title: Job stress management and ergonomic intervention for work-related upper extremity symptoms. A prospective study of computer users: I. Study design and incidence of musculoskeletal symptoms and disorders. A field study of supplementary rest breaks for data-entry operators Effect of keyboard keyswitch design on hand pain. Effects of software programs stimulating regular breaks and exercises on work-related neck and upper-limb disorders. Musculoskeletal, visual and psychosocial stress in VDU operators before and after multidisciplinary ergonomic interventions. A 6 years prospective study--Part II. A randomised controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users A prospective study of computer users: II. Postural risk factors for musculoskeletal symptoms and disorders. Group Training with Healthy Computing Practices to Prevent Repetitive Strain Injury (RSI): A Preliminary Study The effect of forearm support on musculoskeletal discomfort during call centre work. Will Visual Discomfort among Visual Display Unit (VDU) Users Change in Development When Moving from Single Vision Lenses to Specially Designed VDU Progressive Lenses? Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Computer terminal work and the benefit of microbreaks. Effects of an ergonomic training program on workers with video display units. Comparative randomised controlled clinical trial of a herbal eye drop with artificial tear and placebo in computer vision syndrome. A comprehensive work injury prevention program with clerical and office workers: phase I. Effect of Four Computer Keyboards in Computer Users with Upper Extremity Musculoskeletal Disorders The use of yoked base-up and base-in prism for reducing eye strain at the computer. Productivity associated with visual status of computer users. Effects of an active ergonomics training program on risk exposure, worker beliefs, and symptoms in computer users. Effects of ergonomic intervention in work with video display units. Musculoskeletal, visual and psychosocial stress in VDU operators before and after multidisciplinary ergonomic interventions. Use of keyboards and symptoms in the neck and arm: evidence from a national survey. Effects of Ergorest® Arm Supports on Muscle Strain and Wrist Positions During the Use of the Mouse and Keyboard in Work With Visual Display Units: A Work Site Intervention Effects of two eye drop products on computer users with subjective ocular discomfort. A controlled study of the effect of neck school in medical secretaries.
abstract: In practice the secondary prevention of work-related upper extremity ( WRUE ) symptoms generally targets biomechanical risk factors . Psychosocial risk factors have also been shown to play an important role in the development of WRUE symptom severity and future disability . The addition of a stress management component to biomechanically focused interventions may result in greater improvements in WRUE symptoms and functional limitations than intervening in the biomechanical risk factors alone . Seventy office workers with WRUE symptoms were r and omly assigned to an ergonomics intervention group ( assessment and modification of work station and stretching exercises ) or a combined ergonomic and job stress intervention group ( ergonomic intervention plus two 1-h workshops on the identification and management of workplace stress ) . Baseline , 3- and 12-month follow-up measures of observed ergonomic risks and self-reported ergonomic risks , job stress , pain , symptoms , functional limitation , and general physical and mental health were obtained from all participants . While both groups experienced significant decreases in pain , symptoms , and functional limitation from baseline to three months with improvements continuing to 12 months post baseline , no significant differences between groups were observed for any outcome measures . Findings indicate that the additional two-session job stress management component did not significantly enhance the short- or long-term improvements brought about by the ergonomic intervention alone BACKGROUND A prospect i ve study of computer users was performed to determine the occurrence of and evaluate risk factors for  neck or shoulder ( N/S ) and h and or arm ( H/A ) musculoskeletal symptoms ( MSS ) and disorders ( MSD ) . METHODS Individuals ( n = 632 ) newly hired into jobs requiring > or = 15 hr/week of computer use were followed for up to 3 years . At study entry , workstation dimensions and worker postures were measured and medical and psychosocial risk factors were assessed . Daily diaries were used to document work practice s and incident MSS . Those reporting MSS were examined for specific MSD . Incidence rates of MSS and MSD were estimated with survival analysis . Cox regression models were used to evaluate associations between participant characteristics at entry and MSS and MSD . RESULTS The annual incidence of N/S MSS was 58 cases/100 person-years and of N/S MSD was 35 cases/100 person-years . The