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.

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 hand 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.

These results provide further converging evidence that supplementary breaks reliably minimize discomfort and eyestrain without impairing productivity. Low compliance in performing stretches prevented valid assessment of stretching effects. Further research on stretching exercises and exercise compliance is warranted.

Self-report data on musculoskeletal discomfort were collected from several hundred VDT users in two agencies of a state government. Aspects of worker posture and workstation design were objectively assessed for 40 of the VDT users. Multiple regression analyses were used to examine the relationship between these ergonomic variables and musculoskeletal discomfort. Effects of ergonomic factors on musculoskeletal discomfort were clearly evident in the analyses. Regression models explained up to 38% of the variance in discomfort at different body sites. Of special interest was that leg discomfort increased with low, soft seat pans, suggesting that postural constraint is more important than thigh compression as a risk factor for leg discomfort in VDT work. In addition, arm discomfort increased with increases in keyboard height above elbow level, supporting arguments for low placement of the keyboard. Finally, high levels of neck and shoulder girdle discomfort observed in the study population suggest the need for further attention to the control of cervicobrachial pain syndromes in VDT work.

Momentary reductions in the electrical activity of working muscles (EMG gaps) contribute to the explanation for the relationship between psychosocial stress and musculoskeletal problems in computer work. EMG activity and gaps in the left and right trapezii were monitored in 23 participants under low and high mental workload (LMW and HMW) demands during computer data entry. Increases in EMG activity and decreases in EMG-gap frequencies in both left and right trapezius muscles were greater during HMW than LMW. In addition, heart period and end-tidal CO2 were lower during HMW, whereas self-reported mood states were higher during HMW. The correspondence between lower end-tidal CO2 and lower EMG-gap frequencies suggests that hyperventilation (overbreathing) may mediate trapezius muscle activation. The reduction of EMG gaps suggests that the salutary benefits of momentary rest from musculoskeletal work are diminished during mental stress.