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As
more and more work, education and recreation involves computers, everyone
needs to be aware of the hazards of computer - related health disorders
like Carpal tunnel syndrome, Repetitive stress Injuries, Computer vision
syndrome, Cyber addiction etc. These conditions can be serious and painful
and if neglected can cause young and physically fit individuals leave
computer dependent careers or be permanently disabled.
These conditions are far easier to prevent than to cure once contracted,
by having a healthy lifestyle and work habits and working at ergonomically
good workstation. |
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| INTRODUCTION |
The
one thing that has had the greatest impact on our lives in modern time
is the computer.Along with smaller size and affordable prices, there
has been the advent of the Internet. This has ensured that people use
this technology either at their place of work or at home. This has led
to an increase in computer related injuries like eye strain, wrist and
back pain, etc. There is a rare reporting of the above mentioned computer
related problems amongst programmers in literature.4,6 The problems
noted above are similar to that cited in literature.1,2
Computer related injuries which began to be reported in India five years
ago are now developing into an epidemic among computer users. It is
estimated that world-wide, 25% of computer users are already suffering
from computer related injuries.8 The United States has to shell out
more than 2 billion US dollars annually for having ignored these computer
related problems.5 It is now proved that the duration of work and computer
- related problems are positively correlated.7 It is not uncommon these
days for people having to leave computer dependent careers or even be
permanently disabled and unable to perform tasks such as driving or
dressing themselves. Occupationally caused RSI rank first among the
health problems, in the frequency with which they affect the quality
of life.1
Thus with rampant and excessive use of computers we are now entering
into a new era of computer related health problems. Let us discuss a
few of these problems along with their preventive and control measures. |
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| CarpAl
Tunnel Syndrome |
Carpal
Tunnel syndrome is a condition that occurs when the median nerve is
squeezed as it crosses the wrist to enter the hand.
The median nerve arises at the level of the sixth cervical vertebra
in the neck. It supplies the muscles of the forearm, which pronate the
arm. It also supplies the muscles that bend the middle finger and the
thumb. It provides sensations to the palmar surface of the hand.
The carpal tunnel is an area on the palm side of the wrist bordered
on one side by the carpal bones and on the other side by the flexor
retinaculum. If the available space within the strong walled tunnel
is reduced the nerve is compressed.
It has been recognized that repetitive movement at the wrist, as occurs
with prolonged use of a computer keyboard can lead to inflammation in
the carpal tunnel leading to carpal tunnel syndrome.
The clinical signs and symptoms include numbness and tingling in the
thumb, index and middle finger. In the later stages wasting and weakness
of thenar muscles with sensory deficiency occurs. There is clumsiness
in carrying out fine movements.
If the symptoms are not very severe, carpal tunnel syndrome can be treated
conservatively with rest, warm compresses, wrist splints, anti-inflammatory
medications and steroid injections. If the symptoms are severe, a surgical
carpal ligament release procedure may be necessary. |
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| Repetitive
Strain Injuries (RSI) |
They
occur from repeated physical movements which cause damage to tendons,
nerves, muscles and other soft tissues. Repetitive strain injuries are
on the rise with increased computer use, faulty typing techniques, poor
body posture and positions. Lack of adequate rest between work and excessive
use of force while using the mouse or the keyboard can lead to repetitive
stress injuries (RSI).
The symptoms of RSI are tightness, discomfort, stiffness, burning in
the hands, wrist, fingers, forearms and elbows. Tingling, coldness and
numbness of the hands with loss of strength and lack of co-ordination
occurs. There is pain in the upper back, shoulders and neck and a need
to massage them. |
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| Computer
Vision Syndrome |
There
is no scientific evidence to indicate that regular use of computer threatens
eye health or results in permanent visual damage. Computer vision syndrome
is the complex of eye and vision problems related to near work which
are experienced during computer use. The symptoms consists of fatigue,
headache, dry eyes, eye strain, blurred vision, neck pain, backache,
altered colour perception, double vision, etc. People who use computers
for more than two hours per day can develop computer vision syndrome.
Predisposing conditions like uncorrected or improperly corrected refractive
errors, binocular dysfunctions and focussing deficiencies may exacerbate
the problem. Poor lighting, inadequate viewing distance, improperly
designed workstation, poor contrast, glare and reflection all contribute
to computer vision syndrome. |
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| Electromagnetic
Radiation |
To
date there is no clear evidence of a link between the Weak Electromagnetic
radiation fields generated by computer and any health problems. Computers
are however still in their relative infancy and we do not have enough
data to determine the effect of the electromagnetic radiation on our
health. |
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| Depression |
A
recent study has found a high degree of co-relation between the time
spend on-line and an increased incidence of depression. It is believed
that these individuals lead an unfulfilled social life, which leads
to further loneliness and depression. |
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| Computer
Addiction or Cyber addiction or Internet Addictive Disorders |
This
is a problem very similar to pathological gambling or compulsive shopping.
The symptoms of computer addiction are quite specific. The psychological
symptoms are
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Having
a sense of well-being or euphoria while at the computer. |
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Inability to stop the activity and craving for more time at the
computer |
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Neglect of family and friends, lieing to employers and family
about his activities. Problems with school or job. |
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Feeling empty, depressed or irritable when not at the computer. |
Along with the psychological
symptoms, physical symptoms like carpal tunnel syndrome, dry eyes, migraine,
headaches, backaches, eating irregularities, failure to attend to personal
hygiene, sleep disturbances are also known to occur.
Like any other addictions this can also be treated with the help of
cognitive behaviour therapy which teaches the patient to identify the
problem, to solve the problem and to learn coping skills to prevent
a relapse. Often medication can help in the treatment.
