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Workplace interventions to prevent musculoskeletal and visual symptoms and disorders among computer users: A systematic review

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Abstract

Background: The literature examining the effects of workstation, eyewear and behavioral interventions on musculoskeletal and visual symptoms among computer users is large and heterogeneous. Methods: A systematic review of the literature used a best evidence synthesis approach to address the general question “Do office interventions among computer users have an effect on musculoskeletal or visual health?” This was followed by an evaluation of specific interventions. Results: The initial search identified 7313 articles which were reduced to 31 studies based on content and quality. Overall, a mixed level of evidence was observed for the general question. Moderate evidence was observed for: (1) no effect of workstation adjustment, (2) no effect of rest breaks and exercise and (3) positive effect of alternative pointing devices. For all other interventions mixed or insufficient evidence of effect was observed. Conclusion: Few high quality studies were found that examined the effects of interventions in the office on musculoskeletal or visual health.

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References

  1. AHRQ Guidelines. http://www.ahrq.gov/; 2005.

  2. Andersen JH, Thomsen JF, Overgaard E. Computer use and carpal tunnel syndrome: A 1-year follow-up study. 2003;289:2963–69.

  3. Bergqvist U, Wolgast E, Nilsson B, Voss M. The influence of VDT work on musculoskeletal disorders. Ergonomics 1995;38:754–62.

    Article  PubMed  CAS  Google Scholar 

  4. Cochrane Manual. http://www.cochrane.org/admin/manual.html; 2005.

  5. Cole BL. Do video display units cause visual problems? A bedside story about the processes of public health decision-making. Clin Exp Optom 2003;86:205–20.

    Article  PubMed  Google Scholar 

  6. Cole D, Rivilis I, VanEerd D, Cullen K, Irvin E, Kramer D. Effectiveness of Participatory Ergonomic Interventions: A Systematic Review. Toronto: Institute for Work & Health; 2005.

    Google Scholar 

  7. Côé P, Cassidy JD, Carroll L, Frank JW, Bombardier C. A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 2001;26(19):E445–58.

    Article  Google Scholar 

  8. Daum KM, Clore KA, Simms SS, Wilczek DD, Vesely JW, Spittle BM, Good GW. Productivity Associated with visual status of computer users. Optometry 2004;75:33–47.

    PubMed  Google Scholar 

  9. Franche R, Cullen K, Clarke J, Irvin E, Sinclair S, Frank J, Institute for Work & Health Workplace-Based RTW Intervention Literature Review Research Team. Workplace-based return-to-work interventions: A systematic review of the quantitative literature. J Occup Rehabil 2005;15(4):607–31.

    Article  PubMed  Google Scholar 

  10. Gerr F, Marcus M, Ensor C. A prospective study of computer users: I. Study design and incidence of musculoskeletal symptoms and disorders. Am J Ind Med 2002;41:222–35.

    Article  Google Scholar 

  11. Gerr F, Marcus M, Monfaith C. Epidemiology of musculoskeletal disorders among computer users: lesson learned from the role of posture and keyboard use. J Electromyogr Kinesiol 2004;14(1):25–31.

    Article  PubMed  Google Scholar 

  12. Hagberg M, Rempel D. Work-related disorders and the operation of computer VDT’s. Chapter 58 in Handbook of Human-Computer Interaction, 2nd Edition. M. Helander, T.K. Landauer, P. Prabhu (eds.), Elsevier Science BV; 1997.

  13. Hales TR, Sauter SL, Peterson MR. Musculoskeletal disorders among visual display terminal users in a telecommunications company. Ergonomics 1994;37:1603–21.

    Article  PubMed  CAS  Google Scholar 

  14. Karsh B, Moro FBP, Smith MJ. The efficacy of workplace ergonomic interventions to control musculoskeletal disorders: A critical examination of the peer-reviewed literature. Theoret Issues Ergon Sci 2001;2(l):3–96.

    Google Scholar 

  15. Kemmlert K. Economic impact of ergonomic intervention – Four case studies. J Occup Rehabil 1996;6(l):17–32.

    Article  Google Scholar 

  16. Kryger AI, Andersen JH, Lassen CF. Does computer use pose an occupational hazard for forearm pain; from the NUDATA study. Occup Environ Med 2003;60:el4.

