Pain from keyboard strain

Press, 24 October 1989, Page 28

Pain from keyboard strain

The restriction of keyboarding work to four hours a day is one of the more drastic solutions offered to occupational strain injuries by Dr Bill Turner, a Christchurch physician who specialises in occupational disorders.

Occupational strain injuries (OSI) is an umbrella term encompassing RSI — repetitive strain injury — which has struck, many keyboard operators. It covers the arm and wrist injuries of RSI as well as neck problems.

Dr Turner told a seminar on RSI, organised by Computer Land Christchurch, that OSI was increasing in New Zealand. Up to March 31 this year, 6500 cases had been reported to the Accident Compensation Commission — at a cost to the country of $l7 million. “That would be a gross under-reporting. There will be a whole range of other cases,” Dr Turner said.

Hours of work were one of the stresses that caused the disease. “I am now beginning to think that eight hours at a keyboard is too much: perhaps four hours is as far as we should go,” he told the seminar.

OSI is more prevalent on the factory floor among process workers, where there is more physical repetitive work, but office work with ever more computer terminals is the growth area. Recovery depends on when OSI is diagnosed. The first symptoms are what Dr Turner describes as a “deep, bone-type ache,” weakness, numbness, or a pins-and-needles feeling. The symptoms occur late in a shift. Work output is not affected. After one to three months the symptoms worsen, and occur earlier in the shift. Lumps may occur on tendons. Some doctors who examine persons with second-stage symptoms find nothing, but Dr Turner says the victims always have trigger points around the scapula (shoulder blades). “Press the trigger points and you get pain in the arms.” In the second stage, the symptoms generally fast longer, but usually

disappear over the weekend.

In the third stage, the disease is entrenched, and pain is permanent whether the person is working or not.

Dr Turner said treatment for those with stage one of OSI was simple and effective. The work practice or equipment used was changed. “We don’t need to send them off for physiotherapy, or give them pills.”

In the second or third stage, medical treatment is used. Rest is the most significant factor, but doctors also may prescribe physiotherapy, splints, drugs, or surgery. The return to work has to be gradual, and at a rate to suit the individual.

Some people never recover. Those who have been away from work for six months have only a 10 per cent to 20 per cent chance of returning to their jobs. Those who have symptoms in both arms have lesser chances of recov-

ery,’ in Dr Turner’s experience. Persons with a strong case of Raynaud’s disease, a circulatory disorder which makes the fingers blue, red, or very white, should stay away from keyboarding work, in his view. These people seemed prone to OSI. Persons with a history of ganglion cysts needed to be on guard for OSI as well. 1 But a general predisposition to developing OSI related to an individual’s physical capacities. External factors which affect the incidence of OSI include: • Ergonomics. The person must be seated at the right height relative to the keyboard, and have a suitable angle between the eyes and the screen. Manuscripts being keyed in should be on a clipboard, and not flat on the desk. If the keyboarder’s feet are off the floor, a footrest should be used.

• Tenseness. People who are tense are more

likely to develop OSI. • Task design. Regular rest breaks are necessary if the task design does not supply sufficient work variation. • The typing rate. Trouble seems to begin at about 10,000 to 11,000 keystrokes an hour, Dr Turner has found. He advocates that keyboarders keep to the rate they achieved when they learned the skill. They “should not operate at some expectation beyond their ability brought on them by the boss.” Anyone who keyboards at 20,000 strokes an hour will probably develop OSI, he believes. “A lot of OSI cases I see give you a history of having to meet deadlines and of work overloads," Dr Turner said. OSI entails injury to the sufferer, but studies show that psychological and social conditions are important factors. For example, there is a strong correlation with work conditions.

“If you work in an environment where you can’t see outside the window, and the boss is giving you heaps all the time, there is a big chance of getting arm pain. You don’t have to be doing anything in the way of repetitive work," Communication between management and employees and personal recognition were two of the most important factors in job satisfaction, which is closely related to the chances of developing OSI. Generally, medical methods are failing to solve OSI. “All treatments doctors offer are failing: physiotherapy, acupuncture, surgery, all the therapies. They help some, but by and large they do not seem to get people back to work,” said Dr Turner. Modifying work does, .however, . help. “We haven’t got the answer. The people who run offices and manage industry have the answer."