Ergonomics in Office Work

Introduction

Office work is diverse, with jobs ranging from those that demand a high level of skill and knowledge (for example journalists and financial administrators), to those where the worker has little control over their work or the organisation of their working day, such as call centre and data processing work. Although widely regarded as low risk environments, the large (and growing) proportion of employees within the EU who work in office environments means that a significant number of workers are potentially exposed to any risks to their health that might arise.

In the modern office much of the focus in terms of risks to health relate to the use of computers in some form. However, it is important to recognise that computers are not the only potential source of risk. Some health problems arise from the essentially sedentary nature of many office-based jobs (regardless of whether a computer is used or not); while documents and papers can be heavy (especially in bulk) and might lead to manual handling risks (especially when combined with sustained sitting and a general lack of movement).

Many office jobs have become increasingly dependent on the use of computers, or would not exist in their current form without the advent of such computer systems. Computers have almost entirely replaced typewriters for any work involving the production or editing of text (reports, letters, etc.) and have transformed communication systems through developments such as email and instant messaging.

As well as transforming how text and other material are produced, this has also transformed jobs. Thus few organisations still have the equivalent of a dedicated typing pool where staff specifically trained in ‘keyboard work’ carried out their work. Instead, staff primarily employed for other forms of expertise are usually required to carry such tasks out themselves.

In a further technological development, the advent of portable systems such as laptops and, in more recent years, smartphones and tablets, has created additional changes, not only to the physical manner in which such devices are used but also in where they are used, moving ‘computer work’ out of the office and into the café, hotel, train, home and many other locations. Increasing concerns have been expressed that such changes are leading to a blurring of the distinction between work and non-work with potentially negative impacts on ‘work-life balance’. Even with more conventional computers, technological developments mean that an employee no longer needs to be in a centralised physical office and the development of ‘telework’ allows employees to work in remote locations (including their home). Teleworking provides a variety of new challenges, not just in terms of communication and how such work is organised but working away from centralised, controlled premises makes it more difficult for the employer to ensure that the teleworker is provided with a safe and healthy workplace in which to work.

In an additional complication, the increasing use of computing technologies in the office has been paralleled with a growth in their use at home. Starting with ‘home computers’ this has now extended to many of the same array of smart devices as used in working environments.

This has had two major consequences. Firstly, it has increased the extent of ‘exposure’ of individuals to some of the physical risks associated with the use of these technologies and secondly, this development has led to some authorities seeking to absolve employers from any adverse consequences because of the problem of attribution of any problems (especially musculoskeletal problems) to work rather than home use.

Risks and hazards facing office workers

As noted above, working in an office is often regarded as low-risk although there are a number of risks to their health that office workers are exposed to:

• Postural problems: Almost regardless of how an office worker works there is growing recognition of the important role of movement in maintaining musculoskeletal health; and that remaining in an essentially fixed posture for extended periods is not conducive to good health. When that posture involves sitting, then any impact of a lack of movement is exacerbated by the fact that the sedentary posture is fundamentally bad for the back (and other parts of the body - there are even some clinical case reports of Deep Vein Thrombosis (DVT) from sustained sedentary postures). Obviously how an employee does sit and work (including the posture they adopt in interacting with their computer systems) can compound the effect of the sedentary nature of their work. Prolonged poor postures, especially awkward limb and neck positions, arising from insufficient attention being paid to the layout of office equipment such as display screens, keyboards and other input devices will accelerate or exacerbate the development of musculoskeletal symptoms.

• Duration, intensity and design of office work: In industrial workplaces, the risk of musculoskeletal problems arising from sustained repetitive activity has long been recognised. It is now recognised that working for long periods without a break, with a computer keyboard and/or non-keyboard input devices that involve frequent and repetitive hand/wrist movements, can contribute to the risk of such problems in office workplaces. The impact of these physical factors can be heightened by the high levels of concentration, and information overload resulting from some forms of computer-based work or, in other cases, by their repetitive monotonous nature.
• Psychosocial factors: Psychosocial risks to health in the workplace include: excessive workloads, conflicting demands, a lack of influence over the way the job is done, job insecurity, and a lack of support from management or colleagues. Many of these can be encountered in office work, with or without the use of computers (although in some cases, the impact of computing technologies on how jobs are structured can play a major role – such as in call centres). The potential impact of these factors is two-fold. Firstly they can have a direct impact on the mental and physical health of workers. Secondly, there is a growing body of evidence that they can contribute to (and exacerbate) the risk of musculoskeletal problems.
• Environment: a good physical working environment is important, not only for health and well-being but also because an inadequate environment can have a negative impact on concentration and communication therefore impairing work performance. Unsuitable temperatures, draughts, inadequate lighting, excessive or disturbing noise can all have an adverse impact.

