- Email: [email protected]
Solving workplace problems associated with VDTs
Applied Ergonomics 1988, 19.2, 99-102
Solving workplace problems associated with VDTs A.J.M. Slovak and C. Trevers Occupational Health Service, FisonsPharmaceuticalDivision, Loughborough, Leics LE11 0BB, UK The introduction of VDTs into the vast majority of modern working environments represents a substantial change in the disciplines of work for many people. This paper describes how the health and safety issues associated with this change were managed in one organisation by the acquisition of ergonomics skills and their combination with occupational health surveillance techniques. The results show that ergonomics problems far outweighed symptomatic complaints, but symptomatic complaints were strongly associated with high VDT occupancy. The processes used resulted in high response rates from VDT users and an excellent 'clear-up' rate of problems. The solution of these problems was quantified in terms of difficulty and cost.
Keywords: Working environment, visual display units, occupational health
Introduction In our occupational health units, early reports of VDT user problems usually centred on adverse symptomatic experiences. At first, these were investigated piecemeal and were found to be largely ameliorated by attention to basic ergonomics factors. Although the number of reports was relatively small, their growth was roughly proportional to the exponential growth in the number of VDTs being installed. Since it is well-recognised as a truism of occupational health practice that only a small proportion of problems will be voluntarily reported in any such situation, arrangements were made to investigate usage pro-actively and in a systematic way. Being then a new and complex subject, it was recognised that expertise would need to be acquired from outside the organisation to tackle the matter properly. Accordingly, a group of professional ergonomists were contracted to provide a one-day module of informationary assessment and problem-solving training for occupational health nurses specifically to deal with VDT related problems. This paper is a description of the process which ensued. An attempt was made to listen objectively to what workpeople were saying and to respond to it effectively. The techniques used were simple but directly based on ergonomics disciplines. They can be applied widely under the guidance of appropriately trained personnel.
information is confidential and in their control. This was clearly stated in the preamble. Also, the procedure to be used for responding to and acting upon the questionnaire was clearly outlined. A particularly important feature of the questionnaire was its differentiating of ergonomics and symptomatic problems so that their relationship could subsequently be explored. Finally, certain issues, such as reproductive health, will be seen to be absent. The main reason for this was one of questionable relevance. Nevertheless, it seemed important to offer reassurance and the opportunity for confidential discussion if desired. The questionnaire is to be found as an appendix to this paper. Respondents reporting ergonomics or symptomatic problems were followed up by the trained occupational health nurses. Solutions to problems were identified and remedies agreed between respondents, assessors and managers. This process was piloted on one major manufacturing site and an audit was performed of the immediate effectiveness of the process. This audit examined difficulty of solution of problems, accuracy of responses and the cost of agreed remedies.
Results
Methods
There was a 92% overall response rate in a target population of 205 persons. Some 68% of respondents described problems, 32% did not. An average of 2.5 problems per person reporting problems was found (range 1-8). Of these problems, 82% were ergonomics and 18% symptomatic. Details of certain of these problems are listed below.