    Article  Google Scholar 

  17. Lassen CF, Mikkelsen S, Kryger AI, Brandt L, Overgaard E, Thomsen JF, Vilstrup I, Andersen JH. Elbow and wrist/hand symptoms among 6943 computer operators: a 1-year follow-up study (the NUDATA study). Am J Ind Med 2004;46:521–33.

    Article  PubMed  Google Scholar 

  18. Marcus M, Gerr F, Monteilh C. A prospective study of computer users: II. Postural risk factors for musculoskeletal symptoms and disorders. Am J Ind Med 2002;41:236–49.

    Article  PubMed  Google Scholar 

  19. NRC and IOM Report. Musculoskeletal Disorders and the Workplace. National Research Council and Institute of Medicine. Washington, DC: National Academy Press; 2001.

  20. Palmer KT, Cooper C, Walker-Bone K, Syddall H, Coggon D. Use of keyboards and symptoms in the neck and arm: evidence from a national survey. Occup Med 2001;51:392–5.

    Article  CAS  Google Scholar 

  21. Punnett L, Bergqvist U. Visual display unit work and upper extremity musculoskeletal disorders, A review of epidemiological findings. National Institute for Working Life – Ergonomic Expert Committee Document 1997;1:1–173.

    Google Scholar 

  22. Schena S, Paradiso V, Schinosa L. Heartbreaking roadwork. Circulation 2000;101(22):2669–70.

    PubMed  CAS  Google Scholar 

  23. Sheedy JE, Shaw-McMinn PG. Diagnosing and treating computer-related vision problems. Philadelphia: Butterworth-Heinemann; 2003, p. 288.

    Google Scholar 

  24. Slavin RE. Best-evidence synthesis: An intelligent alternative to meta-analysis. J Clin Epidemiol 1995;48:9–18.

    Article  PubMed  CAS  Google Scholar 

  25. Starck J. Preface. Noise Health 2005;7(26):1.

    Article  Google Scholar 

  26. Stein SC, Lieberman J, Pasquale M. Letter to the Editor [3] (multiple letters). J Trauma-Injury Infect Crit Care 2004;56(2):457.

    Article  Google Scholar 

  27. Tompa E, Trevithick S, McLeod C. Working Paper #213. A systematic Review of the prevention incentives of insurance and regulatory mechanisms for occupational health and safety. Toronto institute for Work & Health; 2004.

  28. Aaras A, Ro O, Thoresen M. Can a more neutral position of the forearm when operating a computer mouse reduce the pain level for visual display unit operators? A prospective epidemiological intervention study. Int J Human Comput Interact 1999;11(2):79–94.

    Article  Google Scholar 

  29. Aaras A, Dainoff M, Ro O, Thoresen M. Can a more neutral position of the forearm when operating a computer mouse reduce the pain level for VDU operators? Int J Ind Ergon 2002;30(4-5):307–24.

    Article  Google Scholar 

  30. Aaras A, Horgen G, Bjorset HH, Ro O, Walsoe H. Musculoskeletal, visual and psychosocial stress in VDU operators before and after multidisciplinary ergonomic interventions. A 6 years prospective study-Part II. Appl Ergon 2001;32(6):559–71.

    Article  PubMed  CAS  Google Scholar 

  31. Aaras A, Horgen G, Bjorset HH, Ro O, Thoresen M. Musculoskeletal, visual and psychosocial stress in VDU operators before and after multidisciplinary ergonomic interventions. Appl Ergon 1998;29(5):335–54.

    Article  PubMed  CAS  Google Scholar 

  32. Amick BC III, Robertson MM, DeRango K, Bazzani L, Moore A, Rooney T, Harrist R. Effect of office ergonomics intervention on reducing musculoskeletal symptoms. Spine 2003;28(24):2706–11.

    Article  PubMed  Google Scholar 

  33. Biswas NR, Nainiwal SK, Das GK, Langan U, Dadeya SC, Mongre PK, Ravi AK, Baidya P. Comparative randomised controlled clinical trial of a herbal eye drop with artificial tear and placebo in computer vision syndrome. J Indian Med Assoc 2003;101(3)212:208–9.

    Google Scholar 

  34. Bohr PC. Efficacy of office ergonomics education. J Occup Rehabil 2000;10(4):243–55.

    Article  Google Scholar 

  35. Brisson C, Montreuil S, Punnett L. Effects of an ergonomic training program on workers with video display units. Scand J Work Environ Health 1999;25(3):255–63.

