New Keyboards Try Dividing to Conquer Typing Injuries : Ergonomics: Sales of the more expensive units are slow and there is little medical data yet to show that they work.

Mounted on the edge of a desk, the prototype looks like a conventional computer keyboard on life support after surviving an ax attack.

Dividing the keyboard into halves attached to rods and hinges, the custom keyboard allows typists to rotate the two sides to position their hands vertically, as if holding a basketball, instead of using it in the flat, horizontal position demanded by a conventional keyboard.

Like many alternative designs that have been introduced as PC use has spread into homes and offices across the country, the adjustable keyboard being developed by Irvine-based Genovation Inc. is meant to reduce typing stress by allowing users to change their posture and hand position as they work.

“If repetition is the problem, variation is the solution,” said Kevin Conway, a Santa Rosa physical therapist who holds three patents on the device.

Conway began work on it about three years ago after treating a stream of data-entry workers, newspaper reporters, cash-register clerks and other workers who complained of hand, wrist and arm pain after using a computer terminal all day.

But are such typist-friendly devices ahead of the curve or ahead of their time? Even Conway agrees that the medical justification for such keyboards is spotty. Lawsuits will likely have as great an influence as government regulation in determining how soon these alternative keyboards are adopted as standard equipment by companies and home users.

Despite a favorable response to its prototype at industry trade shows, Genovation executives are not sure whether they will put the design into production. At a retail price Genovation estimates at $500 to $600, Conway’s keyboard would be pricier than a basic, $100 adjustable model built in conjunction with software giant Microsoft Corp.

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Joseph Meshi, Genovation’s executive vice president, said he also worries that aside from Microsoft’s design, most of the other so-called ergonomic keyboards--those designed to better fit users’ hand and wrist movements--aren’t selling well. Most manufacturers of such keyboards are small start-up companies, which do not release data on their sales or profitability.

“What we’re hearing from the market, and the reason I’m a little bit negative about this, is that companies are buying small quantities of these keyboards and supplying them only for those people (employees) who insist on having them,” he said.

Instead, the Irvine-based company may stick to its core business of making related products like key pads for cash-registers and add-on key pads for laptop computers.

Only when major PC makers begin to include adjustable keyboards as part of their original equipment will they catch on with users and companies, Meshi said.

Today just a few PC manufacturers include the Microsoft keyboard, which divides the letter keys of a standard keyboard into two angled sections. And last year Apple Computer began offering a split keyboard of its own that sells for $115.

In fact, neither Genovation nor any of the current manufacturers of ergonomic keyboards make medical claims of the usefulness of their devices for avoiding repetitive stress injuries.

Instead, they say only that the various hand positions allowed by their products will permit more comfortable typing by encouraging better posture.

“The science is extremely complicated, and the number of variables involved are so numerous, it’s very difficult to draw an exact cause-and-effect relationship between the computer keyboard and symptoms of physical problems,” says Jeffrey Szmanda, president of the Health Care Keyboard Co. of Wauwatosa, Wisc.

The company recently obtained approval from the U.S. Food and Drug Administration to market its device to people already suffering from disabilities. It is only because it has such approval, Szmanda said, that his company dares to mention “cumulative-trauma disorders” in the manual that accompanies its $795 keyboard.

If companies are reluctant to tout the medical effectiveness of their products, they are only following the uncertainty expressed by the California Occupational Safety and Health Standards Board last month when it voted 6-0 against a measure that would have established the country’s first comprehensive ergonomics program for office workers.

James Smith, a RAND Corp. economist and one of the board members who voted against the proposal, said some action is probably needed to deal with rising injury rates, but that there hasn’t been enough study of the hardware that might be required.

“The future is that you have to deal with it. There’s no question that there’s going to be a growing workplace health problem,” he said. But until he sees additional data on how much alternative keyboards would help, Smith said he can’t vote to impose standards on companies. “It’s really lowbrow science we’re seeing at this point. “It’s hard to distinguish science from advocacy.”

Smith said he expects the board will continue to discuss standards in coming months. And the federal government may issue its own regulations or guidelines on ergonomic standards by the end of this year as well.

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Regulators like the state’s health board have also been hesitant because government agencies have collected few statistics to measure rates of keyboard-caused injuries or of whether such injuries are growing.

According to the Federal Bureau of Labor Statistics, of the 89,875 cases of repetitive motion injuries that resulted in one or more lost work days in 1992, 11,111 were associated with typing or repetitive key entry.

For many of those workers, the injuries can be severe and career-destroying.

Costa Mesa resident Pam Allison, 28, suffered nerve damage and carpal tunnel syndrome after working as a secretary for 10 years for several companies. No longer able to type or write for long periods, or even open jars, she is now developing a home child-care business.

“When it first happened, I didn’t know what to do. This was how I made my livelihood,” she said. “Of course I thought it wouldn’t happen to me.”

Prodded by the rise of such cases, 1992 was the first year the Department of Labor broke down keyboard-injury statistics. That is also the only year it has tabulated the figures. Repetitive-motion disorders are reported far more frequently by blue-collar employees, such as those who work in meat-packing plants, knitting mills and auto factories, according to the bureau.

In lieu of more conclusive data or medical studies about injuries from keyboard use, the growth of product-liability lawsuits against computer manufacturers--now numbering in the thousands--have become the main measure of the seriousness of the problem.

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Earlier this year, Compaq Computer Corp. won a lawsuit brought by a Houston secretary who claimed that her injuries left her unable to work. In another case, scheduled to go to trial the first week of January, a Hastings, Minn., school district employee is seeking damages for the injuries she claims were caused by using keyboards on IBM and Apple PCs for several years.

