Two desktops - twice the health risk?

Ergonomics is not just about hardware -- it should be applied to every aspect of how a task is undertaken, including the state of mind of the person concerned, according to expert Peter Buckle, Professor of Health Ergonomics at The Robens Institute for Health Ergonomics.

Professor Buckle claims that IT professionals could be at particular risk of incurring Repetitive Strain Injury (RSI) complaints because they frequently have more than one monitor, or even complete systems, on their desks and very little research has been done on the long-term health risks associated with using multiple workstations.

As part of RSI Week, ZDNet UK spoke with Professor Buckle, whose department is part of The European Institute of Health and Medical Sciences based at the University of Surrey, about minimising RSI exposure and whether software and hardware manufacturers are taking the issue seriously.

What type of activities lead to RSI-type complaints?
The causes we know about include people working for long periods of time in very fixed postures -- especially if those postures involve you working with a bit of your body away from a neutral position. A neutral position would probably be with your arm resting on your thigh or something like that, with your elbow close to your side. The moment you start doing anything that moves away from the neutral position means your muscles are having to work against gravity or to hold the joint at a particular angle and that gets fatiguing after a while. If you are working in this position for two or three hours, then when you stop you'll often find that you get some pain or a twinge and that's what we're working to avoid.

Another problem we know about stress. Your perception of what is going on is different also, and that can exacerbate things. Some of those things are to do with the input device -- the keyboard or the mouse -- but some are to do with the type of work undertaken.

You've carried out some research looking into the relationship between different Non-Keyboard Input Devices (NKIDs) and RSI. Did you reach any conclusions such as whether a track-ball is safer than a mouse?
The kind of advice we give to people is not, 'Is the tracker-ball right, is the mouse right?' but to try different devices and find one that suits the way you work. Second, if you're not using the mouse get your hand off it -- put it down by your side.

The focus on the mouse is quite an important one because we've all moved in the past five to 10 years from systems that are predominantly keyboard-based to GUI-type interfaces. So you're using the mouse probably as much as your keyboard. That is quite an important change for everybody, which is why the mouse is up in the frame.

So is a keyboard a safer way of interacting with the computer?
Well, one of the things we promote these days is using short keyboards. These are the keyboards without the numeric keypad section, which how often do you use anyway? The effect of those -- as most people are right handed -- is to push the mouse even further out away from the body. With a short keyboard you can get the mouse closer to the mid-line of the body so you're reducing the static load on the shoulder and you get a lot less discomfort.

How widely available are short keyboards? Is the industry doing enough to market them?
Yes, you can buy them, they're out there but they don't come as standard. When you buy a PC you have to buy quite a lot of standard, you have to buy Microsoft software -- not that I'm going to comment on that -- but we also end up with mouse and keyboard as standard even if that's not what we wanted and I think that's a shame. If you had a choice I would be advocating that most people buy short keyboards and perhaps optical mice, which are less dependent on the mouse mat being a good quality mouse mat.

One of the things we have done is provide a checklist for people of what kind of things they should be thinking about when they buy a mouse. There are basic things that need to be met -- you don't just buy a mouse because it's got fifteen different buttons on it; in fact that's probably the worst thing you could do. Also the mouse is no longer a simple bit of kit; you need training to get the best out of it. An awful lot of people don't know that if you click the right button you get a whole different set of menus coming up and that you can customise those menus to whatever you like so you can cut down on the number of keystrokes you need.

Are there any aspects of the way IT professionals work that could make them particularly susceptible to RSI?
I do meet a lot of IT specialists and one of the problems that they have in particular is that they are often using multiple screens and multiple systems. That is a real challenge because we don't have any regulations out there about multiple screen use. What regulations there are have just vee modified from single-screen use. The principles you need to apply are the same: you look at what you use most frequently and look for the risk factors. But also a lot of IT people are working in a 24/7 environment, where you have got people coming into your system when you're not there, with shift work. In that kind of situation you need a lot more flexibility; you can't just set your system up for yourself and leave it, because someone else is going to come in and change it all round.

So I think IT people need particularly good risk assessments to be made of their workplace. All this is meant to happen under a set of regulations that came out in 1992 called the Display Screen Equipment (DSE) regulations. So all offices are meant to be risk-assessed but it would be interesting to ask around your office and find out when it was risk-assessed. And that assessment should happen any time anything changes in your office, and that doesn't just mean hardware; if your software changes completely, the tasks you do and how you do them changes completely. But I would say that if you are using more than one screen at your desk then those risk assessments will have to be quite specialised.

Do you think the IT industry and IT vendors in particular are addressing these kinds of issues adequately in terms of how they create and market hardware?
I think at the moment short keyboards and their like tend to be more expensive. It is seen as being a luxury when actually it should be seen as being essential. The kind of parallel I used to draw is if that you were a craftsperson 50 years ago you would have a set of tools handmade for you so they fitted your hand and were shaped and angled the way you wanted. These days we are all expected to use bog-standard tools -- using them for eight to 10 hours a day without any thought or whether they are designed for us or how we lay them out or anything. There are some regulations around which should help as anybody using a computer should have their environment risk-assessed but putting that into practice is another thing.

Have you looked into the positive or negative impact of tablet PC devices on RSI?
We have looked at touch screens and that type of thing. I think what we are starting to see in the industry as a whole is that there are more and more modalities you can use to make changes in the computer. You can use touch screens, voice-recognition software, mice, digitising tablets, keyboards, but there is very little research on what might be right for an individual doing a given job.

Is it a case of the more ways you can interact with the machine the better?
Well, I tend to say let's find out what you're using the machine for and let's select devices that will make it easier for you to do your job and more comfortable. I've been working with someone recently who uses a small handheld computer; for writing very short notes and putting in reminders that's fine, but if you were going to do more than that it would be inappropriate. Also if your computer isn't properly tailored to your needs you could end up with a machine that is too slow, so you spend a lot of time with your finger poised on a button waiting for the file to open; so suddenly you are putting a lot of unnecessary load on the muscles of your hand because your computer isn't powerful enough, basically. People often think that ergonomics refers to some piece of hardware but it's actually about the whole task and what hinders you in doing your job.

Do you think software companies are thinking about RSI issues sufficiently when developing new applications?
I have not seen a huge amount of evidence that they do i.e. no. I presume that you're using a Windows-based environment? Every time you close a file you have to track across the screen and locate a very tiny icon with a cross in it, in the top right-hand corner. Imagine the amount of unnecessary movement that causes people everyday. You can do it by clicking other keys -- I know that -- but most people use the mouse and it's an awful lot of unnecessary cursor movement across the screen it seems to me.

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