Conference 7.286::digital

    Some problems can be addressed via the following:
    
    For wrist pain, lower the keyboard.  For cube ensembles, there is what
    is called an articulating keyboard for attaching underneath the desk
    that can effectively lower the keyboard that will eliminate the wrist
    pain syndrome from typing on a keyboard that is TOO HIGH.
    
    For elbow pain, get a chair with padded arm-rests.
    
    For eyestrain, make sure you are two feet back from the screen, and
    take frequent breaks away from looking at the screen.
    
    I had all these problems and this was how I effectively addressed them.
    
    

    When I moved to a staff job, I took the desk and chair that I was
    given, sat down, and started to work.  Being the new kid on the block,
    I was given the chair no one wanted, in the cube that was left over.  I
    worked in that cube for quite some time.  That was some 9 years ago.
    
    Today, after suffering from some severe back pains, I have a chair
    adjusted to the proper height, with proper back and lumbar support, a
    keyboard set up so I'm comfortable with it, a terminal with a *clean
    screen* set up in a comfortable location.  I spend some seven hours a
    day sitting in this chair working with this terminal: it's to my
    advantage to ensure that my work environment is both healthy and
    comfortable!
    
    I'm constantly amazed at the people who don't know how to set their
    chair to the proper height, and are therefore sitting way too low for
    their desk; or who *never* clean their screen, and so are peering
    through this haze of gunk.  People who just don't realise how important
    their work environment is to their physical well being.
    
    That old chair is still around.  It's a spare guest chair that gets
    shifted around to whomever needs an extra.  Sometimes I find myself
    sitting in it for an informal meeting ... sure does help to make the
    meetings short! :-)

    Re .1: 
    
    Great suggestions!  But how many people are aware that they need to do
    this?  I would say that 95+% of the offices I walk by are a disaster
    waiting to happen.  I hear that there are corporate level meetings
    being held to discuss the problem.  In the mean time someone needs to
    get the message out to the troops before permanent damage is done.
    In our CC 4 of the 5 people who have changed AFTER the fact are still
    having pain so there may be permanent damage in those cases.  I myself
    was not aware that having the KBD to high or leaning your arms on the
    edge of the desk would cause a problem until I went to the nurse with
    pain and they gave me this nice brochure that show how one should do
    it.

    Does RSI include Carpal Tunnel Syndrome?  This is a very common
    malady among keyboard users.
    
    About the common work/health hazards associated with our jobs, and
    the comment that "95+% of the offices... are a disaster waiting
    to happen..."  I often wondered why we don't have a Safety Engineering
    Department, whose job it is to walk through work areas and make
    recommendations to safer, healthier work environments.
    
    One problem that I've noted - even in my general work area - is
    cord-attackia.  I have more power cords, cables, etc., floating
    around the floor of my cubicle, it looks like a hungry snake pit.

    Carpal tunnel.  Interesting.  I was giving a presentation to a group of
    about 12 people I didn't know.  I asked if any of them had carpal
    tunnel.  About 4 raised their hands.
    
    I had a motorcycle accident that twisted my spine, and compressed my
    neck.  I find it very difficult to work at a CRT now.  It really
    bothers my neck and back.  
    
    As to eyestrain, it seems like my eyes are rapidly going downhill.  I
    don't know whether that's CRTstrain or advancing middle age! :-)
    
                                       Bill
                                       

    What is carpal tunnel?
    
    		Alfred

And if you're assigned to be resident full-time at the customer site, many 
times you get the WORST possible desk, chair, etc.  I've been at some of these 
sites myself and have suffered the backaches; luckily they've been temporary 
(until my next assignment).  But what can you do when you ask the customer
for better equipment and they say they've done the best they can?

As for the eyestrain, it's hard to train yourself to take frequent breaks for 
your eyes when you can't even make yourself go to the bathroom when you first 
notice the need!

"just one more compile, just one more link, then I'll go...",
Kyra

    re .4: Does RSI include Carpal Tunnel Syndrome?
    
    	Yes
    
    Re .6: What is Carpal Tunnel Syndrome?
    
    	From the Business Week article:  The tendons that control the hand
    	and fingers swell and crimips the median nerve in the carpal tunnel
    	where it and the tendons pass through the wrist.  The median nerve
    	provides feeling to the hand.  Pain from the compressed nerve can
    	travel to the shoulders, neck and upper back.
    
    For additional info on Carpal Tunnel you may want to look in
    HYDRA::MEDICAL topic 39.

    There is a band of ligaments at your wrists and ankles that anchor the
    tendons going into your fingers and toes.  The sheath is laid out
    in your forearm something like, and in the rough position of, a sweatband.
    Repeated movements of the carpals (those things with the nails on them)
    can cause irritation in the carpal tunnel, which closes off the rather
    small openings.  This can in turn lead to more irritation.
    
    I think I have a mild case of carpal tunnel syndrome.  Sometimes when
    I've been typing a while or shuffling through printouts, my fingers
    tingle as if I'm leaning on my elbows.
    
    By the way, Note 859 of this conference and its replies discuss another
    possible danger of working with VDTs: extremely low frequency electric
    and magnetic fields.

  There's also a discussion of Carpal Tunnel Syndrome in the TERMINALS
  notesfile at HANNAH::TERMINALS.

                                   Atlant

    re: .9
    
>    Repeated movements of the carpals (those things with the nails on them)
    
    A minor nit: the bones which form the fingers are called the phalanges;
    the carpals are in the lower part of the hand, just above the wrist.
    The metacarpals are located between the carpals and the first knuckles
    (the metacarpalphalangeal (MCP) joints).

I think there's another discussion on carpal tunnel syndrome in DNEAST::FLYFISH.
It's when the pesky things swim under your boat, taking the line with 'em...

    There is a long discussion in here somewhere concerning eyestrain. One
    of the more common problems is simply age.  As we all get older, like
    over 40, the eye lens gets thicker and can no longer focus both near
    and far.  The result is that the eye cannot focus, say, on both a book
    and your VDT: one of them will be out of focus. The result can be
    eyestrain, headaches, and a variety of other symptoms.

    Here are two solutions. Go to your ophthamologist, have him check your
    eyes in general, and get a glasses prescription specifically for
    focusing on your terminal.  DEC WILL PAY FOR THOSE GLASSES.  YOUR
    HEALTH OFFICE HAS A BOOK WITH THE PROCEDURE!.

    Another choice is to get a workstation with bigger characters. That's
    what I'm using now: the characters are almost twice normal size, and I
    no longer get any headaches.

    re: -1
    
    I was part of that discussion..over a year ago.  I had an eye exam,
    filled out the forms, sent them to my manager, and never heard from
    them again.  My manager (now my EX manager) can't seem to find time to
    "find" the forms, so I can re submit.
    
    I finally gave up on dealing with him.  I have an appointment with an
    opthamalologist (sp?) at the end of this month, the forms are once
    again ready to be submitted and hopefully some new glasses will appear
    some day in the future.
    
    Of course, I wound up paying for both exams.  (wish i could get the
    ex-UM to pay for the first exam!)  8*)
    
    if and when I ever get the VDT glasses, I'll post the results here.  
    
    but, don't hold your breath!
    
    tony	(frustrated_but_not_giving_up)

    Congratulations!  Welcome to the wonderful world of RSI.
    
    This has been a recognised problem for several years in Australia,
    Israel and some European countries.  In fact, at one stage it was
    called the 'Australian disease', because this problem seemed only to
    occur Down Under.  Of course, now we know better...
    
    It cost my wife her job, and there are many people who have been so
    severly affected by it that they cannot perform simple mechanical
    functions like hold up a book.  But just make sure you avoid the
    following history.  When the problem was widely recognised by the
    doctors (itself a major problem) worker's compensation cost the
    government and business hundreds of millions of dollars, and lots, lots
    more by way of ergonomic furniture and job redesigns etc (it is not
    confined to DTE operators).  Then, the government decides that its
    compo bill is too high, and automatically restrospectively dissallows
    most RSI cases and demands the money back (over $10k in our case for
    physiotherapy etc).  At the appeal hearing (lawyers salivate now) it
    flew in a doctor from over three hundred kilometres away because they
    couldn't find one locally who didn't believe in RSI.  We were lucky -
    the gutless wonder presiding at the tribunal decided, in truly
    Solomon-like fashion, that my wife had RSI up to but not beyond her
    quitting her job.  So, we don't have to pay back the bills, but neither
    does she get any sort of pension, and there's still part of the
    lawyer's fees (said wimp was less than generous in awarding costs). 
    Fortunately stopping work has considerably eased the problem, and I
    doubt it'll be permanent.
    
    RSI sufferers beware!  Until doctors in the US widely accept that the
    braod range of problems like tenosynovitis and so on are in fact
    directly attributable to bad job design and bad ergonomics you are in
    for a very rough ride.  RSI has few observable symptoms (swelling in
    the wrists is common) and because it mostly seems to consist of 'it
    hurts' is wide open for accusations of that peculiarly American phrase:
    'gold bricking'.  Be prepared for open disbelief.  RSI is, in a manner
    of speaking, career limiting in more ways than one...

    The author of this topic has asked me to post here a note on Carpal
    Tunnel Syndrome that I first placed in the MEDICAL notes file.
        
    - Phil Duncan
    
    ps, the copy below is now in 39.39, not 618.0 of the MEDICAL conf.
    
    
          <<< HYDRA::DISK$USERPACK02:[NOTES$LIBRARY]MEDICAL.NOTE;1 >>>
                       -< Medical Questions and Answers >-
================================================================================
Note 618.0         Chronic wrist pain (Carpal Tunnel Syndrome)        No replies
BUOVAX::DUNCAN "Phil"                               100 lines  12-JAN-1990 13:14
--------------------------------------------------------------------------------


    I believe I have identified the reason, at least in part, for the 
    increasing onset of painful wrist syndrome ("Carpal Tunnel Syndrome")
    that is becoming increasingly common in Digital.  I have recently 
    started to experience this pain myself and it suddenly occurred to
    me what is likely to be the primary cause (at least in my case).

    The keyboard group may not like this but it's worth pointing out
    if it's true for others. The LK201 keyboard has a basic feature that 
    seems to promote my pain, and in my opinion is suspect as a primary 
    contributing cause of the syndrome.
    
    This feature is not the keyboard design per se but instead the design of 
    the *keys* on the keyboard. Specifically, it is the softness of the keys 
    to the touch. This sensitivity of the keys encourages a user to adopt 
    certain positional habits of the hands and fingers during intermittent 
    pauses while typing. This tendency is further promoted by the lack of
    a section below the space bar that can act as a natural hand/wrist
    support.

    The position assumed by most people I have observed (including myself)
    is the temporary lifting and holding of the fingers directly over the keys
    during momentary pauses while otherwise continuously typing. Accompanying 
    this action is also an increase in the acute angle of the top junction of
    hand and wrist (pulling back). A user is encouraged to do this because 
    the keys on the LK201 keyboard are so soft to the touch that they cannot 
    withstand passive finger pressure or resting of the fingers directly on 
    the keys without unintentional typing of characters. Consequently, there 
    is a natural tendency to forcibly pull back the fingers and suspend them 
    over the keys during these pauses.

