere in pupils by the end of the school day, if compared with traditional for schools fluorescent lighting (FL). With the help of specially matched methods for psychophysiological examination there was performed the testing of changes in the functional state of the neuro-psychiatric in pupils during the school day and there was made an analysis of these changes in dependence on the type of lighting the classroom. LL, if compared to FL, was established to lead to a significant weakening of the negative changes of functional lability of the visual analyzer, the power of excitation of the nervous system and cognitive functions, as well as to an increase in positive changes in psychomotorics. The data obtained allow us to recommend the use of LED lighting equipment in modern schools.

Web-based office ergonomics intervention on work-related complaints: a field study

The aim of this study was a proof of concept to examine the effects of a Web-based office ergonomics intervention on subjects' individual workplace adjustments. An intervention study was conducted with 24 office workers lasting 6 weeks with three consecutive phases (before, 1 and 5 weeks after the intervention). Employees used a purpose-made website for adjusting their computer workplaces without any personal support of ergonomics experts. Workplace measurements were taken directly on site and by analysing photos taken of the employee. Self-reported complaints were assessed by filling in a questionnaire. It was found that 96% of the employees changed their workplaces on their own and retained them mostly unchanged after the intervention. Furthermore, self-reported musculoskeletal complaints and headache symptoms decreased significantly after the intervention. These findings suggest an improvement of workplace conditions so that cost-effective ergonomic Web-based interventions appear promising in further research and application.

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.

Influence of viewing distance and size of tv on visual fatigue and feeling of involvement

Using physiological and psychological measurements, we carried out experiments to investigate the influence of viewing distance and TV screen size on visual fatigue and feeling of involvement using 17-inch, 42-inch and 65-inch displays. The experiment was an ordinary viewing test with the content similar to everyday TV programs for one hour including scenery, sport, drama, etc., with commercials sandwiched in between. The number of participants was 16 (8 persons aged 21-31, and 8 persons aged 50-70) for each display size. In all, 48 participants viewed 3 display sizes. In our physiological evaluation, CFF (critical flicker fusion frequency), blink rate and a sympathetic nerve activity index were used; and in the psychological evaluation, questionnaires and interviews were employed. Our results, based on physiological and psychological measurements, suggest the opti- mum viewing distance to be around 165-220 cm, irrespective of screen size. Our evaluations, which are based on optimum viewing distance for minimal visual fatigue and a closer feeling of involvement, might therefore not agree with the currently recommended viewing distance, which is defined as 2 or 3 times the display's height.

A replicated field intervention study evaluating the impact of a highly adjustable chair and office ergonomics training on visual symptoms

OBJECTIVE

Examine the effects of two office ergonomics interventions in reducing visual symptoms at a private sector worksite.

METHODS

A quasi-experimental study design evaluated the effects of a highly adjustable chair with office ergonomics training intervention (CWT group) and the training only (TO group) compared with no intervention (CO group). Data collection occurred 2 and 1 month(s) pre-intervention and 2, 6 and 12 months post-intervention. During each data collection period, a work environment and health questionnaire (covariates) and daily health diary (outcomes) were completed. Multilevel statistical models tested hypotheses.

RESULTS

Both the training only intervention (p<0.001) and the chair with training intervention (p=0.01) reduced visual symptoms after 12 months.

CONCLUSION

The office ergonomics training alone and coupled with a highly adjustable chair reduced visual symptoms. In replicating results from a public sector worksite at a private sector worksite the external validity of the interventions is strengthened, thus broadening its generalizability.

A field intervention examining the impact of an office ergonomics training and a highly adjustable chair on visual symptoms in a public sector organization

OBJECTIVE

Examine the effect of a multi-component office ergonomics intervention on visual symptom reductions.

METHODS

Office workers were assigned to either a group receiving a highly adjustable chair with office ergonomics training (CWT), a training-only group (TO) or a control group (C). A work environment and health questionnaire was administered 2 and 1 month(s) pre-intervention and 3, 6, and 12 months post-intervention. Multi-level statistical models tested hypotheses.

