Musculoskeletal disorders among visual display terminal users in a telecommunications company.

The relationship between workplace factors and work-related upper extremity musculoskeletal disorders (UE disorders) was assessed in a cross-sectional study of 533 telecommunication employees utilizing video display terminals (VDTs). Cases of UE disorders were defined using symptom questionnaires and physical examinations. Data on demographics, individual factors (medical conditions and recreational activities), work organization and practices, and psychosocial aspects of work, including electronic performance monitoring (EPM), were obtained by questionnaire. Associations between workplace factors and UE disorders were assessed by multiple logistic models generated for each of the four UE areas (neck, shoulder, elbow, hand/wrists). One-hundred and eleven (22%) participants met our case definition for UE disorders. Probable tendon-related disorders were the most common (15% of participants). Probable nerve entrapment syndromes were found in 4% of participants. The hand/wrist was the area most affected, 12% of participants. The following variables had associations in the final models (p < 0.05) with at least one of the four UE disorders, although the strength of these associations were modest. Non-white race, a diagnosis of a thyroid condition (self-reported) use of bifocals at work, and seven psychosocial variables (fear of being replaced by computers, increasing work pressure, surges in workload, routine work lacking decision-making opportunities, high information processing demands, jobs which required a variety of tasks and lack of a production standard) were associated with UE disorders. This study indicates that work-related UE musculoskeletal disorders are relatively common among telecommunication workers who use VDTs, and adds to the evidence that the psychosocial work environment is related to the occurrence of these disorders.

[1]  A Carkeet,et al.  Workstation variables and visual discomfort associated with VDTs. , 1990, Applied ergonomics.

[2]  L. Cronbach Coefficient alpha and the internal structure of tests , 1951 .

[3]  Rossi Am,et al.  Video display terminal use and reported health symptoms among Massachusetts clerical workers , 1987 .

[4]  H. P. Sims,et al.  The Measurement of Job Characteristics , 1976 .

[5]  P Leino,et al.  Symptoms of stress predict musculoskeletal disorders. , 1989, Journal of epidemiology and community health.

[6]  S J Dain,et al.  Postural modifications of VDU operators wearing bifocal spectacles. , 1988, Applied ergonomics.

[7]  B L Margolis,et al.  Job stress: an unlisted occupational hazard. , 1974, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[8]  M. Feldman,et al.  Life events stress and psychosocial factors in men with peptic ulcer disease. A multidimensional case-controlled study. , 1986, Gastroenterology.

[9]  Stanislav V. Kasl,et al.  Termination: The consequences of job loss , 1977 .

[10]  B Hocking,et al.  Epidemiological aspects of “repetition strain injury” in Telecom Australia , 1987, The Medical journal of Australia.

[11]  E M Cottington,et al.  Stressful work conditions and diastolic blood pressure among blue collar factory workers. , 1987, American journal of epidemiology.

[12]  R H Westgaard,et al.  Generation of muscle tension additional to postural muscle load. , 1987, Ergonomics.

[13]  Thomas A. Finholt,et al.  The mystery of RSI. , 1988, The American psychologist.

[14]  E Grandjean,et al.  Postural and visual loads at VDT workplaces. I. Constrained postures. , 1981, Ergonomics.

[15]  Harry Finkelstein,et al.  Stenosing tendovaginitis at the radial styloid process , 1930 .

[16]  G. Lister The Hand: Diagnosis and Indications , 1984 .

[17]  J Duncan,et al.  Keyboard operating posture and symptoms in operating. , 1974, Ergonomics.

[18]  G. S. Phalen,et al.  The carpal-tunnel syndrome. Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. , 1966, The Journal of bone and joint surgery. American volume.

[19]  C. Pieper,et al.  Job, psychological factors and coronary heart disease. Swedish prospective findings and US prevalence findings using a new occupational inference method. , 1982, Advances in cardiology.

[20]  G B Andersson,et al.  The correlation between work environment and the occurrence of cervicobrachial symptoms. , 1989, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[21]  S. Hoppenfeld,et al.  Physical examination of the spine and extremities , 1976 .

