Officehealth.

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OFFICE HEALTH IN THE

DIGITAL MEDIA ENVIRONMENT
The digital media office has undergone dramatic
changes in the last two decades. Some of the
changes have resulted in benefits such as
increased efficiency. In the digital media office it is
possible to design and print files, look up
information in files, read electronic mail and
participate in interoffice conferences without ever
leaving the chair.
One of the results of this new work pattern is an
increase in the number of painful conditions
involving the back, neck, wrist and head. The major
factor contributing to these injuries is the long
period of time a designer sits in the chair. Another is
the increase in repetitive motions required with the
use of keyboards. The arrangement of lighting and
VDT screens also contributes to the incidence of
work-related complaints

Posture Problems
Why is sitting bad for you?
Sitting for long periods of time has two important
effects on the human body: an increase of muscular
tension and a constriction of the spine. Both
contribute to pain in the back and neck.
Muscles can be involved in two types of activity:
dynamic effort and static effort. Dynamic effort is
characterized by movement; the muscle fibers are
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contracted and relaxed rhythmically. Static effort

occurs when a muscle is contracted and held in the
contracted position for some time. Bloodflow is
restricted in a contracted muscle.
Dynamic effort, such as walking, is easy to sustain
for long periods of time because fresh, oxygenated
blood flows in a muscle every time it releases.
Static effort, however, results in a continual deficit of
blood supply to the contracted muscle, so a
statically held muscle cannot rid itself of metabolic
waste products. It is these waste products which
produce the feelings of pain, tenderness and
fatigue. Most jobs have a combination of dynamic
and static effort tasks. Even individual tasks can
have elements of both; for example, typing on a
keyboard involves the fingers dynamically and the
arms and shoulders statically. It is the statically held
muscles that eventually become painful and sore.
A second factor contributing to occupational back
pain concerns the orthopaedic aspects of the sitting
posture. The human spine has a set of natural
curves that become distorted when sitting. The
lower back, or lumbar region, which normally curves
forward, becomes bowed out. The backward tilting
pelvis puts pressure on the intervertebral disks and
nerves. The disks are fluid-filled sacs which act as
cushions between the vertebrae. If the disks
degenerate, then the resulting pressure on the
spinal bones and nerves can cause pain

How is back pain treated?

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As the causes of back pain are many, there are

many approaches to treatment. Medical doctors are
often consulted, as well as orthopaedic specialists.
If surgery is not warranted, they will often
recommend a regime of rest, painkillers and
physical therapy.
Physical Therapists are often included to oversee
the physical exercises. Many people prefer the
services offered by chiropractors for their back pain.
For some, this treatment offers immediate relief and
has the added benefit of being drug-free.
Acupuncture has relieved some people, as well as
massage therapy.
There is no final consensus as to the best treatment
for back pain. Different individuals will find help in a
number of different treatments. Nevertheless, most
people experience the largest amount of pain relief
through a regular exercise plan of walking or
swimming. There are many who find a cessation of
symptoms through this action alone.

Carpal Tunnel Syndrome (CTS)

What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome (CTS) is associated with
many jobs which involve repetitious motion of the
wrist. The use of computer keyboards is a potential
cause of CTS for many workers. CTS is a painful
condition of the wrist and forearm that is a result of
repetitive hand motion. Its cause can be traced to a
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u-shaped cluster of bones at the base of palm

which forms the base and sides of the carpal tunnel.
A tough ligament forms the roof of the carpal
tunnel. Running through the tunnel are the flexor
tendons and the median nerve, which operate the
thumb and the first three fingers. CTS occurs
when overwork, such as prolonged gripping,
repetitive flexing of the fingers, or constant
vibration causes the flexor tendons to become
inflamed, putting pressure on the median nerve.
There are other, non-occupational, causes of
pressure on the nerve which can result in CTS,
such as the normal aging process, fluid retention
(particularly during pregnancy), or a previous bone
dislocation or fracture. Irritation resulting from
these non-occupational factors can aggravate
occupational CTS.
One reason that CTS is often unrecognized as
work-related is that the early symptoms usually
occur at night. These early signs can be pain,
tingling, or numbness in the hand or forearm. As the
condition becomes more advanced, there can be a
loss of sensation in the hand or stiffness in the hand
and fingers, with a gradual loss of grip strength and
control of the thumb and first three fingers. Left
untreated, CTS can cause permanent nerve
damage, with a deterioration of the large muscle of
the thumb. Because of the variety of symptoms,
CTS can be misdiagnosed, particularly as arthritis.
There are several tests used by physicians to
diagnose CTS.
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How is CTS treated?

