Safeguard your career

According to a recent study by the TUC, one in fifty of all workers – that’s half a million people – have a Repetitive Strain Injury and six people are losing their jobs in the UK every week because of it.

As an office professional and key board user you could be at increased risk from RSI. To safe guard your career and your personal well being, you and your company should be seriously assessing your workstation, identifying risks and implementing strategies to minimise the danger from a condition that could have a devastating effect on your life.

The RSI Association (www.rsi.org.uk) has designated 23rd –29th February as the first International RSI Awareness week to highlight the causes and impress upon employers the importance of setting up internal process and ensuring that the latest ergonomic advice is being followed. So, what is RSI? What are the causes and symptoms and how you can minimise your risk?

Definition

RSI is not, in itself, a medical diagnosis. It's an umbrella term originally coined by the media and used to cover a range of more than 20 specific disorders of named musculoskeletal conditions (such as Tenosynovitis, Cramp of the Hand, Tendinitis, etc.) as well as 'diffuse RSI' which is more difficult to define but which recent research attributes to nerve damage. These are almost always occupational in origin. 'Repetitive Strain Injury' is a term similar to that of 'sports injury' in that it tells more about how the injury was sustained, rather than what the injury actually is.

Causes

Repetitive Strain Injuries are unlikely to have one single cause. In most cases, a mix of factors will combine to result in an RSI-type condition. Some of these factors, the primary factors, are mainly to do with the environment. However there will usually also be some secondary factors, which may be personal to the individual.

Primary factors may include:-

• ergonomically unsound workstation
• prolonged periods of work without adequate breaks
• sustained overuse from too much repetitive movement
• poor posture
• excessive workload
• patterns of work
• a cold working environment

Secondary factors may include a predisposition such as age, intrinsic strength, and general health which all contribute to differing levels of tolerance to repetitive or prolonged strain in individuals. Stress makes muscles and soft tissues tense up, and when they tense up, they are more likely to be injured. Both physical and social stressors at work may contribute to this process.

Symptoms

RSI conditions occur in both upper and lower limbs as well affecting the spine in various areas, which in turn can cause referred pain into the limbs, making diagnosis difficult. Symptoms include numbness, tingling, sharp pain, dull ache, weakness, loss of grip and restricted movement of limbs can render people incapable of carrying out the simplest of tasks, at home or at work. Lack of accurate diagnosis and access to appropriate treatment further exacerbates the condition, frequently resulting in job loss and economic deprivation.

What are the Risks?

Whilst not confined to keyboard workers, there is no doubt that the increased prevalence of RSI is related to the huge rise in computer use since the late 1980s.

There are many actions associated with computer use which, if left uncorrected, may lead to RSI-type conditions. Some of these actions can be avoided by better workstation or equipment design, and more on this later. However, many of you will also need to consider changing your computer style.

You could be at risk if:-

- You have a tendency to type with your wrist resting on the desk in front of the keyboard
- You use the mouse by leaning against the desk and all movements pivot from the wrist
- Your chair, desk or monitor is too high or too low
- You don’t take enough breaks
- Your posture is poor

Percentage of employers concerned about upper limb disorders in the workplace

London	Midlands	North West	Northern	South East	Yorkshire & Humberside
36%	38%	40%	34%	35%	38%
Source TUC Safety Report Survey 2003

Preventative Steps that you can take

Avoid awkward postures and position your body comfortably. Keep in mind that changing your posture during extended tasks may also help you avoid discomfort and fatigue.

Adapt your surroundings and arrange your computing equipment to promote a comfortable and relaxed body posture. Set up your workstation to avoid discomfort - this depends on your unique body size and work environment - however, the following suggestions may help to provide you with a more comfortable environment.

Select a chair that supports your lower back, and adjust your work surface and chair height to assume a comfortable and natural body posture. Don't let the chair press into the back of your knees.

Clear away items from beneath your desk to allow comfortable leg positioning and movement, and use a footrest if your feet do not rest comfortably on the floor.

To minimise reaching and to promote comfortable shoulder and arm postures, place your keyboard and mouse at the same height, approx elbow level. Your upper arms should fall relaxed to your sides.

Use a headset if your job calls for constant phone use. Cradling the phone between your shoulder and neck is a sure way to see life sideways.

Centre your keyboard in front of you with your mouse/trackball close to it, and make sure frequently used items are comfortably within arm’s reach.

Know your easy-reach zone. Place frequently used items comfortably within arm’s reach, without an obstacle course of coffee cups and clutter. Think about where you place things like your diary, telephone, task list, folders etc. Your ea-reach zone should be within 26-34 inches in front of your body.

Keep your wrists straight whilst typing or using a mouse/trackball. If your keyboard has legs, extend them if this helps you keep a comfortable and straight wrist position. Type with your hands and wrists floating above the keyboard, so that you can use your whole arm to reach for distant keys instead of stretching your fingers.