RESULTS

The CWT intervention lowered daily visual symptoms (p < 0.01) post-intervention. The TO group did not significantly differ from the control group. The CWT group differed significantly from the TO group (p = 0.01) post-intervention.

CONCLUSION

Workers who received a highly adjustable chair and office ergonomics training had reduced visual symptoms and the effect was maintained through twelve months post-intervention. The lack of a training-only group effect supports implementing training in conjunction with the highly adjustable chair to reduce visual symptoms.

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.

Ergonomics in the computer workstation

BACKGROUND

Awareness of effects of long term use of computer and application of ergonomics in the computer workstation is important for preventing musculoskeletal disorders, eyestrain and psychosocial effects.

OBJECTIVES

To determine the awareness of physical and psychological effects of prolonged computer usage and application of ergonomicsin the workstation.

DESIGN

One hundred and eighty one people were interviewed from tertiary educational institutions, telecommunications and media houses within Nairobi, Kenya.

SUBJECTS

Descriptive cross sectional study.

RESULTS

Majority (89.8%) of the respondents felt that prolonged computer use had an adverse effect on their health, with only 12.4% having received formal training on the same. Assessment of their workstations revealed the most applied ergonomic measure as feet placement on the floor: 100% (181) followed by correct monitor placement with 94.4% (171) fulfilling the requirements. The least applied ergonomic measures were non reflecting wall paint: 5% (9) and adjustable desk 9.9% (18).

CONCLUSION

There is awareness among computer users on the effects of prolonged computer use but there is limited application of ergonomic measures.

Evaluation of the effect of viewing distance on visual fatigue in a home viewing environment

The authors report here the results of evaluation experiments designed to explore the effect of viewing distance on visual fatigue. Two kinds of visual content (normal content and content likely to cause visual fatigue) were used by means of physiological measurements of subject responses while viewing a 42-inch PDP display, followed by psychological evaluations in the form of post-experiment interviews. Both experiments showed that visual fatigue reached a minimum at a distance of 3 to 4 times the height of the display (3-4H; 165 cm-220 cm) and that sympathetic nerve activity peaked at around 3H. These results indicate that the ideal viewing distance for minimal visual fatigue and a closer feeling of involvement might be at around 3H.

[Computer visual syndrome and occupational ophthalmopathy in PC operators]

Information technologies development resulted in occupational ophthalmopathy in PC users. The article covers criteria to define the risk group for prevention and rehabilitation measures.

Effects of VDT workstation lighting conditions on operator visual workload

Industrial lighting covers a wide range of different characteristics of working interiors and work tasks. This study investigated the effects of illumination on visual workload in visual display terminal (VDT) workstation. Ten college students (5 males and 5 females) were recruited as participants to perform VDT signal detection tasks. A randomized block design was utilized with four light colors (red, blue, green and white), two ambient illumination levels (20 lux and 340 lux), with the subject as the block. The dependent variables were the change of critical fusion frequency (CFF), visual acuity, reaction time of targets detection, error rates, and rating scores in a subjective questionnaire. The study results showed that both visual acuity and the subjective visual fatigue were significantly affected by the color of light. The illumination had significant effect on CFF threshold change and reaction time. Subjects prefer to perform VDT task under blue and white lights than green and red. Based on these findings, the study discusses and suggests ways of color lighting and ambient illumination to promote operators' visual performance and prevent visual fatigue effectively.

Supplementary breaks and stretching exercises for data entry operators: a follow-up field study

BACKGROUND

This study expanded previous NIOSH-IRS research examining the effects of rest breaks and stretching exercises on symptoms and performance in data-entry workers.

METHODS

All workers spent 4 weeks with conventional breaks (two 15 min breaks per day) and 4 weeks with supplementary breaks (two 15 min breaks plus four 5 min breaks per day). One-half were assigned at random to a group instructed to perform brief stretching exercises during breaks. The remainder comprised the "no stretching" (control) group.

