Health Issues Related Computer Use
BUS 5505: Fundamentals of Information Systems and Quantitative Methods
December 4, 2009
Although it is unlikely that computer equipment will be dangerous itself, it can be used in ways which can be hazardous to health of staff ("Computer health and," 2003). Ergonomics is an applied science devoted to incorporating comfort, efficiency, and safety into the design of items in the workplace (Shelly, & Vermaat, 2008). Studies done using ergonomics show that using the correct chair, keyboard, display device, and work surface configurations helps computer users work comfortably and efficiently and also preserve their health. According to previous studies, the majority of computer workers experience some eye or vision symptoms, but what was not clear was if whether these problems occur to a greater extent in these workers than in others who work in other visually demanding occupations. A national survey of doctors of optometry found that more than 14% of their present patients with eye or vision-related symptoms resulting from computer work. Working on a computer for a long period of time can cause different types of forearm and wrist CTDs, which are inflammation of tendons, nerve sheaths, and ligaments and damage to the soft tissues. Tenosynovitis, ganglion cysts, de Quervain’s disease, lateral epicondylitis, and carpal tunnel syndrome are different types of CTDs caused by computer use. Symptoms of CTDs are pain, numbness, tingling, or weakness in muscles or movement of arms, hands and fingers. The Health and Safety Work Act explains how employers must minimize risks for all workers and also the legal standards for computer equipment. There are four main regulations that cover the use of computer equipment under the Health and Safety Work Act. These regulations are the Health and Safety (Display Screen Equipment) Regulations 1992, the Management of Health and Safety at Work Regulations 1992, the Provisions and Use of Workplace Equipment Regulations 1992 and the Workplace (Health, Safety, and Welfare) Regulations 1992. In today’s society, it is very unusual to obtain an occupation that does involve the use computers. Computers are utilized by employees and employers in convenience stores, office buildings, factories and even in fast food restaurants. But has it ever occurred to these employees and their employers that repeated computer use can cause minor, and sometimes major, health issues. Many people are currently employed at a job has required me to use a computer eight or more hours a day. Not long after working on these jobs, some began to notice tension in their neck, and problems with their vision. This is what prompted the collection of research on what type of health issues are caused by repetitive or extensive computer use and also if any regulations had been passed to cut down on computer related health injuries. Although it is unlikely that computer equipment will be dangerous itself, it can be used in ways which can be hazardous to health of staff ("Computer health and," 2003). This means that it is not necessarily true that using computers will cause health problems, but if computers are used improperly over periods of time, health problems can arise. Some of these health issues include problems with vision and eyesight, muscular stress and strain, cumulative trauma disorders. Ergonomics is an applied science devoted to incorporating comfort, efficiency, and safety into the design of items in the workplace (Shelly, & Vermaat, 2008). Studies done using ergonomics show that using the correct chair, keyboard, display device, and work surface configurations helps computer users work comfortably and efficiently and also preserve their health. This paper will discuss health issues associated computer use and some measures that can be taken to prevent them. Regulation that placed in force to protect employees from being injured by computer use will also be touched on in this paper. Vision or eyesight related issues will be the first health issues that will be addressed. According to previous studies, the majority of computer workers experience some eye or vision symptoms, but what was not clear was if whether these problems occur to a greater extent in these workers than in others who work in other visually demanding occupations. A national survey of doctors of optometry found that more than 14% of their present patients with eye or vision-related symptoms resulting from computer work. The most common symptoms are eyestrain, headaches, blurred vision and neck or shoulder pain ("The Effects of," 1997). Surveys of computer workers show that eye and vision problems are the most frequently reported health-related problems, generally occurring in 70 to 75 percent of computer workers ("The Relationship of," 2006). Working at a computer is visually demanding because of frequent saccadic eye movement, continuous focusing, and alignment demands. Visual problems occur when the visual demands of the task exceed the visual abilities of the individual to comfortably perform the task. These tasks involve repetitious muscular activity; therefore many computer related vision problems can be considered a form musculoskeletal disorder. These problems are commonly referred to as cumulative trauma disorders (CTDs) or repetitive stress injuries (RSIs). Computer Vision Syndrome (CVS) is another vision problem associated with repetitive or