Type with a light touch and keep your hands and fingers relaxed – the same when using your mouse/trackball and don’t grip it tightly.

The average typist on a conventional QWERTY keyboard moves his or her fingers between 12 and 20 miles a day! Use keyboard shortcuts wherever possible – fewer keystrokes means less strain on your hands and wrists. Or use different methods to perform the same task i.e. using the wheel of your mouse to scroll and then the arrow keys on the keyboard. If you would like to download or print a helpful list of shortcuts Click Here.

Avoid resting your palms or wrists on any type of surface while typing. Use a palm rest, if provided.

Position the top the screen near eye level – if you wear glasses you may need to lower the screen but do talk to a qualified health professional about what’s best for you.

Centre your monitor directly in front of you, (not to the side) about an arms length away. If you are referring to documents more frequently than your screen, consider placing your documents directly in front of you and the monitor to the side, rather than the other way around. Alternatively think about using a document holder to position them near eye level.

To minimise eyestrain avoid glare by placing your screen away from light sources, using window blinds to control light levels. You can also adjust the brightness and contrast of the monitor. Keep your screen clean and if you wear glasses, clean them too. Adjusting onscreen font sizes may also make viewing your screen more comfortable too.

Take regular breaks! This is important to prevent muscle fatigue. Do simple low-impact stretching exercises to help reduce soreness and tension. Don’t miss your lunch break! Try to get out of the office to avoid eating lunch at your desk. And, if you really, really can’t take a break then change the task – perhaps make a phone call where you can stand up and stretch.

Drink plenty of water to encourage blood flow and avoid dehydration.

Your lifestyle can have an effect too. Eating a balanced diet, getting adequate rest and overall fitness improves the strength and flexibility of your body.

Minimise stress wherever possible! Try relaxation and breathing exercises and talk to your manager if you are stressed. Be aware that it can be a contributory factor towards developing an RSI condition.

Don’t just carry on. If you begin to experience any discomfort, talk to your managers about any adjustments that can be made to help you. Be careful when using painkillers – you need to be aware that these do not treat an injury – just mask the pain. If you are in pain or discomfort it is best to seek medical advice straight away.

Preventative Steps that your employer can take

The key word is ergonomics. Ergonomics is about ensuring a good 'fit' between people and the things they use. People vary enormously in height, weight, physical strength, and ability to handle information.

Designing tasks, equipment and workstations to suit you the operator can reduce RSI, and a company’s failure to observe ergonomic principles can thus have serious repercussions, not only for you but also for the whole organisation.

All employers have Statutory and Common Law duties to ensure the health, safety and welfare of their employees. Employees have a duty to look after their own health and safety (or others affected by their work), and to follow training and use equipment in a safe manner.

In addition, The Health and Safety (Display Screen Equipment) Regulations 1992, which cover the use of computers, require your employer to carry out specific Risk Assessments of users’ workstations to minimize or eliminate risks. This also covers home workstations or other forms of flexible working (e.g. use of laptops etc.).

THE HEALTH AND SAFETY (DISPLAY SCREEN EQUIPMENT) REGULATIONS 1992
The Health And Safety (Display Screen Equipment) Regulations state that employers must: • assess display screen equipment workstations and reduce risks • ensure that work stations satisfy the minimum requirements of the schedule (see below) • provide eye and eyesight tests, at request, to users and pay for corrective appliances if required • plan work to ensure there are breaks and changes of activity - short frequent breaks are considered more useful than longer less frequent ones (some physios now recommend 5 minutes break every half hour and others recommend 30 second micro-breaks every 10 minutes.) • provide training in the use of the workstation • provide information to staff about all aspects of health and safety relating to their workstations and the measures taken by the employer to comply with the above. The schedule lays down the minimum requirements for: The screen: must have a clean, stable image, with adjustable contrast and brightness, be able to tilt and swivel and be free of reflective glare. Keyboard: must be tiltable and separate from the screen. Space in front of the keyboard must be sufficient to provide support for the users hands and arms. The surface of the keyboard must be non reflective. Key symbols must be easily legible and keys arranged to facilitate use. Work desk or surface: must be sufficiently large to allow a flexible arrangement of screen, keyboard, documents and related equipment. The surface of the desk will be of low reflectance. A document holder must be provided that is stable and adjustable. Work chair: must be stable and allow freedom of movement. The seat back must be adjustable in both height and tilt. Footrests and wrist rests must be made available to users who want them. The Working Environment: • space: the workstation must be dimensioned and designed so as to provide sufficient space for the operator or user to change position and vary movements. • lighting: any room lighting or task lighting provided must ensure satisfactory lighting conditions and an appropriate contrast between the screen and the background environment, taking into account the type of work and the vision requirements of the operator or user. Possible disturbing glare and reflections on the screen or other equipment must be prevented by co-ordinating workplace and workstation layout with the positioning and technical characteristics of the artificial light sources. • reflections and glare: workstations must be so designed that sources of light, such as windows and other openings, transparent or translucent walls, and brightly coloured fixtures or walls cause no direct glare and no distracting reflections on the screen. Windows must be fitted with a suitable system of adjustable covering to attenuate the daylight that falls on the workstation. • noise: noise emitted by equipment belonging to any workstation must be taken into account when a workstation is being equipped, with a view in particular to ensuring that attention is not distracted and speech is not disturbed. • heat: equipment belonging to any workstation must not produce excess heat which could cause discomfort to operators or users. • radiation: all radiation with the exception of the visible part of the electromagnetic spectrum must be reduced to negligible levels from the point of view of the protection of operators’ or users’ health and safety. • humidity: an adequate level of humidity must be established and maintained
To download & print The Health and Safety (Display Screen Equipment Regulations 1992) and for a Workstation diagram Click Here