First contact with VDT users was made by questionnaire administered through the internal mail. The questionnaire was designed to be comprehensive but simple and quick to answer. Certain features are worthy of special note. In order to obtain reliable answers and an adequately high response rate, respondents must be certain that the
The relationship between problem frequency and intensity of work is presented in Table 1. It should be noted that this problem frequency represents all problems (ergonomics and symptomatic). Problem averages and ranges are given for each 10% increment in VDT occupancy. A similar breakdown just for symptoms was not possible because of the
0003 6870/88/02 0099-04 $03.00 © 1988 Butterworth & Co (Publishers) Ltd
Applied Ergonomics
June 1988
99
Table 1: VDT occupancy vs problems reported
% VDU work
10
20
30
40
50
60
70
80
90
100
% persons complaining of problems
50
58
62
68
65
62
60
75
87
87
Range: No of problems
0-4
0-6
1-8
1-6
0--6
0-7
0--5
0-6
0--7
0-7
Average No of problems
1.72
1'81
2-72
3'20
2-55
1.55
1"44
3'25
3"40
4"00
Symptoms per person
0"45
relatively small numbers involved and here a comparison is given between greater and lesser than 50% VDT work. A large number of different ergonomics parameters were enquired into by the questionnaire and the more important of these are detailed below. The most important of these were problems of seating and space. With seating, adjustment, back support and overall comfort were recorded. In regard to space, an overall view was sought on ability to work on the allotted surfaces. Illumination problems were very frequent; they were also more easy to solve. In some cases flicker was unavoidable because equipment was operated at 'state of the art' limits with variable vector loading and here no solution was practicable. All these data are summarised in Table 2. Information was sought about eye disturbances, namely: sore eyes, red eyes, pain, blurring and other problems. Surprisingly, musculoskeletal problems were more common than eye problems if the former were lumped together, although hand, wrist and forearm symptoms of the type now Table 2: Principal ergonomics problems reported
(percentage of respondents reporting) Seating (adjustment, backcomfort, general)
20%
Lack of space
36% 6%
Flicker interfering with work
Reflections interfering with work
36%
Bare bulbs or fluorescent tubes
13%
Table 3: Symptomatic problems (work related in parentheses)
Eyes (combined)
24% (18%)
Hands, wrists, forearm
4% ( 3 % )
Neck
21% (14%)
Low back
23% (18%)
Rash - facial
4% (2%)
Headache
16% (10%)
1"26
referred to as repetition strain injury were quite uncommon. People were asked to differentiate between problems that they felt were associated with work and those that were not. It can be postulated that the difference between the numbers is a reflection of an appreciable level of underlying morbidity in the general population Table 3 illustrates these findings. Solutions to problems were scored as easy, fairly simple or hard. Costs were also scored on in a similar way, less than £10.00, less than £100.00, more than £100.00. Average cost per individual was about £300.00. Subjective impressions were also sought from assessors about whether problems were serious or not and whether respondents' attitudes to them were trivial or not (Table 4). Discussion Overall response rate to the survey questionnaires was vexy high at 92%. This suggests that people had something to say, were willing to say it and felt reasonably confident of evoking a meaningful response. Levels of problem reporting were high when compared with symptom-only surveys but in line with or a little lower than other VDT usage surveys (Knave et al, 1984). Simple problems of seating and surface space were frequent observations. The issue of seating has been widely addressed but simple workspace has not. It is a very basic requirement yet most published guidance documents are very coy about it. The experience of our respondents would suggest that an area of worksurface at least 100% greater than with typical typing work needs to be dedicated to the job when VDTs are used, unless all transactions are paperless. Manoeuvrability about the workstation and problems of work-plane variance were much less common. Sub-optimal illumination was also common as might be expected in offices and rooms which, in the main, had not been purpose-built or adapted for VDT operation. Reflections and glares from natural and artificial light sources did, however, prove generally easy to remedy once the problems were pin-pointed. This was also true of levels of illumination. The only exception to this was where space or more general room layout problems prevented satisfactory re-orientation of equipment.