    Holding the fingers up over the keys during momentary and short pauses 
    causes continuous tendon and possibly nerve strain in the hands and
    wrists. It is logical to assume that the tendons and nerves never have 
    adequate recovery ("rest") time because the action before and after 
    the strained pause is continuous exercise (typing). So the soft keys 
    encourage a cycle of action for the fingers, hands, and wrists that 
    is essentially the following sequence:

		exercise/strain/exercise/strain...etc.

    Note that there is really no rest interval. Although my medical 
    background is limited to having been an Emergency Medical Technician,
    it doesn't take an M.D. to figure out that tendons, nerves, and
    muscles that are denied adequate rest intervals during continuous
    exertions are at risk of cumulative damage.

    This situation with the LK201 should be contrasted with that of the 
    VT100 keyboard. With the VT100, the keys are not nearly as "soft"
    as are those of the LK201, and therefore they not only allow but they
    encourage one to *rest* the fingers directly on the keys during 
    short pauses in continuous typing. Resting of the fingers on the
    keys is further encouraged by the existence of a bulbous base section
    below the space bar. This base acts as a natural hand/wrist support,
    a feature lacking with the LK201. (I encourage anyone to make these
    comparisons side by side.)

    Instead of encouraging a pattern of exercise/strain/exercise as with 
    the LK201, the VT100 keyboard encourages the following pattern for
    the same activity:

		exercise/rest/exercise/rest...etc.
 
    Momentary rest periods are crucial for general tissue recovery during 
    any continuous exercise.

    I never in 7 years of using a VT100 every day had any wrist pain 
    whatsoever. Now not only I and other programmers but *non-programmers*
    (who are usually less terminal-intensive) are reporting the problem.
    I have now had an LK201 for a year and a half and I'm having the hand
    and wrist pain. I have since "re-adopted" a VT100 and I find myself
    naturally resting my fingers on the keys during pauses in typing.

    I believe that this is not a problem with "repetitive motion" per se 
    (as seems to be generally believed) but that the introduction of 
    soft keys on our keyboards has encouraged natural tendencies that 
    replace periods of intermittent rest with periods of stationary strain 
    during natural pauses in otherwise repetitive typing. Resting for a 
    short time such as every 20 minutes when using the LK201 keyboard 
    (as is sometimes suggested) may be helpful but I doubt (my opinion only)
    it would fully compensate for such a marathon of exercise and alternating 
    strain in the long term.

    Wrist supports or angle adjustments used to combat this disease also
    seem unlikely to me to be completely effective because the softness of the 
    keys still encourages one to hold the fingers in a strained position 
    to avoid unwanted typing during natural pauses.

    In conclusion, I think that the "soft keys" feature of the LK201 should 
    be seriously reviewed by the company as encouraging terminal habits that 
    contribute significantly to the onset of Carpal Tunnel Syndrome. Too many 
    people are reporting problems and pain for us to ignore this as a likely 
    connection to this potentially hand-debilitating disease.
    
    - Phil Duncan

      Mail Stop: BUO/E23 
      DTN: 249-1836
      Email: PHIL DUNCAN @BUO
    
    

.16 makes no sense to me.

Even on a mechanical typewriter, you can't relax your wrists and put the weight
of your hands/arms on the keys without activating the keys. Just letting your
fingers touch the keys on a VT100 keyboard really doesn't let your fingers,
wrists or arms "rest" in any sense of the word.

Likewise, resting your wrists on the VT100 doesn't allowe you to rest your
fingers or your wrists, just your arms. If you relax your wrists, you'll type
characters. In fact, I've heard that one of the *causes* of pain is resting
your wrists (usually on the table) and holding your fingers up at an angle to
avoid hitting the keys.
                          

    re: .17
     
>   Just letting your fingers touch the keys on a VT100 keyboard really
>   doesn't let your fingers, wrists or arms "rest" in any sense of the word.

>   Likewise, resting your wrists on the VT100 doesn't allowe you to rest your
>   fingers or your wrists, just your arms. If you relax your wrists,
>   you'll type characters. 
    
    That's interesting that your VT100 keyboard keys do not allow you to
    rest your fingers without typing.  Every VT100 that I have had in
    the past (incl. the current one) does support passive finger pressure.
    And I completely rest my fingers and wrist. In case there's a
    misunderstanding, I mean here that the fingers - not the wrist -
    rest directly on the keys. The wrists also rest, but on the base
    section around the space bar (that's what I meant by that section
    being a good "wrist support").
    
    I have also had several others test resting their fingers on 
    several different VT100 keyboards, and no unintentional typing occurred.  
    
    One factor that may explain your different results is that there may
    be some individual VT100 keyboards that, either by mfging differences or
    just plain long use, have less resistance to passive finger pressure. 
    Another factor may be hand size - if you have especially large hands and 
    wrists, the weight may possibly exceed even the resistance of the 
    VT100 board (although I tested a person with "large" hands as well).
    
    Or, perhaps your positioning is different from me and some others. 
    Some people don't rest their hands at all, but hover them over the
    keyboard, letting their fingers "droop" over the keyboard for rest. 
    That seems to me to be a healthier way to do it, but most people
    I've observed don't seem to do that.
    
    I am among those who have the keyboard positioned such that my arms
    rest on either the chair-arm or desk, my palms are in front and
    to the side of the space bar (on the desk for LK201, on the base
    part of keyboard for VT100), and my fingers (of course) do the 
    walking on the keyboard. Whether this is the "professional" way
    to type I don't know. But I have observed many people with similar
    hand positions while using keyboards.
    
    I do agree with you that resting the wrists and pulling back the
    fingers at an angle to avoid hitting the keys is the cause of pain; 
    in fact that's my point - many people rest their wrists and the LK201 
    forces one to hold the fingers back to avoid hitting the keys, whereas
    the VT100 keyboard allows one to rest them directly on the keys.
    
    Have you tried other VT100 keyboards?  I'd be interested in hearing the
    results.
    
    BTW, I have noticably fewer instances of wrist pain since I re-adopted
    a VT100 keyboard. Psychosomatic? Perhaps, but I doubt it.
        
    - Phil

    Thanks to  our site nurse, I have a comfortable position typing on
    an  LK201  Keyboard. She found a relatively soft foam pad, about 1
    inch  thick  (I think they're sold as knee pads for gardening) and
    put  that  in front of the keypad. I then raised the front edge of
    the  keyboard  about  1/4"  (using  a  post-it  pad), and left the
    supporting legs in for the rear edge of the keypad. I can (and do)
    rest my wrists on the foam pad, and don't find the need to rest my
    fingers on the keys.  I'm told this works for many people.

--David

    I get symptoms of overuse/CTS from use of the mouse, as do many others.
    Thought the cause was traceable to repetitive, tiny motions.  But, what
    helped me was supporting my arms on a table, switching my "mouse hand"
    from the left to the right hand, and taking frequent breaks.  I find
    that lengthy time periods of typing still cause my left forearm to go
    bonkers.  Hadn't thought about the style keyboard before, will have to
    try the suggestions on for size.
    
    Overuse & CTS sure aren't imaginary--any good physical therapist can
    feel the soft tissue inflamation & muscle spasms.  Mine worked on my
    left arm last night for about 15 minutes before it felt anywhere near
    normal.  (I need to add that part of my problem is peripheral nerve
    damage caused by a motorcycle accident.  Typing sure doesn't help!)

    I use my LK201 withut the support legs.  I find that by leaving the
    keyboard "flat" I can work with both wrists resting on the desktop and
    my fingers in a relaxed curve, resting o the key when I'm not actively
    typing.
    
    A problem I've noticed is that the average desk is simply not deep
    enough to provide eithe proper eye relief or sufficient space in front
    of the keyboard for wrist support.  You tend to end up with your nose
    about 8" from the scren and the keyboard hanging off the edge of the
    desk.  This almost guarantees eye and hand/wrist problems.
    
    Those articulated keyboard holders are probably the worst since they
    typically make no provision for wrist support.  I was stuck with one
    for most of last year and ended up brining in a piece of 1x3 lumber to
    force the keyboard to the back of the tray and provide some support at
    the front.
    
    -dave

                Just as an interesting comment on this - the LK201 was
        designed to meet the European DIN standards in existance at the
        time (early '82) which supposedly took into account the need for
        a place for the wrist. As I remeber it, the standard called for
        a maximum height of the home row keys from the desktop to be
        30mm or less unless a place was provided on the keyboard to rest
        the wrist. (The desktop being considered the place within the
        30mm restriction.) Since this would have made the keyboard "too
        large" in the eyes of the Industrial Design people, the keyboard
        was made to meet the 30mm requirement which it just meets
        without the feet. The feet were an afterthought brought on when
        we got numerous complaints about the keyboard being too "flat".
                
                /s/     Bob

    Re: wrist rests.
    
    I find that the 19" monitors leave too little room on the standard desks 
    here for the keyboard and wrist support.  I eve made an acrylic keyboard
    "extension" but that doesn't leave me with much room either.
     
    Of course, the 15" monitors allow one to trade some wrist strain for eye
    strain..
    
    re: mouse troubles
    
    I find that the mouse intensive game "Tetris" (after hours of course :-) 
    leaves my right arm numb after about 10 minutes.  No more Tetris for me.
    
    __Rich

re .19:

>    Thanks to  our site nurse, I have a comfortable position typing on
>    an  LK201  Keyboard. She found a relatively soft foam pad, about 1
>    inch  thick  (I think they're sold as knee pads for gardening) and
>    put  that  in front of the keypad. I then raised the front edge of
>    the  keyboard  about  1/4"  (using  a  post-it  pad), and left the
>    supporting legs in for the rear edge of the keypad. I can (and do)
>    rest my wrists on the foam pad, and don't find the need to rest my
>    fingers on the keys.  I'm told this works for many people.

One down, 127,999 to go...

/Tom

    re: mouse problems & wrists 
    
    Get a track ball, CSS can give you a handle on them.
    
    Scooter

    	I'm wondering if anyone else has had the kind of eye discomfort
    	that I have had.  I'm bothered by overhead lights in front of me.
    	There isn't any glare from behind me, just the overheads.

    	I think what is happening is that the light is entering my eyes `at
    	an angle' and hitting my retina outside the center portion.  I have
    	been told that the outer portion of the eye is especially sensitive
    	to light, but less so to color.  Thus, the overhead illumination
    	is striking the most sensitive part.

    	I have reduced the number of overhead lights in front of me by
    	facing a near-by wall.  It is only luck that gives me a wall to
    	face.  Only partial luck at that, it is a partial wall, and
    	there is one overhead to the left of the top of my screen.

    	Friends have suggested that I simply wear a visor. (and black bands
    	around my rolled-up white sleeves, just like the bankers/accountants
    	of old... :-)

    	Does anyone else have this problem?

    	Is this another HAZARD of Computing?

    				Paul Komar.  
    

    re: .26
    
    I have heard of problems with different types of light before.  Our
    church recently changed over its overhead lighting to "soft" lighting,
    as opposed to "hard" lighting.  The difference was apparently quite
    noticeable to those who were bothered by the previous "hard" light.
    
