final full paper computer and health complaints amel ibrahim27july2006%255b1%255d

8/14/2019 Final Full Paper Computer and Health Complaints Amel Ibrahim27july2006%255B1%255D

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Prolonged Computer Use

ASNJ. Vol.5, No. 1, 2006 65

Health complaints associated with prolonged computer use as perceived

by computer users

Lamiaa Amin Awad , Lecturer

Community Health Nursing Dept, Faculty of Nursing, Mansoura University

Sahar Mohamed Soliman, LecturerCommunity Health Nursing Dept, Faculty of Nursing, Mansoura University

Amel Ibrahim Ahmed , LecturerCommunity Health Nursing Dept, Faculty of Nursing, Mansoura University

Computers have become ubiquitous in the office work place and their use is growing. They have

many advantages for inventory management, record management, electronic communication and office

automation. Computerized jobs are more sedentary; require more cognitive processing, mental attention

and less physical expenditure of energy. Many jobs that require heavy daily computer use have been

found to be stressful. The length of working in front of video display units (VDT) may be a direct cause

of reported health complaints among computer users. This study is conducted to relate the duration ofexposure to health effects resulting from computer use. The present study was carried out in different

computer workstations at Alexandria and Mansoura cities. These work stations were chosen from

technical schools and private computer offices. The study included 600 computer users (271 from

technical schools and 329 from private computer offices). A structured questionnaire sheet was

developed and used to assess the personal data of participants, appropriateness of workstation

environment, and ergonomic criteria of computer station in addition to health complaints of the studied

computer users. The results indicate that the majority of the studied population complained ofmusculoskeletal and eye discomforts

IntroductionToday, almost every one interacts with

computers on a daily basis for several reasonssuch as creating ideas, producing documents,retrieving information and corresponding withfriends. Along with the expanding use of thistechnology adverse health changes for computerusers was reported. An increased number ofcomputer workstations in the work place haveresulted in health concerns related to vision andbody aches and pains. Problems associated withcomputer workstations are generally temporaryand can often be solved using simple correctivemeasures (1). Many studies in several developedcountries have reported that visual displayterminal (VDT) has adverse health effects onvisual system, musculoskeletal system; also causesstress related disorder, skin disorder,photosensitive epilepsy, and adverse pregnancyoutcome. Visual symptoms that may beexperienced by computer operators are visualfatigue, blurred or double vision, burning andtearing eyes, headaches and frequent changes ineyeglass prescription (2-4). The AmericanOptometric Association AOA reports that over 10million patients a year schedule eye exams due tocomputer-related vision problems. WHO (2001)(5)

concluded that visual system discomfort is a

common problem when working with VDTs andthere was no evidence of damage or permanentimpairment to the visual system, but it onlyappears in the form of visual fatigue, headacheand blurring of vision (6). A study of NIOSHindicated that; 75% of VDT users complained ofoccasional aching or burning eyes at work,followed by blurred vision, also it was found thatup to 90% of computer uses report visualproblems and eye irritation (7).

Other health complaints are musculoskeletalproblems reported in 22% of computer users; these

problems appear in the form of low back pain,hand pain and stiffness in the neck and shoulders.Moreover; muscle tightness and tenderness occurdue to repetitive movement, support of the headin a fixed posture to look at the screen and holdingthe arms over the keyboard for prolonged periods,also it may be due to poor ergonomics ofworkstation (7-12). Musculoskeletal problemsoccurring with computer use may range fromsimple muscle fatigue or neck and back ache tocumulative trauma disorders; which areassociated with tasks that require repetitive

motions occurring over long periods of time. Astudy conducted on 21 patients who suffered from


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ASNJ. Vol.5, No. 1, 2006 67

b- Oral approval was obtained fromschools managers and workstations directors.

c- Oral approval was obtained fromparticipants to be included in the study.2-Development of the study tool:

a- The researchers developed the

questionnaire form after reviewing of recentliteratures then the content validity was testedby experts in that field.

b- A pilot study was carried out on 20computer users. These were chosen randomlyfrom other computer workstation to ensurethe clarity of the questionnaire.3-Data collection:

a- Data collection was conductedduring the period from October 2004 to March2005 through the interview of participantsduring visits to work stations on two days per

week to explain the aim of the work, themeaning of questions and the method ofquestionnaire filling. Each visit consumedapproximately 1.30 to 3 hours.

b- Data was scanned to excludeindividuals who do not fulfill the statedcriteria of the target population.