Table 4: Audit of problems tackled
100
Difficulty
Easy 20%
Moderate 34%
Hard 65%
Cost
< £ 1 0 22%
< £ 1 0 0 13%
> £ 1 0 0 65%
Severity
Serious 64%
Not serious
Attitude
Reasonable95%
Trivial
Applied Ergonomics
June 1988
36%
5%
The results showed that ergonomics problems outweighed symptomatic problems in a ratio of approximately 4 to 1. Symptoms were overwhelmingly described in association with ergonomics problems and when found alone were usually due to pre-existing disease. People were well able to identify correlations between their problems and their work and usually did so soberly and without exaggeration. The results in Table 1 show an interesting relationship between VDT occupancy and the number of problems experienced. Whilst profound inferences should not be drawn from these data alone, it would seem reasonable to suggest that what we are observing here may be two different populations although no doubt they overlap. One population works at the VDT and the other with the VDT. The latter population, including such people as designers, programmers and scientists, largely occupies the 10-50% range. Their problem rates at low levels of usage are quite high, which suggests they may be willing to tolerate discomfort because VDT work is only an incidental part of the job. The increased problem rate moving towards 40-50% is mirrored by that in the other population - the secretaries and accounts personnel - at 80-100%. These findings nicely identify priority target groups for remedial action. The grading of difficulty of solutions to problems may seem rather vague and is perhaps best explained a little further. Easy tasks were those where simple alterations consequent on discussions between respondent and assessor solved the problem (e g, changing orientation of a terminal). Tasks of moderate difficulty required more complex interaction involving some input from managers and perhaps other departments (e g, office services, carpenters, etc). Such jobs might involve installing blinds or new chairs or desks. Difficult tasks were those where a prolonged series of negotiations, alterations, etc were necessary to effect satisfactory change. In these cases there was a more profound alteration of the physical parts of the work environment as well as changes in job organisation, rotation of jobs, etc. Crucial to dealing with the latter two categories was accurate identification of the problem and agreement on the necessary action. The nurse assessors proved efficacious catalysts to this process. The costs involved, on a per capita basis, are not insubstantial although relatively small in relation to the total spent on each terminal unit or, indeed, overall wage costs. Improvements in work efficiency can reasonably be expected in many cases but objective proof was not sought in this study. The best opportunity to do this would probably lie in a before/after study in a workmeasured fast-keying department. Historically, guidance on VDT installation was offered in an in-house document supplemented by manufacturer's literature. In retrospect, it is apparent that managers and staff found all these sources of guidance difficult to apply practically. What seemed very clear to people in the front line was the shortage of realistic, down-to-earth experience of what the problems were likely to be and how they could sensibly be solved. From the experience that we have gained from this survey, perhaps .much more than from the growing scientific literature on the subject, we have produced a much modified revision of our guidance which addresses these problems. With heightened awareness and educated expectations of appropriate working conditions, equipment and building
designers, managers and workpeople and all the other interested parties will gradually develop the necessary insights which should make problem-free VDT installation a routine. This learning curve, we consider, will take some 4 or 5 years to reach maturity in NW Europe. It will be repeated further along the timescale elsewhere. The approach which was used to tackle this problem combined occupational health, epidemiological and ergonomics techniques. Whilst all occupational health personnel receive some ergonomics training, the skills imparted are strictly limited yet the key figures in the success or failure of this process were the nurse assessors. The concept of using people trained to carry out defined and limited tasks is hardly new, having been used widely to train military personnel especially in World War II. In this case the process was used more creatively to develop new skills within existing personnel to provide not only a solution to a problem but also job enrichment and personal growth whilst spreading the application of ergonomics principles. It is a process we hope to develop further. To the social historian of the future, the health and safety issues which arose as the consequence of the rapid and widespread introduction of VDTs into the workplace will provide exemplary illustrations of the power and influence of the media and the particular prejudices and manoeuvrings of a number of interest groups - namely, trade unions, manufacturers, employers and government agencies. As part of this process, the conclusion might be drawn that the professional groups most directly concerned - ergonomists, hygienists, occupational health and safety specialists - responded to the challenges presented to them rather slowly and with a measure of heedlessness to the implications of this particular technological revolution. There are some excuses for this. Psychologically, the strongest of these has probably been the spurious familiarity of the television screen, forgetting perhaps that the screen is only one part of the total system of work. Further, VDTs were first being widely introduced, in Europe at least, at a time of economic shock and maximal stringency. They were thus seen by many as sheer necessity for the improvement of efficiency and thereby as some guarantee or talisman of survival. Finally, in the face of these exigencies, those interest groups who hoped to regulate and derive trade-offs from the introduction of new technology were forced into hyperbole with regard to hazard and risk. Unfortunately for them this was relatively rapidly and easily rebutted in several crucial instances with consequent credibility problems for the Jeremiahs. Little comfort can be drawn from this last point, it could have been different. References Knave, B., Wibom, R., Yoss, M., and Nyman, K.G.