Workplace assessments

Assessments of work equipment, environment and methods are the responsibility of your employer and should be undertaken by qualified personnel or ergonomic consultants.

The following factors are known to contribute to RSI and should be taken into account:

• Frequency and duration of repetitive movements
• Force used in performing the movements
• Absence of adequate recuperative breaks
• Awkward postures, particularly degree of fixed muscle loading in the trunk, shoulders and arms
• Degree of stress
• Sudden changes in work pace
• Vibration

Work culture

Work should be organised in such a way that your health and safety is not put at risk. The work culture can be improved in a number of ways by, for example:

• Improving communications between management and staff in both directions
• Consulting employees and their representatives about their jobs and any changes to them
• Ensuring that jobs which pose a risk and which cannot be completely eliminated are rotated so that no individual spends long on that task
• Ensuring that all employees have sufficient variety of tasks to enable them to use different muscles and postures and to make their job more satisfying
• Providing adequate rest breaks to prevent the build up of fatigue and by ensuring that the breaks are taken
• Identifying and removing stress factors from the workplace
• Giving workers control over their pace of work and how they plan their day
• Removing piece rate and payment by results systems that make earnings dependent on excessive work rates
• Removing bonus, performance or monitoring schemes which make workers push themselves beyond their capacities
• Having proper monitoring and reporting procedures for symptoms of RSI

The Economic Consequences

It goes without saying that the most important consequence of RSI is the injury caused to sufferers and the effect it has on their life. But, it can also be an expensive business for companies that don't take the risks of RSI seriously or protect their employees from injury.

The Association of British Insurers says that work related upper limb disorders such as RSI are now one of the top five claims on employers' liability.

Organisations that employ strategies to improve work-place ergonomics have found that musculoskeletal-disorders (resulting in lost work time) were 3 times less likely to occur (Schneider 1998)

5.4 million working days were lost in sick leave due to RSI last year alone (TUC)

Dealing with the impact of RSI conditions accounts for between 0.5% and 2% of gross national income (Buckle & Devereaux, 1999)

The cost to UK industry is between £5 billion and £20 billion annually (estimate based on Buckle and Devereaux 1999)

Don't suffer in silence!

An important element of any policy to prevent RSI in the workplace is the development of a notification system and you should report any signs or symptoms of RSI to your line manager. Make sure your notification is logged in the accident book, which all companies should have. Your line manager should have responsibility for monitoring incidences and should propose remedial action, including the reviewing the risk assessment. It is important that you are taken seriously and given a sympathetic hearing. With or without your company's encouragement - you should visit your doctor.

Products & Services
There is an enormous range of ergonomically designed products from computer and office accessories, software, furniture, workstation solutions to services such as ergonomic consultants. Check out The RSI Association’s helpful directory by Clicking Here
Downloads
To download & print correct and incorrect workstation set up Click Here Windows Shortcut Keys:  Click Here Mac Shortcut Keys & Tips:  Click Here Free EyeKon screensaver. When installed on a PC, the EyeKon flashes up every 90 minutes of continuous keyboard use, inviting the user to 'Take a Break' and rest their eyes. The EyeKon Screensaver is produced by Guide Dogs for the Blind, a reputable organisation, however as with any installation, please check your IT policy prior to downloading and installing this screensaver. Click Here
Useful Contacts
The RSI Association is a registered charity providing help and information to people with Repetitive Strain Injury. As well as providing comprehensive information about RSI via their website (Click Here) there is a freephone hotline on 0800 018 5012 For the The RSI Association’s product and services directory Click Here Employers seeking guidance on measures that will help to prevent RSI should refer to the HSE publication ‘Upper Limb Disorders: Assessing The Risks’ ISBN 0717607518. Single free copies or priced packs of 10 are available from HSE books,or Click Here Or for small business ‘Aching Arms (or RSI)' Click Here The Health and Safety (Display Screen Equipment Regulations 1992) can be read by Clicking Here ‘Consulting Employees on Health & Safety’ – A guide to Law from the HSE Click Here The Ergonomic Society provides a list of registered Ergonomic Consultants visit: Click Here
Information compiled by Jane Olsen, with thanks to The RSI Association