most common N/S MSD was somatic pain syndrome . The annual incidence of H/A MSS was 39 cases/100 person-years and of H/A MSD was 21 cases/100 person-years . The most common H/A disorder was deQuervain 's tendonitis . Forty-six percent of N/S and 32 % of H/A MSS occurred during the first month of follow-up . Gender , age , ethnicity , and prior history of N/S pain were associated with N/S MSS and MSD . Gender , prior history of H/A pain , prior computer use , and children at home were associated with either H/A MSS or MSD . CONCLUSIONS H/A and N/S MSS and MSD were common among computer users . More than 50 % of computer users reported MSS during the first year after starting a new job This study examined the effects of supplementary rest breaks on musculoskeletal discomfort , eyestrain , mood , and performance in data -entry workers . Two rest break schedules were compared in a within-subjects design . Workers alternated between a ‘ conventional ’ and a ‘ supplementary ’ schedule in 4-week intervals . The conventional schedule contained a 15-min break during the first half of the work shift and a 15-min break during the second half of the shift . The supplementary schedule contained the same two 15-min breaks , and a 5-min break during each hour which otherwise did not contain a break , for a total of 20 extra minutes of break time . Results are based on data from 42 workers . They indicated that discomfort in several areas of the body , and eyestrain , were significantly lower under the supplementary than under the conventional schedule . While symptoms increased from pre- to post-work periods under both schedules , the magnitude of the increases was significantly less under the supplementary schedule . In addition , increases in discomfort of the right forearm , wrist and h and over the course of the work week under the conventional schedule were eliminated under the supplementary schedule . These beneficial effects were obtained without reductions in data -entry performance This r and omized clinical trial evaluated the effects of keyboard keyswitch design on computer users with h and paresthesias . Twenty computer users were matched and r and omly assigned to keyboard A ( n = 10 ) or B ( n = 10 ) . The keyboards were of conventional layout and differed in keyswitch design . Various outcome measures were assessed during the 12 weeks of use . Subjects assigned keyboard A experienced a decrease in h and pain between weeks 6 and 12 when compared with keyboard B subjects ( P = 0.05 ) and demonstrated an improvement in the Phalen test time ( right h and , P = 0.006 ; left h and , P = 0.06 ) . Keyboard assignment had no significant effect on change in h and function or median nerve latency . We conclude that use of keyboard A for 12 weeks led to a reduction in h and pain and an improved physical examination finding when compared with keyboard B. There was no corresponding improvement in h and function or median nerve latency OBJECTIVES This study evaluated the effects on work-related neck and upper-limb disorders  among computer workers stimulated ( by a software program ) to take regular breaks and perform physical exercises . Possible effects on sick leave and productivity were studied as well . A r and omized controlled design was used with cluster r and omization . Altogether 268 computer workers with complaints in the neck or an upper limb from 22 office locations were r and omized into a control group , one intervention group stimulated to take extra breaks and one intervention group stimulated to perform exercises during the extra breaks during an 8-weekperiod . Question naires were administered before and after the intervention , and questions were generated by the software during the intervention period . Computer usage was recorded online . RESULTS The data on self-reported recovery suggested a favorable effect ; more subjects in the intervention groups than in the control group reported recovery ( 55 % versus 34 % ) from their complaints and fewer reported deterioration ( 4 % versus 20 % ) . However , a comparison between the reported pre- and postintervention scores on the severity and frequency of the complaints showed no significant differences in the change among the three groups . No effects on sick leave were observed . The subjects in the intervention groups showed higher productivity . CONCLUSIONS The use of a software program stimulating workers to take regular breaks contributes to perceived recovery from neck or upper-limb complaints . There seems to be no additional effects from performing physical exercises during these breaks A prospect i ve epidemiological field study covering a 2 years period has earlier been published . The study has a parallel group design with two intervention groups ( T and S ) and one  control group ( C ) of Visual Display Unit ( VDU ) operators . The present paper covers the period from 2 to 6 years of the study . After 3.5 years , the C group got the same intervention in terms of new lighting