workplace ergonomic conditions -case study

THE ERGONOMIC CONDITIONS 1

The Ergonomic Conditions of Nekita’s Computer Workstation

Jelissa Edwards

Nekita Linton

University of the West Indies Open Campus


The Ergonomic Conditions of Nekita’s Computer Workstation

According to Nekita (2015), “ergonomics is the study of the interface between the

worker, work methods, equipment and the working environment” (p. 27), while ergonomic

hazards refer to any of the aforementioned factors that have the potential to cause harm in the

workplace. Nekita’s computer workstation (including the equipment and working environment)

poses a threat to her health because it is not ergonomically friendly. Thus, it is considered an

ergonomic hazard; which explains her recent complaints regarding wrist pain, back pain, sore

eyes, headaches, and shoulder and neck pain. There are several possible medical diagnoses for

Nekita’s symptoms that would be threatening not only to her health but also to the organization.

She could be experiencing several repetitive strain injuries (RSIs), such as carpel tunnel in the

wrist caused by a non-ergonomically friendly keyboard, long hourly use of a computer mouse, or

a poorly positioned keyboard/mouse. Furthermore, another RSI Nekita may be experiencing is

lumbar back strain or sprain caused by a non-ergonomically friendly chair that doesn’t support

the lower back, a poorly positioned desk that forces bending or slouching, or poor posture while

sitting. She might also be experiencing eyestrain caused by improper lighting (dim or bright

light), glare from the computer monitor, or a poorly positioned monitor not at eye level.

Additionally, eyestrain can often lead to temple headaches; however, the constant ringing noise

from a telephone could also be a cause of this. In addition, she could be affected by inflammation

of the shoulders and neck caused by constantly holding a telephone between her shoulders and

neck or by a poorly positioned desk and computer monitor that forces bad posture.

Understanding the definition of ergonomics and ergonomic hazards such as those currently

present in Nekita’s workplace and the importance for much-needed improvements based on

Nekeita’s health complaints is self-explanatory. Ergonomics in the workplace are important


because they aid in the protection of employees, staff, and customers. Thus,I recommend

rearranging Nekita’s computer workstation.

Repetitive Strain Injuries (RSIs)

Computers have changed the way organizations do business today, and their use

continues to rise. Kahn (2003) indicated that the use of computer technology increased from 25%

in 1984 to nearly 45% in 1993, and since then the percentage has continued to increase in the

United States. Although computer technology has its benefits, it’s also important to consider its

disadvantages, such as those noted by Kahn (2003) as “reports of adverse health effects to

computer operators” (p. 93). One adverse health effect to which computer operators are prone is

repetitive strain injuries (RSIs), defined by Scott (2015) in his article as a “cumulative trauma

disorder (CTD) stemming from prolonged repetitive, forceful, or awkward hand movements”

resulting in “damage to muscles, tendons, and nerves of the neck, shoulder, forearm, and hand”

(para. 3–6) . An RSI, which refers to a family of medical diagnoses, can affect more than just

these areas, including the back and the eyes.

Carpel Tunnel Syndrome

Carpel tunnel syndrome, as illustrated by Kahn (2003), is a member of the RSI family

and is defined as “a chronic condition characterized by numbness, tingling, and pain in the

thumb, index, and middle fingers” (p. 68). It is a result of pressure being applied to the median

nerve, which passes through the carpel tunnel syndrome, understood to be a ligament located at

the front of the wrist (Kahn, 2003). Additionally, Kahn (2003) explained that carpel tunnel

syndrome occurs when the wrist is subjected to constant stress and strains such as “gripping or

pinching with the wrist held flexed” (p. 68) . Computer operators like Nekita may experience

constant stress on the wrist due to non-ergonomically friendly keyboards (those with a wrist rest


to be more precise). According to Hedge (2014), based on a study done by Dr. David Rampell,

“a wrist rest can actually increase pressure inside the carpal tunnel by compressing the

undersurface of the wrist” (para. 10). The research stated the applied pressure beneath the wrist

(intracarpel pressure) that enters the carpel tunnel via the transverse carpel ligament is doubled

with the use of a wrist rest. Another thing that could be the cause of stress on Nekita’s wrists is

her constant use of a computer mouse. The constant clicking, scrolling, holding, and moving of

the mouse can cause fatigue and strain. Furthermore, a poorly positioned keyboard/mouse tray

that is either too low or too high forces stretching and awkward positioning of the hands and

bending of the wrists, which may also lead to strains or sprains.