Any of the signs and symptom listed above need to be dealt with at the
earliest to limit the damage and prevent disabilities. In addition to
that the following recommendations should be followed to prevent and
control computer related health problems.
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| Work
habits |
Use
proper posture to reduce stress on muscles, bones and tendons. Site of
a 90oangle with your arms reaching to the key board, at a 100oangle. Your
knees should extend 4-6 inches off the edge of the seat and bend at a
90oangle. Use an adjustable chair with full back support. Raise your chair
to level where your knees are slightly below the level of your hips.
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Use
correct typing techniques. Avoid using force while typing or holding
the mouse. |
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Avoid
holding the telephone between your neck and shoulders. |
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Keep your body and mind as relaxed as possible, breathe regularly
and deeply. Keep your hands and arms warm. |
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Alternate non-computer jobs with computer jobs. |
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Eliminate
unnecessary computer usage. |
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Take micro breaks at least every 15-30 mins. Use ‘break
reminder’ software packages. Longer breaks should be taken
every hour or two of intensive computer use. Do stretching exercises
during breaks. |
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Lead a healthy life style. |
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Use of speech recognition software as alternative to the keyboard
input can be tried. |
The
Work Station
: The elements of a good work station setup include - A good adjustable
chair with firm support, a good seat cushioning with a waterfall front
edge, pneumatic seat height adjustability, swivel seat, five legs with
casters.
The seat should provide firm support to the lumbar region of the back
and should accommodate a slightly backward lean. The chair’s adjustment
controls should be easy to operate and to reach. If the chair height
is too high at the lowest adjustment, a footrest can be used.
Keyboard : The computer keyboard should be placed at approximately
elbow height with the surface at a comfortable angle. The hands and
wrists should be held in a neutral position when typing. The wrists
should be straight and not bend upwards, downwards or sideways. The
shoulders should be relaxed, the upper arms should hang comfortable
down along the sides of the body and the elbows should not be cocked
out away from the body.
Mouse : The mouse should be so placed that the shoulders and
upper arms can be relaxed and close to the body while operating the
mouse. Keep the wrist and hands in neutral position. Use as little force
as possible. Use of mouse wrist support can be useful.
Monitor : The top of the display screen should be at a slightly below
eye level and about 18" to 24" away from the face. Copy should
be placed on a copy stand in front of the worker and at about the same
height as the monitor.
Vision : Have your vision checked frequently. If you wear corrective
lenses inquire about lenses that have a focal distance designed for
working at a computer.
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Contact
lens users should blink frequently and use eye moisturizing
drops to avoid dry eye syndrome. |
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Increase the font size. |
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Reduce glare by using glare reduction filters and hoods. Spectacles
with anti-reflection coating can be used.
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Position
the monitor at eye level. The angle of the screen should be
easily visible. Adjust the monitor’s brightness and contrast.
Clean the screen frequently. |
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Dark
letters on a light background should be used to reduce eye strain. |
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Choose
a monitor with good resolution for clarity of characters on
the screen. The screen refresh rate should be least 60 Hz to
eliminate screen flicker. |
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Investigate
vision enhancement training and exercise to strengthen your
eyes and enhance your visual ability. |
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Some visual skills important for computer users are tracking,
fixation, and focus change, near vision acuity, binocularity
and maintaining attention. |
20/20/20 exercise : Take a short break of 20 second approximately
every 20 minutes and look at an object more than 20 feet away.
Palming exercise : Briskly rub your hands and palms together
for 5 to 10 seconds, until they are warm. Cup the warmed palm over your
closed eyes. Relax your brow. Breathe regularly and easily.
Other considerations : Keep your office temperature at a comfortable
68-72oF. Keep office noise at a level that is not distracting.
Reduce exposure to electromagnetic radiation by placing work stations
more than 4 feet from the backs of other work stations and moving copiers
and laser printers away from the work station areas.
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| CONCLUSIONS |
Thus
from what has been stated above, it appears that there are definite
syndromes that occur with prolonged computer use. It is also clear,
however, that if certain rules are observed and appropriate precautions
taken, the risk of any of these occurring can be minimized and people
affected with computer related disorders can be treated.
Subjects who change their lifestyles, have an ergonomic work station
and posture have relatively symptom - free working and better work performance.
However people who do not make the necessary changes have moderate to
severe discomfort and have to fall back on medication for relief.3 |
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| REFERENCES |
| • |
Choudhary
S Bakhtiar, Suneetha S. Can we prevent. Occupational stress in
computer professional? Ind J Occu Env Med 2000; 4 (1)
: 4-6. . |
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Choudhary
S Bakhtiar, Sapur Suneetha, Deb PS. Awkward posture and Development
of RSI in computer Professionals. Int J Occu and Env Med
2002; 10-12. |
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Choudhary S Bakhtiar, Vijaya Rao, Suneetha S. Attitude alters the
Risk for Development of RSI in software Professionals. Ind J
Occu and Env Med 2003; 7 : 1. |
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Greenwald MJ, Blake R. Long lasting visual aftereffects from viewing
a computer video display. New England J Medicine 1983;
309-15. |
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Internet
help cope with computer based ailments. In: Computer Express Web
Vision; 14 December 1983; 12. |
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Rao CK, Chandu K, Vasantha V. Hardships of soft people “A
clinical study of ocular and visual discomfort in video display
terminal (VDT) users. Indian Journal of Occupational and Environmental
Medicine 1999; 3 (1) : 14-7. |
| • |
Shah PB, Reddy PSN, Hegde SC. Computer related health disorders.
A new era in Occupation Health. Indian Journal of Occupational
Health 1999; 1-3. |
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The Times of India “Computer users falling into mousetrap"
: Doctors dated 31.3.2003. Page no. 5. |
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