    I'm afraid that I don't know any technical details about the matter,
    only that there can be a significant difference in the type of light
    tube used in the fixture (besides the fact that the "soft" tubes are
    more expensive, that is  8^).
    
    -- Russ

	I have a flag and cardboard hanging around my office to kill the
	harsh lights.. I want to pull them out of the ceiling and replace
	them with some nice incandesant (sp?) lights.. Whomever designed
	the lighting in ZK3 should be shot. I get incredible headaches
	from my eyes being overly exercised by the lights up here and
	their slow flicker rate.. Time to get a BB gun.

							mike

re: .26

I suspect that you are bothered not so much by the peripheral vision effects
of he lights in fromt of you, but because as you move and look about, 
your central vision is sometimes aimed at the lights over your screen.
Contrast between target and surround is a well-examined parameter of workspace
design.  You could check on this aspect of human factors with a modicum
of research.
A couple of hints for possible immediate benefit, however:
  1) Put a hood around your screen so the view from beyond your screen
     is less distracting.  This will also move the focal distance to the
     surround closer to that of your target, reducing fatigue from 
     changing distance accommodation.
  2) Raise your display to be more at head level.  I have found that
     I am comfortable with the top edge of my screens at eye level
     when my head is aimed directly forward.  This reduces neck fatigue
     as well as making my target more naturally positioned.

- tom powers]

    
    A gentle qarter-turn twist of the florescent tube...
    
    The maintenance people are usually open to this type of solution (at
    least they were in MRO1).

>Note 1004.26           Warning: Computing can be HAZARDOUS              26 of 27
>HPSRAD::KOMAR "You can't fool Nature"                26 lines   5-FEB-1990 18:26

>        I'm wondering if anyone else has had the kind of eye discomfort
>        that I have had.  I'm bothered by overhead lights in front of me.
>        There isn't any glare from behind me, just the overheads.
>

	Have you considered a glaucoma test???

		Rgds,
			Stephen

    I had similar problems to .26 and .28 in ZKO3-4. Moving offices helped
    me and the new inhabitant of my old office has adopted the '� turn
    fix'. I also used a 'sun shade' over the screen to cut down on
    reflected glare.
    
    I get the impression that it never occured to whoever designed the
    office space in ZKO3 that we might use computers.
    
    gary

re .26:  Part of the problem is that the fluorescent lights we have here
in MRO2-3 are the crappy ones without the directional shades.  The group
next to us when they had their area redone put in new lights; subsequently,
their lighting is much better than ours.  I don't have a problem with 
glare off the screen but rather with fluorescent lights in my peripheral
vision regardless of what direction I face my terminal in.

Re: .30
    
>    A gentle qarter-turn twist of the florescent tube...
>    
>    The maintenance people are usually open to this type of solution (at
>    least they were in MRO1).
    
    They aren't open to it here in DLB5.  A few weeks ago facilities sent
    out a message about premature ballast failures caused by people
    removing flourescent lamps above their offices.  Checking with your
    maintenance people first is a good idea.
    
    Following is part of the message that was sent out.
    							Larry

It appears that we are have been having a problem with individuals removing 
the flourescent lamps from the ceiling fixtures above their offices. (Please
read the attached memo.) This causes the electronic ballasts to prematurely 
fail, and they are quite expensive to replace. It also has negative impact on  
the overall appearance of the office areas. I realize that some people are 
bothered by the glare on the video screen and that is why they remove the lamps.
This however has negative implications, and it would be greatly appreciated if 
they would seek other alternatives to eliminate the glare.

    One wonders why they don't just fix the problem, instead of writing
    memos about the workarounds....
    
    (a rhetorical question... I have a pretty good idea why)
    
    gary

Justifying it on the grounds of not killing ballasts is quite reasonable,
but the idea that we need to "maintain the overall look of the office area"
REALLY turns me the wrong way.

If somebody needs the light you wish to turn off, that's one thing
(and I believe the description of lights seen over the top of one's tube
make this a serious consideration0, but if it's over your office,
and it's in your way, and nobody else needs it, then get them to find a way 
to off the light without damaging the fixture.

re .34:

> It appears that we are have been having a problem with individuals removing 
> the flourescent lamps from the ceiling fixtures above their offices. (Please
> read the attached memo.) This causes the electronic ballasts to prematurely 
> fail, and they are quite expensive to replace. It also has negative impact on  
> the overall appearance of the office areas. I realize that some people are 
> bothered by the glare on the video screen and that is why they remove the lamps.
> This however has negative implications, and it would be greatly appreciated if 
> they would seek other alternatives to eliminate the glare.

	"Negative impact", "negative implications"? This is woolly thinking,
	intended to head you off without giving a good reason. "Facilities
	were made for man, and not man for facilities". In other words, you
	are doing work which further the corporations goals (like, paying our
	salaries). Facilities are there to HELP YOU. If they don't, they need
	to be reprimanded or removed.

	Unless customers are often around, they can &*^%$#&^% the "overall
	appearance of the office areas". This is not a boutique, it's
	a leading-edge high tech company where WORK gets done.

	Btw, the word is "fluorescent" not "flourescent". This is a
	permutation often seen in Notes - probably just a typo, like
	the way I'm always typing "thrid" for "third". But it makes me
	think of a big floury rolling pin on the ceiling! 8-)

	/Tom

    I forget where this note was and posted this elsewhere...

    In a previous life, where I had the authority to change things, :-), I
    found that removing the translucent panels and putting in the open
    mirror-finish grids (wedge-shaped cross-section to reflect downward)
    significantly reduced glare and also improved the look of our office. We
    also replaced all the bulbs with warm fluorecents.

    -Peters

    I thought that fixtures were wired such that if you removed a tube, the
    input power to the ballast is disconnected.  I also thought that that
    was required for all "high-voltage" ballasts (certainly for 40 watt
    tubes) by NEC?
    
    Can anyone verify that "electronic" ballasts are still energized when a
    tube is removed?
    
    /s/ Jim Williams

    I just started reading this conference.  Thank god!  Now I know I'm not
    crazy.  I just went through the rigors of moving my cube and having one
    overhead light turned off.  All to get rid of glare.  I've also started
    wearing tinted glasses instead of my contacts.  I've been somewhat
    harassed (though light-heartedly) by my co-workers.  But anyway,
    regarding the lights, this is what my electrician friend told me:
    Most offices use blue-white (hard) lights, because they show colord
    better than orange-white (soft) lights.  According to him, the soft
    or warm-white color corrective lights don't cost any more than the
    others.  However, when I called facilities to ask if these were
    available, they shushed me off and never called me back.  So, I
    bought a table lamp with an soft-white bulb.  Supposedly the 
    incandescent light will filter the fluorescent and neutralize it.
    BTW, the advantage of the warm lights is that it doesn't bounce back
    off desks, paper, etc.  So, I'm still cruising here.  But will 
    probably try to get a glare filter for my tube.  I hear Radio Shack
    sells one that will fit vt330's.  So, between my terminal being stacked
    on books to bring it eye-level, my orthopedic chair (which DEC
    provided) and my lights-out cube..... they think I'm crazy anyway.

	re .40

	>    Supposedly the incandescent light will filter the fluorescent
	>    and neutralize it.

	Your eyes see the smoother spectrum of the incandescent light
	mixed with comparatively narrow color spikes of the fluorescent.

	>    ... they think I'm crazy anyway.

	You're not.  Don't worry.  "They" will be the ones with tension
	headaches, irritability, and failed vision at an early age.

	Regards, Robert.

    re: .13, .14 (and elsewhere in this conference)
    
    Well, it was a struggle, but they finaly arrived.
    
    DEC has a benefit whereby they will pay for eyeglasses for those who
    must use a special prescription for video display terminal (like
    myself).  This normally rusults from the human aging process creating a
    condition preventing eyes from focusing at different distances, thus
    requiring help from eyeglasses.
    
    The policy states that the employee must pay for his/her own eye
    examination, obtaining a prescription, which is submitted to a
    eyeglasses vendor (American Optical) through normal purchasing
    channels.  The documentation and forms are obtainable from Health
    Services.
    
    I first started this procedure in January, 1989.  I was in the field
    (Texas) at the time, and no one knew diddly about it.  Ultimately (May,
    '89) I transferred to Bedford and wound up having to start the process
    all over again.  The nurses in Health Services here were very, very
    helpful.  But, beyond them, no one knew diddly about it!  Wound up with
    me doing much of the legwork (that's ok) trying to contact managers,
    corporate health, and various purchasing departments, before the
    glasses were ordered.  
    
    Then, American Optical didn't have the (executive bifocal) lens I ordered 
    and rejected the order with a request it be re-submitted with one they
    did have.  
    
    Finally, this week, the glasses arrived.  
    
    The frames are warped.  The lenses appear to be twisted in them so that
    the bifocal cut is level.  The bifocal cut is at least 4 millimetres
    too high, requiring me to bob my head up and down.  Plus, the
    opthamalogist who did the initial exam on me was very frustrated by the
    various forms provided by DEC to fill out.  His statement was that
    "this is the wrong way to obtain these glasses".
    
    American Optical charged DEC 68 bucks for these glasses, and they are
    marginal at best.  I would have rejected them if the cost was mine (the
    exam did cost me over $65 as it was).
    
    Do I recommend YOU use this procedure?  Not on your life!  It's not
    worth the effort, confusion and time.  
    
    But, in case you want to try it, here is the procedure:
    
    1. Read ADAPTATION OF HEALTH SERVICES POLICY AND PROCEDURE of 1 August
    1984 FOR USE BY THE U.S. FIELD WITHOUT HEALTH SERVICES (Sept. 1985)
    
    2. Obtain the A.O. Safety Products eye glasses order form from Health
    Services.
    
    3. If possible, fill out the A.O. VGs PRESCRIPITON ORDER FORM complete
    with the five measurements for your workstation environment.
    
    4. Take both forms to your doctor, and get a prescription specifically
    for Video Display use.  Be sure that is noted, since DEC will not buy
    you glasses for normal use.
    
    5. Submit your completed forms (including your selection of lens and
    frame from the SAFETY PRODUCTS form) to your U.M. who will then sign
    and forward them to purchasing.  
    
    6. If Purchasing balks because the order does not specify a dollar
    amount (our local office refused to process the order without some sort
    of SWAG price)...my bifocal glasses were billed to DEC at $68.  Use
    that amount.
    
    7. Wait.  (It took many weeks)
    
    tony

I too have tried to use this program.

The emphesis has been on cost, not on my eye needs or really 
correcting my problems which are related to terminal use.

The glasses made HAD to be heavy safety glasses.

They did their utmost to make sure the glasses were not generally 
useful, even though my Opthamologist said this would help.

After weeks and weeks, the glasses were delivered.  The prescription 
was wrong!  Found out only after problems and having them checked 
myself.

I have contacted Corporate Health Services numerous times with 
specifics of my experiences -- they always say they will get back 
and never have.  

Oh, the glasses which were delivered cost Digital all of 35.00.

