Ergonomics Associated with DSE
Introduction
Display Screen Equipment (DSE) are important components of most businesses and organizations today. DSE constitutes any electronic equipment which has a keyboard, a display screen, and a third component, especially a storage component. Based on this definition, there are much equipment which qualify to be categorized as DSE; however, DSE conventionally refers to computer equipment. DSEs have users and operators. The user is the person who is in contact with the equipment for most of the time. Despite their usefulness and utter necessity, if poorly regulated, DSEs pose serious health threats to the user. Due to this, many countries including the UK have come up with legislations which are meant to protect the user of DSE from the health hazards that the equipment pose. This paper a report of the DSE ergonomics assessment that was done for five workers at a firm called Eagle Investments. The precedence of the report is set by an analysis of the various health effects that can result from continued DSE use and the various legislations passed in the UK to curb the same.
Health Hazards of DSE
Numerous studies carried out across the globe have found DSEs to have many negative effects on the health of the user. In fact, DSE is ranked among the biggest work-related health hazards in industries like banking, insurance, and energy and in central government in the UK. The relative risk of being diagnosed with these DSE-associated health effects increases with the increase in time of usage of the equipment. These health issues range from musculoskeletal problems to reproductive health issues.
Repetitive Strain Injuries (RSI) which are also referred to as Work Related Upper Limb Disorders (WRULDs) as the most frequently related health concerns among DSE users which can be directly attributed to continuous DSE use (Lacerda et al., 2005 p.107). RSIs/WRULDs are a range of disorders of nerves, muscles, tendons, and joints mainly of the upper limbs which include the fingers, wrists, forearms, elbows, arms, and shoulders (Lacerda et al., 2005 p.107). RSIs also affect the neck. This kind of injuries are attributed to continuous and pressurized arm and finger movements especially during keying. These movements eventually traumatize nerves and muscles within the upper limb and neck hence pain and inflammation. Maintenance of the same posture for long hours during keying also contributes to neck and lower-back pains. Apart from pain, RSIs/WRULDs can present with tenderness of affected part; a feeling of heaviness; swelling; tingling sensation; especially where the fingertips are affected; numbness; joint restriction (Lacerda et al., 2005 p.107). Workers whose work is in high demand and highly stressful or those who have little control over their work are more likely to suffer this kind of injuries (Palmer et al., 2007 p. 64). In the long-term such injuries and the effect of maintaining a similar posture for long hours can be a contributing factor to the decreasing age of onset of osteoarthritis being seen.
Long hours of sitting or other forms of immobility while using DSEs have been associated increased thromboembolic events in DSEs users (Healy et al., 2010 p.448). Immobility allows for venous stasis hence allowing blood in deep veins of the lower limbs to coagulate; this is called thrombosis (Healy et al., 2010 p.450). Movement of such thrombi to other parts of the body, embolism, can have catastrophic effects including sudden death and stroke.
The second health hazard that has been heavily associated with prolonged use of DSEs is psychological stress. Physical and mental fatigues are the main causes of work-related psychological stress. The resultant psychological stress also impacts on the bodies physicality thus worsening fatigue hence a vicious cycle is created (Johnson and Montanheiro, 1997 p.71). Such a cycle can lead to a crisis if not identified and dealt with early enough. Apart from the physical fatigue, Johnson and Montanheiro (1997 p. 77) also attributes psychological stress among frequent users of DSEs to: little control over work, working conditions, and working methods; performance of many tasks requiring high concentration and attention; inability to fully use one’s skills; high expectations from the organization and monotony; insufficient breaks; limited opportunities for social interaction due to long working hours; insufficient rewards for the work being performed – limited resources, inadequate pay, and low self-esteem.
Thirdly, due to their visual demands, DSEs have been shown to impact the user’s eyesight negatively (Prabhu et al., 2014 p.3). The visual defects that can be attributed to DSEs have been called Computer Vision Syndrome before (Anshel, 2005 p.24). The visual issues usually start as episodes of visual fatigue which present with reduced visual performance, redness or soreness of eyes, headaches, and adoption of awkward postures (Prabhu et al., 2014 p.3). This awkward postures that are adapted in a bid to try and visualize things better largely contribute to the musculoskeletal problems, especially those of the back and neck, which have been discussed before. For people with preexisting visual problems who start using DSEs frequently, their visual problems may become obvious for those who were not aware of the preexisting condition or the conditions might complicate in those who knew their conditions (Anshel, 2005 p.29). Anshel (2005 p.27) also asserts that badly positioned workstations, poor lighting, poor screen design, and uncorrected eye defects are at the heart of DSEs-related visual problems.