    PubMed  CAS  Google Scholar 

  36. Butzon SP, Eagels SR. Prescribing for the moderate-to-advanced ametropic presbyopic VDT user. A comparison of the Technica Progressive and Datalite CRT trifocal. J Am Optom Assoc 1997;68(8):495–502.

    PubMed  CAS  Google Scholar 

  37. Butzon SP, Sheedy JE, Nilsen E. The efficacy of computer glasses in reduction of computer worker symptoms. Optometry 2002;73(4):221–30.

    PubMed  Google Scholar 

  38. Cook C, Burgess-Limerick R. The effect of forearm support on musculoskeletal discomfort during call centre work. Appl Ergon 2004;35(4)337–42.

    Article  PubMed  Google Scholar 

  39. Feuerstein M, Nicholas RA, Huang GD, Dimberg L, Ali D, Rogers H. Job stress management and ergonomic intervention for work-related upper extremity symptoms. Appl Ergon 2004;35(6):565–74.

    Article  PubMed  Google Scholar 

  40. Fostervold KI, Buckmann E, Lie I. VDU-screen filters: Remedy or the ubiquitous Hawthorne effect? Int J Ind Ergon 2001;27(2):107–18.

    Article  Google Scholar 

  41. Galinsky TL, Swanson NG, Sauter SL, Hurrell JJ, Schleifer LM. A field study of supplementary rest breaks for data-entry operators. Ergonomics 2000;43(5):622–38.

    Article  PubMed  CAS  Google Scholar 

  42. Gerr F, Marcus M, Monteilh C, Hannan L, Ortiz D, Kleinbaum D. A randomized controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users. Occup Environ Med 2005;62:478–87.

    Article  PubMed  CAS  Google Scholar 

  43. Greene BL, DeJoy DM, Olejnik S. Effects of an active ergonomics training program on risk exposure, worker beliefs, and symptoms in computer users. WORK: J Prev Assess Rehabil 2005;24(1):41–52.

    Google Scholar 

  44. Henning RA, Jacques P, Kissel GV, Sullivan AB, Alteras-Webb SM. Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics 1997;40(1):78–91.

    Article  PubMed  CAS  Google Scholar 

  45. Hladky A, Prochazka B. Using a screen filter positively influences the physical well-being of VDU operators. Cent Eur J Public Health 1998;6(3):249–53.

    PubMed  CAS  Google Scholar 

  46. Horgen G, Aaras A, Thoresen M. Will visual discomfort among Visual Display Unit (VDU) users change in development when moving from single vision lenses to specially designed VDU progressive lenses? Optom Vis Sci 2004;81(5):341–9.

    Article  PubMed  Google Scholar 

  47. Kamwendo K, Linton SJ. A controlled study of the effect of Neck School in Medical Secretaries. Scand J Rehabil Med 1991;23:143–52.

    PubMed  CAS  Google Scholar 

  48. Ketola R, Toivonen R, Hakkanen M, Luukkonen R, Takala EP, Viikari-Juntura E, Expert Group. Effects of ergonomic intervention in work with video display units. Scand J Work Environ Health 2002;28(1):18–24.

    PubMed  Google Scholar 

  49. Lintula M, Nevala-Puranen N, Louhevaara V. Effects of Ergorest arm supports on muscle strain and wrist positions during the use of the mouse and keyboard in work with visual display units: a work site intervention. Int J Occup Safety Ergon 2001;7(1):103–16.

    CAS  Google Scholar 

  50. Martin SA, Irvine JL, Fluharty K, Gatty CM. Students for WORK. A comprehensive work injury prevention program with clerical and office workers: phase I. WORK: J Prev Assess Rehabil 2003;21(2):185–96.

    Google Scholar 

  51. Gatty CM. A comprehensive work injury prevention program with clerical and office workers: Phase II. Work 2004;23(2):131–7.

    PubMed  Google Scholar 

  52. Mclean L, Tingley M, Scott RN, Rickards J. Computer terminal work and the benefit of microbreaks. Appl Ergon 2001;32(3):225–37.

    Article  PubMed  CAS  Google Scholar 

  53. Mekhora K, Liston CB, Nanthavanij S, Cole JH. The effect of ergonomic intervention on discomfort in computer users with tension neck syndrome. Int J Ind Ergon 2000;26(3):367–79.