BTW, the corporation has an official publication which states that
CRT use does not cause eye problems!  I sent Health Services a
Stanford Study which indicates the opposite; the hope was that the
"official" stance (and response) might be altered. 

	~Mike

    Would you please post the extract from the "official publication which
    states that CRT use does not cause eye problems!"?  If the extract is
    too long, please post a reference.

    I got the 'VTD' glasses.  One of the requirements was to take the
    glasses back to the doctor to verify the correct perscription.
    
    But, they are totally useless!  They were made with safety glass.
    much, much to heavey with my perscription.  they sit as a useless piece
    of junk.  If I wanted a brick on my nose, I'd have put a brick there.
    
    BTW, I noticed no difference between them and{my regular glasses.t(
    
    ed
    

The Digital publication I reference in .44 is
"Introduction to Video Display Terminals (VDTs) for Managers and 
Operators".  It is dated January 1985, I don't know if it has been 
reissued since that date.  The back cover gives the following codes 
which may be useful to order: "ED-28864-86/86 04 03 20.0".

	~Mike

    Well, I got this DEC Earth Vision pamphlet in the mail the other day
    and in there it says "We shall provide our employees with a safe and
    healthful workplace".  Well I've been having arm & hand pain now for
    over a year and on my managers white board is a list of 13 people that
    have complained in someway shape or form about similar problems. 
    Recently I confronted the person in charge of Health & Safety here in
    the MRO complex and ask him what they are going to do to prevent the
    spread of this problem.  His response was that THEY ARE HAVING MEETINGS
    on the problem.  As far as I know they have been having meetings on this
    problem for a YEAR or more now.

Inspired by this note, I ordered an "articulated keyboard rest" through our
hardware guy.  It has both adjustable height and tilt and has the added 
feature of folding away under my desk when not needed.  

I love it.  At last I am comfortable.  I have never had any trouble, but I was
never comfortable.  

In the course of getting mine, I found that the facilities people at my site
had made (non adjustable) keyboard racks for a few people at the site.  I also 
had to tell the nurse  I was willing to be considered an experiment.  I never 
heard back from her.  I also heard that some sites actually have typing-height 
cutouts in their desks.  

Of course, everybody is terrified that everybody will want one, but hey.
At one point, someone asked if I had a back chair and then complained because
I had my own and not one of the official ones.

I think you have to be a string-puller and get the collaboration of other 
string-pullers to get an articulated keyboard rest, but if typing at a 
desk is your job and it's painful or uncomfortable, you should go for it.

    re .49: "...but if typing at a desk is your job and it's painful
             or uncomfortable, you should go for it."
    
    Anyone that has a keyboard that is the improper height should
    immediately demand whatever to get that keyboard at the proper
    height because by the time the pain develops one may have a permanent
    injury.
    
    The other thing to be avoided at all cost is resting your arms on the
    edge of your desk while typing as it is possible to damage the nerves
    in your arms.  This is what I had been doing for years and a little
    over a year ago I was resting my arms on sharp edge of the desk typing
    and all the sudden my right arm went numbish and had a severe case of
    "pins & needles".  Over one year later if I rest my lower arm on anything
    (even a soft pillow) within a few minutes I develop arm pain.
    

    RE: .49
    
    Can you give us more information on where you purchased your arm rest.
    I have one that does not tilt and it is of no use.  I want to have it 
    bent to an angle.  What angle is yours at?
    
    Thanks,
    Pam

    here is my cubicle environment:
    
    i needed VDT glasses to see the terminal...hadda take my old ones off,
    etc.   i ordered DEC sponsored glasses...finally got them, and they
    need to go back for refitting/rework.  
    
    in order to use the glasses, i have to put the terminal (vt320) on top
    of a "student kit box" on top of my desk so it would be high enough to
    see OVER the bifocal cut.
    
    my keyboard is on top of the desk.  how high SHOULD it be???  it's all
    centered in the corner of the cube, so both arms rest on TOP of the
    desk when typing...no other way.
    
    is there something wrong with this picture?
    
    tony

   Just the other day we determined to make life a bit easier for a
   person in our group with a severe (temporary!) vision problem,
   by providing them with a LARGE CHARACTER display terminal.  For
   those that don't already know how this can be done, see Note #
   140.3 in REGENT::FONTS.  You'll also need a VAXstation...

Answering .51.  Sorry it took so long, but I wanted to get the catalog.

My keyboard is mounted on a "Deluxe Tuck-away Keyboard Shelf" (#C5337) in
the catalog from Global Computer Supplies. (1-800-8-GLOBAL).

I keep it tilted down about 10 degrees off horizontal.  As for height, it
stays in any position you put it in, but I move it up and down during the
day for variety's sake.  It can also be locked in position, both height and
tilt.  The ability to tuck it away under the desk is an unexpected bonus.

Many firms offer these devices, each slightly different.  My site is ordering a
new kind for each person who requests one so they can figure out which is the
best.  I have heard that all desks at NUO are fitted with these things.

I repeat, if you feel like you need one of these, start pulling strings to 
get one.  They're great.

	I am in a "standard" District office with Steelcase cubes, and I have
been using the pencil drawer for a keyboard shelf for some time.  The drawer
edge is rounded, the heel of my palms fit nicely on it with no discomfort, and
the angle seems good, no idea what degree, though.  And, using PC DECWindows, I
get a break from the keyboard, occasionally!

    
    Here's an idea for integrating the keyboard and mouse that I sent to
    the IDEAS CENTRAL @OGO box.  What do you think?  Anyone got any money
    time and engineering skill to prototype?
    
                  I N T E R O F F I C E   M E M O R A N D U M

                                        Date:     15-May-1990 01:11pm EDT
                                        From:     David Carnell @ALF
                                                  CARNELL.DAVID
                                        Dept:     Proposal Designers
                                        Tel No:   385-2901 404772-2901

TO:  Remote Addressee                     ( IDEAS CENTRAL @OGO )

CC:  Remote Addressee                     ( SAM FULLER @MLO )
CC:  Remote Addressee                     ( WILLIAM STRECKER @MLO )
CC:  Remote Addressee                     ( EMPLOYEE INVOLVEMENT @CFO )
CC:  Remote Addressee                     ( DAVE LITTLE @ALF )

Subject: Keyboard Engineering Design Idea Suggestion

Not being aware of either Digital or anyone else offering this keyboard, I 
would like to outline a keyboard engineering design change that might be 
patentable and fulfill a future market requirement, perhaps enabling 
Digital to set a new standard.

Carpal tunnel syndrome is an increasing medical problem occurring in the 
hands and wrist, especially among people using computer keyboards 
regularly.  In this case the medical problem develops when using a 
keyboard that is sitting too high, namely up on the desk with the computer 
terminal.  The solution to alleviate the pain and avoid the syndrome that 
may lead to necessary surgery is to lower the keyboard by purchasing and 
installing an articulating keyboard platform beneath the desk.

The problem comes back, however, when upgrading to computer terminals using 
keyboards AND mouses.  While one may be able to lower the keyboard, the 
mouse device must now be back up on the desk in order to use it 
effectively.  Trying to use the mouse on a piece of hard surface sitting 
precariously on one's lap is awkward and not ergonomically optimum for 
productive work when using both the keyboard and mouse, working back and 
forth constantly.

Keeping the mouse up on the desk is conducive to carpal tunnel syndrome and 
does not lead to an even flow of work motion, because one has to bend 
forward and up with the wrists constantly, and then bend back to use the 
keyboard; or keep bent forward all the time to use both, which is not 
ergonomically effective either.

I believe a better approach might be to consider designing the mouse into 
the keyboard.

Namely, on the far left bottom of the keyboard, have three new keys for the 
mouse buttons one, two and three.  On the far right of this new keyboard, 
have an inbedded roller ball (like used in arcade games but less sensitive) 
for moving the cursor.

Thus, with this design, keyboard and "mouse" are incorporated into the 
same keyboard where the computer terminal user can use either, efficiently 
and effectively with minimum motion, correctly seated, on a correctly 
lowered keyboard sitting on an articulating keyboard platform, all ensuring 
optimum ergonomics and enabling the user to avoid carpal tunnel syndrome 
when using regularly the new roller ball mouse and keyboard.

What do you think?  Has Digital done this already?  Someone else?

Regards,
David
    

    Dave,
    
    Excellent idea.  I like to work with the keyboard in my lap sometimes,
    and find the need to reach out to the desktop for a mouse disrupts my
    work flow and train of thought.
    
    As to prior art:
    
    1)	Xerox incorpoated a touch-sensitive pad (called a "cat") on the
    	keyboard for the 860 word processor somewhere around 1983.  The	
    	"cat" controlled the cursor and was operated by stroking it with
    	the right forefinger (or, I suppose, any other finger you wished to
    	use).
    
    2)	To see where the state of the art in keyboards might be going, take
    	a look at page 284 of the May 1990 issue of _Byte_.  Datadesk has
    	introduced a modular keyboard consisting of a baseplate and the
    	function key row.  Into this you can add combinations of components
    	including:
    		QWERTY keyboard
    		Dvorak keyobard
    		10-key numeric keypad
    		15-key function keypad
    		Editing keypad (arrow keys, pg up, pg dn, etc.)
    		24-key prgrammable macro-key block
    		Trackball
    
    	It also features both IBM and MacIntosh compatibility!
    
    -dave

    There was a gadget similar to what .56 describes running around DSG for
    some informal testing about a year ago: a small trackball and button
    pad grafted onto the right side (sorry, lefties) of an LK201.  (I used
    it; I liked it; I didn't want to give it back.) You could probably
    contact Paul Nelson in the VIPS Input Devices group for more
    information.

Sorry to be a killjoy on this, but this idea has already been
implemented by others.  This is not to say that we should not do it but
I believe that this configuration is found in a few laptops on the
market.

John

    re .56/.59
    
    Keytronic (I think) have had such a keyboard available for several
    years even for an ordinary PC. Works fine for those who like track
    balls but not for those who prefer the freedom of a real rodent.
    
    j.e.

    How about a foot-operated mouse/track ball/whatever? I'd love to be
    able to leave my hands on the keyboard while selecting windows...
    
    -b

    Foot and voice operated mice are probably done already.

    But how about eye ball ? 

    The thing should know which icon I focus on .

Re: .61
>>    How about a foot-operated mouse/track ball/whatever? I'd love to be
>>    able to leave my hands on the keyboard while selecting windows...

Foot-operated mice already exist....They call them rats! ;-)

No joke.

Dave

    There is a device called "The Private Eye" which is a one inch square
    screen (red leds) that mounts on a 'headband' and is placed just below
    the eye. It uses the CGA standard.
    I wonder if this device would help prevent both eye strain from glare
    and neck/muscle strain caused by screen being too high or low?
    
    So, has anyone tried one of these devices?
    