Statistical analysisSPSS package (version 0.9) was used for the

statistical analysis of the obtained data. Kendall's-tau- b test was used to estimate the correlationbetween prolongation of computer usage and the

occurrence of health complaints.

ResultsIt's apparent from demographic characteristics

of computer users in table (1) that the ages of thecomputer users included in the study ranged from13 up to 45 years and distributed in three agegroups. The first group 18 constitute 48.3% of thestudied population with a mean age of 16.8 1.3years, the second group aged from >18 to less than30 years and they present 29.4% of the studiedpopulation with a mean age of 23.1 3.3 years, and

the third group aged >30 years to include 22.3% ofstudied population with mean age of 36.6 1.3.The overall mean age is 23.18.1 years, more thanhalf of them are males.

Concerning computer using pattern; the meanduration of work is 4.9 3.6 years and the meandaily working hours is 3.72.8 hours. All of theparticipants reported that they dont get a restperiod during working hours. About 45% of thestudied population is studying computer sciencefollowed by 35 % working in computer field asprogrammers or typist, and the rest of the studied

population is using computer for retrievinginformation or entertainments table (2).

Generally, the majority of computerworkstations have a comfortable workenvironment as perceived by the studiedpopulation regarding temperature, ventilation,light and quietness. As regards to ergonomicfeatures more than two thirds have a appropriate

seat height and seat base while 51.5% have asuitable seat back. Almost one quadrant of themhave arm and/ or foot rest in their workstations.Also nearly half of the studied computer usershave appropriate angle of key board to elbow andkey board fixers. Three quadrants use curved-small mouse and appropriate monitor distance(around 75cm) and monitor level in relation tovision span, also most of monitors are clear andhave comfortable brightness table (3).

Table (4) shows that the most prevailed healthcomplaints among computer users aremusculoskeletal complaints (neck pain in 48.5%,backache in 47.3%, hand pain in 43.7%, handnumbness in 27% and leg pain in 27%) and visualcomplaints (blurring of vision in 50.8%, eyefatigue in 46.7%, eye tearing 37.8%, eye redness26.2% and eye itching 22.3%). Moreover; 24.7%and 11.5% of the studied population complain ofheadache and irritability respectively. All of thesecomplaints started after at least one year of usingcomputer.

Table (5) describes the frequency of healthcomplaints in relation to their onset. Eyecomplaints and musculoskeletal complaints havethe highest frequency within the first and secondyears of using computer (3.2% and 14.5% of eyecomplaints, especially eye fatigue, blurring ofvision and eye irritation in the form of tearing anditching.) and (2.8% and 12.5% of musculoskeletalcomplaints especially hand pain and neck pain)respectively. While Psycho- sensory complaints(headache and irritability) obviously appearedwithin the second and third year of usingcomputer.

Table (6) illustrates that duration of work anddaily working hours have a positive significantcorrelation with the most of health complaints. Alleye complaints are significantly correlated withduration of work except eye tearing which isinsignificantly correlated with this factor. Also,eye complaints are significantly correlated withdaily working hours except deterioration of visionis insignificantly correlated with this factor. Whileall musculoskeletal complaints which aresignificantly correlated with both duration ofwork and daily working hours except leg pain andhand numbness showed insignificant correlation.In addition irritability is significantly correlatedwith duration of work and daily working hours.


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ASNJ. Vol.5, No. 1, 2006 68

All of the studied population neither takebreak nor make physical exercise during work.Discussion:

The computer's role as an essential office andhome technological resource has developed fasterthan has general public understanding of potential

health problems from poor body alignment andeffects of long hours in front of a keyboard andscreen. Moreover, since these conditions typicallydo not cause acute pain or other immediatewarning signs, many people are slow to connecttheir initial discomfort to their computer use andassociated poor ergonomics (17).