Fourth, an association between reproductive health issues in both males and females with continued DSEs use has emerged before. DSEs seem to be most hazardous to pregnant women (Tikkanen et al., 1990 p. 64). DSEs are known to produce both ionizing and non-ionizing electromagnetic radiations, albeit extremely low levels of these according to international recommendations, which could be a factor in causing miscarriages and birth defects. In males, long hours of sitting has been associated with increased temperatures around the scrotum thus jeopardizing the whole function of the testes which are designed to work optimally at lower temperatures. Moreover, Sheynkin and colleagues (2005 p.454) also associate positioning of laptops on the lap for long periods with the same male reproductive problems. Past research has also noted menstrual issues like oligomenorrhea, menorrhagia, and dysmenorrhea in women who are exposed to DSEs for most of the time. The incidence of pre-menstrual syndrome was also shown to be increased in such women. Psychological stress seems to play an important role in the occurrence of these menstrual problems since it can impact on hormonal balance.
Skin problems ranging from occasional itching and erythema of facial and nuchal skin have been reported in DSEs users. These have been attributed to inadequate ventilation, excess static electricity and low levels of relative humidity in working stations. Hormonal imbalance secondary to psychological stress could also have a role to play here.
Finally, though rare, an exacerbation of photosensitive epilepsy is one of the biggest health hazards of DSEs use. According to Pinto and colleagues (2005 p.175), photosensitive epilepsy can be triggered by bright and flickering light. It is a medical emergency whenever it occurs.
Legislation on the use of DSEs in the UK
An act of parliament meant to ensure the safety of all DSEs users was passed in the UK on the fifth of November 1992 (Council, 2012 p.1). With these act of parliament also came an Approved Code of Practice for DSE use. The regulations were triggered by an increased incidence of prolonged DSEs use-related morbidities. These statutory regulations range from the setting of the workstation to the training of users.
First, the DSE user has to be comfortable (Council, 2012 p.2). Several regulations in the act were meant to ensure this. These include: use of armchairs that ensure that the top of the screen is in the same horizontal plane as the eyes of the user; adequate space and a proper document store; properly set screen to avoid glare and bright reflections; adequate but not excess lighting; properly adjusted screen brightness and contrast for the amount of lighting in the room; properly cleaned screen surface; space for leg movement below the desk; footrests for smaller users to reduce pressure on legs and knees.
Secondly, the employer should provide for regular changes of activity or regular breaks to prevent long periods of immobility, fatigue, eye strain, and boredom (Council, 2012 p.3). Short and frequent breaks are more effective than few long breaks. Moreover, the timing of the breaks should be such that they are provided before tiredness sets in rather than having breaks for recovery.
Thirdly, there are statutory regulations that aim to protect users from the health risks associated with portable computers. With these, the employer should consider the risk of users having to carry heavy equipment every time (Council, 2012 p.4). Users should look to use firm surfaces or docking stations whenever they are using portable computers and to angle the screens of the equipment properly to avoid eye strain and unnecessary reflections (Council, 2012 p.4).
Fourth, employers should either look for properly trained DSE users or train their own users. The training should look to focus on: potential risks of DSE use and the regulations at the particular premise; proper adjustment of furniture and organization of workstation; proper cleaning of screens and other accessories; signs and symptoms of potential health outcomes and how to solicit for help in case they are noted; use of a DSE workstation checklist (Council, 2012 p.5). the ACoP requires the employer to train their employees.
Fifth, employers should oversee the provision of eye tests for their workers (Council, 2012 p.5). The Approved Code of Practice (ACoP) requires that in case the eye tests reveal that a particular worker requires spectacles specifically for DSE use, the employer should provide for this. Moreover, the employer should find out basic information about the tests from the optician and update the users.