    Thanks & regards,
    

>                      <<< Note 1004.64 by AKOV13::POPE >>>
>                                -< Private Eye >-

One problem with a device like this for regular use would be that you
can't move your head to get a different view of the screen or to reduce
postural fatigue.  If you move your head, the device moves too, which makes
it hard to track what's there.
There are two major components to visual tracking: eye movement and 
head movement.  In the normal case, you can track to a constant location
by a combination of eye and head movement.  If your neck gets tired,
you can lower your head and raise your eyes and maintain constant tracking.
Withg a head mounted display, if your neck gets tired, you can move it and not
have to move your eyes, but if your eye muscles get tired, you have no recourse
but to readjust the headband.
A fix for this problem is to be able to adjust the position of the image 
in the display, as is done with virtual reality (real world simulation)
displays.

- tom]

    Three articles in the July 1990 MACWORLD magazine:
    
    Is Your Computer Killing You? - page 23
    Comfortable Computing - page 71
    The Magnetic-Field Menace - page 136
    
    The MRO1 Library has a copy of this issue.

    Re: .65
    I have never heard of artificial reality displays. Where might I see
    one in the real world?
    I am serious.  My wife worked with video terminals for a numbers of
    years.  Each year her vision deteriorated and glasses became 'stonger'
    each year.  For the past 6 years she has not seen a terminal and each
    year her vision improved to the point she no longer needs glasses.
    
    I realized this is not proof of cause and effect.  However I began
    spending more and more time in front of a terminal.  Now, each year I
    need new glasses.  I have two young kids.  If there is any connection
    and if there is a way I might prevent the problem for next generation,
    well, I'll give it a try.
    
    Regards,
    

    re: -1
    
    Even if there is a connection, there is no way to pass on an acquired
    disability genetically - especially if the offspring are already born!
    
    Al
    

    re: .67
    
    I know it's not polite, but:  How old is your wife and what was
    her eye condition?
    
    The normal progression of eyesight as one ages past the 30-35 mark
    is toward far-sightedness.  The normal progression of myopia
    (near-sightedness) is to worsen until the mid 30's.  The net of
    this is that the average near-sighted person finds their eyesight
    worsening - i.e. stronger and stronger perscriptions - until they
    reach the turn-around point, which may be anywhere from 25-50 but
    averages 30-35.  Then their eyes get better and better, as measured
    by less and less near-sightedness.  It is not uncommon for myopic
    people to spend their last decade or so no longer in need of corrective
    lenses.  (Though by then, we can no longer do anything about the
    things we can now see!)
    
    Personal experience - I just returned from the optometrist's, and
    one eye has 'imporved'.  It's the one which is closer to the
    VAXstation I spend my time with.  
    
    
    Don
    

    
    
    
    My eyes were getting bad from staring at terminals. VT 52's to start
    vt100's, VT200's the last terminal I had was a 340. I would leave at
    the end of the day and it would take about 1/2 hour for my eyes to be
    able to focus on things far away. I now have a VSII/GPX and run large
    windows with large fonts I have not had eye trouble in over 1 year. I
    would not work with anything else now for any length of time. If I had
    to go back to a smaller screen I would claim a medical disability and
    see what happens...
    
                                -=-=-R~C-=-=-

    I don't think there is any question that terminals can cause eyestrain,
    and eyestrain can have multiple symptoms such as headache. I got a
    workstation with larger letters to cure just such a problem, and it
    worked great.

    It is an entirely different question of whether or not terminals can
    cause permanent damage. and what the mechanism is. Furthermore, some of
    the preceding notes have been precisely correct as to the progression
    of eye changes with age. If you have trouble, see an opthamologist(sp).

    re: -1
    
    I was referring to the unstated fact that my kids are beginning to
    spend a lot of time looking at video terminals and that eye-strain may
    be related to the screen....not genetics.
    
    Jim
    

    Well, I am relieved.  You have hit the symptoms and age quite well.
    
    I guess I should know more about eyes, while I still have two.
    
    Thanks.
    
    Jim
    

    Did anyone hear on the news a few weeks ago about a young girl (and I
    will be vague because I dont remember the exact details) that was
    apparently playing a video game on her home system that caused her to 
    to have an epileptic fit.
    
    This amazed me to think that this could happen.  But I am one to play
    on occasion and can remember the feeling I get when the adrenaline
    begins flowing.
    
    wt                                                   

    Yes, I also heard it, but I believe the person was known to have
    epilepsy, and that a certain sequence of flashing bright colors
    displayed by the video game brought on a seizure. Since this behavior
    has been the foundation of a number of movie plots, I assume it's a
    fairly well known effect of epilepsy.
    
    There was no indication that j-random-child will be thrown into a
    seizure by a marathon session with Super-Duper-Mario-XVII.

    Such seizures are known as "photic". They are a common form of epilepsy
    and are caused by the flicker of a tv screen, whether showing a video
    game or an ordinary TV show.
    
    Andy

    RE: 75 Thank you for 'softening' the blow of reading "epileptic fit".
    Those of us with seizure disorders would prefer to have the public
    refer to us as having a seizure disorder not an epileptic fit.
    
    RE: 74  Please read 76.
    
    Thanks

re note 10004.69           
                           
    My eyesight started to get worse when I was 21.  I needed glasses
    only occasionally to drive or watch TV when I was tired, or when
    I remembered to put them on.
                           
    However, Since I joined DIGITAL at just 23, my eyesight became more
    and more short-sighted every six months, ie I needed a new prescription
    every six months!  Every time I visited the Opticians, they kept
    telling me a) it would slow down by the time I'm 25 b) there is
    no proof that VDUs have a detrimental effect on eyes.
                           
    Well, I'm now nearly 28 and have just received yet another stronger
    prescription...it has slowed down a little - about 8-12 months per
    prescription...but it hasn't stopped yet!
                           
    My eyesight has only worsened since I joined DEC.  I'd never even
    seen a VDU before then.
                     
    What really bugs me was that I had "near perfect" eyesight as I
    grew up...and now I can't see a thing without help.  It really
    depresses me sometimes!
    
    Regards
    ALEX
    in the UK

    When I last visited my ophthalmologist about 5 years ago he told me
    that he had so many DEC people coming in with eye problems that he
    was to the point of calling up DEC and complaining.

>        When I last visited my ophthalmologist about 5 years ago he told me
>    that he had so many DEC people coming in with eye problems that he
>    was to the point of calling up DEC and complaining.

    Wait till you get older, Ed. I visit MY opthalmologist every 6
    months!!!
    
    He's got a lot of DECtoids too. He too has commented
    on all the business he gets from DEC. he likes the business, but
    he also says that there are some rather standard problems he can expect
    with a DEC person. Near sightedness, frequent visits, and tri-focals,
    are par for the course. 
    
    			=-=-=-=-=-=g=-=-=-=-= 
  

    
    
    I also think one of the advantages of having a uVAXII with a large
    screen is now I don't sit with my face about 6 inches from the screen.
    I sit back in my chair now. Also the screen is so large it forces my
    eyes to move around more as opposed to looking at a smaller video
    screen and being able to read anything on it without moving your
    head or eyes.
    
    
                    -=-=-R~C-=-=-

    It'll be interesting to see how (or if) the new VT1000 flat screen
    display helps (or not) vision in employees at DEC (and customers).
    
    Bruce Evans

I imagine the eyesight problems with VDUs is also related to family health
history, genetics, and so on.

I am still rather young, 28, but have been working with VDUs full time for
easily the last 10 years. Haven't noticed my eyesight getting any worse in
the last 10 years despite my diabetes. Then again, I have pretty bad
eyesight to begin with (20/350?) so maybe VDUs don't ruin your eyesight if
it is already bad?

	FWIW, Rich

>> I imagine the eyesight problems with VDUs is also related to family health
>> history, genetics, and so on.

Some of it, but I found my eyesight gets worse only when I have a terminal
that is out of focus.  Field service won't typically fix out of focus 
terminals unless they consider the tube shot. 

I've found color terminals are far worse than monochrome.  Maybe it's because
it's harder to aim 3 electron guns?

M

    I would have to agree with many problems being genetically related, and 
    would also have to say that it has alot to do with the way you treat
    your eyes when you are not at work.  Spending time in smokey rooms,
    outside in bright sun, not wearing proper protection, many other
    things can also hurt.  Don't get me wrong, I agree also that
    terminals can hurt your eyes, but there are many people that do not
    take care of their eyes and it just seems that a terminal is the easy
    way out.
    
    I might start to sound like a reporter, always picking at the other
    side, but I have been working with VDU's for 15 years now and still
    have 20/15 vision in both eyes.  (My doctor says that I will wear
    glasses someday, both my "parents" do).
    
    I also have to agree that color terminals are terrible.  I have always
    had monochrome until a few months ago.  I began a new job with a color
    VT and noticed that my eyes were much more tired each day.  I just
    changed back to a monochrome, much better. 
    
    
                 -wt-
    

>                    <<< Note 1004.82 by NWD002::EVANS_BR >>>
>                            -< will it be better?? >-
>
>    It'll be interesting to see how (or if) the new VT1000 flat screen
>    display helps (or not) vision in employees at DEC (and customers).

The VT1000 has a  nasty  habit  that  can make it incredibly difficult to
love;  it tends to  hang  up  in never-never land at unpredictable times.

HOWEVER,,,,,

The ability to have characters that are 0.2" high is enough to compensate
for the terminal's otherwise poor manners.  It  was  getting to the point
where I was looking into bi-, tri-, or quadrafocal glasses.

Kudos for monster character sizes; for shame for releasing a product that
performs so poorly.

Dave

    People who do close work over long periods are always at higher risk of
    developing myopia. The trick is to arrest the problem before it begins
    steamrolling.
    
    My eyes began going bad when I was 11 years old. Going to optometrists
    for several years, all those guys ever did was prescribe stronger and
    stronger glasses untill my vision reached 20/200 or so.
    
    About 5 years ago I started going to an eye MD (surgeon) who suggested
    eye relaxation excersizes and WEAKER prescriptions. After three years 
    of therapy with this guy, my vision has actually improved!!
    
    At work and in bright sunshine otherwise, I use a very weak prescription 
    that allows me to do close work without strain. When driving at night,
    I use a stronger presciption which is STILL much weaker than the
    prescrption I used when I first began going to this particular doctor.
    
    I also know of another friend who went to a different doctor. His
    problems had just began (started getting headaches, slightly blurred
    vision when working at a VDT). His doctor prescribed "relaxation"
    lenses that in effect pushed the VDT image AWAY. The result has been
    that the vision-damage cycle never got started, and my friend still,
    after some 5 years, has 20/20 vision.
    
    The point of all this is: don't let a eye treatment professional force
    you into the vision-damage cycle with newly strengthened presciptions
    every year! ask about alternative treatments, etc. By the way, the eye
    therapy I participated in was paid 80% by the health plan I was part of
    at the time.
    
    								JAH

    Just reading these notes suggests less credence be given any reports
    of TV's (and their children) damaging eyes.
    
    The monitor preferences are interesting:  I like mono B&W - dislike
    green and HATE amber.  But I *LOVE* my colour monitor because I
    can decide the colours and the strength of them.  Personalizing
    the machine not only to my general tastes (I like white to cyan
    writing on a blue background), but also to my mood-at-the-moment
    is great.
    
    For those poor mid-twenties of you who find corrective lenses getting
    stronger each year:  at 43, one eye has turned around and the other
    has almost stopped getting worse.  You have a l-o-n-g way to go,
    whether you work here or not.
    
