International Journal of Industrial Ergonomics
Self-reported working conditions of VDU operators and associations with musculoskeletal symptoms: a cross-sectional study focussing on gender differences
Introduction
In recent years, the occurrence of work-related musculoskeletal disorders in the neck and upper limbs, such as finger extensor and flexor tendinitis, carpal tunnel syndrome and neck-shoulder myofascial pain, has increased dramatically and now account for nearly 70% of reported occupational illnesses in the USA (Bureau of Labour Statistics, 1996). Computer-intensive workplaces report a high prevalence and incidence of such disorders among the workers (Bergqvist et al., 1995; Faucette and Rempel, 1994; Punnett and Bergqvist, 1997; Tittiranonda et al., 1999). Among the working population in Sweden today, 68% of all men and 63% of all women use personal computers at work. Computerised work is likely to increase (SCB, 1999; Ekman et al., 2000). Of all reported work injuries due to musculoskeletal illness in Sweden, work with computer equipment was reported as the cause of the problems among 13% of the women and 4% of the men in 1998, compared with 6% and 1%, respectively, in 1992 (Wigaeus Tornqvist et al., 2001a).
Several epidemiological studies show that intensive computer work and factors related to work organisation, as well as physical and psychosocial exposures in computer work, are associated with increased risk of neck and upper extremity disorders (Tittiranonda et al., 1999; Ekman et al., 2000; Wigaeus Tornqvist et al., 2001a).
Studies of modern working conditions report substantial changes in work organisation and work content, concerning factors like downsizing, just-in-time jobs, time pressure, job demands and decision latitude (Aronsson, 1999; Härenstam et al., 2001). To a great extent this also concerns computerised modern work.
New technical devices are continuously being introduced to supplement the keyboard, such as the computer mouse, track-ball, computer pen, pointer, track-point, track-pad and even voice control. A good ergonomic design of the computer workstation is important to avoid musculoskeletal disorders (Sauter et al., 1991; Karlqvist, 1998; Aarås et al., 1999). The design is also important for comfort, productivity and quality of the VDU-produced work (Tittiranonda et al., 1999; Jensen et al., 2001).
Exposures relevant to the occurrence of musculoskeletal disorders include both physical workload and the organisation of work in general (Punnett and Herbert, 2000). There is scientific evidence of cause-and-effect relationships between repetitive motion, forceful work, and postural stress for disorders of the back and upper extremities (Bernard, 1997). The risk is particularly high when two or more of these job features are simultaneous and exert synergistic effects. Thus, primary prevention of musculoskeletal disorders in the workplace should include ergonomics programs that emphasize, e.g. the ergonomic design of workstations, equipment, tools, and work organisation to fit the capabilities and limitations of the human body (Hagberg et al., 1995; Westgaard and Winkel, 1997). Work organisation determines, e.g. work pace, repetitiveness, duration of exposures, and recovery time as well as psychosocial dimensions of the work environment such as decision latitude, psychosocial job demands, and social support from supervisors and among co-workers. High psychological work demands typically involve both rapid physical work pace and feelings of time pressure. Highly stereotyped finger motion patterns occur when a manual job both is monotonous and offers little decision autonomy (Punnett and Herbert, 2000).
Being a female is often described as a “risk factor” for many musculoskeletal disorders because prevalence in the general population and in large groups of employees have been reported to be twice as high among women compared to men (Viikari-Juntura et al., 1991; de Zwart et al., 1997). As Punnett and Herbert (2000) point out, depending of the gender segregated labour market it is essential to distinguish between gender differences in crude prevalence or risk and differences in the effects of occupational exposures on musculoskeletal outcome. The associations of musculoskeletal disorders with gender and occupational ergonomic exposures should be assessed separately in order to determine whether women are at increased risk when exposed to the same ergonomic stressors as men.
The aim of the present study was to describe working conditions and the prevalence of musculoskeletal symptoms among male and female VDU operators, and to assess associations between work-related physical and psychosocial exposures, respectively, and neck and upper limb symptoms, and whether these associations differed between women and men.
Section snippets
Study design
The present study is the baseline of a prospective cohort study aiming at identifying risk and preventive factors for musculoskeletal disorders and impaired performance during work with a computer mouse and other input devices.
Information about symptoms, work organisation, work content, physical, psychosocial and individual factors during the preceding month was collected by questionnaire at baseline.
Together with the employers and the Occupational Health Care Centres of the different work
Working hours and tasks
Ordinary working hours for the men were 39 (SD:3.9) h/week and 37 (SD:6.0) for the women. Among the men, 69% worked overtime with an average of 4.1 (SD:4.2) h/week, and among the women, 63% with an average of 3.2 (SD:5.0) h/week. Computer work was the most common work task for both men and women, averaging 3.6 h/day and 3.9 h/day (Table 1). Only three men and five women had not done computer work during the last month. Dominating work tasks, besides computer work, lasting for at least 30 min/day,
Discussion
The results from this study confirm associations between earlier suggested harmful exposures among VDU operators and symptoms in the neck/shoulders, shoulder joint/upper arms and elbow/forearm/hands (Punnett and Bergqvist, 1997; Tittiranonda et al., 1999). Such harmful exposures include work organisational as well as physical and psychosocial exposures (Wells et al., 2001).
Acknowledgements
Financial support from the Swedish Work Environmental Fund is greatly acknowledged. We are also grateful to all work sites and subjects who participated in the study and to everybody in the “Epi-mouse group” who contributed with highly qualified work in the data collection.
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