1984,
An epidemiological study on VDU operators with special reference to eye strain and other medical symptoms. Proc XXI International Cong Occupational Health, 43(2), 379. A P P E N D I X I: Q u e s t i o n n a i r e f o r V D T o p e r a t o r s This questionnaire is being sent to VDU operators as well as a number of other people doing visual tracking jobs. It is to be a check that you are able to do this w o r k in comfort and w i t h o u t any problems. The replies you give are in medical confidence and will not be seen by anyone other
Applied Ergonomics
June 1988
101
than my staff. If your replies suggest that further investigation is needed you will be asked to come and see me or one of my nursing staff. Any further action following on from this interview will be agreed with you. This action may consist of a physical examination to assess the medical basis of your complaints and/or a visit to your worksite where the occupational health nurses, who have been specially trained for this task, will carry out the appropriate assessment. Any recommendations coming out of these assessments will be the basis of discussion between yourself, your manager and my department.
Dr A.J.M. Slovak Divisional Medical Officer
DEPARTMENT . . . . . . . . . . .
Questions 1. How long do you spend working with a screen each week? Circle the right percentage. 10
20
30
40
Y
N
Y
N
4. Is there room for all your work on the surface available?
Y
N
5. Are you able to do your work comfortably in the workstation as set up?
Y
N
6. If no to Q5 please state problems briefly . . . . . .
VISION
NAME . . . . . . . . . . . . . . . . . .
0
2. Is your table adjustable for height? 3. Do you have a lectern?
50
60
70
80
90
100 %
2. What sort of work do you mainly do? Circle the main job. word processing
1. Do you regularly get sore eyes?
Y
N
2. Do you regularly get red eyes?
Y
N
3. Do you regularly get pain behind the eyes?
Y
N
4. Do you regularly get blurred vision?
Y
N
5. Do you regularly get any other problems with the eyes?
Y
6. If YES to any of these do you attribute any of these complaints to your work?
Y
7. Have you had your eyesight checked in the last 4 years?
Y
N
data transfer other
0 THER
if other, describe here . . . . . . . . . . . . . . . . . . . . . . . . . . .
PH YSI CA L
FOR A L L OTHER QUESTIONS just circle O f o r (~for
YES or
NO as appropriate, i e: Do you like strawberries? Y / N
ILL UMINA TION 1. Can you adjust the intensity (strength) of the image on your screen?
Y / N
2. Is there any flicker on your screen?
Y / N
3. If yes, can you stop it?
Y / N
4. Are there any reflections from lights, windows, etc, on your screen?
Y / N
5. Do these cause any problems with your work?
Y / N
6. Is there any glare from shiny surfaces (e g, walls, notice boards, etc) in your room which interferes with your work? Y
N
7. Does the lighting in your room cause glare?
Y
N
8. Is the lighting in your room obtained from bare bulbs or bare fluorescent tubes?
Y
N
1. Is the seat adjustable for height?
Y
N
2. Does the seat provide comfortable back support?
Y
N
3. Is the seat otherwise comfortable?
Y
N
4. Do you have a footrest?
Y
N
Y
N
1. Do you regularly get neck or shoulder pain?
Y
N
2. Do you regularly get pain in your fingers?
Y
N
3. Do you regularly get pain in your wrists?
Y
N
4. Do you regularly get pain in your forearms?
Y
N
5. Do you regularly get pain in your lower back?
Y
N
6. If YES to any of these, do you attribute any of these complaints to your work?
Y
N
OTHER BODY SYSTEMS 1. Do you regularly get irritation on your face?
Y
N
2. Do you regularly get a rash on your face?
Y
N
3. Do you regularly get headaches?
Y
N
4. If YES to any of these, do you attribute any of these complaints to your work?
Y
N
5. Do you have any other symptoms which you feel may be related to your work? If YES, state below
SEA TING (for screen operation only)
SCREEN AND TABLE 1. Is the keyboard separately movable from the screen?
102
Applied Ergonomics
June 1988
Footnote From time to time the media carry stories about various health scares related to V D T use. We now have a thick file of stories which have come and gone. Should you wish to know about these in more detail you are welcome to discuss it with my staff in confidence or to ask for more information through your manager or your Health and Safety Committee. Suffice it to say that, at present, all but minor problems are rare.