system , new workplaces and at last an optometric examination and corrections if needed . The C group reported a significant reduction in visual discomfort after interventions while the two groups ( T and S ) continued to report significant reduction of visual discomfort after 6 years . By supporting the forearm on the table top , the C group reported significant reduction of shoulder and neck pain while the T group reported significant reduction in shoulder and back pain after 6 years . Organizational and psychosocial factors at work and outside work did not show any significant changes during the study period Aims : To examine the effect of two workstation and postural interventions on the incidence of  musculoskeletal symptoms among computer users . Methods : R and omised controlled trial of two distinct workstation and postural interventions ( an alternate intervention and a conventional intervention ) among 376 persons using computer keyboards for more than 15 hours per week . The incidence of neck/shoulder symptoms and h and /arm symptoms during six months of follow up among individuals in the intervention groups was compared to the incidence in computer users who did not receive an intervention ( comparison group ) . For individuals in the intervention groups , study staff adjusted workstations , where possible , and trained individuals to assume the intervention postures . Individuals reported musculoskeletal symptoms in a weekly diary . Participants who reported discomfort intensity of 6 or greater on a 0–10 visual analogue scale or who reported musculoskeletal symptoms requiring use of analgesic medication were considered symptomatic . Results : There were no significant differences in the incidence of musculoskeletal symptoms among the three intervention groups . Twenty two ( 18.5 % ) participants in the alternate intervention group , 25 ( 20.2 % ) in the conventional intervention group , and 25 ( 21.7 % ) in the comparison group developed incident arm or h and symptoms . Thirty eight ( 33.3 % ) participants in the alternate intervention group , 36 ( 31.0 % ) in the conventional intervention group , and 33 ( 30.3 % ) in the comparison group developed incident neck or shoulder symptoms . Compliance with all components of the intervention was attained for only 25–38 % of individuals , due mainly to the inflexibility of workstation configurations . Conclusions : This study provides evidence that two specific workplace postural interventions are unlikely to reduce the risk of upper extremity musculoskeletal symptoms among computer users BACKGROUND Despite widespread recommendations regarding posture during computer use , associations between specific postures and musculoskeletal health are not well characterized . METHODS Six hundred and thirty-two newly hired computer users were followed prospect ively to evaluate associations between posture and neck or shoulder ( N/S ) and h and or arm ( H/A ) musculoskeletal symptoms and musculoskeletal disorders . Participants ' postures were measured at entry and they reported symptoms on weekly diaries . Participants reporting symptoms were examined for specific disorders . Multivariate Cox regression models were used to estimate associations between postural variables and risk of symptoms and disorders , controlling for confounding variables . RESULTS Keying with an inner elbow angle > 121 degrees , greater downward head tilt , and presence of armrests on the participants chair were associated with lower risk of N/S symptoms or N/S disorders .  Keying with elbow height below the height of the " J " key and the presence of a telephone shoulder rest were associated with a greater risk of N/S symptoms or N/S disorders . Horizontal location of the " J " key > 12 cm from the edge of the desk was associated with a lower risk of H/A symptoms and H/A disorders . Use of a keyboard with the " J " key > 3.5 cm above the table surface , key activation force > 48 g , and radial wrist deviation of > 5 degrees while using a mouse was associated with a greater risk of H/A symptoms or H/A disorders . The number of hours keying/week was associated with H/A symptoms and disorders . CONCLUSIONS The results suggest that the risk of musculoskeletal symptoms and musculoskeletal disorders may be reduced by encouraging specific seated postures This pilot study investigated whether group training , in which participants become role models and coaches , would reduce discomfort as compared to a nontreatment Control Group . Sixteen experimental participants participated in 6 weekly 2-hr group sessions of a Healthy Computing program whereas 12 control participants received no training .  