Sixth, since DSE workstations are amenable to frequent changes, regular reviews are important (Council, 2012 p.6). A firm can set a time frame for DSE review. However, a review is necessary when: there have been major changes in workstation infrastructure, hardware or software; users have changed workstations; there has been a considerable change in nature of work; the available controls are thought to be causing other problems. The ACoP requires the firm to train staff who can serve as internal reviewers.
There are exemptions to this regulations. Military personnel of the UK or those visiting are exempted from the regulation since their contact with DSE is on short-term (Council, 2012 p.6). Self-employed people should look to ensure these regulations in their premises too.
Assessment Report
I assessed five members of staff from a firm called Eagle Investments. The assessment was done was a standard ergonomic assessment which was meant to identify any DSE-associated risks for the workers and how these can be solved. The assessment was done in line with statutory regulations of the UK including the 1992 amendment and the Approved Code of Practice (ACoP) for DSE users.
The firm is a retail shop for small electronic gadgets like cellphones, radios, DVD players, and decoders. They also specialize in selling all types of watches and their accessories. Accessories to the other electronic gadgets are also sold. The firm is situated on a busy street in Merseyside and has many customers. The volume of business at the firm is, therefore, pretty big. After interviewing the proprietor, I concluded that on average, the firm made a net profit of £20000 in a month.
The firm has a total of twenty-one staff in five departments. The first of these is the managerial department. This department is run by the firm’s proprietor. The department also doubles as the ICT department in the firm as the proprietor is the chief ICT expert in the firm. The second department is the human resource department. The department is mainly concerned with hiring, monitoring, and firing workers whenever there is a need to. The department has two members – both who use the computer for most of their work. The third is the finance department. The department consists of two cashiers. For these, they do all their work on computers. Fourth, is the sales department; this department has the highest number of employees. The employees in this department are responsible for ensuring neatness and order of commodities on display and on shelves. They also talk to customers at a personal level and help customers in choosing the commodities which suit them best before referring the customer to the cashier where payment is made. Not all members of this department use computers, though. Only three of them are responsible for keying the agreed deal into the system for the cashiers to see. Lastly is the reception department. The department has two receptionists who work in shifts. Their work mainly is welcoming customers and ushering them to the place where they can get whatever they are looking for. The receptionists work also involves the use of computers.
In this exercise, only five staff members at Eagle Investments were assessed. Each of the five members of staff assessed was from a different department. Apart from the proprietor who was assessed in the managerial/ICT department, the employees chosen for assessment in the other departments were the latest to be employed. This assessment was meant to determine if the current DSE use had posed any risks to their health or had already started to interfere with their health. An assessment form meant to serve that purpose has been attached at the end of the report.
At the beginning of the assessment, the employee being assessed was to mention their name, that of the assessor, and the tasks they are required to do as part of their job description. The next section of the assessment forms asked questions regarding the comfort of the computer screens, especially for their eyes. All the staff assessed agreed that the characters on the screens of the DSE they were using were well defined. One of the staff complained that the screen that they were using had problems with adjustment of contrast and brightness. One of the staff also reported that the screen they were using could not be swiveled easily for optimal vision and comfort. Coincidentally, the screen that had issues with contrast and brightness was the same that had issues with mobility.
The second part of the assessment for looked to determine whether the firm followed the 1992 amendment and the ACoP for DSE use in setting up the workstations. All workers had adjustable tables provided for their screen. All workers had their keyboards on matt surfaces and with all characters properly legible. The workers also agreed that the keyboards were in good conditions and one did not need to use much strength when keying. All keyboards were separate from the screens and could be tilted. All workers had space in front of their keyboards and their workstations were spacious enough to allow for placement of elbows. Four of the workers reported that their desks had a document holder which was placed appropriately; one complained that the holder was too far for a person of their height. All the workers agreed that their work chairs allowed space for movements and their height could be adjusted. All seats could also be tilted and had arms where the user could rest their elbows. All chairs had a footrest but one worker complained that the footrest was too far for his height. All workstations assessed had adequate space below the work table for movement and of lower limbs and changes in sitting posture. All workstations were reported to have adequate lighting and humidity. However, two of the workers complained that they were unable to set this lighting and humidity conditions to their most preferred levels.