Solving workplace problems associated with VDTs A.J.M. Slovak and C. Trevers Occupational Health Service, FisonsPharmaceuticalDivision, Loughborough, Leics LE11 0BB, UK The introduction of VDTs into the vast majority of modern working environments represents a substantial change in the disciplines of work for many people. This paper describes how the health and safety issues associated with this change were managed in one organisation by the acquisition of ergonomics skills and their combination with occupational health surveillance techniques. The results show that ergonomics problems far outweighed symptomatic complaints, but symptomatic complaints were strongly associated with high VDT occupancy. The processes used resulted in high response rates from VDT users and an excellent 'clear-up' rate of problems. The solution of these problems was quantified in terms of difficulty and cost.
Keywords: Working environment, visual display units, occupational health
Introduction In our occupational health units, early reports of VDT user problems usually centred on adverse symptomatic experiences. At first, these were investigated piecemeal and were found to be largely ameliorated by attention to basic ergonomics factors. Although the number of reports was relatively small, their growth was roughly proportional to the exponential growth in the number of VDTs being installed. Since it is well-recognised as a truism of occupational health practice that only a small proportion of problems will be voluntarily reported in any such situation, arrangements were made to investigate usage pro-actively and in a systematic way. Being then a new and complex subject, it was recognised that expertise would need to be acquired from outside the organisation to tackle the matter properly. Accordingly, a group of professional ergonomists were contracted to provide a one-day module of informationary assessment and problem-solving training for occupational health nurses specifically to deal with VDT related problems. This paper is a description of the process which ensued. An attempt was made to listen objectively to what workpeople were saying and to respond to it effectively. The techniques used were simple but directly based on ergonomics disciplines. They can be applied widely under the guidance of appropriately trained personnel.
information is confidential and in their control. This was clearly stated in the preamble. Also, the procedure to be used for responding to and acting upon the questionnaire was clearly outlined. A particularly important feature of the questionnaire was its differentiating of ergonomics and symptomatic problems so that their relationship could subsequently be explored. Finally, certain issues, such as reproductive health, will be seen to be absent. The main reason for this was one of questionable relevance. Nevertheless, it seemed important to offer reassurance and the opportunity for confidential discussion if desired. The questionnaire is to be found as an appendix to this paper. Respondents reporting ergonomics or symptomatic problems were followed up by the trained occupational health nurses. Solutions to problems were identified and remedies agreed between respondents, assessors and managers. This process was piloted on one major manufacturing site and an audit was performed of the immediate effectiveness of the process. This audit examined difficulty of solution of problems, accuracy of responses and the cost of agreed remedies.
Results
Methods
There was a 92% overall response rate in a target population of 205 persons. Some 68% of respondents described problems, 32% did not. An average of 2.5 problems per person reporting problems was found (range 1-8). Of these problems, 82% were ergonomics and 18% symptomatic. Details of certain of these problems are listed below.
