Ergonomics and exercise reduce the risk of cumulative trauma disorder

Telemarketing, Feb 1994 by Lesin, Benjamin E

The personal computer has multiplied productivity, but it has also increased the incidence of carpal tunnel syndrome, tendinitis and tennis elbow -- disorders caused by the stress of repetitive motion. Working at a computer keyboard doesn't seem dangerous. Actually, it' s easier than typing at an electric typewriter. That may be the problem.

When compared with a typewriter, a computer requires less movement. A typewriter forces the operator to take natural breaks and use different muscles, as when changing paper or fixing mistakes with correction fluid.

A computer user can pound keys indefinitely. An individual who types 60 words a minute will hit the keys 18,000 times an hour, or 108,000 keystrokes in six hours. The average person uses about eight ounces of force per keystroke. That doesn't seem like much, but it adds up to 25 tons of force per day exerted through the fingertips.

THE CUMULATIVE EFFECT CAN BE DISABLING PAIN

Common complaints involve the fingers, hands, wrists, arms, shoulders, neck and back. The first symptoms usually are an occasional ache, numbness or tingling sensation in the fingers, hand or forearm. Left unchecked, the disorder can graduate to constant pain and for a full-blown disorder, the inability to do such simple tasks as combing hair, opening a door or holding a pencil.

Treating these disorders can involve rest, immobilization of the affected area and, in extreme cases, surgery. Recovery can take as long as a year.

CTD COSTS RISING

These cumulative trauma disorders (CTD) are costing American industry money -- through lost productivity, medical costs, workers' compensation and even legal costs.

The U.S. Bureau of Labor Statistics reported 224,000 cases of repeated trauma illnesses in a 1991 survey, which was about 60 percent of all work-related illnesses reported. The report said that over the past several years, disorders associated with repeated trauma have increased in both number and as a percentage of total cases of work-related illnesses reported.

Although the majority of cumulative trauma disorder cases occur in blue-collar occupations, the problem is growing in the office. A three-year study by the National Institute of Occupational Safety and Health (NIOSH) at U.S. West found 111 of 518 employees who used computers suffered from cumulative trauma disorder.

The cumulative trauma disorder epidemic is costly. Medical costs for treating carpal tunnel syndrome (CTS) can range from $4,000 to $7,500, and the National Council on Compensation Insurance estimates that medical care and lost wages for an average CTD claim is $29,000, about 50 percent more than other work-related injury or illness. The National Safety Council said CTD costs $7 billion annually in workers' compensation. Roger Stephens, who directs the Occupational Safety and Health Administration's office of ergonomics, said that total costs for cumulative trauma disorder could be as high as $50 billion per year.

There are also potential legal costs. King County, Washington was sued by four 911 telephone operators. Part of the settlement of that suit included the installation of ergonomic furniture, a limit on job tasks and help with finding other jobs for injured workers.

Employees with cumulative trauma disorder are probably covered under the Americans with Disabilities Act (ADA), which requires that companies with more than 25 employees make reasonable accommodations for disabled employees. This could include job restructuring, part-time or modified work schedules, and assignment to another position. The ADA also provides for compensatory damages up to $300,000.

CTD CAN BE PREVENTED

However, cumulative trauma disorder among computer users can be prevented by providing an ergonomic workplace and adopting new work habits appropriate for personal computer use.

A 1991 NIOSH report said organizations that invest in an ergonomic workplace experience a 24-percent increase in productivity.

ERGONOMICS MEANS TAILORING THE WORKSPACE TO THE EMPLOYEE

Ergonomics is not just new furniture and accessories, but tailoring the workspace to fit each employee to assure comfort, reduce strain and avoid injury.

The capability to adjust the workspace is particularly important when a workstation is shared; for example, if an individual who is 5'6" tall is replaced by someone who is 6'2", an adjustment is essential.

Good ergonomics begins with a comfortable chair that promotes good posture and allows the employee to change positions throughout the day. (See "Office Chairs And Productivity -- Exploring The Ergonomic Link" on page 55.)

The keyboard should be at a height so the shoulders are relaxed. In most cases, this appears to be about an inch lower than the standard desk, or 28 inches high. The arms should be held comfortably at the side, with forearms parallel to the floor. The wrists should be extended slightly, with the thumbs approximately aligned with the forearm and knuckles slightly higher than the wrist. There should be space in front of the keyboard to provide a space to rest the hands.