The next section of the forms was meant to determine if working with DSE had started to affect the health of the users. None of the workers assessed reported new neck, lower back, arm, forearm, elbow, wrist or finger pain since they started working with DSE at the firm. Two of the workers, however, reported a feeling of mental and physical fatigue that they were not feeling before they were employed at the firm. The mental fatigue was often accompanied by a headache in one of the workers. Only one worker, who happened to be the manager reported progressively increasing visual fatigue since he started the firm.
With this information that was derived from the assessment, action can be taken to make the workstations far more comfortable for the users. Since the one worker who reported that the screen they were using did not have adjustable contrast and brightness also happens to be the one who reported an increase in mental and physical fatigue accompanied by headaches since they started working at the firm, reviewing the workstation would be appropriate. In the review, it is necessary to change the screen to one whose position, contrast and brightness can be adjusted. The other worker who mentioned an increase in mental and physical fatigue happened to be the one who complained of the footrest and document holder at their workstation being too far for a person of their short height. For this case, customization of the workstation to the demands of the worker can provide an ultimate solution.
Generally, the three workers, including the manager, who reported any health effects that they attributed to work at the firm should request for an advanced ergonomic assessment. This advanced assessment is meant to characterize their problems so as to know how best to solve them. The firm proprietor should organize for this assessment as soon as possible.
One control strategy which could aid the firm in the long term would be ergonomic training of some members of staff. Robertson and O’Neill (2003 p 493) identify employee training as an important way of preventing musculoskeletal morbidities due to their occupation. Considering the number of employees at Eagle investments, training two employees would be adequate as the ratio of ergonomic trained employees to those who are not trained would be 1:9. Moreover, the employer is required to provide ergonomic training to workers as part of their legal duty towards the ACoP. The two who shall be trained shall be DSE assessor for the firm. This will aid the firm in managing all health and safety issues at the workplace without having to involve outside consultants.
The training has benefits to the trainee and the firm in general. In fact, the best thing for a firm is having many employees who are competent DSE ergonomic assessors. As Ball and Heaton (2003 p.153) put it, the trainee will be able to identify ergonomic problems at their workplace, provide input in planning for changes in design at the workplace, understand the causes and prevention strategies for musculoskeletal and eye disorders at the workplace, improve the productivity of the firm, improve the wellbeing of the other workers in the organization, and make informed decisions regarding the design of the workplace.
The training institution provides delegates who look to utilize the ergonomic assessment tools already present at the firm in horning the assessment skills of the trainees. Usually, the trainee is a chartered ergonomist. In the process of training, the ergonomist will help the trainee in identifying a few ergonomic issues that exist at the workplace hence free service. One of the skills that the trainee will be impacted with is how to use an ACoP workstation checklist to quickly assess a workstation. The trainees are also impacted with knowledge that can help them identify when complications arise during the assessment process and how to deal with them (Ball and Heaton, 2003 p.153). Finally, after the assessments, a trained assessor should be able to tell if and when specialist advice is required.
The good thing is that all these interventions will not cost Eagle Investments too much. The price of an adjustable and standard workstation computer monitor does not exceed £100. Secondly, the cost of training two employees in ergonomics is not much. A training institution called RSA, which is based in the UK, puts the cost DSE assessor training at £775. The goodness of this is that the training, which takes one day, can be attended by up to fifteen workers. Butler (2003 p.35) encourages firms to involve ergonomists or hire trained ergonomists of their own as it won’t cost the firm but rather reduce their expenditure. However, because of the work demands and the number of workers at Eagle Investments, two workers would be appropriate. The other advantage is that during the training, the trainer and trainees can use the one workstation which needs to be customized to the user and, therefore, solve the problem; killing two birds with the same stone. The total cost of the proposals in this report does not exceed £875.
Conclusion
Ergonomics assessment is important for any business firm whose employees are involved with DSE frequently. This is because prolonged use of DSE can pose serious health threats to the user. Ergonomic assessments are meant to identify the health risks at the workplace and determine the best interventions for solving these. In this assessment report, various risk factors for poor DSE-associated health outcomes were identified and some of those poor health outcomes reported. The various interventions that can solve the identified risks are also included in the report. The most important intervention identified, however, is employee training. Trained DSE ergonomic assessors are an asset to a firm and it is well worth for Eagle Investments to invest in the same. As Butler (2003 p.36) found out, having a trained e
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