First contact with VDT users was made by questionnaire administered through the internal mail. The questionnaire was designed to be comprehensive but simple and quick to answer. Certain features are worthy of special note. In order to obtain reliable answers and an adequately high response rate, respondents must be certain that the
The relationship between problem frequency and intensity of work is presented in Table 1. It should be noted that this problem frequency represents all problems (ergonomics and symptomatic). Problem averages and ranges are given for each 10% increment in VDT occupancy. A similar breakdown just for symptoms was not possible because of the
0003 6870/88/02 0099-04 $03.00 © 1988 Butterworth & Co (Publishers) Ltd
Applied Ergonomics
June 1988
99
Table 1: VDT occupancy vs problems reported
% VDU work
10
20
30
40
50
60
70
80
90
100
% persons complaining of problems
50
58
62
68
65
62
60
75
87
87
Range: No of problems
0-4
0-6
1-8
1-6
0--6
0-7
0--5
0-6
0--7
0-7
Average No of problems
1.72
1'81
2-72
3'20
2-55
1.55
1"44
3'25
3"40
4"00
Symptoms per person
0"45
relatively small numbers involved and here a comparison is given between greater and lesser than 50% VDT work. A large number of different ergonomics parameters were enquired into by the questionnaire and the more important of these are detailed below. The most important of these were problems of seating and space. With seating, adjustment, back support and overall comfort were recorded. In regard to space, an overall view was sought on ability to work on the allotted surfaces. Illumination problems were very frequent; they were also more easy to solve. In some cases flicker was unavoidable because equipment was operated at 'state of the art' limits with variable vector loading and here no solution was practicable. All these data are summarised in Table 2. Information was sought about eye disturbances, namely: sore eyes, red eyes, pain, blurring and other problems. Surprisingly, musculoskeletal problems were more common than eye problems if the former were lumped together, although hand, wrist and forearm symptoms of the type now Table 2: Principal ergonomics problems reported
(percentage of respondents reporting) Seating (adjustment, backcomfort, general)
20%
Lack of space
36% 6%
Flicker interfering with work
Reflections interfering with work
36%
Bare bulbs or fluorescent tubes
13%
Table 3: Symptomatic problems (work related in parentheses)
Eyes (combined)
24% (18%)
Hands, wrists, forearm
4% ( 3 % )
Neck
21% (14%)
Low back
23% (18%)
Rash - facial
4% (2%)
Headache
16% (10%)
1"26
referred to as repetition strain injury were quite uncommon. People were asked to differentiate between problems that they felt were associated with work and those that were not. It can be postulated that the difference between the numbers is a reflection of an appreciable level of underlying morbidity in the general population Table 3 illustrates these findings. Solutions to problems were scored as easy, fairly simple or hard. Costs were also scored on in a similar way, less than £10.00, less than £100.00, more than £100.00. Average cost per individual was about £300.00. Subjective impressions were also sought from assessors about whether problems were serious or not and whether respondents' attitudes to them were trivial or not (Table 4). Discussion Overall response rate to the survey questionnaires was vexy high at 92%. This suggests that people had something to say, were willing to say it and felt reasonably confident of evoking a meaningful response. Levels of problem reporting were high when compared with symptom-only surveys but in line with or a little lower than other VDT usage surveys (Knave et al, 1984). Simple problems of seating and surface space were frequent observations. The issue of seating has been widely addressed but simple workspace has not. It is a very basic requirement yet most published guidance documents are very coy about it. The experience of our respondents would suggest that an area of worksurface at least 100% greater than with typical typing work needs to be dedicated to the job when VDTs are used, unless all transactions are paperless. Manoeuvrability about the workstation and problems of work-plane variance were much less common. Sub-optimal illumination was also common as might be expected in offices and rooms which, in the main, had not been purpose-built or adapted for VDT operation. Reflections and glares from natural and artificial light sources did, however, prove generally easy to remedy once the problems were pin-pointed. This was also true of levels of illumination. The only exception to this was where space or more general room layout problems prevented satisfactory re-orientation of equipment.