RESULTS

51 workers (stretch group n = 21; no stretch group n = 30) completed the study symptom questionnaires. Discomfort and eyestrain were significantly lower with supplementary breaks, and supplementary breaks attenuated accumulation of discomfort and eyestrain during work sessions. Data-entry speed was significantly faster with supplementary breaks so that work output was maintained, despite replacing 20 min of work time with break time. In the stretch group, workers reported stretching during only 25% of conventional breaks and 39% of supplementary breaks, and no significant effects of stretching on discomfort or performance were observed.

CONCLUSIONS

These results provide further converging evidence that supplementary breaks reliably minimize discomfort and eyestrain without impairing productivity. Low compliance in performing stretches prevented valid assessment of stretching effects. Further research on stretching exercises and exercise compliance is warranted.

[The preventive ergophthalmic evaluation of work places in call centers: a useful instrument for the prevention of work related asthenopic symptoms]

The study of a correct lay-out of work places equipped with VDT/PC in call centres, if carried out before the beginning of work activities needs an interdisciplinary cooperation among OH&S operators. However, such a preventive evaluation can relevantly reduce onset and severity of asthenopic symptoms frequently reported by this kind of operators. Consequently, such preventive evaluation can avoid the necessity of carrying out those complex and expensive structural lay-out modifications, which are frequently needed to reduce VDT/PC workers' asthenopic symptoms.

Influence of work duration or physical symptoms on mental health among Japanese visual display terminal users

The present study examined the relationship of work duration or physical symptoms to the mental health of visual display terminal (VDT) workers in Japan. The mental health status of 2,327 VDT users at an administrative office was investigated using the 12-item General Health Questionnaire (GHQ-12). Subjects were asked about their age, sex, hours of daily VDT use, rest and breaks during VDT work, eyestrain, and musculoskeletal pain. Logistic regression analysis was used to evaluate the associations with mental health status (GHQ-12 scores). The mean age of subjects was 39.5 yr (SD=10.3). Among all subjects, 36.7% could rest during VDT work and 66.9% received breaks during VDT work. The proportion of subjects who reported eyestrain and musculoskeletal pain were 19.6% and 25.7%, respectively. Eighteen percent of subjects were classified into a GHQ-12 high score group. Logistic regression analysis showed that age less than 40 yr, not receiving breaks during VDT work, and the presence of eyestrain and musculoskeletal pain were significantly associated with poor mental health status (high GHQ-12 scores). Using a VDT for more than 5 h/d and being female were also marginally associated with high GHQ scores (p<0.1). In conclusion, the management of physical health as well as work duration is important for good mental health status among VDT users.

[Ophthalmologist and "computer vision syndrome"]

The authors had tried to collect the data available on the Internet about a subject that we consider as being totally ignored in the Romanian scientific literature and unexpectedly insufficiently treated in the specialized ophthalmologic literature. Known in the specialty literature under the generic name of "Computer vision syndrome", it is defined by the American Optometric Association as a complex of eye and vision problems related to the activities which stress the near vision and which are experienced in relation, or during, the use of the computer. During the consultations we hear frequent complaints of eye-strain - asthenopia, headaches, blurred distance and/or near vision, dry and irritated eyes, slow refocusing, neck and backache, photophobia, sensation of diplopia, light sensitivity, and double vision, but because of the lack of information, we overlooked them too easily, without going thoroughly into the real motives. In most of the developed countries, there are recommendations issued by renowned medical associations with regard to the definition, the diagnosis, and the methods for the prevention, treatment and periodical control of the symptoms found in computer users, in conjunction with an extremely detailed ergonomic legislation. We found out that these problems incite a much too low interest in our country. We would like to rouse the interest of our ophthalmologist colleagues in the understanding and the recognition of these symptoms and in their treatment, or at least their improvement, through specialized measures or through the cooperation with our specialist occupational medicine colleagues.

[Take high of the study of VDT related eye symptoms]

The characteristics of visual display terminal (VDT) and related eye symptoms were analyzed. Research of the effect of VDT on visual function, visual development and characteristics of ocular surface was presented. Currently research still stays in the initial stage. Intensive research of VDT related eye problem will provide effective prevention and treatment methods for clinic work.

