Gunnar Horgen

Musculoskeletal, visual and psychosocial stress in VDU operators before and after multidisciplinary ergonomic interventions

The study has a parallel group design with two intervention groups (T and S) and one control group (C) of VDU operators. Three serial interventions were carried out in the T and S groups, first a new lighting system, then new workplaces and last an optometric examination and corrections if needed. The new lighting gave significantly increased illuminance levels, increased luminances of the room surfaces and better luminance distribution. The two intervention groups reported significant improvement of the lighting conditions, as well as of the visual conditions and significantly reduced visual discomfort and glare. Significant reduction of headache was found in one of the intervention groups. Optometric corrections reduced the visual discomfort in both the intervention groups. When looking at those given new corrections, a significant reduction was found in the T group and a clear tendency was also found in the S group. The C group reported no improvements for any of these health outcomes. The workplace intervention gave the operator the possibility to support the whole forearm and hand on the table top. Before the intervention there were no significant differences between the three groups regarding shoulder pain and static trapezius electromyographic (EMG) load. Two years after the intervention, a significant reduction of shoulder pain was reported in the T and S groups in parallel with a significant reduction in static trapezius load, while no such reduction was found in the C group. At the same time, both static trapezius load and shoulder pain were significantly lower in the T and S groups compared with the C group. Pain in the forearm and hand showed no significant changes in any of the groups during the study period. However, there seem to be a relationship between pain in the forearm and hand and the time the operator used the mouse. The C group reported significantly higher intensity of pain and used the mouse significantly more than the S group.

Musculoskeletal, visual and psychosocial stress in VDU operators before and after multidisciplinary ergonomic interventions. A 6 years prospective study--Part II.

A prospective epidemiological field study covering a 2 years period has earlier been published. The study has a parallel group design with two intervention groups (T and S) and one control group (C) of Visual Display Unit (VDU) operators. The present paper covers the period from 2 to 6 years of the study. After 3.5 years, the C group got the same intervention in terms of new lighting system, new workplaces and at last an optometric examination and corrections if needed. The C group reported a significant reduction in visual discomfort after interventions while the two groups (T and S) continued to report significant reduction of visual discomfort after 6 years. By supporting the forearm on the table top, the C group reported significant reduction of shoulder and neck pain while the T group reported significant reduction in shoulder and back pain after 6 years. Organizational and psychosocial factors at work and outside work did not show any significant changes during the study period.

Work With the Visual Display Unit: Health Consequences

This article is a review of the international literature regarding health consequences for visual display unit (VDU) workers. The 2 main problems reported by VDU workers, visual discomfort and musculoskeletal pain, are particularly focused. Important factors for designing the lighting system and workplace are given. A procedure for optometric corrections is discussed. This article emphasizes the importance of multidisciplinary cooperation to reduce visual discomfort and musculoskeletal pain.

Is there a reduction in postural load when wearing progressive lenses during VDT work over a three-month period?

In an initial study, 18 VDT operators were found to have a higher muscle load in the neck/ shoulder region when using progressive lenses compared with single-vision lenses, while working on a VDT unit. For single-vision lenses, a higher flexion angle in the neck was also discovered. The present study investigates whether this higher muscle load is reduced when a progressive correction is worn for a three-month period. Adaptation in terms of reduced muscle load measured by electromyography (EMG) was not discovered. Head flexion angle was smaller when using progressive correction as compared with single-vision lenses. Some practical implications for occupational optometry are discussed.

A cross-country comparison of short- and long-term effects of an ergonomic intervention on musculoskeletal discomfort, eyestrain and psychosocial stress in VDT operators: selected aspects of the international project.

Three groups of data entry female visual display terminal (VDT) workers from Norway (n = 30), Poland (n = 33) and the USA (n = 29) were compared. Before intervention, the Norwegian group reported more neck pain compared with the Polish group. The Polish group reported less shoulder pain than both the U.S. and the Norwegian groups. The clinical examination documented fewer symptoms and signs of musculoskeletal illness among the Polish participants compared with the Norwegian and the U.S. groups. After intervention, the Norwegian group reported a reduction in neck pain while the U.S. group reported a reduction in shoulder pain. The Polish group reported an increase in neck, shoulder and forearm pain at follow-up compared to after intervention. The Polish group recorded higher flexion of the upper arm at follow-up parallel with an increase of pain in the upper part of the body. Visual discomfort showed variable results in the 3 countries.

Will Visual discomfort among Visual display unit (VDU) users change in development when moving from single vision lenses to specially designed VDU progressive lenses

Purpose. Three types of progressive additions lenses (PAL) specially designed for VDU-work and one single vision lens were compared in a prospective field study. The aim was to investigate if these progressive lenses created a difference in the development of visual discomfort compared to single vision lenses when working on an optimized VDU-workstation. Methods. The study had a prospective, parallel group design, with four groups of VDU-workers. Approximately 40 subjects in each group, selected after careful task analysis with special attention towards the visual angles and distances to the work tasks. The groups were followed over one year. A questionnaire concerning visual conditions, working conditions, discomfort in different body areas, the status of the subjects’ optometric corrections, psychological factors both at work and at home, amount, frequency and duration of VDU-work etc. was filled in before the intervention, after six months and after one year. No other contact was made with the subjects. The VDU-lenses included were Interview (Essilor), Gradal RD (Zeiss) and Technica (American Optical). Pain intensity and duration were assessed on a 100 mm Visual Analogue Scale (VAS) before the intervention, and six and twelve months after the intervention. All subjects were given a complete optometric examination. Results. Only small changes in the development of headache and visual discomfort were registered. However, the subjective evaluation of area of clear vision and overall satisfaction was significantly improved for the Interview and Gradal RD lens (p < 0.05). There were no significant changes for Technica and single vision lenses. Conclusion. Lens designs that cover viewing distances from near and out to approximately 2 meters work well compared to lens designs trying to cover greater range of clear vision. When tasks analysis shows that single vision correction may be used, this is still an acceptable solution.