    As to correcting:  There are two other effective ways of getting
    your short-sightedness fixed:  
    
    LASER surgery, which shaves away the surface of the lens to match 
    the mis-shapen eyeball it serves.  The disadvantage is that you can 
    only make the lens thinner, the advantage (biggie, here) is that it 
    can often correct astigmatism which is a lens disorder, anyway.
                                         
    Another alternative is orthokeratology, a process where the lens
    is reshaped by a series of contact lenses in much the same way braces
    fix teeth (but, I understand, without the pain).  The advantage
    is that there is no surgery or removal of bits.  On the other hand,
    it takes several years and is quite expensive.
    
    Being a chicken, I put up with my glasses.
    
    
    Don
    

re: .88

One more addition to your list of nearsightedness fixes:

Radial keratotomy.  This was pioneered by a Russian doctor.  It involves 
scoring the surface of the lense, causing it to flatten out a bit, thereby
allowing you to see a bit better.  The operation hasn't been around long
enough to know what the long-term effects might be. 

>    Being a chicken, I put up with my glasses.

Amen to that one!

Ray

re: .88, .89

It's not the lens, which is inside the eyeball, but the cornea, which
is the outmost part of the eye, that is both the source of astigmatism and
that which is operated on by the referenced surgeries.
Also, the cornea is BY FAR the more important focusing mechanism
for the eye.  Out of something like 23 diopters of focusing power
in the eye, about 18 are accounted for in the cornea.
The rest is in the lens, which is just mostly for fine tuning the image.
For reference, nearsightedness of as little as two diopters is enough
to require that glasses be worn for driving.

- tom]

    Re: .90
    
    That leaves 5 diopters for the lens to do "fine tuning", and a
    mis-focus of 2 diapters there can require driving glasses, as you say.
    
    But it's the lens that gets thicker and less flexible with age so that
    the eye cannot accomodate (adjust for distance).

    There was an article on the front page (left column) of the Sunday NY
    Times (June 17th) about hand problems from keyboard use.

Date: Mon, 13 Aug 90 21:20:17 PDT
From: [email protected] (Allan "Just say NO to postcard requests!" Meers)
Subject: Computer noise linked to stress -- computers vs. women
 
Dr. Caroline Dow and Dr. Douglas Covert, assistant professors of
communication at the University of Evansville Indiana, believe they
have linked noise made by video display terminals with stress symptoms
in women, who hear high-frequency sounds better than men.
 
The AP article, reported in the Aug 12, 1990 San Jose Mercury News (all the
news we twist to fit*), reports that the couple first became interested when Dow
noticed the subconciously irritating effect that a university computer she was
using had on her.
 
Tests on 41 students in April 1987 showed that the subjects exhibited the
stress symptoms of speeded up work and a doubling of their error rate when
doing clerical work in a room where the high-pitched sound was created.  Dow
said, "We can all work through that sound, but it is tiring and distracting."
They hope their research will be expanded on by others, possibly linking the
noise with headaches, tension, miscarriages, and other health problems.
 
Men are rarely bothered by the 16 kilohertz pure-tone sound, as they generally
cannot hear frequencies above 15kHz, while women can hear up to around 18
kilohertz, Dow also said.  Dow and Covert were to present their findings at the
Minneapolis national convention for Education in Journalism and Mass
Communications.
 
   [Also noted by Andrew E. Birner, Zenith.  
   NOTE * I thought it was "All the news that fits we print."  PGN]
 

    re -.1 "Computer noise linked to stress in women"
    
    Computers and their peripherals are not intended to make these noises,
    and if they do, there is probably something wrong with them.  Most
    audible reproductions of the frequencies at which the displays operate
    are caused by 'loose' components and can be corrected by replacing
    them or using a drop or two of epoxy.
      
    Any background noise can be a nuisance and adds greatly (and
    pointlessly) to the processing load of the brain - which is why
    so much effort has gone into designing sound-absorbing cubicle walls
    and other building materials and making office equipment quiter
    in general.
    
    To suggest the way the article does that it is a gender-specific
    problem by applying an arbitrary drop-off point to a statistical
    average is as stupid as suggesting that the problem doesn't exist
    because, using my own arbitrary drop-off point of 10%, no equipment
    makes that noise. 
    
    Besides, I can still hear televisions, (but neither my Rainbow nor
    Vaxstation, save for their fans & disks -  DISKS?  DISKS?  did I
    'hear' someone mention the incredible VOLUME of our 3�" hard drives?) 
    and my hearing is rapidly degrading due to age and last I looked I 
    wasn't a woman.
    
    
    Don
    who-thinks-computers-are-safer-to-work-with-than-people
    

    Article in the August 20, 1990 NEWSWEEK magazine on page 57:
    
    	Casualties of the Keyboard

    Frequency detection is probably (loosely) related to mass, and women
    generally are smaller than men.
    
    						Ann B.

RE: .96

It has no relationship whatsoever to body mass.  It *does* have a relationship
to the thickness of the tympanum, middle ear bones, etc. of the human ear.
These structures tend to be smaller and more delicate (statistically) in women
and children than in men and that is why, statistically, women and children
can hear higher frequencies.

--PSW

    The high-pitched whine from the cooling fans on many PC's and
    Workstations has always driven me bonkers.  Marginal components
    in some terminals can also make similar noises.  I have no hesitation
    about swapping out such equipment, and I can well believe that it
    is a signifcant health hazard.
    
    I suspect that high-pitched tones at the threshold of the audible
    range can also affect my collegues - whether they can hear them or 
    not!  The "Alert" reflex is largely unconsious and completely
    involuntary.
    
    Let's hope the package engineering folks for the 3100, 5000, et
    al are paying attention!

RE: .98

The high-pitched whine usually isn't cooling fans.  Usually, it's either
horizontal retrace noise from the monitor (you can also hear this from TV sets;
I can always tell where the video sales section of a department store is long
before I actualy see any signs for it), or noise from voltage regulators in
the power supply.  The VAX-11/780 was a prime offender in the last category.
The interesting thing with the 780 was that the voltage regulator noise changed
pitch depending on the instructions being executed.  I could tell whether our
VAX was doing anything by listening to it.

--PSW

    I knew several people who were unable to use a VT100 (remember those??)
    because they could hear the high-pitched "video noise" and could not
    tolerate it -- my hearing isn't that good so I never had any trouble.
    Most of the affected people were men, surprisingly.
     
    A lot of people complain that my VAXstation 3100, which was originally
    a prototype and so is wired into a nonstandard metal box instead of the
    usual box, is very noisy, too.  I can hear fan and disk noises (and
    this box resonates with the disk noise), but I can't hear the
    high-pitched sound so it doesn't bother me.
    
    /Charlotte

re      <<< Note 1004.99 by PSW::WINALSKI "Careful with that VAX, Eugene" >>>

>pitch depending on the instructions being executed.  I could tell whether our
>VAX was doing anything by listening to it.

   I used to work with an 11/70 with RPR02's (Mechanical detents on the head
   positioners.) You could "hear" a sort on those... And you could see what
   was happening on the light panel on the RP11-E controller. Sigh...
   
   q
   

    I understand that early this week that NBC on the evening news did a
    segment on injuries related to keyboard use. It might have been on
    October 23 (+/- 1 day).  If anyone happened to video tape this I would
    like to view it if at all possible.
    

    CTS can be helped by the use of B5,B6 this will help the wrist get
    better in about a month or so you should feel better. Just a few lines 
    Don Allen

Article        22465
Path: ryn.mro4.dec.com!shlump.nac.dec.com!news.crl.dec.com!deccrl!bloom-beacon!bu.edu!nntp-read!miranda
From: [email protected] (Linda Li)
Newsgroups: sci.med
Subject: Re: VDT Dangers
Message-ID: <[email protected]>
Date: 22 Mar 91 14:12:37 GMT
References: <[email protected]>
Sender: [email protected]
Organization: Boston University School of Medicine
Lines: 67
In-reply-to: [email protected]'s message of 21 Mar 91 20:25:57 GMT
 
> In article <[email protected]> [email protected] (Jennifer
> Irani) writes: 
 
>  I was wondering if anyone knew if there have been any reports on dangers
>  associated with computer terminals.  I have heard about possible harm
>  to pregnant women.  Are there any documented reports on the possible
>  health risks to working in front of a computer for extended periods of
>  time?
 
 
This is from the March 14, 1991 (Volume 234, Number 11) issue of the
New England Journal of Medicine.  It's just the abstract.  If you're
interested in the entire article, I suggest you visit your nearest
library. 
 
	ABSTRACT
 
	Background: The relation between spontaneous abortion and the
	use of video display terminals (VDTs) is of great public
	health concern.  Previous investigators of this issue have
	reported inconsistent findings.
 
	Methods:  To determine whether electromagnetic fields emitted
	by VDTs are associated with an increased risk of spontaneous
	abortion, a cohort of female telephone operators who used VDTs
	at work was compared with a cohort of operators who did not
	use VDTs.  To obtain reliable estimates of exposure, we
	determined the number of hours of VDT use per week from
	company records and measured electromagnetic fields at VDT
	workstations and, for purposes of comparison, at workstations
	without VDTs.  Operators who used VDTs had higher abdominal
	exposure to a very-low-frequency (15 kHz) electromagnetic
	fields (workstations without VDTs did not emit
	very-low-frequency energy).  Abdominal exposure to
	extremely-low-frequency fields (45 to 60 Hz) was similar for
	both operators who used VDTs and those who did not.  Among the
	2430 women interviewed, there were 882 pregnancies that met
	out criteria for inclusion in the study.
 
	Results:  We found not excess risk of spontaneous abortion
	among women who used VDTs during the first trimester of
	pregnancy (odds ratio = .93, 95 percent confidence interval,
	0.63 to 1.38), and no dose-response relation was apparent when
	we examined the women's work hours of VDT use per week (odds
	ratio for 1 to 25 hours per per week = 1.04; 95 percent
	confidence interval, 0.61 to 1.79; odds ratio for >25 hours
	per week = 1.00; 95 percent confidence interval, 0.61 to
	1.64).  There continued to be no risk associated with the use
	of VDTs when we accounted for multiple pregnancies, conducted
	separate analyses of early abortion, late abortion, and all
	fetal losses, or limited our analyses to spontaneous abortions
	for which a physician was consulted.
 
	Conclusions:  The use of VDTs and exposure to the accompanying
	electromagnetic fields were not associated with an increased
	risk of spontaneous in this study (N Engl J Med 1991;
	324:727-33.)
 
		---------------------------------------------
 
 
	Linda Li
	Boston University School of Medicine
	Boston, MA
 
 
	"Two years down...two to go"

See note 1538 for information on using a voice recognition system to give
arms/hands time to heal from RSI injury.

Greetings, and welcome to C+HEALTH.

This list is intended to promote sharing of information, experiences, concerns,
and advice about computers and health. Anecdotal evidence, media reports, and
some formal studies suggest that computer users are at risk from misuse and
overuse of computers. Eyestrain, headache, carpal tunnel syndrome, and other
apparently computer-related maladies are increasing. And, it would appear that
colleges, universities, and other institutions have been slow to respond with
education, training, office and lab design, furniture purchasing, and other
programs that could make computing more healthful -- and productive.