The Effect of Antireflection Film Use on Blink Rate and Asthenopic Symptoms during Visual Display Terminal Work

PURPOSE

To investigate the effect of visual display terminal antireflection (AR) films on blink rate and subjective symptoms of asthenopia.

METHODS

This was a nonrandomized, prospective clinical trial in which 7 healthy volunteers underwent blink rate measurements with a blink rate recording system while viewing a DVD on a computer display for 10 minutes. The measurements were carried out without an AR film on terminal displays initially. The same tasks were performed on the next day with an AR film on the displays. The subjects were also required to score their symptoms of asthenopia on a visual analog scale before and just after DVD viewing. The changes in blink rate and asthenopia scores with AR film use were assessed by the Student t test.

RESULTS

The mean baseline blink rate was 15.7 +/- 5.9 blinks /min, which decreased significantly to 9.6 +/- 4.3 blinks/min after DVD viewing without an AR film (P < 0.05). The mean baseline and final blink rates for DVD viewing with an AR film were 14.6 +/- 9.2 and 14.3 +/- 9.2 blinks/min, respectively. There were no significant differences between baseline and final blink rates after DVD viewing with an AR film (P > 0.05). The mean cumulative visual analog asthenopic symptom score after DVD viewing without an AR film was 72 +/- 18% compared with the mean cumulative symptom score of 52 +/- 11% after DVD viewing with an AR film. The difference was statistically significant (P < 0.05).

CONCLUSIONS

Visual display terminal work appears to be associated with asthenopic symptoms and decreased blink rates. The use of AR films on computer displays may prevent both reflections of light from screen surfaces and reduction in blink rates resulting in fewer asthenopic symptoms.

Reduction of asthenopia related to accommodative relaxation by means of far point stimuli

PURPOSE

To conduct an experimental investigation of the effect of accommodative relaxation using far point shift stimuli for the reduction of asthenopia.

METHODS

Twenty-two female students accommodated to a far point shift stimuli during a 2-min period immediately after a 15-min sustained task on a three-dimensional display. Before and after the trial, their accommodative step response and symptoms were assessed. The far point shift stimuli in the optical system, which were presented on a refractometer, were created by moving the target scenery images from far to near, lineally centred about the far point position of each eye. During 2 min of fixating on the far point shift stimuli, changes in refraction were recorded in the same eye.

RESULTS

While looking at the far point shift stimuli, 10 of 22 subjects had changes in refraction that showed a hypermetropic shift, and the other 12 subjects had changes in refraction that showed a myopic shift. The time taken for the accommodative step response from far to near post-trial in the myopic shift group was markedly prolonged, and the accommodative lag at the far target in the optometer was significantly increased. In the myopic shift group, the symptoms of "eye fatigue", "eye pain", "eye heaviness", and "eye dryness" also increased after the trial. In the hyperopic shift group, however, only the symptom of "eye dryness" increased, with no reduction of accommodation function.

CONCLUSIONS

We suggest that accommodative relaxation by accommodative far point shift stimuli is effective in the reduction of asthenopia.

True Three-Dimensional Displays that Allow Viewers to Dynamically Shift Accommodation, Bringing Objects Displayed at Different Viewing Distances Into and Out of Focus

Under natural viewing conditions, viewers do not just passively perceive. Instead, they dynamically scan the visual scene by shifting their eye fixation and focus between objects at different viewing distances. In doing so, the oculomotor processes of accommodation (eye focus) and vergence (angle between lines of sight of two eyes) must be shifted synchronously to place new objects in sharp focus in the center of each retina. Accordingly, nature has reflexively linked accommodation and vergence, such that a change in one process automatically drives a matching change in the other. Conventional stereoscopic displays force viewers to try to decouple these processes, because while they must dynamically vary vergence angle to view objects at different stereoscopic distances, they must keep accommodation at a fixed distance--or else the entire display will slip out of focus. This decoupling generates eye fatigue and compromises image quality when viewing such displays. In an effort to solve this accommodation/vergence mismatch problem, we have built various prototype displays that can vary the focus of objects at different distances in a displayed scene to match vergence and stereoscopic retinal disparity demands and better simulate natural viewing conditions. By adjusting the focus of individual objects in a scene to match their stereoscopic retinal disparity, the cues to ocular accommodation and vergence are brought into agreement. As in natural vision, the viewer brings different objects into focus by shifting accommodation. As the mismatch between accommodation and vergence is decreased, natural viewing conditions are better simulated and eye fatigue should decrease.