Solutions. There are a few solutions that can reduce carpel tunnel strain. According to the

website Carpel Tunnel Headquarters, it is important to consider a few objectives for providing a

computer workstation that’s ergonomically friendly. One suggestion is the selection of what is

described as a “proper keyboard.” Carpel Tunnel Headquarters has suggested an ergonomic, V-

shaped keyboard that is affixed “to the natural human form when typing” (para. 10). Although

the websites has also stated that using a V-shaped keyboard takes some getting used to, it is also

considered beneficial, and one without a wrist rest is considered best. The reason for this is, as

mentioned earlier, that studies have proved wrist rests can also cause carpel tunnel injury with

improper use. Nonetheless, Hedge (2014) explained that, if using a wrist rest, the palms (not the

wrists) should be placed on the wrist rest.

Rest breaks are another considered solution for persons that use the computer for

prolonged hours. Prolonged use of a computer mouse can eventually become stressful on the

wrists, which is part of the reason Hedge (2014) suggested “rest breaks” “every 30 to 60

minutes” (para. 10).


Additionally, an adjustable keyboard/mouse tray that is capable of a negative tilt was

considered by Hedge (2014) to be highly recommended. An adjustable keyboard/mouse tray

allows the mouse to be used with the upper arms relaxed and close to the body and the “wrist in a

comfortable and neutral position” (para. 3).

Asthenopia (Eyestrain)

Apart from carpel tunnel syndrome, asthenopia (eyestrain) is also an RSI. As Kahn

(2003) noted, “Eyestrain and eye irritation are among the most frequent complaints of computer

operators” (p. 94). Asthenopia, as illustrated by Dahl (2014), is caused by concentrating the eyes

on a visual such as a computer monitor for long periods, “straining to see in very dim light, and

exposure to extreme brightness or glare” (para. 4). As such, regarding Nekita’s complaints of

sore eyes, asthenopia (eyestrain) may be what she’s experiencing. Based on the information

given earlier, this could be due to exposure to bright lighting coming from her computer monitor

or dim lighting that’s forcing Nekita to squint for a better visual. Glare from the computer screen

that causes squinting, long hours at the computer that exert fatigue, and the positioning of the

computer monitor are all factors at her workstation that could contribute to the stress and strain

being placed on her eyes. Dahl (2014) noted in his article a few of the symptoms that his patients

diagnosed with asthenopia experienced. Similar to those that Kahn (2003) listed, these symptoms

include sore eyes, blurred or doubled vision, and, the most common, temple headaches. Nekita is

also experiencing headaches, which could be triggered by noise (such as the loud, continuous

ringing of a telephone); however, eyestrain or asthenopia, which she may have, could also be a

contribution.

Solutions. Carpel Tunnel Headquarters and Hedge (2014) suggested throughout their

articles avoiding bright lighting and glare from computer monitors by using anti-glare screens


and a reasonable level of lighting on personal computers (PCs). Computer monitors in front of

windows sometimes cause a washed-out appearance on the display screen, making it difficult to

see; as a solution Hedge (2014) suggested either covering windows with drapes or using a shade

for regulation.

Apart from bright lighting, dim lighting too low to see clearly can also be regulated by

changing the lighting, usually available in a computer’s settings, to one that’s more appropriate

for the computer operator.

Taking one-minute eye breaks every fifteen minutes is also another solution for

asthenopia (eyestrains). According to Hedge (2014) staring at the computer screen for too long

alters the eyes’ natural functionality, forcing them to blink less often, and in doing so, the eyes

are exposed to excessive amounts of air. Hedge (2014) also recommended looking at an object

that is at least twenty feet away and blinking rapidly during breaks; this allows the eye muscles

to relax, refreshes the tear film, and clears dust from the eyes. Since headaches are associated

with eyestrain, eye breaks can also reduce headaches.

However, loud noises, which can also be the cause of headaches, can either be measured

and reduced to a more acceptable level or masked with white noise. Hedge (2014) recommended

low-volume music such as light classical tunes “to mask the hum of any fans or other sound

sources” (para. 10).