This study revealed that 70% of the studiedpopulation suffered from musculoskeletaldiscomfort namely, neck pain, hand pain andbackache. These results are in agreement withother studies that reported a high prevalence of

musculoskeletal discomfort among computerusers in the form of neck pain, backache and handpain (18-21). This musculoskeletal complaints; maybe due to poor ergonomic environment that maylead to cumulative trauma, unhealthy posture,fixed position for extended period of time and/ orlacking for performing simple physical exercise toimprove blood circulation.

Computer vision syndrome is the number onecause of eye strain in the computer work station.Working at the computer is visually demanding, itrequires excessive ocular motility, continuous eyefocusing and alignment demands (22- 23). Problemsoccur when these demands exceed the visualability of an individual. Studies conducted inEgypt (2000) (3), Australia (2000) (24) and Italy(1999)(25) found that eye discomfort was associatedwith computer use, mainly eye strain,deterioration of vision, aching or burning eyes andblurred vision. All of mentioned results agreedwith the present study that revealed several eyecomplaints that are eye fatigue, blurring of vision,redness of eye, itching eye and deterioration invision that lead to changing eye glass. Also therevealed headache and irritability among thestudied population were reported by otherresearchers as a result of using computer (1, 26).These complaints may be due to the emission ofchemical vapors and hotness from computers thatcontain a lot of plastics, and/ or prolongedfocusing on computer screen.

Extensive and prolonged use of computers atthe work place and at home today, has given riseto a range of computer related health complaints.There are three broad categories of healthproblems, visual, musculoskeletal, and mentalstress. The reasons for these problems arerepetitive activities such as data entry and using

the keyboard, prolonged periods looking at themonitor, working with intense mentalconcentration, or alternatively, long periods ofmonotonous tasks (27).

The more the hours users spent in front of acomputer screen the higher the incidence of

computer syndrome. Gerr and Monteilh C 2004 (28)reported an association between health outcomesand daily hours of computer use. The presentstudy indicated a significant effect of workduration on eye discomfort, musculoskeletaldiscomfort and irritability either with duration ofworking years or duration of working daily hours.This result was similar to Al-Wehedy et al. (1999)(21) and Jensen 2004 (29) who found that theduration of computer use predicate a highprevalence of musculoskeletal disorders andheadache that increase significantly withincreasing the working years and daily workinghours. Jackson et al 1997 (30) revealed thatprolonged exposure to computer screen may leadto visual and general work related symptomstwice as frequently as those who spent less timeworking computer screen. Shimai et al 1986 (31)and Nakazawa et al 2002 (32) reported a positivecorrelation between musculoskeletal, eyediscomfort and length of computer service. Thelength of daily working hours is considered as arisk factor for the development of musculoskeletalcomplaints among computer users (33). In addition,Rechichi et al 1996 (34) found that the main factordetermining visual fatigue in VDT operators is theamount of time spent. Also, Travers and Stanton2002 (35) found that visual disturbancemanifestation appeared to increase as duration ofvideo display terminals (VDT) increased.

Many studies recommended that individualshould have recovery time ranged from 10 to 15minutes each hour during computer work. Alsoregular stretch break ranged from 30 o 60 secondevery half hour is needed to improve bloodcirculation and decrease the level of discomfortthat is associated with sitting in one position (29, 36).Conclusion

The study indicated that the prevalence ofgeneral disorders among computer users increasesignificantly with the duration of computer useand the number of working hours, also complaintsstarted after at least one year of using computerand increased by time.Recommendations

So it is recommended to perform a periodicalmedical checkup for early detection of sign andsymptoms related to computer use, take at leastten minutes break each work hour and performsimple exercise during working time.