Although, as noted above, the risks to health associated with office work are not solely related to the use of computers or computing technologies, nevertheless, a very high proportion of workers in office workplaces carry out their work with the aid of such devices. The provisions of the EU Directive on the use of Display Screen Equipment (DSE), which embodies a number of ergonomics provisions, is particularly relevant (see below for details of the legal framework). The Directive identifies three categories of risk relating to the use of DSE (a term used to encompass various computing technologies of the time although now (2016) somewhat outdated). The Directive identifies possible risks to “eyesight, physical problems (musculoskeletal disorders) and problems of mental stress".

There is a widespread consensus in the scientific literature that work with computers does not cause any damage to the eyes or eyesight. Although prolonged detailed visual work can lead to visual discomfort and transient symptoms such as those associated, for example with drying of the eyes, there is no reliable evidence to support the suggestion that such work actually damages eyesight. In a UK-based study of over 1500 computer users, Melrose et al (2006)^[1] found that the level of reported ocular symptoms was no different to the levels reported in population-based studies. This suggests that there is no particular relationship between office (DSE) work and visual problems leading to a higher incidence of such problems. Temporary or transient symptoms such as headaches, and tired, red or sore eyes may be caused by concentrating on the display screen for a long time, poor positioning of the computer, flickering screens, inadequate lighting, glare and reflection, or poor legibility of paper or screen documents.

As noted above, the psychosocial risks which can lead to mental stress or other health problems are well-known and have been long established. However, although some of these can be present in work which involves the use of DSE, they are generally recognised as being associated with the nature of the work, rather than any intrinsic risks associated with DSE use. However, there are growing concerns that the growth of ‘new DSE’ such as smartphones and tablets is leading to the expectation amongst some employers for workers to check emails, etc. when not at work. This blurring of the ‘work-life balance’ can lead to psychosocial risks.

The main health consequences that arise from working with DSE are musculoskeletal disorders (MSDs), conditions affecting the muscles, tendons, ligaments, nerves and other soft tissues and joints of the neck, upper limbs (shoulders, arms, hands, wrists, fingers), back or lower limbs (knees, hips, feet). Symptoms include pain, swelling, tingling and numbness, and may result in difficulty moving or long-term disability if no action is taken.

The term covers conditions with specific medical diagnoses (e.g. frozen shoulder, carpal tunnel syndrome (CTS)), and others where there is pain without specific symptoms. Neck, upper limb and back pain are of particular concern for office workers given the repetitive, static and intensive nature of their work.

Although there is little doubt that office work involving the use of computers can provoke symptoms or exacerbate existing MSDs, there is some question over the extent to which such work directly causes them, as opposed to provoking symptoms of pre-existing disorders (such as appears to be the case for CTS).

Different countries and authorities use a number of different terms to describe MSDs. These include Cumulative Trauma Disorders, Upper Limb Disorders, and Repetitive Strain Injuries (RSI). Some sources also use the latter term as a ‘diagnosis’ (although not one with any clinical definition) which they apply to non-specific symptoms.

Legislation

In the late 80s the Council of the European Communities launched a programme concerning safety, hygiene and health at work. Two of the resulting Council Directives are of particular relevance to the office environment: the Manual Handling Directive^[1] and the DSE Directive^[2]. Although there will undoubtedly be manual handling activities in office environments by far the most important (at least in terms of number of employees affected) is the DSE Directive. This defines minimum safety and health requirements for work with display screen equipment. These minimum requirements were designed to encourage improvements, especially in the working environment, to ensure a better level of protection of safety and health for workers who use display screens.

The key definitions in this Directive are:

• Display screen equipment - an alpha-numeric or graphic display screen, regardless of the display process employed.
• Workstation - an assembly comprising display screen equipment, which may be provided with a keyboard or input device and/or software determining the operator/machine interface, optional accessories, peripherals including the diskette drive, telephone, modem, printer, document holder, work chair and work desk or work surface, and the immediate work environment.
• Worker - any worker who habitually uses display screen equipment as a significant part of their normal work.