extensive computer use. CVS is the complex of eye and vision problems related to near work which are experienced during or related to computer use. CVS it characterized by visual symptoms which result from interaction with a computer display or its environment, ("Computer vision syndrome," 2009). Fifty to ninety percent of computer workers have visual symptoms and twenty-two percent of that fifty to ninety percent have musculoskeletal disorders. It was indicated that 10 million primary eye care examinations provided in the United States are because of visual problems at video display terminal (VDTs), such as computer screens. Although it is not likely that vision issues caused by computer use are permanent, if uncorrected or under corrected, these problems may affect a person’s visual performance and comfort. Some ways to help reduce vision related problems due to computer use are to reduce or eliminate the amount of glare on the computer screen, make sure the screen and characters on the screen are large enough to by seen and read, take breaks every 30 minutes by looking away from screen for about 10 seconds, and drink plenty of water and blink frequently to keep the eyes lubricated. Vision problems are not the only health issues associated with extensive or repetitive computer use. As previously mentioned extensive or repeated computer use can also cause cumulative trauma disorders. Working on a computer for a long period of time can cause different types of forearm and wrist CTDs, which are inflammation of tendons, nerve sheaths, and ligaments and damage to the soft tissues. Tenosynovitis, ganglion cysts, de Quervain’s disease, lateral epicondylitis, and carpal tunnel syndrome are different types of CTDs caused by computer use. Symptoms of CTDs are pain, numbness, tingling, or weakness in muscles or movement of arms, hands and fingers. Inflammation of the lining of the sheath that surrounds a tendon is called tenosynovitis. Strain, infection, injury, and/or overuse can all cause tenosynovitis. Symptoms of tenosynovitis are difficultly moving a joint, joint stiffness in affected area, pain and tenderness around joint, and pain when moving joint. These symptoms may also be combined with fever and redness. This type of injury is treated mainly by resting the joint, but a splint or brace may be used to immobilize the tendon. Also applying heat or cold to the area can help reduce pain and inflammation. Anti-inflammatory medications, like ibuprofen can be used to relieve pain and reduce inflammation. If the case is severe enough, surgery may be required, but this is rare. Most people with tenosynovitis recover fully with treatment, but if it is not treated, the tendon may become permanently restricted or it may rupture (Chen, 2008). To prevent tenosynovitis, avoid overusing and repetitive movements of tendons. If the continues to condition develop and becomes a chronic condition, the tendon may become damaged and recovery may be slow or incomplete. Ganglion cysts are another CTD that can be caused by repeatedly applying stress to the wrist. They are more common in women than in men and it is not really known what triggers the formation of the ganglion. Ganglion cysts arise from the capsule of a joint or the sheath of a tendon and they contain a thick, clear, mucus-like fluid found in the joint ("Ganglion (cyst) of," 2007). These cysts can be found different places on the wrist and are most of the time harmless and disappear on their own. They start out small not as painful, but as they get larger, they become more painful and are very unattractive. But they will decrease in size with rest. To treat ganglion cysts, a wrist brace or splint may be used to immobilize wrist. Also the fluid may be drained from it in a procedure called aspiration. In some cases surgery may be needed and if this is the case, part of the involved joint capsule or tendon may be removed. De Quervain’s disease is also caused by repetitive wrist movement. This is a problem that makes the bottom of your thumb numb and the side of your wrist hurt due to the tendon becoming swollen (Erstad, 2009). Symptoms of this disease are pain at the wrist or fingers or squeaking, crackling, snapping, creaking when the wrist or thumb moves. There may also be numbness in the wrist or thumb. De Quervain’s disease may cause cysts that, if they aren’t treated , may spread up the forearm or down to the thumb. Treatments for de Quervain’s disease are rest, ice or heat applied to area, pain medication, steroid shot(s), and if bad enough, surgery. Occupational therapy may also be needed after surgery. Lateral epicondylitis, also known as tennis elbow, is a condition caused by overuse of the elbow. It is a very painful, inflammation of the tendons on the outside of the elbow that join the forearm muscles. These muscles and tendons become damaged from overuse and repeated motions which leads to pain and tenderness on the outside of the elbow ("Tennis elbow (lateral," 2009). Symptoms of lateral epicondylitis are pain or burning at the outer elbow and weak grip strength. Eighty to ninety-five percent of patients have success with non surgical treatments ("Tennis elbow (lateral," 2009). The arm should get proper rest and pain medication can be taken to reduce swelling and pain. Physical therapy, braces, steroid injections, shock wave therapy and/or surgery may be used to correct later epicondylitis if the condition gets bad enough. Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist ("Carpal tunnel syndrome," 2008). The median nerve controls sensations and impulses to the palm side of the thumb and fingers. Carpal tunnel syndrome can be caused by a combination of factors that increase pressure on the median nerve and tendons of the carpal tunnel. This is more prominent in women than in men which may be due to the fact that the carpal tunnel is smaller in women. Symptoms of carpal tunnel syndrome are swelling, burning, itching, numbness, and/or tingling in the palm of the hand and fingers. Carpal tunnel syndrome can be treated with medication, exercise, therapy, and/or surgery. Stretching exercises, wearing splints or braces to keep wrist straight, and wearing fingerless gloves can prevent carpal tunnel syndrome. Now that some of the major health issued related to computer use has been addressed, the Health and Safety Work Act will be discussed. The Health and Safety Work Act explains how employers must minimize risks for all workers and also the legal standards for computer equipment. There are four main regulations that cover the use of computer equipment under the Health and Safety Work Act. These regulations are the Health and Safety (Display Screen Equipment) Regulations 1992, the Management of Health and Safety at Work Regulations 1992, the Provisions and Use of Workplace Equipment Regulations 1992 and the Workplace (Health, Safety, and Welfare) Regulations 1992. The Health and Safety (Display Screen Equipment) Regulations 1992 is summarized as followed: Analysis of workstations 2.—(1) Every employer shall perform a suitable and sufficient analysis of those workstations which: (regardless of who has provided them) are used for the purposes of his undertaking by users; or have been provided by him and are used for the purposes of his undertaking by operators, for the purpose of assessing the health and safety risks to which those persons are exposed in consequence of that use. (2) Any assessment made by an employer in pursuance of paragraph (1) shall be reviewed by him if: there is reason to suspect that it is no longer valid; or there has been a significant change in the matters to which it relates; and where as a result of any such review changes to an assessment are required, the employer concerned shall make them. (3) The employer shall reduce the risks identified in consequence of an assessment to the lowest extent reasonably practicable. Requirements for workstations 3.—(1) Every employer shall ensure that any workstation first put into service on or after 1st January 1993 which: (regardless of who has provided it) may be used for the purposes of his undertaking by users; or has been provided by him and may be used for the purposes of his undertaking by operators, meets the requirements laid down in the Schedule to these Regulations to the extent specified in paragraph 1 thereof. (2) Every employer shall ensure that any workstation first put into service on or before 31st December 1992 which: (regardless of who provided it) may be used for the purposes of his undertaking by users; or was provided by him and may be used for the purposes of his undertaking by operators, meets the requirements laid down in the Schedule to these Regulations to the extent specified in paragraph 1 thereof not later than 31st December 1996. Daily work routine of users 4. Every employer shall so plan the activities of users at work in his undertaking that their daily work on display screen equipment is periodically interrupted by such breaks or changes of activity as reduce their workload at that equipment. Eyes and eyesight 5.—(1) Where a person: is already a user on the date of coming into force of these Regulations; or is an employee who does not habitually use display screen equipment as a significant part of his normal work but is to become a user in the undertaking in which he is already employed, his employer shall ensure that he is provided at his request with an appropriate eye and eyesight test, any such test to be carried out by a competent person. (2) Any eye and eyesight test provided in accordance must be carried out as soon as practicable after being requested by the user concerned. (3) At regular intervals after an employee has been provided with an eye and eyesight test in accordance with paragraphs (1) and (2), his employer shall, subject to paragraph (6), ensure that he is provided with a further eye and eyesight test of an appropriate nature, any such test to be carried out by a competent person. (4) Where a user experiences visual difficulties which may reasonably be considered to be caused by work on display screen equipment, his employer shall ensure that he is provided at his request with an appropriate eye and eyesight test, any such test to be carried out by a competent person as soon as practicable after being requested as aforesaid. (5) Every employer shall ensure that each user employed by him is provided with special corrective appliances appropriate for the work being done by the user concerned where: normal corrective appliances cannot be used; and the result of any eye and eyesight test which the user has been given in accordance with this regulation shows such provision to be necessary. (6) Nothing in paragraph (3) shall require an employer to provide any employee with an eye and eyesight test against that employee's will ("The Health and," 1992).