[Lighting condition analysis at work]

Following a wide review of the national and international technical standards which make up the principal reference points when designing illumination systems for work areas, the most commonly used methods of photometric analysis are examined from both a medical and technical point of view. It can be observed that photometric analysis of the work place, which currently is almost exclusively based on the measurements of illuminance, does not appear to adequately reach the targets set by Occupational Health and Occupational Hygiene, for reasons pertaining to the anatomy and physiopathology of the visual function. Moreover, the procedures applied to evaluate the workers' subjectivity and/or symptomatology, that both in research and during on-site investigations makes use predominantly of self-administered questionnaires, shows some shortcomings in terms of reliability and validity. In conclusion, it is proposed, especially in studies regarding office environments (i) to carry out photometric analysis where primary and secondary luminance is always measured and, if light-linked subjectivity is required (ii) to make available valid and precise questionnaires whose administration be followed by a multivariate data analysis.

[The significance of prevention in decreasing visual fatigue in the learning activities of young schoolchildren]

The impact of school loads on visual function was studied in 65 pupils from different classes. Visual fatigue preventive measures were used in a study group; they were not employed in a control group. The children from the study group showed less visual fatigue determined by the light flash test than did those from the control group.

Photometry in the workplace: the rationale for a new method

OBJECTIVES

The assessment of lighting conditions in workplaces has traditionally focused on the measurement of illuminance. The rationale for a new method for the detailed evaluation of natural and artificial light in 'near work' situations, involving the assessment of luminance, is described.

METHODS

The procedure comprises four successive phases: (1) identify object/images observed during work tasks; (2) outline the area of the operator's visual field where gaze is predominantly directed; (3) measure luminances in the visual field, pin-pointing all sources of primary and secondary luminance, and constructing iso-luminance maps; and (4) compare luminance ratios.

RESULTS

The procedure was illustrated using the common example of near work in an office environment. Illuminance was found to be inadequate to evaluate the effects of natural and artificial environmental light in the workplace. This is due to the fact that the luxmeter is designed to integrate the light detected over a large angle, whereas in near work the operator's retina is mainly stimulated by light originating from objects/images placed in the occupational visual field.

CONCLUSIONS

A detailed measurement of luminance within the occupational visual field is consistent with ocular anatomy and physiology, and can be used as part of a risk assessment for visual disturbances and to rationalize lighting at workstations.

Importance and Effects of Altered Workplace Ergonomics in Modern Radiology Suites

The transition from a film-based to a filmless soft-copy picture archiving and communication system (PACS)-based environment has resulted in improved work flow as well as increased productivity, diagnostic accuracy, and job satisfaction. Adapting to this filmless environment in an efficient manner requires seamless integration of various components such as PACS workstations, the Internet and hospital intranet, speech recognition software, paperless electronic hospital medical records, e-mail, office software, and telecommunications. However, the importance of optimizing workplace ergonomics has received little attention. Factors such as the position of the work chair, workstation table, keyboard, mouse, and monitors, along with monitor refresh rates and ambient room lighting, have become secondary considerations. Paying close attention to the basics of workplace ergonomics can go a long way in increasing productivity and reducing fatigue, thus allowing full realization of the potential benefits of a PACS. Optimization of workplace ergonomics should be considered in the basic design of any modern radiology suite.

Factors leading to the Computer Vision Syndrome: an issue at the contemporary workplace

INTRODUCTION

Vision and eye related problems are common among computer users, and have been collectively called the Computer Vision Syndrome (CVS).

