eDocAmerica Health Tips

As an eDocAmerica client, it goes without saying that you are knowledgeable about the use of a computer. In fact a large percentage of our clients make their living at a computer workstation. With so much work being done in a seated position, a comfortable workstation is of greater importance than ever before. As with many other jobs, there are occupational hazards related to working on a computer. For example, poor sitting posture and poorly designed workspaces are major causes of neck and back pain. This week's health tip will focus on ways of improving the "ergonomics" of your workstation. These are measures designed to maximize productivity by reduction of operator fatigue and discomfort.

Chair adjustments


		Contrary to the popular belief that sitting is relaxing, it is actually hard on the back. Sitting for long periods of time can cause increased pressure on the intervertebral discs - the spongy discs between the vertebra. Sitting is also hard on the feet and legs. Gravity tends to pool blood in the legs and feet and create a sluggish return to the heart.

The following recommendations can help increase comfort for computer users:

"Dynamic sitting" - don't stay in one static position for extended periods of time.
When performing daily tasks, alternate between sitting and standing or take small walking breaks throughout the day.
The chair back should have a lumbar support
Adjust height of backrest to support the natural inward curve of the lower back.
It may be useful to use a rolled towel, lumbar roll or cushion to support the low back.
The angle of the back rest is subjective but the trunk and upper legs should form an angle between 90 and 115 degrees.
Adjust height of chair so feet rest flat on floor
- Sit upright in the chair with the low back against the backrest and the shoulders touching the backrest.
- Thighs should be parallel to the floor and knees at about the same level as the hips.
- Back of knees should not come in direct contact with the edge of the seat pan. There should be 2-4 inches between the edge of the seat and the back of the knee
Arm rests should be removable and the distance between the arm rests should be adjustable.
- Adjust height and/or width of armrests so they allow the user to rest arms at their sides and relax/drop their shoulders while keyboarding.
- Elbows and lower arms should rest lightly on armrests so as not to cause circulatory or nerve problems.
Have enough space under your work surface so that you can pull your self all the way up to the edge of the desk with room for your legs and knees to fit comfortably.

Proper keyboard and mouse set up and usage


		Many ergonomic problems associated with computer workstations occur in the shoulder, elbow, forearm, wrist, and hand. Continuous work on the computer may expose soft tissues in these areas to repetition, awkward postures, and forceful exertions, especially if the workstation is not set up properly.

The following adjustments should be made to your workstation to help prevent the development of an ergonomic problem in the upper extremities:

First adjust your chair as mentioned above, then with your arms resting comfortably at your side, raise your forearms to form a 90 degree angle with your upper arms.
Adjust keyboard height so shoulders can relax and allow arms to rest at sides.
Position the keyboard directly in front and be close to the user to avoid excessive extended reaching.
Forearms parallel to the floor (approximately 90 degree angle at elbow).
Mouse should be placed adjacent to keyboard and at the same height as the keyboard.
When using the mouse, do not bend your wrist upward. Make sure you are sitting high enough for the workstation to be slightly below elbow height so that your hand rests naturally on the mouse.
A padded wrist rest will help to keep your wrist in a straight and neutral position while typing and keep your arms off the sharp edges of the work surface.
Do not rest your wrists or hands on a palm or wrist rest when you are keying. These rests are designed to provide support only during breaks from keying.
The slope of the keyboard may need to be adjusted so that it is flat in order that your wrists are straight and not bent back while you are typing.
Press the keys gently; do not bang them or hold them down for long periods. Keep your shoulders, arms, hands, and fingers relaxed.

Monitor position and placement


Once the chair and work surface height are properly adjusted, the computer monitor should be placed so the top of the screen is at or just below eye level when seated in an upright position. The following suggestions can help prevent the development of eye strain, neck pain and shoulder fatigue while using your computer workstation:

Make sure the surface of the viewing screen is clean.
Adjust brightness and contrast to optimum comfort.
Position the monitor directly in front of the user to avoid excessive twisting of the neck.
Position the monitor at a comfortable viewing distance, approximately 18-30 inches from the user.
Position monitors away from direct lighting which creates excessive glare or use a glare filter over the monitor to reduce glare.
Adjust the monitor tilt so that ceiling lights do not reflect on your screen.
If a document holder is used, it should be placed at approximately the same height as the monitor and at the same distance from the eyes to prevent frequent eye shifts between the monitor screen and reference materials.

Bifocal and trifocal wearers have to pay particular attention to the placement of their monitor. Wearers of bifocals and trifocals often unknowingly tilt their heads backwards so they can read the screen through the lower portion of their glasses. This can sometimes lead to neck, shoulder, and back discomfort. Potential solutions include either lowering the computer monitor or purchasing glasses designed specifically for working at the computer.

In addition to these ergonomic measures, it helps to periodically stretch or perform exercises during the work day to relieve fatigued muscles and joints. An excellent description of several exercises appropriate for the office setting can be found by following this link:

http://www.nismat.org/ptcor/ergo/index.html

This site also includes photographs of good and bad office ergonomics so that you can visually appreciate what's right and what's wrong. By following the measures mentioned, most of you will be able to work more productively and more comfortably while on the computer.