The Management of Health at Safety at Work Regulations 1992 is summarized as

followed:

Risk assessment 3.—(1) Every employer shall make a suitable and sufficient assessment of: the risks to the health and safety of his employees to which they are exposed whilst they are at work; and the risks to the health and safety of persons not in his employment arising out of or in connection with the conduct by him of his undertaking, for the purpose of identifying the measures he needs to take to comply with the requirements and prohibitions imposed upon him by or under the relevant statutory provisions. Health and safety arrangements 4.—(1) Every employer shall make and give effect to such arrangements as are appropriate, having regard to the nature of his activities and the size of his undertaking, for the effective planning, organization, control, monitoring and review of the preventive and protective measures. Health surveillance 5. Every employer shall ensure that his employees are provided with such health surveillance as is appropriate having regard to the risks to their health and safety which are identified by the assessment. Health and safety assistance 6.—(1) Every employer shall, subject to paragraphs (6) and (7), appoint one or more competent persons to assist him in undertaking the measures he needs to take to comply with the requirements and prohibitions imposed upon him by or under the relevant statutory provisions. (2) Where an employer appoints persons in accordance with paragraph (1), he shall make arrangements for ensuring adequate co-operation between them. (3) The employer shall ensure that the number of persons appointed under paragraph (1), the time available for them to fulfill their functions and the means at their disposal are adequate having regard to the size of his undertaking, the risks to which his employees are exposed and the distribution of those risks throughout the undertaking. (4) The employer shall ensure that: (a) any person appointed by him in accordance with paragraph (1) who is not in his employment: (i) is informed of the factors known by him to affect, or suspected by him of affecting, the health and safety of any other person who may be affected by the conduct of his undertaking, and (ii) has access to the information referred to in regulation 8; and (b) any person appointed by him in accordance with paragraph (1) is given such information about any person working in his undertaking who is— (i) employed by him under a fixed-term contract of employment, or (ii) employed in an employment business, as is necessary to enable that person properly to carry out the function specified in that paragraph. Procedures for serious and imminent danger and for danger areas 7.—(1) Every employer shall: establish and where necessary give effect to appropriate procedures to be followed in the event of serious and imminent danger to persons at work in his undertaking; nominate a sufficient number of competent persons to implement those procedures insofar as they relate to the evacuation from premises of persons at work in his undertaking; and ensure that none of his employees has access to any area occupied by him to which it is necessary to restrict access on grounds of health and safety unless the employee concerned has received adequate health and safety instruction. Information for employees 8. Every employer shall provide his employees with comprehensible and relevant information on: the risks to their health and safety identified by the assessment; the preventive and protective measures; and the identity of those persons nominated by him in. Employees' duties 12.—(1) Every employee shall use any machinery, equipment, dangerous substance, transport equipment, means of production or safety device provided to him by his employer in accordance both with any training in the use of the equipment concerned which has been received by him and the instructions respecting that use which have been provided to him by the said employer in compliance with the requirements and prohibitions imposed upon that employer by or under the relevant statutory provisions. (2) Every employee shall inform his employer or any other employee of that employer with specific responsibility for the health and safety of his fellow employees: of any work situation which a person with the first-mentioned employee's training and instruction would reasonably consider represented a serious and immediate danger to health and safety; and of any matter which a person with the first-mentioned employee's training and instruction would reasonably consider represented a shortcoming in the employer's protection arrangements for health and safety ("The Management of," 2000).

The Provision and Use of Work Equipment Regulations 1992 is summarized as followed:

Suitability of work equipment 5.—(1) Every employer shall ensure that work equipment is so constructed or adapted as to be suitable for the purpose for which it is used or provided. (2) In selecting work equipment, every employer shall have regard to the working conditions and to the risks to the health and safety of persons which exist in the premises or undertaking in which that work equipment is to be used and any additional risk posed by the use of that work equipment. (3) Every employer shall ensure that work equipment is used only for operations for which, and under conditions for which, it is suitable. Maintenance 6.—(1) Every employer shall ensure that work equipment is maintained in an efficient state, in efficient working order and in good repair. (2) Every employer shall ensure that where any machinery has a maintenance log, the log is kept up to date. Specific risks 7.—(1) Where the use of work equipment is likely to involve a specific risk to health or safety, every employer shall ensure that: the use of that work equipment is restricted to those persons given the task of using it; and repairs, modifications, maintenance or servicing of that work equipment is restricted to those persons who have been specifically designated to perform operations of that description (whether or not also authorized to perform other operations). Dangerous parts of machinery 11.—(1) Every employer shall ensure that measures are taken in accordance with paragraph (2) which are effective: to prevent access to any dangerous part of machinery or to any rotating stock-bar; or to stop the movement of any dangerous part of machinery or rotating stock-bar before any part of a person enters a danger zone. Isolation from sources of energy 19.—(1) Every employer shall ensure that where appropriate work equipment is provided with suitable means to isolate it from all its sources of energy. (2) Without prejudice to the generality of paragraph (1), the means mentioned in that paragraph shall not be suitable unless they are clearly identifiable and readily accessible. (3) Every employer shall take appropriate measures to ensure that re-connection of any energy source to work equipment does not expose any person using the work equipment to any risk to his health or safety. Stability 20. Every employer shall ensure that work equipment or any part of work equipment is stabilized by clamping or otherwise where necessary for purposes of health or safety. Lighting 21. Every employer shall ensure that suitable and sufficient lighting, which takes account of the operations to be carried out, is provided at any place where a person uses work equipment. Maintenance operations 22. Every employer shall take appropriate measures to ensure that work equipment is so constructed or adapted that, so far as is reasonably practicable, maintenance operations which involve a risk to health or safety can be carried out while the work equipment is shut down or, in other cases: maintenance operations can be carried out without exposing the person carrying them out to a risk to his health or safety; or appropriate measures can be taken for the protection of any person carrying out maintenance operations which involve a risk to his health or safety ("The Provision and," 2000 ).