METHODS

An observational study in order to identify the risk factors leading to the CVS was done. Twenty-eight participants answered a validated questionnaire, and had their workstations examined. The questionnaire evaluated personal, environmental, ergonomic factors, and physiologic response of computer users. The distance from the eye to the computers' monitor (A), the computers' monitor height (B), and visual axis height (C) were measured. The difference between B and C was calculated and labeled as D. Angles of gaze to the computer monitor were calculated using the formula: angle=tan(-1)(D/ A). Angles were divided into two groups: participants with angles of gaze ranging from 0 degrees to 13.9 degrees were included in Group 1; and participants gazing at angles larger than 14 degrees were included in Group 2. Statistical analysis of the evaluated variables was made.

RESULTS

Computer users in both groups used more tear supplements (as part of the syndrome) than expected. This association was statistically significant (p<0.10). Participants in Group 1 reported more pain than participants in Group 2. Associations between the CVS and other personal or ergonomic variables were not statistically significant.

CONCLUSIONS

Our findings show that most important factor leading to the syndrome is the angle of gaze at the computer monitor. Pain in computer users is diminished when gazing downwards at angles of 14 degrees or more. The CVS remains an under estimated and poorly understood issue at the workplace. The general public, health professionals, the government, and private industries need to be educated about the CVS.

[Influence of different lighting levels at workstations with video display terminals on operators' work efficiency]

The aim of this work was to evaluate the influence of different lighting levels at workstations with video display terminals (VDTs) on the course of the operators' visual work, and to determine the optimal levels of lighting at VDT workstations. For two kinds of job (entry of figures from a typescript and edition of the text displayed on the screen), the work capacity, the degree of the visual strain and the operators' subjective symptoms were determined for four lighting levels (200, 300, 500 and 750 lx). It was found that the work at VDT workstations may overload the visual system and cause eyes complaints as well as the reduction of accommodation or convergence strength. It was also noted that the edition of the text displayed on the screen is more burdening for operators than the entry of figures from a typescript. Moreover, the examination results showed that the lighting at VDT workstations should be higher than 200 lx and that 300 lx makes the work conditions most comfortable during the entry of figures from a typescript, and 500 lx during the edition of the text displayed on the screen.

Ergonomic Office Design and Aging: A Quasi-Experimental Field Study of Employee Reactions to an Ergonomics Intervention Program

A naturally occurring quasi-experimental longitudinal field study of 87 municipal employees using pretest and posttest measures investigated the effects of an office workstation ergonomics intervention program on employees' perceptions of their workstation characteristics, levels of persistent pain, eyestrain, and workstation satisfaction. The study examined whether reactions differed between younger and older employees. Results revealed that workstation improvements were associated with enhanced perceptions of the workstation's ergonomic qualities, less upper back pain, and greater workstation satisfaction. Among those experiencing an improvement, the perceptions of workstation ergonomic qualities increased more for younger than older employees, supporting the "impressionable years" framework in the psychological literature on aging. Implications for human resources managers are discussed.

Effects of taurine supplementation on VDT work induced visual stress

In order to evaluate the effects of dietary taurine supplementation on visual fatigue induced by visual display terminals (VDT) work, 25 male college students aged from 20 to 24 years who were not engaged in VDT work were selected to participate in the study. Volunteers were randomly assigned to either the taurine supplementation (n=13) or the placebo supplementation control group (n=12). Before and after 12 days of taurine (3 g/day) or placebo supplementation, two identical 2.5-hr VDT work tests were performed while recording the P100, N75 and N145 latencies and P100 amplitude of pattern visual evoked potential (PVEP) and the frequency of critical flicker fusion (CFF). Following 2.5-hr of VDT work, the P100 and N75 latencies of PVEP increased ( P<0.01) while the P100 amplitude decreased significantly ( P<0.01). The frequency of CFF also reduced significantly ( P<0.01). After 12 days of taurine supplementation, the reduction in P100 amplitude after VDT work alleviated significantly ( P<0.05). The results suggest that taurine supplementation alleviates visual fatigue induced by VDT work.