None of the participants reported symptoms to their supervisors nor were they receiving medical treatment for repetitive strain injury prior to the program . The program included training in ergonomic principles , psychophysiological awareness and control , sEMG practice at the workstation , and coaching coworkers . Using two-tailed t tests to analyze the data , the Experimental Group reported ( 1 ) a significant overall reduction in most body symptoms as compared to the Control Group and ( 2 ) a significant increase in positive work-style habits , such as taking breaks at the computer , as compared to the Control Group . This study suggests that employees could possibly improve health and work style patterns based on a holistic training program delivered in a group format followed by individual practice Using a computer keyboard with the forearms unsupported has been proposed as a causal factor for  neck/shoulder and arm/h and diagnoses . Recent laboratory and field studies have demonstrated that forearm support might be preferable to working in the traditional " floating " posture . The aim of this study was to determine whether providing forearm support when using a normal computer workstation would decrease musculoskeletal discomfort in intensive computer users in a call centre . A r and omised controlled study ( n = 59 ) , of 6 weeks duration was conducted . Thirty participants ( Group 1 ) were allocated to forearm support using the desk surface with the remainder ( Group 2 ) acting as a control group . At 6 weeks , the control group was also set up with forearm support . Both groups were then monitored for another 6 weeks . Question naires were used at 1 , 6 and 12 weeks to obtain information about discomfort , workstation setup , working posture and comfort .  Nine participants ( Group 1 n = 6 , Group 2 n = 3 ) withdrew within a week of commencing forearm support either due to discomfort or difficulty in maintaining the posture . At 6 weeks , the group using forearm support generated significantly fewer reports of discomfort in the neck and back , although the difference between the groups was not statistically significant . At 12 weeks , there were fewer reports of neck , back and wrist discomfort when preintervention discomfort was compared with post intervention discomfort . These findings indicate that for the majority of users , forearm support may be preferable to the " floating " posture implicit in current guidelines for computer workstation setup Purpose . Three types of progressive additions lenses ( PAL ) specially design ed for VDU-work and one single vision lens were compared in a prospect i ve field study . The aim was to investigate if these progressive lenses created a difference in the development of visual discomfort compared to single vision lenses when working on an optimized VDU-workstation . Methods . The study had a prospect i ve , parallel group design , with four groups of VDU-workers . Approximately 40 subjects in each group , selected after careful task analysis with special attention towards the visual angles and distances to the work tasks . The groups were followed over one year . A question naire concerning visual conditions , working conditions , discomfort in different body areas , the status of the subjects ’ optometric corrections , psychological factors both at work and at home , amount , frequency and duration of VDU-work etc . was filled in before the intervention , after six months and after one year . No other contact was made with the subjects . The VDU-lenses included were Interview ( Essilor ) , Gradal RD ( Zeiss ) and Technica ( American Optical ) . Pain intensity and duration were assessed on a 100 mm Visual Analogue Scale ( VAS ) before the intervention , and six and twelve months after the intervention . All subjects were given a complete optometric examination . Results . Only small changes in the development of headache and visual discomfort were registered . However , the subjective evaluation of area of clear vision and overall satisfaction was significantly improved for the Interview and Gradal RD lens ( p < 0.05 ) . There were no significant changes for Technica and single vision lenses . Conclusion . Lens design s that cover viewing distances from near and out to approximately 2 meters work well compared to lens design s trying to cover greater range of clear vision . When tasks analysis shows that single vision correction may be used , this is still an acceptable solution Computer operators at two work sites ( n = 73 , n = 19 ) were prompted to take three 30-s and one 3-min break from computer work each hour in addition to conventional rest breaks . Some operators were asked to perform stretching exercises during the short breaks . Mood state and musculoskeletal discomfort were assessed at each work site over a 2- or 3-week baseline period and a 4- or 6-week treatment period , respectively . Operator productivity measures were obtained from company records . Operators complied with about half of the added breaks but favoured 3-min breaks over 30-s breaks . No improvement in productivity or well-being was found at the larger work site . At the smaller work site , productivity , eye , leg and foot comfort all improved when the short breaks included stretching exercises . These results provide evidence that