Table 4: Audit of problems tackled
100
Difficulty
Easy 20%
Moderate 34%
Hard 65%
Cost
< £ 1 0 22%
< £ 1 0 0 13%
> £ 1 0 0 65%
Severity
Serious 64%
Not serious
Attitude
Reasonable95%
Trivial
Applied Ergonomics
June 1988
36%
5%
The results showed that ergonomics problems outweighed symptomatic problems in a ratio of approximately 4 to 1. Symptoms were overwhelmingly described in association with ergonomics problems and when found alone were usually due to pre-existing disease. People were well able to identify correlations between their problems and their work and usually did so soberly and without exaggeration. The results in Table 1 show an interesting relationship between VDT occupancy and the number of problems experienced. Whilst profound inferences should not be drawn from these data alone, it would seem reasonable to suggest that what we are observing here may be two different populations although no doubt they overlap. One population works at the VDT and the other with the VDT. The latter population, including such people as designers, programmers and scientists, largely occupies the 10-50% range. Their problem rates at low levels of usage are quite high, which suggests they may be willing to tolerate discomfort because VDT work is only an incidental part of the job. The increased problem rate moving towards 40-50% is mirrored by that in the other population - the secretaries and accounts personnel - at 80-100%. These findings nicely identify priority target groups for remedial action. The grading of difficulty of solutions to problems may seem rather vague and is perhaps best explained a little further. Easy tasks were those where simple alterations consequent on discussions between respondent and assessor solved the problem (e g, changing orientation of a terminal). Tasks of moderate difficulty required more complex interaction involving some input from managers and perhaps other departments (e g, office services, carpenters, etc). Such jobs might involve installing blinds or new chairs or desks. Difficult tasks were those where a prolonged series of negotiations, alterations, etc were necessary to effect satisfactory change. In these cases there was a more profound alteration of the physical parts of the work environment as well as changes in job organisation, rotation of jobs, etc. Crucial to dealing with the latter two categories was accurate identification of the problem and agreement on the necessary action. The nurse assessors proved efficacious catalysts to this process. The costs involved, on a per capita basis, are not insubstantial although relatively small in relation to the total spent on each terminal unit or, indeed, overall wage costs. Improvements in work efficiency can reasonably be expected in many cases but objective proof was not sought in this study. The best opportunity to do this would probably lie in a before/after study in a workmeasured fast-keying department. Historically, guidance on VDT installation was offered in an in-house document supplemented by manufacturer's literature. In retrospect, it is apparent that managers and staff found all these sources of guidance difficult to apply practically. What seemed very clear to people in the front line was the shortage of realistic, down-to-earth experience of what the problems were likely to be and how they could sensibly be solved. From the experience that we have gained from this survey, perhaps .much more than from the growing scientific literature on the subject, we have produced a much modified revision of our guidance which addresses these problems. With heightened awareness and educated expectations of appropriate working conditions, equipment and building
designers, managers and workpeople and all the other interested parties will gradually develop the necessary insights which should make problem-free VDT installation a routine. This learning curve, we consider, will take some 4 or 5 years to reach maturity in NW Europe. It will be repeated further along the timescale elsewhere. The approach which was used to tackle this problem combined occupational health, epidemiological and ergonomics techniques. Whilst all occupational health personnel receive some ergonomics training, the skills imparted are strictly limited yet the key figures in the success or failure of this process were the nurse assessors. The concept of using people trained to carry out defined and limited tasks is hardly new, having been used widely to train military personnel especially in World War II. In this case the process was used more creatively to develop new skills within existing personnel to provide not only a solution to a problem but also job enrichment and personal growth whilst spreading the application of ergonomics principles. It is a process we hope to develop further. To the social historian of the future, the health and safety issues which arose as the consequence of the rapid and widespread introduction of VDTs into the workplace will provide exemplary illustrations of the power and influence of the media and the particular prejudices and manoeuvrings of a number of interest groups - namely, trade unions, manufacturers, employers and government agencies. As part of this process, the conclusion might be drawn that the professional groups most directly concerned - ergonomists, hygienists, occupational health and safety specialists - responded to the challenges presented to them rather slowly and with a measure of heedlessness to the implications of this particular technological revolution. There are some excuses for this. Psychologically, the strongest of these has probably been the spurious familiarity of the television screen, forgetting perhaps that the screen is only one part of the total system of work. Further, VDTs were first being widely introduced, in Europe at least, at a time of economic shock and maximal stringency. They were thus seen by many as sheer necessity for the improvement of efficiency and thereby as some guarantee or talisman of survival. Finally, in the face of these exigencies, those interest groups who hoped to regulate and derive trade-offs from the introduction of new technology were forced into hyperbole with regard to hazard and risk. Unfortunately for them this was relatively rapidly and easily rebutted in several crucial instances with consequent credibility problems for the Jeremiahs. Little comfort can be drawn from this last point, it could have been different. References Knave, B., Wibom, R., Yoss, M., and Nyman, K.G.