In its early stages, CTS can be treated
conservatively, without surgery. Relief in mild cases
can be provided with stretching exercises. Simply
stopping work every hour to gently rotate the wrists
and arms to increase circulation and relieve muscle
tension can reduce the stress on the carpal tunnel.
Further steps include the wearing of a wrist splint at
night and, if possible, on the job. Icing the wrist can
sometimes reduce the symptoms. Anti-inflammatory
drugs such as Motrin and Advil can be used to
reduce the tendon inflammation; cortisone shots
can also be administered.
In cases where symptoms are so advanced that
they do not respond to any of the above treatments,
carpal tunnel release surgery may be the only
recourse. This surgery divides the transverse
ligament to open up the carpal tunnel. Although
initially successful, surgery may not be the cure.
Continued pain, tenderness, and a perceptibly
decreased grip are not unusual. Scarring of the
divided ligament may put pressure on the nerve
again, causing a re-occurance of symptoms.

Can CTS be prevented?

Obviously, the real key to eliminating CTS is
prevention. Workers should make a conscious effort
to use proper posturing and grips. The posture of
the wrist should be in line with the hand to prevent
pinching with the carpal tunnel. Avoid using bent
(flexed), extended or twisted wrist positions for long
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periods of time. Workers using keyboards on a

continual basis should change the angle of their
chair to properly align the wrists. If the job consists
of varied work, switch tasks often. If constant
repetition is required, rest the hands periodically.

Early detection of CTS is particularly important

since it can be more easily treated in its mild
stages. Don't allow the pain to reach intolerable
levels before seeking treatment. On-the-job pain
that lasts more than an hour should be interpreted
as a danger sign. Symptoms that occur at night
should also be considered a warning. Always report
such pain to a supervisor.

Vision Problems
Human eyes were made for most efficient seeing at
a distance. But, as you know, VDT use demands
using your eyes at a closer range, usually intensely,
over long periods of time. This alone can strain your
eyes and may cause vision problems to develop or
aggravate existing vision conditions. Effects on the
eye vary depending on the individual and the work
station. Some of the factors influencing this are:
Eye Fatigue:
Viewing VDTs at a close range for long
periods can be very tiring, and over a long
period of time may cause temporary
deterioration of vision. VDT operators
should take periodic breaks in open areas away
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from their machines, in addition to alternating an

hour or two of screen work with an hour of another
kind of work that would allow viewing from a greater
distance and more body movement. Two hours is
the maximum time that should be spent doing
continuous screen work.
Glare:
Eyestrain can be caused by improper positioning of
the terminal in relation to surrounding office lighting,
windows, shiny surfaces and background colors.
Glare from a VDT screen that reflects surrounding
light can be reduced by
using nonreflective glass as
well as altering the lighting
structures in the vicinity of
the screen. Installing blinds
or awnings on the nearby
windows, relocating the machine for better lighting
or relocating the light fixtures can significantly
reduce glare from the glass of the VDT.
If a terminal is positioned against a background that
makes it difficult for the eyes to adjust to the images
on the screen, such as a white wall or a window,
strain can also result. In this case, the pupils are
adjusting to the bright background rather than to the
darker screen, and the images on the screen
become difficult to see. The VDT operators often
compensate by bending their heads or turning their
bodies to block the light, causing muscle strain as
well.
Successful solutions include dimming the lights,
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changing the location of the VDT, painting or