We welcome questions and answers; article and book reviews; hardware, software,
and furniture evaluations; approaches to influencing institutional policy;
speculation; and humor. Medical, legal, technical, financial, aesthetic, and
administrative viewpoints are encouraged. We hope that this forum will be of
interest to end users, computing managers, epidemiologists, and policymakers.

Subscribers to this list may also wish to participate in EDUCOM's Project EASI:
Equal Access to Software for Instruction, "dedicated to assisting higher
education in developing computer support services for people with
disabilities." EASI provides information and guidance on campus applications of
adaptive computer technology. For information on EASI, contact Carmela
Castorina, [email protected].

In general, C+Health will focus on individual and institutional measures for
"keeping healthy people healthy" as well as remedies for restoring temporarily
disabled people to health. We suggest that computing issues related to  those
with permanent disabilities be referred to our dedicated colleagues at EASI.
Although this distinction will not always be "easy," one goal of C+Health is to
minimize the number of casualties in our increasingly computer-intensive
campuses, offices, and homes.

This list will not be moderated, at least initially, so we encourage
contributors to be succinct, to include relevant parts of messages to which
they are responding, and to append their names, titles, and institutions to
contributions. New users are welcome to send to the list a brief statement of
their experiences and interests in this topic. Unless stated otherwise, it will
be assumed that contributions represent individual opinion rather than
institutional policy.

As list owners, we look forward to your contributions to C+Health,

Judy Smith, Data Analyst, Office of Data Administration and Information
Resource Planning, University of Pennsylvania; [email protected].

Kimberly Updegrove, Lecturer, School of Nursing, University of Pennsylvania;
[email protected].

*****************************************************************************
On-line references on Computing and Health:

The following articles from campus computing newsletters are recommended for
those interested in issues of ergonomics, radiation, light and glare, work
habits and exercise, and related issues and protective measures. Articles can
be retrieved by sending a GET FILENAME FILETYPE command to LISTSERV@BITNIC (not
IUBVM), where FILENAME FILETYPE are shown below in CAPITAL LETTERS.

[From the INTERNET use [email protected] /Fortmiller]

COMPHEAL  DUBEY_J    Computers & Health  (Reed College; 3/91; 520 lines)
COMPHEAL  UPDEGR_D   Computers & Health: Issues & Protective Measures
                     (U of Pennsylvania; 1/91; 262 lines)
CTS       SHEEHA_M   Carpal Tunnel Syndrome  (Indiana U; 11/90; 212 lines)
ERGONOM   UPDEGR_D   Computers Don't Belong on Desktops  (U of Pennsylvania;
                     11/90; 90 lines)
ERGO      BALKITS    Workstation design  (UC Davis; 8/88; 64 lines)
PAIN      BRADLE_J   Computing Pains  (U of Houston; 3/89; 135 lines)
SFVDTLAW  UPDEGR_D   San Francisco VDT Safety Ordinance  (1/91; 146 lines)
VDT       SHEEHA_M   VDT Health Risks  (Indiana U; 11/90; 137 lines)

Thanks to Wendy Rickard-Bollentin of EDUCOM for maintaining the articles
archive of CCNEWS, from which these articles were selected.

*****************************************************************************
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From:	DECPA::"LISTSERV%[email protected]" "Revised List Processor (1.7a)" 16-sep-1991 18:43
To:	VSSCAD::fortmiller
CC:	
Subj:	File: "SFVDTLAW UPDEGR_D" being sent to you

San Francisco Worker Safety Ordinance, December 1990

CONTACT: UPDEGROVE%[email protected]

Amending Part II, Chapter 5 (health code) of the San Francisco
Municipal Code by adding Article 23 requiring employers who
employ video display terminal (VDT) operators to comply with
worker safety requirements.

Section 1301. Findings: Cites NIOSH research into VDT operator
complaints of headaches, general malaise, eyestrain, and other visual
and musculo-skeletal problems, which resulted in recommendations
for VDT workstation design, VDT work breaks, and pre-placement
and periodic visual testing. Cites consensus of NIOSH, WHO, and ANSI
that adjustable VDT workstations in combination with training on
proper adjustment and periodic breaks lead to safer and healthier
work environment for VDT operators.

1302. Definitions: Employer defined as having 15 or more employees
in city, including city government but excluding state and federal
government.

Operator defined as employee who may be epected to use VDT 4
hours or more per shift.

1303. VDT Advisory Committee: Made up of 7 members, charged
with monitoring research and State regulations, making
recommendations on rules and regulations for city.

1304. Workstation standards: All operators to be provided with user-
adjustable workstations and chairs.

Chair specs: upholstered, swiveling, seat pan and backrest adjustable
for height and angle.

Arm rests, padded wrist rests, and foot rests provided upon request
of the operator. Wrist rests shall enable operator to maintain neutral
wrist position.

Terminal display support adjustable so the entire primary viewing
area of the terminal is between zero and sixty degrees below the
eyes.

Keyboard detachable from terminal, in combination with seating and
work surface, adjustable so forearms, wrists, and hands can be
parallel to the floor.

Illumination level between 200-500 lux; "task lighting" upon request.

Glare eliminated by shielding windows, positioning terminals at right
angle to window, and/or anti-glare screens.

Document holder, adjustable for height and angle, provided upon
request.

Screens free of perceptible flicker.

Direct noise of impact printers reduced by covers or isolation.

Comment: Strangely, there is no mention of proper positioning for a
mouse or trackball, which are essential components of Macintoshes
and other window-oriented systems.

1305. Alternative work: Breaks (non-VDT work, rest break, or meal
break) to be provided for 15 minutes after every 2 hours of
repetitive keboard work.

1306. Additional research: Advisory Committee to provide within
two years: (1) recommendations for protecting operators from
possible VDT radiation, including such methods as maintaining a
distance of 1 meter from side or rear of any terminal; and (2)
recommendations for minimizing adverse pregnancy outcomes and
long-term visual impairment. In the interim, employer encouraged to
provide pregnant operators with transfer on request.

1307. Employee education and Training: Guidelines: within 6 months,
info to be provided on known and suspected health effects found to
be associated with VDT work, known and suspected causes of health
effects, protective measures that may be taken including workstation
adjustments and visual examinations, eye and body exercises, and
rights under this ordinance.

1308. Employee Rights: No discharge or discrimination against
complainants.


1309. Variance and Exemption Procedures.

1310. Fees.

1311. Right to entry and inspection: by the Department of Public
Health.

1312. Authority to adopt rules and regulations.

1313. Enforcement: Penalties up to $500/day

1314. Conflict with other laws: Ordinance void if pre-empted by state
or fed.

1315. Severability: If any section held invalid, remainder still in
force.

Amendments:  (Ordinance takes effect 30 days from signing on
12/27/90 according to Mayor's press release.)

Within 1 year: all new work station furniture must be in compliance.

Within 30 months: upgrade as necessary, but not in excess of
$250/station

Within 4 years: full compliance by replacement or upgrading.

-- These notes by Daniel Updegrove, University of Pennsylvania,
based upon reading the San Francisco legislation, identified as "File
no. 118-90-5 (as amended 12/10/90)." Disclaimer: I am neither an
attorney nor a public health specialist; my interest is as a computer
professional.

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% Subject:      File: "SFVDTLAW UPDEGR_D" being sent to you
% To: VSSCAD::fortmiller

    
"Avoiding carpal tunnel syndrome: A guide for computer keyboard users,"
University Computing Times, July-August 1990, pp. 17-19. Author: Mark
Sheehan, University Computing Services, Indiana University, Bloomington, IN
47405. BITNET: Sheehan@IUBACS. 


Carpal tunnel syndrome (CTS) is a painful, debilitating condition. It
involves the median nerve and the flexor tendons that extend from the
forearm into the hand through a "tunnel" made up of the wrist bones, or
carpals, and the transverse carpal ligament (Figure 1). As you move your
hand and fingers, the flexor tendons rub against the sides of the tunnel.
This rubbing can cause irritation of the tendons, causing them to swell.
When the tendons swell they apply pressure to the median nerve. The result
can be tingling, numbness, and eventually debilitating pain.

		
	[Figure 1 (hand) goes here]


CTS affects workers in many fields. It is common among draftsmen,
meatcutters, secretaries, musicians, assembly-line workers, computer users,
automotive repair workers, and many others. CTS can be treated with
steroids, anti-inflammatories, or physical therapy, or with surgery to
loosen the transverse carpal ligament. Recovery of wrist and hand function
is often, but not always, complete.

Causes

Like many skeletomuscular disorders, CTS has a variety of causes. It is
most often the result of a combination of factors. Among these are:

Genetic predisposition. Certain people are more likely than others to get
CTS. The amount of natural lubrication of the flexor tendons varies from
person to person. The less lubrication, the more likely is CTS. One study
has related the cross-sectional shape of the wrist, and the associated
geometry of the carpal tunnel, to CTS. Certain tunnel geometries are more
susceptible to tendon irritation. 

Health and lifestyle. People with diabetes, gout, and rheumatoid arthritis
are more prone than others to develop CTS, as are those experiencing the
hormonal changes related to pregnancy, menopause, and the use of birth
control pills. Job stress has also been linked to an increased likelihood
of CTS. And CTS seems to be more frequent among alcoholics. 

Repetitive motion. The most common cause of CTS that's been attributed to
the workplace is repetitive motion. When you flex your hand or fingers the
flexor tendons rub against the walls of the carpal tunnel. If you allow
your hand time to recover, this rubbing is not likely to lead to
irritation. The amount of recovery time you need varies from fractions of a
second to minutes, depending on many circumstances, including the genetic
and health factors mentioned above, as well as the intensity of the
flexing, the weight of any objects in your hand, and the extent to which
you bend your wrist during flexing.
 
Trauma. A blow to the wrist or forearm can make the tendons swell and cause
or encourage the onset of CTS.


Prevention

Computer keyboard users can take several steps to lower their chances of
developing CTS. Some of these center around the configuration of the
workplace, or "ergonomics." Others have to do with human factors.

Ergonomics. Proper seating is crucial to good ergonomics. The height of
your seat and the position of your backrest should be adjustable. The chair
should be on wheels so you can move it easily. Arm rests on the chair,
though optional, are often helpful.

Figure 2 illustrates many of the points discussed below.

			
			 [Figure 2 (ergonomi) goes here]

	 

Table height. To adjust the chair properly, look first at the height of the
table or desk surface on which your keyboard rests. On the average, a
height of 27-29 inches above the floor is recommended. Taller people will
prefer slightly higher tables than do shorter people. If you can adjust
your table, set your waist angle (see below) at 90 degrees, then adjust
your table so that your elbow makes a  90 degree angle when your hands are
on the keyboard.

Wrist angle. If your keyboard is positioned properly your wrists should be
able to rest comfortably on the table in front of it. Some keyboards are so
"thick" that they require you to bend your hands uncomfortably upward to
reach the keys. If so, it will help to place a raised wrist rest on the
table in front of the keyboard. A keyboard that requires you to bend your
wrists is a common cause of CTS among computer users.