frequent short breaks from continuous computer-mediated work can benefit worker productivity and well-being when the breaks integrate with task dem and Microbreaks are scheduled rest breaks taken to prevent the onset or progression of cumulative trauma disorders in the computerized workstation environment . The authors examined the benefit of microbreaks by investigating myoelectric signal ( MES ) behavior , perceived discomfort , and worker productivity while individuals performed their usual keying work . Participants were r and omly assigned to one of three experimental groups . Each participant provided data from working sessions where they took no breaks , and from working sessions where they took breaks according to their group assignment : microbreaks at their own discretion ( control ) , microbreaks at 20 min intervals , and microbreaks at 40 min intervals . Four main muscle areas were studied : the cervical extensors , the lumbar erector spinae , the upper trapezius/supraspinatus , and the wrist and finger extensors . The authors have previously shown that when computer workers remained seated at their workstation , the muscles performing sustained postural contractions displayed a cyclic trend in the mean frequency ( MNF ) of the MES ( McLean et al. , J. Electrophysiol . Kinesiol . 10 ( 1 ) ( 2000 ) 33 ) . The data provided evidence ( p < 0.05 ) that all microbreak protocol s were associated with a higher frequency of MNF cycling at the wrist extensors , at the neck when microbreaks were taken by the control and 40 min protocol groups , and at the back when breaks were taken by the 20 and 40 min protocol groups . No significant change in the frequency of MNF cycling was noted at the shoulder . It was determined ( p < 0.05 ) that microbreaks had a positive effect on reducing discomfort in all areas studied during computer terminal work , particularly when breaks were taken at 20 min intervals . Finally , microbreaks showed no evidence of a detrimental effect on worker productivity . The underlying cause of MNF cycling , and its relationship to the development of discomfort or cumulative trauma disorders remains to be determined OBJECTIVES This study evaluated the effect of an ergonomic training program on workstation changes and on the prevalence of  musculoskeletal disorders among video display unit ( VDU ) users at a large university . METHODS A pretest-posttest design with a reference group was used with r and om allocation of administrative and geographic units . In each group , the measurements involved direct observation of the workstations , a self-administered question naire , and a physical examination . The measurements were performed 2 weeks before and 6 months after the training in parallel in both groups . The study population was composed of 627 workers ( 81 % of those eligible ) . RESULTS The prevalence of all 3 of the postural stressors evaluated decreased in the experimental group after the training . In the reference group , 2 of the 3 stressors decreased in frequency but to a less extent . Some of these beneficial changes were more frequent in workers under 40 years of age . The prevalence of musculoskeletal disorders decreased among the workers under 40 years of age in the experimental group , from 29 % to 13 % determined by question naire and from 19 % to 3 % determined by physical examination . In other groups , there was no significant change in the prevalence of musculoskeletal disorders . CONCLUSIONS Improvements in postural stressors occurred more frequently in the experimental group , and these beneficial changes tended to be more frequent in workers under 40 years of age . Improvements in musculoskeletal disorders occurred in the experimental group among the workers under 40 years of age A comparative r and omised double masked multicentric clinical trial has been conducted to find out the efficacy and safety of a herbal eye drop preparation , itone eye drops with artificial tear and placebo in 120 patients with computer vision syndrome . Patients using computer for at least 2 hours continuosly per day having symptoms of irritation , foreign body sensation , watering , redness , headache , eyeache and signs of conjunctival congestion , mucous/debris , corneal filaments , corneal staining or lacrimal lake were included in this study . Every patient was instructed to put two drops of either herbal drugs or placebo or artificial tear in the eyes regularly four times for 6 weeks . Objective and subjective findings were recorded at bi-weekly intervals up to six weeks . Side-effects , if any , were also noted . In computer vision syndrome the herbal eye drop preparation was found significantly better than artificial tear ( p < 0.01 ) . No side-effects were noted by any of the drugs . Both subjective and objective improvements were observed in itone treated cases . So , itone can be considered as a useful drug in computer vision syndrome The risk for the development of musculoskeletal disorders and associated