Eye-related pain induced by visually demanding computer work.

Purpose. Eye strain during visually demanding computer work may include glare and increased squinting. The latter may be related to elevated tension in the orbicularis oculi muscle and development of muscle pain. The aim of the study was to investigate the development of discomfort symptoms in relation to muscle activity and muscle blood flow in the orbicularis oculi muscle during computer work with visual strain. Methods. A group of healthy young adults with normal vision was randomly selected. Eye-related symptoms were recorded during a 2-h working session on a laptop. The participants were exposed to visual stressors such as glare and small font. Muscle load and blood flow were measured by electromyography and photoplethysmography, respectively. Results. During 2 h of visually demanding computer work, there was a significant increase in the following symptoms: eye-related pain and tiredness, blurred vision, itchiness, gritty eyes, photophobia, dry eyes, and tearing eyes. Muscle load in orbicularis oculi was significantly increased above baseline and stable at 1 to 1.5% maximal voluntary contraction during the working sessions. Orbicularis oculi muscle blood flow increased significantly during the first part of the working sessions before returning to baseline. There were significant positive correlations between eye-related tiredness and orbicularis oculi muscle load and eye-related pain and muscle blood flow. Subjects who developed eye-related pain showed elevated orbicularis oculi muscle blood flow during computer work, but no differences in muscle load, compared with subjects with minimal pain symptoms. Conclusions. Eyestrain during visually demanding computer work is related to the orbicularis oculi muscle. Muscle pain development during demanding, low-force exercise is associated with increased muscle blood flow, possible secondary to different muscle activity pattern, and/or increased mental stress level in subjects experiencing pain compared with subjects with minimal pain.

The Effect of an Ergonomic Intervention on Musculoskeletal, Psychosocial and Visual Strain of VDT Entry Work: Organization and Methodology of the International Study

This special issue of the International Journal of Occupational Safety and Ergonomics (JOSE) reports the results from an extensive multinational and multidisciplinary collaborative investigation of the impacts on visual display terminal (VDT) work of musculoskeletal, visual, ergonomic, and psychosocial factors. For brevity, this effort has been referred to as the MEPS project (musculoskeletal—eyestrain—psychosocial—stress). This paper lays out the basic methodological structure of the study. The study was conducted in 4 countries utilizing VDT data entry workers as the primary subject population. A battery of objective and subject assessment measures, including muscle load, visual function, physical and visual strain, postural, ergonomic and psychosocial factors, were assessed at 3 different points in time. A pre-test was given prior to an ergonomic intervention. Two post-tests were given 1 month and 1 year after the ergonomic intervention.

Do specially designed visual display unit lenses create increased postural load compared with single-vision lenses during visual display unit work?

Three different types of spectacle lenses, specially designed for visual display unit (VDU) work, were compared with single-vision lenses regarding postural load. The different corrections effect on postural load was measured by using electromyography. Muscle loads were recorded from the trapezius muscle and the infraspinatus muscle. Continuous measurements of body posture were measured by using three dual axis inclinometers attached to the head, back, and upper arm. No significant differences were found between the single-vision lenses and the specially designed VDU lenses regarding muscle load. Small differences were found regarding the head angle. The study concludes that these new lens designs create interesting opportunities for the optometrist to optimize the visual conditions for VDU workers.

Sensory impairments in community health care: a descriptive study of hearing and vision among elderly Norwegians living at home

Background Hearing and vision impairments increase with age and are common risk factors for functional decline reduced social participation and withdrawal. Objective Describe the hearing and vision of home care patients older than 80 years. Methods Ninety-three older adults (80+ years) receiving home care were screened for hearing and vision in their homes. Data were collected using a HEINE Mini 3000® Otoscope to examine the eardrum and presence of earwax, an Entomed SA201-IV portable pure-tone audiometer to measure the pure-tone average (PTAV), a logarithm of the minimum angle of resolution chart to measure visual acuity (VA), and the Combined Serious Sensory Impairment interview guide. Results Slight and moderate hearing impairments were found in 41% and 47% of the population, respectively (mean PTAV =40.4 dB for the better ear), and 40% and 56% had impaired and slightly impaired vision, respectively (mean VA =0.45 for the better eye). The participants’ self-assessments of hearing and vision were only weakly correlated with PTAV and VA values. The visual function was significantly worse in men than in women (P=0.033). Difficulty in performing instrumental activities of daily living because of hearing and vision impairments was experienced by 17% of the participants, whereas 76% experienced no difficulties. When many people were present, 72% of the participants found it difficult to understand speech. Nearly 30% found it tiring to read, and 41% could not read very small print. Conclusion The patients’ self-assessments of their hearing and vision did not correlate strongly with their VA and PTAV scores. Asking the elderly about their overall hearing and vision ability is not sufficient for detecting sensory impairment, and asking more specific questions about what they could not hear and see was not an adequate indicator of the patients’ hearing and vision problems. To detect hearing and vision impairments among elderly home care patients, standardized measurements of their hearing and vision are necessary.