    Article  Google Scholar 

  54. Nelson NA, Silverstein BA. Workplace changes associated with a reduction in musculoskeletal symptoms in office workers. Hum Factors 1998;40(2):337–50.

    Article  PubMed  CAS  Google Scholar 

  55. Peper E, Gibney KH, Wilson VE. Group training with healthy computing practices to prevent repetitive strain injury (RSI): A preliminary study. Appl Psychophysiol Biofeedback 2004;29(4):279–87.

    Article  PubMed  Google Scholar 

  56. Psihogios JP, Sommerich CM, Mirka GA, Moon SD. A field evaluation of monitor placement effects in VDT users. Appl Ergon 2001;32(4):313–25.

    Article  PubMed  CAS  Google Scholar 

  57. Rempel D, Tittiranonda P, Burastero S, Hudes M, So Y. Effect of keyboard keyswitch design on hand pain. J Occup Environ Med 1999; 41(2):111--119.

    Google Scholar 

  58. Rempel D, Krause N, Goldberg R, Benner D, Hudes M, Goldner GU. A randomized controlled trial evaluating the effects of two workstation interventions on upper body pain and incident musculoskeletal disorders among computer operators. Occup Environ Med 2006; 63(5):300–306.

    Google Scholar 

  59. Skilling FC Jr, Weaver TA, Kato KP, Ford JG, Dussia EM. Effects of two eye drop products on computer users with subjective ocular discomfort. Optometry 2005;76(1):47–54.

    PubMed  Google Scholar 

  60. Tittiranonda P, Rempel D, Armstrong T, Burastero S. Effect of four computer keyboards in computer users with upper extremity musculoskeletal disorders. Am J Ind Med 1999;35(6):647–61.

    Article  PubMed  CAS  Google Scholar 

  61. van den Heuvel SG, De Looze MP, Hildebrandt VH, The KH. Effects of software programs stimulating regular breaks and exercises on work-related neck and upper-limb disorders. Scand J Work Environ Health 2003;29(2):106–16.

    PubMed  Google Scholar 

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Acknowledgements

This project was sponsored in part by the Institute for Work & Health, an independent not-for-profit research organization. The Institute receives ongoing support and received direct funding for this review from the Ontario Workplace Safety & Insurance Board. The authors wish to thank: Donald Cole for quality control check, Jonathan Tyson for comments on the report, the assistance of Quenby Mahood, Krista Nolan, and Dan Shannon for obtaining bibliographic information and other materials; Jane Gibson, Tony Culyer, Evelyne Michaels, Kiera Keown, and Cameron Mustard for their editorial advice; and Shanti Raktoe for administrative support. Shelley Brewer is supported by an Occupational Injury Prevention Training Grant (T42 OH008421) from the National Institute for Occupational Safety and Health.

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Authors and Affiliations

  1. The University of Texas, School of Public Health, Southwest Center for Occupational and Environmental Health, Houston, TX, USA

    Shelley Brewer & Benjamin C. Amick III III

  2. The Institute for Work & Health, Toronto, Canada

    Dwayne Van Eerd, Benjamin C. Amick III III, Emma Irvin & Kim Cullen

  3. The University of Texas, School of Public Health, Division of Health Promotion and Behavioral Sciences, Houston, TX, USA

    Benjamin C. Amick III III

  4. University of Alabama-Birmingham, School of Optometry, Birmingham, AL, USA

    Kent M. Daum

  5. University of Iowa, College of Public Health, Department of Environmental and Occupational Health, Iowa City, IA, USA

    Fred Gerr

  6. Texas A & M University Health Science Center, Rural School of Public Health, Department of Environmental & Occupational Health, College Station, TX, USA

    J. Steven Moore

  7. Department of Medicine, University of California, San Francisco, 1301 South 46th Street, Building 163, Richmond, CA, 94804, USA

    David Rempel

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  1. Shelley Brewer
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  9. David Rempel
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Correspondence to David Rempel.

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Brewer, S., Eerd, D.V., Amick III, B.C. et al. Workplace interventions to prevent musculoskeletal and visual symptoms and disorders among computer users: A systematic review. J Occup Rehabil 16, 317–350 (2006). https://doi.org/10.1007/s10926-006-9031-6

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