conditions in clerical and office workers is well documented . The majority of work injury prevention programs for this population were single-faceted ( education , workstation re design , or task modification ) and yielded both positive and negative findings . This pilot study was conducted with 16 full-time clerical and office workers at a small private college . In a r and omized control trial , the intervention group received four hours of individualized training through a multi-faceted injury prevention program . Between group differences in musculoskeletal symptom frequency and intensity and perceived stress and energy levels existed , although were statistically insignificant . There was a statistically significant decrease in Lower Back ache/pain from pre to post measures for the intervention group Eighty computer users with musculoskeletal disorders participated in a six-month , r and omized , placebo-controlled trial evaluating the effects of four computer keyboards on clinical findings , pain severity , functional h and status , and comfort . The alternative geometry keyboards tested were : the Apple Adjustable Keyboard ™ [ kb1 ] , Comfort Keyboard System ™ [ kb2 ] , Microsoft Natural Keyboard ™ [ kb3 ] and placebo . Compared to placebo , kb3 and to a lesser extent kb1 groups demonstrated an improving trend in pain severity and h and function following six months of keyboard use . However , there was no corresponding consistent improvement in clinical findings in the alternative geometry keyboard groups compared to the placebo group . Overall , there was a significant correlation between improvement of pain severity and greater satisfaction with the keyboards . These results provide evidence that keyboard users may experience a reduction in h and pain after several months of use of some alternative geometry keyboards BACKGROUND Eye strain continues to be one of the chief complaints of people working at video display terminals . The increase in extorsion observed on elevation of gaze at near point may induce binocular disruption and strain . Binocular base-up and base-in prism might mitigate some of the visual complaints of computer users because they decrease the elevation and convergence required . A double blind study of 30 computer users indicates a significantly greater preference for a  lens combining prism and plus power than for plus lenses having no prism BACKGROUND The aim of this project is to examine the potential connection between the astigmatic refractive corrections of subjects using computers  and their productivity and comfort . We hypothesize that improving the visual status of subjects using  computers  results in greater productivity , as well as improved visual comfort . METHODS Inclusion criteria required subjects 19 to 30 years of age with complete vision examinations before being enrolled . Using a double-masked , placebo-controlled , r and omized design , subjects completed three experimental tasks calculated to assess the effects of refractive error on productivity ( time to completion and the number of errors ) at a computer . The tasks resembled those commonly undertaken by computer users and involved visual search tasks of : ( 1 ) counties and population s ; ( 2 ) nonsense word search ; and ( 3 ) a modified text-editing task . RESULTS Estimates of productivity for time to completion varied from a minimum of 2.5 % upwards to 28.7 % with 2 D cylinder miscorrection . Assuming a conservative estimate of an overall 2.5 % increase in productivity with appropriate astigmatic refractive correction , our data suggest a favorable cost-benefit ratio of at least 2.3 for the visual correction of an employee ( total cost 268 dollars ) with a salary of 25,000 dollars per year . CONCLUSIONS We conclude that astigmatic refractive error affected both productivity and visual comfort under the conditions of this experiment . These data also suggest a favorable cost-benefit ratio for employers who provide computer-specific eyewear to their employees OBJECTIVE The purpose of this study was to evaluate the effectiveness of an active ergonomics training ( AET ) program in computer users . Two constructs from the social-cognitive theory were adopted to provide a more comprehensive assessment of the proximal markers of behavior change . METHOD Eighty-seven symptomatic and asymptomatic employees who worked at a computer for a minimum of 10 hours per week took part in a prospect i ve r and omized controlled study . Subjects participated in a six-hour training intervention at their workplace . Key elements of the AET intervention were skill development in workstation analysis , active participation , and implementation of multiple prevention strategies . RESULTS After receiving AET , risk factor exposure was significantly reduced for participants at higher risk [ F(1,82 ) = 6.42 , p < 0.01 ] . Significant increases in knowledge [ F(1,74 ) = 8.39 , p < 0.01 ] , self-efficacy [ F(1,73 ) = 6.95 , p < 0.01 ] , and outcome expectations [ F(1,75 ) = 8.75 , p < 0.01 ] were found in the intervention group . When the participants were stratified according to the presence of symptoms at baseline , the group with pain that received the AET intervention had significantly less upper back pain intensity ( z = -2.03 , p < 0.05 ) , pain frequency ( z = -2.70 , p < 0.01 ) , and pain duration ( z = -3.25 , p < 0.01 ) post-intervention than the control group with pain . CONCLUSION Results from this study provide evidence that participative training in workstation ergonomics can improve work postures , work practice s , risk factor exposure , and pain OBJECTIVES This study evaluated the effect of an intensive ergonomic approach and education on workstation changes and  musculoskeletal disorders among workers who used a video display unit ( VDU ) . METHODS A r and omized controlled design was used . The subjects ( N=124 ) were allocated into three groups ( intensive ergonomics , ergonomic education , reference ) using stratified r and om sampling . The evaluation involved question naires , a diary of discomfort , measurements of workload , and an ergonomic rating of the workstations . The assessment s were made 2 weeks before the intervention and after 2 and 10 months of follow-up . RESULTS The intensive and training groups showed less musculoskeletal discomfort than the reference group after 2 months of follow-up . Positive effects on discomfort were seen primarily for the shoulder , neck , and upper back areas . No significant differences were found for the strain levels or prevalence of pain . After the intervention the ergonomic level was distinctly higher in the intensive ergonomic group than in the education or reference group . CONCLUSIONS Both the intensive ergonomics approach and education in ergonomics help reduce discomfort in VDU work . In attempts to improve the physical ergonomics of VDU workstations , the best result will be achieved with cooperative planning in which both workers and practitioners are actively involved The study has a parallel group design with two intervention groups ( T and S ) and one control group ( C ) of VDU operators . Three serial interventions were carried out in the T and S groups , first a new lighting system , then new workplaces and last an optometric examination and corrections if needed . The new lighting gave significantly increased illuminance levels , increased luminances of the room surfaces and better luminance distribution . The two intervention groups reported significant improvement of the lighting conditions , as well as of the visual conditions and significantly reduced visual discomfort and glare . Significant reduction of headache was found in one of the intervention groups . Optometric corrections reduced the visual discomfort in both the intervention groups . When looking at those given new corrections , a significant reduction was found in the T group and a clear tendency was also found in the S group . The C group reported no improvements for any of these health outcomes . The workplace intervention gave the operator the possibility to support the whole forearm and h and on the table top . Before the intervention there were no significant differences between the three groups regarding shoulder pain and static trapezius electromyographic ( EMG ) load . Two years after the intervention , a significant reduction of shoulder pain was reported in the T and S groups in parallel with a significant reduction in static trapezius load , while no such reduction was found in the C group . At the same time , both static trapezius load and shoulder pain were significantly lower in the T and S groups compared with the C group . Pain in the forearm and h and showed no significant changes in any of the groups during the study period . However , there seem to be a relationship between pain in the forearm and h and and the time the operator used the mouse . The C group reported significantly higher intensity of pain and used the mouse significantly more than the S group The objective of this study was to examine the relationship between upper limb symptoms and keyboard use in a population survey . A question naire was mailed to 21,201 subjects aged 16 - 64 years , selected at r and om from the registers of 34 British general practice s. Information was collected on occupation and on regular use of keyboards ( for > 4 h in an average working day ) , pain in the upper limbs and neck , numbness or tingling in the upper limbs , headaches , and feelings of tiredness or stress . Associations were explored by logistic regression , with the result ant odds ratios converted into prevalence ratios ( PRs ) . Among 12,262 respondents , 4899 held non-manual occupations . These included 1871 regular users of keyboards ( e.g. computer operators , data processors , clerks , administrators , secretaries and typists ) .  