How these definitions are interpreted may differ in the national legislation implementing this Directive.

The same Directive sets out employers' obligations regarding the analysis of workstations, the provision of information and training to workers, the planning of daily work routines, the consultation and participation of workers, and the protection of workers' eyes and eyesight. Other obligations laid down in the Directive apply to equipment components present in the workstation, specifically display screens, keyboards, work desks or work surfaces, and work chairs. The Directive further specifies environmental requirements regarding space, lighting, reflections and glare, noise, heat, radiation, and humidity.

One of the drawbacks of the current Directive is that it has failed to keep abreast of changes in technology and working practices. As a result there are no references to computer mice (for example) or for alternative seating technologies/approaches such as sit-stand chairs or standing workstations. It effectively enshrines the concept of the fixed ‘workstation’ in a conventional office environment despite the fact that many workers now do not work at set workstations (e.g. hot-desking) or even set workplaces (e.g. home working). It also excludes “’portable’ systems [interpreted to mean laptops in most Member States] not in prolonged use at a workstation". The interpretation of this in different Member States appears to vary somewhat, thus some exclude laptops completely (they do not comply with other aspects of the legislation, enshrined within the Annex of Minimum Requirements) while others include them where they are used extensively in one place.

Nevertheless, the Directive does acknowledge the importance of taking ergonomic aspects of workstations into account, thereby helping to ensure the consideration of ergonomics principles in the office environment. Applying ergonomics principles to the design and layout of where people work and the work that they do there remains valid, whatever the nature of the workplace and whatever form the technology used takes.

The Directive also outlines principle requirements for the operator/computer interface, particularly regarding the suitability of software for tasks, ease of use, feedback to workers on their performance, adequacy of display information format and pace, and the application of software ergonomics to take account of human data processing.

At the national level, Member States’ legislation brought into force the provisions necessary to comply with this Directive. Legislation is in place in all of the EU Member States. Examples of such legislation are:

• ES: Real Decreto 488/1997 (14 April) [sobre disposiciones mínimas de seguridad y Salud relativas al trabajo con equipos que incluye pantallas de visualización] {Royal Decree 488/1997 of 14 April 1997 on minimum safety and health-related requirements for working with display screens equipment}.
• PT: n.º 349/1993 [Decreto-Lei n.º 349/93 de 1 de Outubro de 1993 que transpõe para a ordem jurídica interna a Directiva n.º 90/270/CEE, do Conselho, de 29 de Maio, relativa às prescrições mínimas de segurança e de saúde respeitantes ao trabalho com equipamentos dotados de visor, Diário da República, I Série-A, N.º 231] transposes the Directive and Portaria n.º 989/93 (6 October) [Portaria n.º 989/93 de 6 de Outubro de 1993 que estabelece as prescrições mínimas de segurança e saúde respeitantes ao trabalho com equipamentos dotados de visor, Diário da República, I Série-B, N.º 234] sets out the minimum requirements for work with display screen equipment.
• UK: Display Screen Equipment Regulations 1992 (DSER) (as amended 2002).

Developing a proactive organisational strategy

It is important for any organisation to have a proactive strategy in place to manage the health of their workforce starting with understanding the relevant issues and making a commitment to act (e.g. workplace risks should be recognised and the management committed to minimising them). This should include having clear reporting systems for health problems, carrying out risk assessments, managing any problems identified, and then implementing and monitoring solutions. Worker participation should be sought and valued. A key feature of the requirements of the Directive (and resultant national legislation is that of information and training. Educating and informing the workforce, e.g. to help workers understand the causes of risk; to identify desirable/undesirable workstation features; and to understand their role in correcting them is vital in ensuring ongoing compliance.

The organisational strategy must identify important issues for the administration and practical execution of the assessments, such as: who should undertake risk assessments, how will they be trained, how will the assessment be conducted and recorded, how will changes be implemented and monitored, and what will be the timescales for the process, including when reassessment will be undertaken. This strategy applies to any working environment, including offices and other locations where similar work is carried out.

Conducting risk assessments

The purpose of conducting a ‘suitable and sufficient’ assessment is to identify work activities and workstation set-up where the health and safety of users is at risk. Employers must eliminate the risks that are identified or reduce them as far as is reasonably practicable, by introducing control measures, recording actions taken, and monitoring how the control measures work in practice.