Tendinitis (Neck and Shoulders)

Another member of the RSI family is tendinitis. It is defined by Kahn (2003) as an

inflammation or irritation of a tendon, a thick fibrous cord that attaches muscle to bone or muscle

to muscle. Therefore, tendinitis can affect any area of the human body that contains muscles and

bones. Kahn (2003) continued to explain that its symptoms may include but aren’t limited to


“pain and swelling, numbness and tingling (hands falling asleep), loss of strength, and reduced

range of motion” (p. 94). Computer operators can be victims of tendinitis—as in Nekita’s case—

within the neck and/or the shoulders. Inflammation of the neck and shoulders can occur due to

constantly holding a telephone between the shoulders and neck in a pinching motion or having a

desk that is to low, causing Nekita to tense and clinch her shoulders while bending her neck to

get a better visual of the computer monitor. Additionally, a poorly positioned monitor (whether

on the right desk height or not) could also be causing Nekita to tense her shoulders and bend her

neck for the same purpose.

Solutions. The use of handheld telephones in the workplace can be difficult for

receptionists. They need their hands to jot things down or search information as they accept

incoming calls from customers requesting information or callers leaving messages. In most

cases, both hands are needed, and thus, receptionists tend to hold the telephone between their

shoulders and neck in a pinching position that can eventually cause injury. To avoid holding the

telephone in such an awkward position, Carpel Tunnel Headquarters suggested the use of

“telephone headsets,” which allow computer operators to keep their heads upright and their

shoulders relaxed.

Another solution for avoiding tendinitis of the shoulders and neck is to adjust the

computer desk and monitor to an appropriate height. According to Hedge (2014), a computer

desk should be a flat surface “between 28”–30” above the floor (suitable for most adults)” (para.

3). This allows receptionists to use the surface for writing as well. As for the computer monitor,

which can also place strain on the neck and shoulders, Hedge (2014) suggested it be placed at a

height that prevents users from tilting their head and or “craning” their necks forward. The

computer monitor should “be in line with a point on the screen about 2–3” below the top of the


monitor casing (not the screen)” (Hedge, 2014, para. 6). A technique used to indicate if one’s

screen is in the correct position is to sit around 100–110 degrees back in a chair with one hand

stretched out and the middle finger pointed horizontally at the screen. According to Hedge

(2014), the middle finger should be within the center of the screen—that’s “17–18 degrees below

horizontal for optimal viewing” (para. 6). He also indicated that one should make suitable

adjustments when this isn’t the case.

Lumbar Back Sprains and Strains (Lower Back Pain)

Kahn (2003) shared research done by the Bureau of Labor Statistics (BLS) that indicated

“more than 1 million workers suffer back injuries each year, and back injuries account for one of

every five workplace injuries or illnesses” (p. 37). Back injuries such as lumbar back sprains or

strains are RSIs caused by overuse or overstretching. The American Association of Neurological

Surgeons (2005) indicated that patients diagnosed with lumbar back sprains and/or strains

experience symptoms such as pain of the lower back, stiffness, lack of mobility, and muscle

spasms .

Nekita is experiencing back pains that could possibly be a strain or sprain of the lower

(lumbar) back. This could be due to a non-ergonomic chair that doesn’t support the lower back

or other areas where support is needed. Another reason for her back pain could be an improperly

positioned desk that forces her to bend and slouch in a manner commonly described as sitting

with a “hunched back.” In fact, most, if not all, RSIs are simply the result of poor posture at a

computer workstation. In some cases, poor posture is habitual, while in other cases, it is a

deliberate behavior. Either can cause injuries that aren’t necessarily connected to or the result of

a non-ergonomic computer workstation or workplace. In fact, poor posture is one of the largest

contributors to RSIs such as the lumbar back strain/sprain in this case. Habitual and deliberate


poor posture is viewed as a self-inflicted injury that may result in loss of work hours,

jeopardizing and altering an organization’s management of its resources.

Solutions. One of the solutions to tendinitis of the shoulders and the neck is to adjust

desks to a suitable height to avoid craning the neck forward and/or tilting the head. Additionally,

a poorly positioned desk that’s too high or too low can also cause a person to arch his/her back to

cope with the desk’s height. Arching the back can cause repetitive strain injuries to the lower

back, as indicated earlier.