Pain in the neck or upper limbs and sensory symptoms were common in the non-manual workers overall ( with 1 week period prevalences of 30 and 15 % , respectively ) , and were associated with older age , smoking , headaches and tiredness or stress . After adjustment for these factors , regular keyboard use was significantly associated with pain in the past week in the shoulders ( PRs 1.2 - 1.4 ) and the wrists or h and s ( PR 1.4 ) , but not with elbow pain or sensory symptoms over the same period , or with neck or upper limb pain that prevented normal activities in the past year . Disabling symptoms were somewhat less prevalent among symptomatic keyboard users than among other symptomatic workers . We conclude that use of keyboards was associated with discomfort at the shoulder and wrist or h and , but risk estimates were lower than generally reported in workplace surveys . Previous estimates of risk in the occupational setting may have been biased by shared expectations , concerns , or other aspects of illness behaviour The effects of Ergorest ® arm supports on wrist angles and musculoskeletal strain in the neck-shoulder-arm region and electrical activity in the shoulder and arm muscles were studied during typing or the use of the mouse in work with a visual display unit ( VDU ) . Twenty-one women were r and omized into 3 groups ( 1 arm support , 2 arm supports , and control ) . Measurements were carried out before and after the 6-week intervention . The wrist extension of the mouse h and , the muscle activity of the trapezius muscle , and the subjective discomfort ratings indicated that 2 arm supports were better than 1 in work with a mouse . The Ergorest ® arm support alleviates muscle and joint strain in VDU work when used for both arms BACKGROUND An increasing number of people seek medical attention for symptoms of visual discomfort due to computer vision syndrome ( CVS ) . We compared the efficacy and adverse event rates of a new eye lubricant , OptiZen ( InnoZen , Inc. , polysorbate 80 0.5 % ) and Visine Original ( Pfizer Consumer Healthcare , tetrahydrozoline HCl 0.05 % ) . METHODS In this double-blind parallel arm trial , 50 healthy men and women , ages 18 to 65 years , with symptoms of CVS who use a video display terminal for a minimum of 4 hours per day were  r and omized to OptiZen ( n = 25 ) or Visine Original ( n= 25 ) , 1 to 2 drops b.i.d . for 5 days . The primary end-points were ocular discomfort and adverse events . RESULTS OptiZen and Visine Original had similar efficacy in alleviating symptoms of ocular discomfort ( odds ratio of 1.23 [ 95 % confidence interval , 0.63 to 2.42 ] , P= 0.55 ) . OptiZen and Visine Original were very similar with respect to odds ratios and 95 % confidence interval ( CI ) for each of the measurement times ( P= 0.72 ) . Visine Original users reported a significantly higher incidence of temporary ocular stinging/burning immediately after drug instillation ( 28 % , 7/25 ) than did OptiZen users ( 4 % , 1/24 ) ( P= 0.05 ) . Patients using  OptiZen were 89 % less likely to have stinging/burning effects than those patients using Visine Original ( 95 % CI : 0.01 to 0.95 ) . DISCUSSION OptiZen and Visine Original are effective at alleviating ocular discomfort associated with prolonged computer use . Adverse event findings suggest that OptiZen causes less ocular discomfort on instillation , potentially attributable to its milder ingredient profile The effect of " neck school " on neck and shoulder disorders was studied in medical secretaries . A  neck school reinforced with compliance enhancing measures ( group B ) was compared with a traditional neck school ( group A ) and a control group ( group C ) . The results show that ergonomical knowledge was good even before the secretaries attended the neck schools and that compliance was significantly higher for group B. When comparisons were made within groups some improvements on neck and shoulder fatigue and pain were noted , particularly for group B. When workload was controlled no significant group differences were found . No differences were noted for range of neck motion , or sick leave in any group . Our conclusion is that neck schools , despite good compliance , appear to be of limited clinical value for prevention of neck and shoulder disorders
target: Moderate evidence was observed for : ( 1 ) no effect of workstation adjustment , ( 2 ) no effect of rest breaks and exercise and ( 3 ) positive effect of alternative pointing devices .
  For all other interventions mixed or insufficient evidence of effect was observed .
  Conclusion : Few high quality studies were found that examined the effects of interventions in the office on musculoskeletal or visual health
background: Background : The literature examining the effects of workstation , eyewear and behavioral interventions on  musculoskeletal and visual symptoms among computer users is large and heterogeneous .
  Methods : A systematic review of the literature used a best evidence synthesis approach to address the general question “ Do office interventions among computer users have an effect on musculoskeletal or visual health ? ”