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ASNJ. Vol.5, No. 1, 2006 69

Table I: Distribution of the studied population according to personal characteristics

ItemNumber

600Percentage%

Mean of

ages (XS.D)

Personal data

Agein years


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ASNJ. Vol.5, No. 1, 2006 70

Table II: Distribution of the studied population according to features of computer using

ItemNumber

600Percentage%

Number of years in using computer>5- 371 61.8

5- 136 22.7

10+ 93 15.5

XS.D 4.93.6

Number of daily working hours in using computer

>5- 436 72.7

5- 124 20.710+ 40 6.7

XS.D 3.72.8

Reasons of using computer

Studying computer sciences 271 45.2

Working in computer field 210 35

Entertainment 67 11.1

Retrieving information 52 8.7


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ASNJ. Vol.5, No. 1, 2006 71

Table III: Distribution of computer workstation according to physical environment criteria

as described by the studied population

ItemNumber

600Percentage%

Workstation environment

Suitable temperature 480 80

Suitable ventilation 449 74.8

Suitable light 420 70

Quiet room 378 63

Ergonomic appropriateness

Seat criteria

Appropriate seat height 417 69.5

Comfort seat base 402 67

Comfort seat back 309 51.5

Presence of foot rest 145 24.2

Presence of arm rest 133 22.2

Key board criteria

Presence of key board fixer 299 49.8

Appropriate angle of key board to elbow 259 43.2

Mouse criteria

Shape

Curved 513 85.5

Straight 87 14.5

Size

Small 431 71.8

Large 169 28.2

Monitor criteria

Appropriate distance from user 447 74.5

Appropriate to vision level 378 63

Comfort brightness 488 81.3

Comfort clearance 468 78


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ASNJ. Vol.5, No. 1, 2006 72

Table IV: Distribution of health complaints among the studied population

ItemNumber

600Percentage%

Musculoskeletal complaints Neck pain 291 48.5

Hand numbness 284 47.3

Hand pain 262 43.7

Legs pain 162 27

Backache 141 47.3

Eye complaints

Blurring of vision 305 50.8Eye fatigue 280 46.7

Eye tearing 227 37.8

Eye redness 157 26.2

Eye itching 134 22.3

Deterioration of vision 96 16

Psycho- sensory complaints

Headache 148 24.7Irritability 69 11.5

Person may be presented by more than complaints


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ASNJ. Vol.5, No. 1, 2006 73

Table V: Distribution of health complaints according to their onset of occurrence

Occurrence

within the first year

Occurrence

within the second

year

Occurrence

within the third yearComplaints

Numbe Percentage Numbe Percentage Numbe Percentage

Eye complaints

Number=

435

14 3.2 63 14.5 358 82.3

Eye tearing 11 2.5 27 6.2 189 43.4

Eye fatigue 10 2.3 43 9.8 227 52.2

Blurring of visio 7 1.6 43 9.8 255 58.6Eye itching 7 1.6 17 3.9 110 25.3

Eye redness 6 1.4 24 5.5 127 29.2

Deterioration

vision4

0.9122

5.170

16.1

Musculoskeletal

complaints

Number=

420

12 2.8 52 12.5 356 84.7

Hand pain 10 2.3 34 8 218 51.9

Neck pain 6 1.3 37 8.5 248 59

Hand numbness 5 1.2 28 6.6 137 32.6

Backache 3 0.7 21 5 251 59.7

Leg pain 2 0.5 23 5.5 117 27.8

Psycho-

sensory complaints

Number=

162

5 3.1 41 25.3 116 71.6

Headache 5 3.2 32 19.7 111 68.5

Irritability 0.0 0.0 9 5.5 60 38.3

Person may be presented by more than complaints


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ASNJ. Vol.5, No. 1, 2006 74

Table VI: Correlation between computer work duration and occurrence of

health complaints

Duration of work Daily working hoursComplaints

r P r PEye fatigue 0.097 0.006 0.246 0.000

Blurring of

vision0.286 0.000 0.294 0.000

Eye redness 0.282 0.000 0.256 0.000

Eye tearing 0.056 0.114 0.205 0.000

Eye itching 0.068 0.056 0.157 0.000

Deteriorationvision

0.085 0.017 0.019 0.593

Neck pain 0.208 0.000 0.172 0.000

Hand pain 0.138 0.000 0.246 0.000

Hand

numbness0.014 0.694 0.062 0.086

Backache 0.228 0.000 0.220 0.000

Leg pain 0.023 0.517 0.007 0.847Headache 0.069 0.051 0.040 0.268

Irritability 0.229 0.000 0.246 0.000

P 0.05

r = correlation coefficient


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ASNJ. Vol.5, No. 1, 2006 1

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