VDTs May Be Key to Office Injuries

The ubiquitous video display terminal that created a post-industrial revolution in the office is increasingly being fingered as the No. 1 occupational hazard for white-collar workers.

Wrist injuries, eyestrain, aching shoulders, stress anxiety and miscarriages have been blamed on the terminals, though there is only inconclusive evidence that VDT use is the direct cause of such health problems.

But worker compensation claims are mounting in offices, regulatory agencies are citing employers for unsafe offices, several local governments are considering measures to regulate VDT use, and afflicted employees are suing a computer manufacturer for allegedly faulty design.

Although questions have been raised about vision damage and effects on pregnancy--with uncertain results from studies of those problems--the VDT is most clearly linked to repetitive-strain injuries of the wrist, arm and shoulder.

Repetitive-strain injuries--called RSI--which result from rapid, repeated and stressful motions, rank as the nation’s leading occupational medical disorders, and more and more cases are being tied to office work. From 1985 to 1987, the number of cases doubled to nearly 73,000, according to the Bureau of Labor Statistics.

The symptoms--pain, numbness and tingling in wrist, hand or arm--can go away with proper rest and treatment, or, as with the debilitating carpal tunnel syndrome that affects the wrist, they can lead to nerve damage that requires surgery.

About 5 million Americans suffer from job-related motion injuries, according to an estimate by the National Institute of Occupational Safety and Health, which projects that more than half of the U.S. work force may be vulnerable to RSI over the next decade.

The American Academy of Orthopedic Surgeons estimates that such injuries cost $27 billion a year in medical treatment and lost income.

“It’s the industrial disease of the information age,” said Rep. Tom Lantos (D-Calif.), whose committee held hearings this year on RSI in the workplace.

RSI is not a new ailment; old-time telegraph operators suffered from a variation called “glass elbow.” But until recently, RSI was mostly limited to factory work.

The proliferation of computers in the workplace has moved that complaint into the office. Nearly 40 million computer terminals--used regularly by about 28 million workers--are installed in U.S. workplaces. Many users are punching up to 18,000 strokes an hour.

In surveys of their members by two unions, the Communications Workers of America and the Newspaper Guild, at least 20% of VDT users reported symptoms of motion injury.

“We’ve seen a truly catastrophic occurrence rate reported,” said David LeGrande, safety coordinator for the Communications Workers. Between 35% and 65% of telephone office workers reported symptoms of RSI in a survey last year of 12,000 union members, he said. More than 20% of telephone operators responding had medically diagnosed wrist and elbow disorders.

The Center for Office Technology, representing VDT manufacturers and buyers, views such complaints as an employee comfort issue that can be resolved by education and proper work practices.

Troubling questions have also been raised about possible health effects of electromagnetic radiation from VDTs, amid reports of high miscarriage rates among some groups of office workers and conflicting data from tests on laboratory animals.

A recent Louis Harris poll conducted for Steelcase Inc., a manufacturer of office furniture, found a surprisingly high 49% of those who use VDTs heavily expressing concern about possible harmful radiation from VDT screens.

But NIOSH, which has measured radiation from VDTs made by dozens of manufacturers, has “not found any VDT emitting radiation of any consequence.”

The agency is sponsoring two epidemiological studies of female office workers who use computers to determine effects on health and pregnancy.

Sweden and other European countries regulate the design and use of VDTs, but there is no government standard in the United States. International Business Machines Corp. sells a low-radiation VDT in the countries with regulations, but not in the United States. Some manufacturers are developing shields, which have been installed in a few U.S. offices, to inhibit electromagnetic radiation.

But most user complaints have centered on chronic pain and crippling injuries of the hands, wrists and arms.

In 1988, the federal Occupational Safety and Health Administration issued its first citation for office injuries linked to VDTs, targeting the Denver offices of U.S. West, where nearly 40% of 500 phone operators suffered painful repetitive-strain injuries.

The company spent more than $2 million on consultants and adjustable chairs, desks and keyboards, plus an estimated $5 million on employee medical costs. But more cases have been diagnosed since the renovations, including some involving new employees.