Providing a chair that supports the lower back can also help prevent RSI lumbar sprains

and strains. According to Hedge (2014), studies have shown that “the best seated posture is a

reclined posture of 100–110 degrees NOT the upright 90 degree posture that is often portrayed”

(para. 4). Therefore, when purchasing a chair one should consider ergonomic features that

incorporate a 100–110-degree sitting posture.

Speaking of posture, Hedge (2014) stressed that “good posture is the basis of good

workstation ergonomics” (para. 7). As such, Hedge (2014) strongly recommended watching a

computer operator’s posture and:

Make sure that the user can reach the keyboard keys with their wrists as flat as possible

(not bent up or down) and straight (not bent left or right).Make sure that the user's elbow

angle (the angle between the inner surface of the upper arm and the forearm) is at or

greater than 90 degrees to avoid nerve compression at the elbow. Make sure that the

upper arm and elbow are as close to the body and as relaxed as possible for mouse use -

avoid overreaching. Also make sure that the wrist is as straight as possible when the

mouse is being used. Make sure the user sits back in the chair and has good back support.

Also check that the feet can be placed flat on the floor or on a footrest. Make sure the


head and neck are as straight as possible .Make sure the posture feels relaxed for the

user.. (para. 7)

Conclusion

In conclusion, Nekita may be experiencing repetitive strain injuries (RSI), which are

understood to be injuries that occur due to recurrent, constant, improper positioning of the body.

RSI is a name for a particular set of injuries. These include injuries such as carpel tunnel

syndrome, asthenopia (eyestrain), tendinitis, and lumbar back sprain and strain, all of which

could be possible diagnoses to explain Nekita’s complaints, including: wrist pains (associated

with carpel tunnel syndrome), sore eyes (associated with eyestrain), neck and shoulder pains

(associated with tendinitis), and lower back pains (associated with lumbar back sprain or strain).

Nekita’s RSIs could be due to a workstation that is not ergonomically friendly. Several things

could possibly be wrong with Nekita’s workstation. For instance, carpel tunnel syndrome could

be due to excessive use of a computer mouse or improper use of the keyboard; asthenopia, also

known as eyestrain, could be due to improper lighting; tendinitis of the neck and shoulders could

be due to a poorly positioned desk at an improper height; and lumbar back strain or sprain could

be due to habitual or deliberate poor posture.

Regardless of Nekita’s injuries being current, her organization could still take a reactive

approach and rearrange her computer workstation to one that’s ergonomically friendly. In doing

so, the organization must ensure solutions that aid in the improvement of Nekita’s health,

including those that focus on the type of furniture (desk and chair), computer equipment

(keyboard, mouse, and monitor), the amount of hours spent at the computer, lighting, noise, other

ergonomic devices (telephone headset and glare filter), and most importantly, her posture.


References

American Association of Neurological Surgeons. (2005, September). Low back strain and sprain.

American Association of Neurological Surgeons. Retrieved from http://goo.gl/rCk6Pk

Carpal Tunnel Syndrome Headquarters. (N.d.). What are some ergonomic solutions for carpal

tunnel relief? Carpal Tunnel Syndrome Headquarters. Retrieved from

Dahl, A. (2014, January 5). Eye strain.MedicineNet. Retrieved from

http://www.medicinenet.com/eye_strain/article.htm

Hedge, A. (2014, December 15). Ergonomic guidelines for arranging a computer workstation—

10 steps for users. Cornell University Ergonomics Web. Retrieved from

http://ergo.human.cornell.edu/ergoguide.html

Kahn, P. A., & Meyer, H. D. (2003). The encyclopedia of work-related illnesses, injuries, and

health issues. New York, NY: Facts on File.

Linton, N. (2015, March 2). Unit 3 assessment and control of safety and health hazards and risks

PDF File. Retrieved from http://2014.tle.courses.open.uwi.edu/mod/resource/view.php?

id=30936

Scott, C. (2015, February 13). Repetitive strain injury. Electrical Engineering and Computer

Science University of Michigan. Retrieved from

http://web.eecs.umich.edu/~cscott/rsi.html##symptoms

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