National Institute for Working Life Ergonomic Expert Committee Document No 1Visual Display Unit Work and Upper Extremity Musculoskeletal DisordersA Review of Epidemiological Findings
Year: 1997
Type: report
Abstract: A review has been undertaken of the epidemiological literature on work with visual display units (VDUs) and neck or upper extremity musculoskeletal problems among office workers. The questions to be answered are whether there is an increased risk of such disorders among VDU users, compared with people working in other types of jobs, and : if so : which specific feature(s) of the VDU device or the work environment are responsible. In addition, the question of whether women using VDUs are at even greater risk than men, and if so, why, has also been investigated. Comprehensive and up-to-date reviews summarising current epidemiologic knowledge about such factors for musculoskeletal problems among VDU users are scarce. This report therefore summarises current epidemiological evidence concerning increased risks of upper extremity and neck disorders among VDU users, what specific features of the VDU device or work environment that may be involved; and whether women using VDUs are at even greater risk than men. A total of 72 relevant reports from 56 epidemiologic studies have been identified. Most were published in peer-reviewed journals, although a few studies have been included from peer-reviewed conference proceedings or technical reports from national research institutions. Only papers written in English or Swedish have been reviewed. These studies cover a range of health endpoints, from non-specific discomfort to median nerve conduction velocity through the carpal tunnel, and a range of exposures from VDU work per se to specific task types, rest break patterns, and keyboard configurations. There is also a great variety in study designs and populations; some studies have compared VDU operators to other employed groups, such as non-VDU clerical workers, and others have used internal comparisons, within groups of VDU users, to examine the effects of many specific features of the VDU work environment. In general, however, inadequate attention has been paid to the consequences of the choice of study population and the range of exposures within which statistical associations or dose-response relationships can be examined. Some general conclusions regarding VDU work and musculoskeletal didsorders emerge from this review. These conclusions are supported both by studies of questionnaire-reported symptoms and studies utilising objective findings from physical examinations or diagnoses. For disorders of the hand and wrist, we found evidence that the use of the VDU or the keyboard was a direct causative agent, mediated primarily through repetitive finger motion and sustained muscle loading across the forearm and wrist. The odds for such disorders among VDU users with at least 4 hours of keyboard work per day appear to be about twice that of those with little or no keyboard work. For neck and shoulder problems, the role of the VDU or the VDU work seems to be less that of a single source of mechanical stresses and more the central feature around which modern office work is organised. This increasingly common pattern of VDU work organisation, with both physical (repetitive finger motions) and work organisational features (task fragmentation), is perhaps less typical of a number of other work environments. Thus, VDU work is often used as a proxy variable, that is, as a symbol which represents this particular combination of exposures. Although not all specific factors have been adequately studied, either singly or in combination with each other, there is convincing evidence regarding some. Strong evidence exists for elevated risks of upper extremity disorders with data entry and similar intensive keying tasks, and for hand and wrist disorders, at least, with hours of keying per day. High work demand and postural stress resulting from poor work-station design and layout also increase the risk of upper extremity disorders. Thus, there is : in our opinion : a scientific basis that justifies ergonomic and work organisation interventions to improve work situations characterised by these conditions. Among VDU workers, upper extremity and neck musculoskeletal disorders are more common among women. Specific reasons for this gender difference have not been fully identified, although they could include differences in job types, housework and childcare, body size and strength, hormonal or other physiological conditions. When men and women were compared within fairly homogenous job groups, they reported similar rates of MSDs. However, few studies have unfortunately been able to compare women and men doing similar VDU tasks.
Authors: Laura Punnett, Ulf Bergqvist
Language: English
Subfield: Social Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2578631630