Some employees in the U.S. West office are suing the manufacturer of the terminals they used, claiming that improper design caused their wrist and arm injuries. The case is pending.

The Communications Workers union, which pressed the Denver complaints with OSHA, now reports an even more serious incidence in U.S. West’s Phoenix offices: 80 cases of carpal tunnel syndrome, twice the number in Denver.

OSHA has no specific standard governing VDTs. To investigate the complaints, the agency cited its authority under the “general duty” legal requirement for employers to provide a safe workplace.

In California, the state job-safety agency ordered the Fresno Bee newspaper in September to install adjustable office furniture, provide hourly VDT work breaks and train employees on proper posture and computer use. Nearly half of the employees regularly using VDTs reported wrist, arm and shoulder pain associated with extended hours on word processors, the agency said, and the worker-days lost to such complaints were two times the average.

A dozen U.S. newspapers have seen clusters of editors, reporters and clerks develop repetitive-strain injuries, allegedly tied to intensive computer use. At the Los Angeles Times, the company installed 1,000 adjustable computer workstations after nearly 200 editorial employees complained of motion-injury symptoms.

“We know what the standard remedies are, even if the same things don’t cause all the cases we see, “ said David Eisen, research director for the Newspaper Guild, a union of newspaper editorial and commercial employees. To minimize chances of injury, experts recommend adjustable, properly designed furniture, short work breaks or mixes of tasks to change body positions, and less stressful work demands.

In the absence of fixed standards for VDT design and use, governments generally have been wary of enacting laws to regulate them. Some public agencies have drawn up specifications for buying new equipment that include ergonomic work stations or screen shielding.

Suffolk County, N.Y., has an ordinance requiring employers to require rest breaks, install good lighting and share costs of eye exams and glasses for regular VDT users. Court challenges have blocked the controversial law.

Much of the problem is finding out how to redesign office computer jobs to avoid work injury, said Michael Smith, industrial engineering professor at the University of Wisconsin. Offices “are going through the same thing that the auto industry did in the ‘40s and ‘50s, only the factors are more subtle,” he said. “Typically, office automation is not implemented in accordance with principles of ergonomics and job design.”

Ergonomics is the study of human adaptation to workplace conditions.

RSI, long known as cumulative trauma disorder in factories and meatpacking plants, is now being called “the VDT disease.” It appeared in Australia beginning in the 1970s, and various surveys found that 20% to 30% of Australian office employees suffered from the symptoms by the 1980s.

“It’s not unique to computers, but we are seeing more cases of it because the proportion of the work force using computers is increasing,” said Vern Anderson, chief of psychophysiology at NIOSH.

“The increased rate of work is a major cause of these disorders,” he said, explaining that such work demands excessive repetition without giving adequate time for the stressed body parts to recover. Streamlined operations on the VDT keyboard may encourage higher expectations of worker productivity, which can create more body stress, Anderson said. Strict employer goals or workers’ own work patterns can create stress, Anderson said, with different effects on different people. Even the most enthusiastic, self-motivated workers develop the problem, he noted.

“I’m not convinced that the body was made to perform thousands of repetitive motions an hour,” said Linda Morse, a specialist in occupational medicine in California’s Silicon Valley who has seen numerous RSI cases among VDT users. “The electronic revolution has outstripped our human muscular and skeletal evolution.”

Why didn’t the syndrome appear with typewriters? It probably did to some extent, although it was not recognized or widely reported, Anderson said.

But there are significant differences. VDT operators can work at least 30% faster than good typists. The striking force required by the manual machine was harder but spread over more parts of the arms and shoulders instead of concentrated in the wrist. Most important, typists change posture more often and take mini-breaks to change paper and ribbons and file letters.

“You can basically do a day’s work without leaving the computer screen, or your chair,” observed Marvin Dainoff, ergonomics expert at Miami University in Ohio. So, he pointed out, “one factor is how much you change your posture and what mix of tasks you have.”

Labor unions are demanding VDT protections in collective bargaining contracts: With many VDT users reporting eyestrain and blurred vision, eye exams and prescription glasses are goals of Service Employees and Newspaper Guild negotiators.