[22]  S J Starr,et al.  Relating posture to discomfort in VDT use. , 1985, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[23]  G A Ryan,et al.  Comparison of data process operators with and without upper limb symptoms. , 2010, Community health studies.

[24]  M Nakaseko,et al.  History of occupational cervicobrachial disorder in Japan. , 1982, Journal of human ergology.

[25]  Andrew P. Smith,et al.  Psychological stress and susceptibility to the common cold. , 1991, The New England journal of medicine.

[26]  J. N. Blau,et al.  Tinel's sign and the carpal tunnel syndrome. , 1987, British medical journal.

[27]  E Grandjean,et al.  Factor analysis of localized fatigue complaints of accounting-machine operators. , 1982, Journal of human ergology.

[28]  J. Schwartz,et al.  The relationship between 'job strain,' workplace diastolic blood pressure, and left ventricular mass index. Results of a case-control study. , 1990, JAMA.

[29]  P. Padmos,et al.  Determinants of the VDU operator's well-being , 1987 .

[30]  T. Armstrong,et al.  Occupational factors and carpal tunnel syndrome. , 1987, American journal of industrial medicine.

[31]  J. Goldberg,et al.  Psychosocial influences on mortality after myocardial infarction. , 1984, The New England journal of medicine.

[32]  William Parkes Beetham,et al.  Physical examination of the joints , 1965 .

[33]  B. Knave,et al.  Work with video display terminals among office employees. I. Subjective symptoms and discomfort. , 1985, Scandinavian journal of work, environment & health.

[34]  N. Graham,et al.  Stress and acute respiratory infection. , 1986, American journal of epidemiology.

[35]  A. Happ,et al.  An Investigation of Health Complaints and Job Stress in Video Display Operations , 1981, Human factors.

[36]  L M Schleifer,et al.  Work Posture, Workstation Design, and Musculoskeletal Discomfort in a VDT Data Entry Task , 1991, Human factors.

[37]  Daniel C. Ganster,et al.  Development of a Scale to Assess Occupational Cognitive Demands , 1987, HCI.

[38]  P Carayon,et al.  Employee stress and health complaints in jobs with and without electronic performance monitoring. , 1992, Applied ergonomics.

[39]  W. Ruberman Psychosocial influences on mortality of patients with coronary heart disease. , 1992, JAMA.

[40]  E Viikari-Juntura,et al.  Interexaminer reliability of observations in physical examinations of the neck. , 1987, Physical therapy.

[41]  J. Hurrell,et al.  Exposure to job stress--a new psychometric instrument. , 1988, Scandinavian journal of work, environment & health.

[42]  R. Arndt,et al.  Work pace, stress, and cumulative trauma disorders. , 1987, The Journal of hand surgery.

[43]  R. Westgaard,et al.  Generation of muscle tension related to a demand of continuing attention , 1987 .

[44]  J. Schwartz,et al.  Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES). , 1988, American journal of public health.

[45]  R. Floru,et al.  Psychophysiological changes during a VDU repetitive task. , 1985, Ergonomics.

[46]  F. Massey,et al.  Introduction to Statistical Analysis , 1970 .

[47]  S J Linton,et al.  Risk factors in the psychosocial work environment for neck and shoulder pain in secretaries. , 1989, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[48]  T J Armstrong,et al.  Hand wrist cumulative trauma disorders in industry. , 1986, British journal of industrial medicine.

[49]  E. Degowin,et al.  Bedside Diagnostic Examination , 1976 .

[50]  L. V. Egeren,et al.  The relationship between job strain and blood pressure at work, at home, and during sleep. , 1992 .

[51]  Steven L. Sauter,et al.  Job and health implications of VDT use: initial results of the Wisconsin-NIOSH study , 1983, CACM.

[52]  Terry A. Beehr,et al.  JOB STRESS, EMPLOYEE HEALTH, AND ORGANIZATIONAL EFFECTIVENESS: A FACET ANALYSIS, MODEL, AND LITERATURE REVIEW , 1978 .