The Workplace (Health, Safety, and Welfare) Regulations 1992 is summarized as followed: Requirements under these Regulations 4.—(1) Every employer shall ensure that every workplace, modification, extension or conversion which is under his control and where any of his employees works complies with any requirement of these Regulations which: applies to that workplace or, as the case may be, to the workplace which contains that modification, extension or conversion; and is in force in respect of the workplace, modification, extension or conversion. Workstations and seating 11.—(1) Every workstation shall be so arranged that it is suitable both for any person at work in the workplace who is likely to work at that workstation and for any work of the undertaking which is likely to be done there. (2) Every workstation outdoors shall be so arranged that: it enables any person at the workstation to leave it swiftly or, as appropriate, to be assisted in the event of an emergency; and it ensures that any person at the workstation is not likely to slip or fall. (3) A suitable seat shall be provided for each person at work in the workplace whose work includes operations of a kind that the work (or a substantial part of it) can or must be done sitting, ("The Workplace (health,,” 2000).

These regulations were developed and are enforced in the UK. The regulations state what employees must do to maintain their employees’ safety and also what they must inform their employees of. They have been paraphrased to fit with the topic of this paper but they are much more extensive and detailed. Since the enforcement of these regulations, the rate of computer related injuries in the work place have decreased. Some recommendations for employees instead of employers would be not to rest wrist or forearm on hard surfaces while using the keyboard, do not use a brace or splint if not needed, reduce glare, keep the eyes lubricated, and if not needed, do not wear contact lens if you will be using the computer for a long period of time. Employers can post ways to prevent computer related injuries in or around workstations. Employers can also post wrist exercises that the employees can do from time to time while at the workstation. Taking into account these recommendations and regulations, the number of computer related injuries in the United States can also be drastically reduced.
Bibliography
Carpal tunnel syndrome fact sheet. (2008, April 10). Retrieved from http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm

Chen, A. (2007, July 17). Tenosynovitis. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/001242.htm

Computer health and safety. (2003, January 27). Retrieved from http://www.ictknowledgebase.org.uk/healthandsafety.

Computer vision syndrome (cvs). (2009, November 23). Retrieved from http://www.aoa.org/x5374.xml

The Effects of computer use on eye health and vision. (1997, April). Retrieved from http://www.aoa.org/documents/EffectsComputerUse.pdf

Erstad, S. (2009, January 5). De quervain's disease. Retrieved from http://www.peacehealth.org/kbase/topic/special/zd1018spec/sec1.htm

Ganglion (cyst) of the wrist. (2007, October). Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=A00006

The Health and safety (display screen equipment) regulations 1992 . (1992, November 5). Retrieved from http://www.opsi.gov.uk/si/si1992/Uksi_19922792_en_1.htm

The Management of health and safety at work regulations 1992 . (2000, September 20). Retrieved from http://www.opsi.gov.uk/si/si1992/Uksi_19922051_en_1.htm

The Provision and use of work equipment regulations 1992 . (2000 , September 20). Retrieved from http://www.opsi.gov.uk/si/si1992/Uksi_19922932_en_1.htm

The Relationship of computer vision syndrome to musculoskeletal disorders. (2006). Retrieved from http://www.aoa.org/x5378.xml

Tennis elbow (lateral epicondylitis). (2009, September). Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=a00068

Shelly, Gary, & Vermaat, Misty. (2008). Discovering computers. Boston, MA: Course Technology.

The Workplace (health, safety and welfare) regulations 1992 . (2000, September 20). Retrieved from http://www.opsi.gov.uk/SI/si1992/Uksi_19923004_en_1.htm