covering the wall facing the terminal in a color or
texture that reflects less light or installing a darker
screen or partition behind the machine. But before
changes are made in any office, it is important to
discuss the proposals with fellow employees,
taking into account their preferences. Darker
lighting, walls and windows may be more
depressing and stressful than the original problem.
Eyeglasses and contacts: Particular problems
occur with workers who wear glasses or contact
lenses. Glasses overcorrect an operator's eyes for
the distance for which they are used with a VDT.
Most glasses correct the wearer's vision for a
reading distance of 10-13 inches, whereas VDT
viewing distances tend to be further, usually 16-20
inches. Workers may find it necessary to be fitted
with special lenses designed for their normal
viewing distance from the screen.
Screen character size and color: The size of the
screen and of the characters plays an important
part in adding to, or detracting from, the comfort of
the operator. A larger screen with a viewing distance
of more than two feet, with a character height of at
least 3/16 of an inch is optimal.
It is also best to avoid use of terminals where there
is a noticeable "flickering" of the characters on the
screen. All VDTs emit light produced by phosphors
which fades rapidly and must be constantly
replenished. Unless the rate of replenishment is at
least 60 times per second, this flickering may be
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discernible to operators. Such terminals require

more concentration and hence, result in more
strain.

What can prevent these VDT problems?

Chairs, keyboards and desks
The most important thing to look for in a chair is
adjustability. The second most important thing is to
take the time to adjust it to your needs. You should
be able to adjust the height so that both feet can
rest on the ground. There should be a back rest
with good lumbar support for you lower back, which
should also be adjustable.
Backrests that lean back in a rocking motion are
also a good feature, as they give the back muscles
a chance to move. The presence of armrests is up
to the operator's preference; the best chairs have
armrests that are removable and (yes!) adjustable.
If you have the opportunity to shop for a new chair,
ask the retailer if they will let you take the chair on
trial. The only way to really tell if the chair is right for
you is to sit in it through the day.
The keyboard should rest at a height that is
comfortable for your arms and shoulders. Put your
hands on your keyboard as if you were going to
type and check your position. You do not want any
strong bending or flexing at the wrists, nor do you
want to have your shoulders scrunched up high.
Sometimes, the keyboard can be lowered by
installing an adjustable, sliding tray underneath the
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workstation. Wrist relief can be sought by having

something soft to rest your wrists on in front of the
keyboard; a small, rolled towel will often work well.
Also, make sure your chair is adjusted properly. If
the chair must go up so you can reach the keyboard
comfortably, then get a foot rest to go under your
feet. Lastly, take a close look at your desk, some of
the newer models have adjustable heights.
Your computer should not be placed with the
monitor too close in front of your face. Placing it at a
distance protects your eyes from strain. If you have
a mouse, place it where you can manipulate it
without strain on your arm or wrist.

Lighting
Use proper lighting. It can have a significant impact
on your visual comfort and efficiency. The lighting
for VDT operation should:
• be about 20 to 50 foot candles, which is about
half the level used in most offices. Lower
lighting can be achieved by using fewer bulbs
or fluorescent tubes, installing lower intensity
tubes, or using dimmer switches.
• match as closely as possible the brightness of
the surroundings with that of the VDT screen
for optimum comfort and efficiency. However,
the contrast between the characters on the
screen and the screen background should be
high.
• minimize reflected glare on VDT screens by
keeping them away from windows and other
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sources of bright light. Use window shades or

drapes to block out excessive sunlight.
Antiglare screens are also available.

Breaks
Take a break! Many authorities recommend a 15
minute alternate task break every hour if you are a
full time user. If you have any duties that take you
away from the computer terminal, divide them up
through the day, so as to prevent long stretches of
work at the terminal. If you have no alternative
duties, take at least ten minutes out of every hour to
stand and stretch - movement is good for the body!

Exercise
Exercise is vitally important to a healthy body. It is a
good idea to practice a regular schedule of exercise
to offset the sedentary lifestyle of the office.
Whatever your choice of exercise, remember that a
little done regularly is better than a lot done
infrequently. Scheduling in twenty minutes a day, or
an hour's worth three times a week can have a
dramatic effect on your health, and, ultimately, on
your work performance.
In addition, it is a good idea to do a variety of
stretching exercises at your desk during the day. It
is recommended that for every hour of computer
work, you take ten minutes to stretch and move.
Concentrate on the hot spots - shake out your
hands and wrists, rotate your head to relieve your
neck muscles, also, touch your toes and roll up
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slowly to combat fatigue in the back. Again, it is

regular consideration for your body which will do the
most to prevent repetitive motion injuries. Make it a
habit!