It is important to be systematic when carrying out a risk assessment, and to take into account all aspects of the work situation. As well as investigating furniture and equipment, software, the environment and health issues with workers, the risk assessment should also explore the way that tasks are organised. It is important to understand what a person is required to do at work in order to conduct a comprehensive risk assessment, and to ask users about the nature and duration of the tasks that they carry out (e.g. any requirement to meet performance targets or to sit in the same position for many hours). Workers' views should be taken into account throughout the risk assessment process (e.g. in the identification, assessment and controlling of risks).

Health and safety professionals can conduct assessments, as can other trained staff who are familiar with the main requirements, who are able to identify hazards and assess risks, who draw valid and reliable conclusions from the data collected and identify steps to reduce risk, who keep clear records and who recognise their own limitations (i.e. they know when to ask for help). It is essential to check that assessors understand information and have reached a suitable level of competence.

Using a checklist can help you identify hazards and evaluate risks. It also provides a record of the risk assessment. There are many checklists available for performing risk assessments, and examples are included in some Member State legislation. Annex A provides one example of such a checklist, and outlines the issues that should be explored in an assessment.

Re-assessment should be conducted at intervals set by the employer according to need and resources. Most importantly, risk assessment should take place where changes occur to the workforce, equipment, work tasks or conditions (including to software).

Ergonomics good practice – reducing hazards and risks

A properly set-up office workstation helps workers maintain a neutral body posture. This is a comfortable working posture, in which the joints are naturally aligned and relaxed, reducing stress and strain on the muscles, tendons, and skeletal system, and minimising the risk of developing MSDs. An adequate workstation also helps to prevent fatigue, eye strain, headaches and stress by controlling environmental conditions.

The guidance below is based upon the assumption of a seated posture using a conventional office chair. An increasing number of alternatives are becoming available including different styles of seating, and standing workstations.

Alternative styles of seating such as kneeling chair and saddle chairs have some advantages over more conventional styles. However, they are not without their drawbacks and cannot be universally recommended.

Although more expensive than a conventional desk, height-adjustable desks allowing the worker to change between sitting and standing postures can be of value, especially for workers with pre-existing back problems who cannot sustain extended periods of sitting. Some manufacturers are now devising add-ons that allow conventional desks to be adapted to sit-stand.

There is growing recognition of the fact that the human body is designed for movement and that many of the health problems associated with sedentary work stem, not necessarily from not sitting ‘correctly’, but from the absence of movement associated with such work. Some authorities suggest a more dynamic work plan, where working posture is changed periodically between sitting and standing^[1]. Other simple measures can include going and talking to work colleagues – instead of sending them an email from three desks away!

Using a conventional seat, a neutral body posture has the following characteristics:

• The head is level, or bent slightly forward, looking straight at the screen and generally in line with the torso (NB. This assumes that the worker looks at the screen as their main visual attention area. Those with poor typing skills may need to look at the keyboard when typing creating a potential conflict).
• The shoulders are relaxed and the upper arms hang normally at the side of the body.
• The back is fully supported, with appropriate lumbar support when sitting vertically or leaning back slightly (preferred).
• The elbows stay close to the body, bent to around 90 degrees or slightly more (not less).
• The hands, wrists, and forearms are ‘straight’ (in an anatomically neutral position which, in some individuals, may actually entail some slight wrist extension – bending backwards), in line and roughly parallel to the floor.
• The thighs and hips are supported by a well-padded seat, and generally parallel to the floor or sloping slightly down (hips higher than knees).
• The knees are no higher than the hips and possibly slightly lower, with the feet slightly forward of the knees.
• The feet are fully supported by the floor or by a footrest. In order to achieve adequate working conditions, the work space and equipment must be carefully selected and positioned.

The following guidance should help in achieving the postural characteristics described above. However, in all cases, the need for an appropriate posture is paramount, rather than regarding the following as ‘rules’ to be obeyed at all times.

Don’t forget that many alternative input devices are now available that can be used instead of a conventional mouse. These can be helpful, especially where workers are experiencing symptoms with mouse use. However, care should always be taken to ensure that the alternative device is not creating further problems. As a further option, voice-activated software can also provide a solution.