1984,
An epidemiological study on VDU operators with special reference to eye strain and other medical symptoms. Proc XXI International Cong Occupational Health, 43(2), 379. A P P E N D I X I: Q u e s t i o n n a i r e f o r V D T o p e r a t o r s This questionnaire is being sent to VDU operators as well as a number of other people doing visual tracking jobs. It is to be a check that you are able to do this w o r k in comfort and w i t h o u t any problems. The replies you give are in medical confidence and will not be seen by anyone other
Applied Ergonomics
June 1988
101
than my staff. If your replies suggest that further investigation is needed you will be asked to come and see me or one of my nursing staff. Any further action following on from this interview will be agreed with you. This action may consist of a physical examination to assess the medical basis of your complaints and/or a visit to your worksite where the occupational health nurses, who have been specially trained for this task, will carry out the appropriate assessment. Any recommendations coming out of these assessments will be the basis of discussion between yourself, your manager and my department.
Dr A.J.M. Slovak Divisional Medical Officer
DEPARTMENT . . . . . . . . . . .
Questions 1. How long do you spend working with a screen each week? Circle the right percentage. 10
20
30
40
Y
N
Y
N
4. Is there room for all your work on the surface available?
Y
N
5. Are you able to do your work comfortably in the workstation as set up?
Y
N
6. If no to Q5 please state problems briefly . . . . . .
VISION
NAME . . . . . . . . . . . . . . . . . .
0
2. Is your table adjustable for height? 3. Do you have a lectern?
50
60
70
80
90
100 %
2. What sort of work do you mainly do? Circle the main job. word processing
1. Do you regularly get sore eyes?
Y
N
2. Do you regularly get red eyes?
Y
N
3. Do you regularly get pain behind the eyes?
Y
N
4. Do you regularly get blurred vision?
Y
N
5. Do you regularly get any other problems with the eyes?
Y
6. If YES to any of these do you attribute any of these complaints to your work?
Y
7. Have you had your eyesight checked in the last 4 years?
Y
N
data transfer other
0 THER
if other, describe here . . . . . . . . . . . . . . . . . . . . . . . . . . .
PH YSI CA L
FOR A L L OTHER QUESTIONS just circle O f o r (~for
YES or
NO as appropriate, i e: Do you like strawberries? Y / N
ILL UMINA TION 1. Can you adjust the intensity (strength) of the image on your screen?
Y / N
2. Is there any flicker on your screen?
Y / N
3. If yes, can you stop it?
Y / N
4. Are there any reflections from lights, windows, etc, on your screen?
Y / N
5. Do these cause any problems with your work?
Y / N
6. Is there any glare from shiny surfaces (e g, walls, notice boards, etc) in your room which interferes with your work? Y
N
7. Does the lighting in your room cause glare?
Y
N
8. Is the lighting in your room obtained from bare bulbs or bare fluorescent tubes?
Y
N
1. Is the seat adjustable for height?
Y
N
2. Does the seat provide comfortable back support?
Y
N
3. Is the seat otherwise comfortable?
Y
N
4. Do you have a footrest?
Y
N
Y
N
1. Do you regularly get neck or shoulder pain?
Y
N
2. Do you regularly get pain in your fingers?
Y
N
3. Do you regularly get pain in your wrists?
Y
N
4. Do you regularly get pain in your forearms?
Y
N
5. Do you regularly get pain in your lower back?
Y
N
6. If YES to any of these, do you attribute any of these complaints to your work?
Y
N
OTHER BODY SYSTEMS 1. Do you regularly get irritation on your face?
Y
N
2. Do you regularly get a rash on your face?
Y
N
3. Do you regularly get headaches?
Y
N
4. If YES to any of these, do you attribute any of these complaints to your work?
Y
N
5. Do you have any other symptoms which you feel may be related to your work? If YES, state below
SEA TING (for screen operation only)
SCREEN AND TABLE 1. Is the keyboard separately movable from the screen?
102
Applied Ergonomics
June 1988
Footnote From time to time the media carry stories about various health scares related to V D T use. We now have a thick file of stories which have come and gone. Should you wish to know about these in more detail you are welcome to discuss it with my staff in confidence or to ask for more information through your manager or your Health and Safety Committee. Suffice it to say that, at present, all but minor problems are rare.