The plaintiff is represented by Levy, Phillips & Konigsberg, a New York firm that represents about 2,000 plaintiffs in various keyboard injury cases against manufacturers of PCs and other equipment.

Danielle Goodman, a lawyer at the firm, said most of the plaintiffs are women, which mirrors the Labor Department statistics that show 10 times as many women as men are injured by keyboard use. The obvious difference, Goodman said, is that most of the secretarial and administrative support jobs that involve continuous typing are held by women.

“We’re arguing that there’s been enough scientific literature that at least should have put the defendants on notice that their keyboards were dangerous,” Goodman said in an interview. “The defendants take the position that there’s a lot of uncertainty . . . but they should at least have a duty to ask more questions than they did” of their equipment’s safety, she said.

Apple declined to comment on the case or to release sales figures for its split keyboard. But other equipment manufacturers say they are concerned about the added costs of including such keyboards with their products as competition increasingly focuses on costs.

“We don’t want to add costs to our machines that we don’t see having an obvious benefit,” said Joan Tharp, a spokeswoman for Hewlett-Packard Co. “There isn’t much customer demand for these things. If we had a clamoring for them, it might be different,” she said.

The most notable enthusiasm for the keyboards comes from Microsoft itself, which says it has sold more than 100,000 of the $99 Microsoft Natural keyboard in two months and that its suppliers don’t have the manufacturing capacity to keep up with demand. Such popularity surprises even Microsoft.

“Keyboards get a low mind-share from customers,” said Keith Kegley, a Microsoft product manager. “They approach it as something they don’t want to think about, they simply get used to it and deal with it. In the end, their bigger interest is to use them.”

Microsoft considered making a more complex, more adjustable keyboard, he said, but “the problem was that people felt as if they were looking at a contraption. Adjustability has to be subtle.”

Microsoft’s success with its keyboard may break open a larger market for smaller companies, said Shirley Lunde, vice president for marketing of Kinesis Corp. in Bothell, Wash., which sells a $390 keyboard whose keys are mostly contained in two concave pods.

With larger distributors beginning to pay attention, she said, overall sales may rapidly increase. A privately held company with revenues of under $100 million, Kinesis does not disclose exact sales or profit figures, Lunde said.

One point all sides can agree on is that even if the sales of alternative keyboards continue to grow, it is doubtful they alone would reduce injury rates.

Dr. David Rempel, director of the University of California’s ergonomics program in Richmond, said more studies are needed to conclude whether any particular design can prevent injury, or even to see how those injuries are caused.

“If you can demonstrate that there’s a health edge with a certain design, you would force every keyboard manufacturer to adopt your design. But that would have to be a very well-done, convincing study, and there are no such studies,” he said.

“The next question is: Given that there are no studies like that underway, what will change users’ opinions about whether they need an input-device? I think they (users) will retreat to how well it works, whether it has any bells and whistles,” he said.

Microsoft’s success probably has more to do with features that make it specialized for the company’s popular Windows operating system than with it ergonomic effectiveness, he said.

Rempel, who was a member of the committee that drafted the standard rejected by the state’s safety board, said he was not surprised that it didn’t pass. More studies are needed to show what particular type of keyboard and positioning can actually reduce injury rates, he said.

“If you just pose the question, ‘What kinds of keyboards work?’ you can get everybody and their brother inventing a design with no biomedical understanding” of what reduces injuries, he said.

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For typists, the costs of the alternative designs are hard to balance against the fear of developing career-ending injuries. Marylou Remy, owner of 9 to 5 Etc., a West Los Angeles secretarial service, said she had been concerned about her own heavy typing for years but couldn’t afford an alternative keyboard until Microsoft’s went on sale earlier this year.

“I kept putting off buying it. It’s funny that even though you know it’s better for you--or you think you know it’s better for you--that the price is still a consideration. $500 is still $500,” she said.

After using the Microsoft keyboard for week, Remy returned it, saying the keys required too much pressure to type.

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The Trouble With Typing

Nearly 90,000 cases of repetitive motion injuries serious enough to require one or more days off work occured at U.S. businesses and factories in 1992, the only year for which such information is available. One in eight of these injuries was caused by typing or key entering, and most of those injured typing were women.

All repetitive motion injuries:

Men: 34.7% Women 65.3% Repetitive typing:

Men: 8.5% Women: 91.5% Repetitive use of tools:

Men: 54% Women: 46%

Days Lost

More than one-third of the 11,111 typing inuries caused the individual to miss a month or more of work. Days off the job:

1 day: 4.6% 2-6 days: 22.8% 7-20 days: 25.6% 21-30 days: 12.0% More than 30 days: 35.0%

Occupational Hazard

More that 80% of the typing problems were suffered by those working in technical, sales and administrative support positions, and half resulted in carpal tunnel syndrome. Injuries per job category and resulting problem:

Technical, sales andadministrative support: 9,180 Managerial and professional: 1,162 Operators, fabricators and laborers: 454 Precision production, craft and repair: 184 Service: 96 Other: 35 Total: 11,111

Nature of the Injury

Carpal tunnel syndrome: 5,658 Tendinitis: 1,425 Soreness, pain: 890 Fractures: 16 Bruises, contusions: 12 Back pain: 11

Other: 1,894 Total: 11,111 Source: Bureau of Labor Statistics; Researched by ROSS KERBER, Los Angeles Times.