The following guidance on workplace environmental conditions might be helpful:

As noted above, nowadays, special reference to the use of laptops is required, since an increasing number of workers use this type of computer all day. Laptop design does not comply with the basic ergonomic requirement for computers to have a separate keyboard and screen. As a result, if the keyboard is in an optimal position for the user, the screen is not, and if the screen's position is optimal the keyboard's is not. The use of laptops alone can lead to an increased risk of musculoskeletal discomfort, particularly in the neck and wrist, compared to a normal desk-top computer, due to the postures that are usually adopted.

Where at all possible to do so, and the length of use warrants it (short uses of less than 20-30 minutes are unlikely to give rise to problems) it is advisable to use at least a separate keyboard, allowing the laptop screen to be raised. Where work tasks involve extensive use of the pointer then a separate mouse or other pointing device is also advisable. Many lightweight portable examples of keyboards and mice (including wireless models) are available which can facilitate such measures. In relatively static environments, use of a docking station may be beneficial, allowing the peripheral devices to remain connected. Where such measures are not possible (perhaps when the user is working away from their usual workplace) then it becomes important to emphasise the importance of breaks, and changes in activity.

One measure adopted in many modern offices is the concept of hot-desking, where workers to not have a personally dedicated workstation but share one with other workers. Again the duration of use is critical but, where an individual is to use such a workstation for prolonged periods, then it becomes important that features of the workstation (such as the display screen and chair) are easily and quickly adjusted to suit the individual wishing to use it and an even stronger emphasis than normal must be placed on information and training, to ensure that the workers is aware of the posture they need to achieve and is sufficiently motivated to take a few moments to make the necessary adjustments.

Regardless of how good the working position is, prolonged static postures are not healthy. Thus, work activity must allow for pauses and micro-pauses, during which workers can:

• Change their working posture frequently by making small adjustments to the chair or backrest.

• Stretch their fingers, hands, arms, and torso.
• Perform different tasks, like filing.
• Stand up and walk around.
• Blink and focus their eyes on objects away from the screen.

Physical variety and regular breaks from the computer during the working day will help to relax muscles. Performing exercises and stretches will also help to reinvigorate the body and mind. Such procedures both increase productivity and reduce discomfort and complaints among computer users, and minimise the risks related to computer usage.

Further information

Checklists

• Display screen equipment (DSE) workstation checklist: https://www.hse.gov.uk/pubns/ck1.htm

Books/leaflets

• Checklists for the Use of Visual Display Units in the Workplace: https://www.worksafe.govt.nz/worksafe/information-guidance/all-guidance-items/guidelines-for-using-computers
• Working with VDUs: https://www.hse.gov.uk/pubns/indg36.pdf
• Woods, V., Hastings, S., Buckle, P. and Haslam, R. 2002, Ergonomics of Using a Mouse or Other Non-keyboard Input Device , HSE Books, RR045, ISBN 0 7176 2162 6. https://www.hse.gov.uk/research/rrhtm/rr045.htm

Websites

The Agency’s MSDs Single Entry Point: https://osha.europa.eu/topics/msds

UK HSE Musculoskeletal Disorders: https://www.hse.gov.uk/msd/index.htm

UK HSE Office health and safety: https://www.hse.gov.uk/office/index.htm

5 Tips for Using a Laptop Computer: https://ergo.human.cornell.edu/culaptoptips.html

References

ISO 9241-6:1999 Ergonomic requirements for office work with visual display terminals (VDTs) -- Part 6: Guidance on the work environment

Health and Safety Executive (2002). Upper limb disorders in the workplace (HSG60). Suffolk, England: HSE Books: https://www.hse.gov.uk/pUbns/priced/hsg60.pdf

Health and Safety Executive (2005) Work-related stress: https://www.hse.gov.uk/stress/index.htm

ANNEX A: COMPUTER WORKSTATION CHECKLIST

Complete the checklist, ticking either the ‘yes’ or ‘no’ column against each risk factor:

Yes’ answers require no further action.

‘No’ answers will require investigation and/or remedial action by the workstation assessor.

A. TASK

B. EQUIPMENT

Display screen

Keyboard

Non-keyboard input device (e.g. mouse)

C. SOFTWARE

D. FURNITURE

E. ENVIRONMENT

F. HEALTH and CONSULTATION

RISK ASSESSMENT ACTIONS Record here the actions required to rectify any problems identified.