Elbow angle. With your hands resting comfortably at the keyboard and your
upper arms vertical, measure the angle between your forearm and your upper
arm (the elbow angle). If it is less than 90 degrees, raise the seat of
your chair. If the angle is greater than 90 degrees, lower the seat. Try to
hold your elbows close to your sides to help minimize "ulnar displacement"
   the sideways bending of the wrist (as when reaching for the "Z" key).

Waist angle. With your elbow angle at 90 degrees, measure the angle between
your upper legs and your spine (the waist angle). This too should be about
90 degrees. If it is less than 90 degrees, your chair may be too low (and
your knees too high). Otherwise, you may need to alter the position of the
backrest or adjust your own posture (nothing provides better support than
sitting up straight). (Note: If making your waist angle 90 degrees changes
your elbow angle, you may need to readjust the height of your chair or
table.)  

Feet. With your elbows and waist at 90 degree angles, your feet should rest
comfortably flat on the floor. If they don't, adjust your chair and table
height and repeat the steps above. If your table isn't adjustable and your
feet don't conmfortably reach the floor, a raised footrest can help.
Otherwise, you may need a different table. 

Work routine

You need very little recovery time between keystrokes to cool and lubricate
the flexor tendons. If you type constantly, however, the need for recovery
builds. Further, working with your hands bent upward at the wrists or
frequently bending your wrists sideways heightens the friction within the
carpal tunnel. It takes longer to recover from these motions. Working under
stress (deadline pressure, anger, or other anxiety) can make matters even
worse. 

Many studies recommend a 10-15 minute break each hour to give yourself the
recovery time you need. This needn't be a break from productive activities
-- just a break from your keyboard. Exercises can help, too. Try the
following: 

    a)Make tight fists, hold for one second, then stretch your fingers out
wide and hold for five seconds. Repeat several times.

    b)With arms outstretched in front of you, raise and lower your hands
several times.  Rotate your hands ten times (make circles in the air with
the fingertips). 

Variety is the key. CTS occurs most frequently in workers whose motions are
not only repetitious but are kept up for hours at a time. If you use a
keyboard, structure your workdays to include a mix of activities each hour.
For example, instead of typing all morning and filing all afternoon, mix
typing and filing throughout the day.

Early detection

The most painful cases of CTS are those that have gone undetected or
untreated over a long time. CTS can be caught easily in its early stages,
however, and much of the pain and all of the disability avoided.

Early symptoms include a tingling in the fingers, often beginning several
hours after work activity has stopped. Because of this delay in the
appearance of symptoms, many CTS sufferers don't make the connection
between their work activities and the pain they feel until it's too late.
The tingling can lead, over time, to stiffness and numbness in the fingers
and hand, and then to severe wrist and hand pain.

For many individuals the early symptoms of CTS go unnoticed. Employers and
coworkers can help one another identify the onset of CTS by watching for
and pointing out any unconscious shaking of the hands, rubbing of the
wrists, or unusual postures or hand positions at the keyboard.

At the first sign of CTS, you should be examined by a doctor who
specializes in hand and wrist disorders. The doctor can perform a number of
simple tests to detect CTS, and can prescribe specific steps for avoiding
the problem.

Summary

Carpal tunnel syndrome is common among computer keyboard users. It can
strike anyone, and its consequences are serious. Awareness of the problem
and its causes is crucial to preventing CTS. With proper ergonomics and
attention to the work routine you can prevent CTS; with early detection and
treatment it need never become debilitating. The employer's attention to
stress levels, proper ergonomics, and the early warning signs of CTS are
important in keeping the ailment at bay in the workplace.
		__________________________________

A note on retrieving the figures: 
  
1. Open an FTP session to the UCS FTP server, IP address 129. 79.16.96.
2. Log in with any (or null) username and password.
3. Issue the command "cwd pub/ucspubs" to get to the UCS publications
directory.
4. Issue the commands "get hand.hqx" and "get ergonomi.hqx" to transfer
those files to your account. 
5. Use a hexbin utility such as that in Stuffit to convert the files from
hexadecimal to binary. They are in MacDraw II format. 

*************************************************************
CCNEWS Copyright Notice

If you use this article, in whole or in part, in printed or
electronic form, you are legally and morally obligated to
credit the author and the original publication name, date,
and page(s). We suggest that you also inform the author of
your intention to use this article, in case there are updates
or corrections that he or she might wish to suggest.

The ideas and opinions expressed in this article, as well as
articles obtained through CCNEWS and the CCNEWS Articles
Archive, do not necessarily reflect those of EDUCOM. EDUCOM
will not accept responsibility for misinformation, nor will
EDUCOM be responsible for misuse of information obtained
through the CCNEWS Articles Archive.

If space and format permit, we would appreciate your
crediting the "Articles database of CCNEWS, the Electronic
Forum for Campus Computing Newsletter Editors, a BITNET-based
service of EDUCOM." We would also appreciate your informing
us (via e-mail to CCNEWS@EDUCOM) when you use an article, so
we will know which articles have proven most useful.

*************************************************************

    Article in the October 1991, BYTE magazine on page 119:
    
    	Health and Safety First
    
    	"Ergonomic issues have taken a backseat to performance, resulting
         in a growing tide of computer-related injuries.  Change is
         needed--now!"

From P.T. Bulletin
September 11, 1991


			Repetitive-Motion Injuries
			Prompt New Call for Action

Citing the grave danger posed to workers by repetitive motion injuries, 31
labor organizations representing workers from almost every occupation filed
a petition asking the Labor Department to issue an emergency temporary
standard on ergonomic hazards to protect workers from work related
musculoskeletal disorders.

"Cumulative trauma disorders are now the leading cause of reported
occupational illness in the nation," the petition states.  Millions of
workers are at risk of injuries from repeated trauma.  According to the
federal government, more than half of the nation's workers now have jobs
with the potential for cumulative trauma disorders.

"Workers with cumulative trauma injuries suffer pain, loss of functional
capacity, and in a significant number of cases, permanent disability.  The
number of reported cumulative trauma cases has increased by over 100 percent
in the past two years.  The magnitude of this increase is unprecedented in
the agency's history," the petition continued.

"The solutions to these problems are at hand, but the tools of enforcement
are not.  It is clear that an emergency temporary standard is necessary to
stem the rising tide of these painful disorders," William Wynn, president of
the United Food and Commercial Workers International Union, stated in a
cover letter which accompanied the transmission of the petition to Secretary
of Labor Lynn Martin.

The petition explains that the alarming increase in the number of
cumulative trauma disorders has "come about from very real and substantial
changes in the workplace created by new technology, such as video display
terminals, increased pace, and the breaking down of jobs into smaller, more
repetitive tasks."

The petition declares that "the growing problem of occupationally related
musculoskeletal disorders requires immediate action by the Occupational
Safety and Health Administration (OSHA) to prevent this workplace epidemic
from reaching even greater proportions.  At the pace OSHA is currently
proceeding, a standard on ergonomic hazards will not be issued for at least
five to seven years.

"Given the grave danger ergonomic hazards pose to workers, we request that
the secretary issue an emergency temporary standard on ergonomic hazards to
require protective measures be instituted immediately," the petition
concluded.

Are the emissions from laser printers bad for your health?

My friend who works in the Civil service says that they have been warned about
this and have to make sure that the vents in the printers don't point towards
anyone.

Does anyone have more information about this?


I'm asking because one of the supposed cost-cutting changes in our office
was to move the noisy, smelly printers from a separate print room and 
scatter them between the cubes.  I know this hurts my concentration, but
is it hurting my health as well?

From,

Greg.

    I believe that as a by product of the corona disharge used during the
    xerographic process that minute amounts of ozone are produced.
    
    The unit has a filter on the side which is supposed to remove the
    residual ozone. The filter is one of the items that is peridoically
    replaced during schedule maintainence.
    
    To my knowledge, we comply with all known regulations for ozone
    emissions. Are to whether those regulations are sufficient is something
    I am not qualified to answer. Check with somebody in the VIPS (Video,
    Imaging, and Printers Group). I believe that Roy McCall (Royalt::) is
    in charge of the Desk Top Printer program.
    
    /jim

    Technically, the "filter" is actually a catalyst, which converts
    the ozone to oxygen.  Our newest laser printers, the DEClasers,
    use a contact technique, which means that there is no corona wire
    at which ozone is formed, and that they produce no ozone to begin
    with.
    
    						Ann B.

    Sounds to me like we should remove all those filters, and run the
    laser printers out-of-doors.

    Cheaper than finding a replacement for freon...

>    Sounds to me like we should remove all those filters, and run the
>    laser printers out-of-doors.

        At ground level ozone is a corrosive pollutant, it is only
        considered beneficial at high levels of the atmosphere. 
        My desk dictionary lists the ozonosphere as occurring at
        approximately 20 to 30 miles above the surface.  If would
        be a real pain to have to go to low earth orbit to pick up
        a printout.

        					B.J.

    
    
    1. a poisonous blue, unstable, gaseous form of oxygen that has 3 atoms
    per molecule rather than the usual two.
    
    2. (informal) pure clean air.
    
    Websters II . new riverside dictionary


From:	US1RMC::"LISTSERV%[email protected]" "Revised List Processor (1.7a)" 15-Nov-1991 13:52
To:	Ed Fortmiller <VSSCAD::fortmiller>
CC:	
Subj:	File: "CTS SPEDE_J" being sent to you


"WHAT COMPUTER USERS NEED TO KNOW ABOUT CARPAL TUNNEL
SYNDROME"

BY JANI FARLOW SPEDE, ASSISTANT EDITOR, NORTHEAST REGIONAL
DATA CENTER, UNIVERSITY OF FLORIDA (JSPEDE@NERVM OR
[email protected]).

THIS ARTICLE APPEARED IN "/UPDATE," VOLUME 19, NUMBER 9/10,
SEPTEMBER/OCTOBER, 1991.

Believe it or not, the machine that has seemed to do nothing but help
you get through those tough tasks can possibly hinder your physical
health--really hinder, to the point where you won't ever worry about
using a keyboard again.

This shocking message is bombarding the media and depicting carpal
tunnel syndrome (CTS) as an epidemic, especially among computer
users.  But do computers really cause CTS and can anyone who uses a
computer get it?  What preventive measures can be taken against
CTS?

This is what you need to know: 1) CTS may affect anyone who uses a
computer, but some people are more likely to suffer than others. 2)
While preventive methods are excellent, they are not always a cure.

As computer users, you should also know some specifics about the
above items, so let's shed some more light.

What is CTS

CTS is a condition that involves the flexor tendons which extend from
the wrist to the hand (see Diagram 1). These tendons, as well as the
median nerve, are enclosed in a bony canal, or "tunnel." The tunnel
consists of bones (carpals) and is roofed by a rigid transverse carpal
ligament. When the hand is flexed, the flexor tendons rub up against
the tunnel. In the case of repetitive motion, such friction may cause
the tendons to swell. Because the swollen tendons apply pressure to
the median nerve, the median nerve then suffers from compression
and degeneration, which is ultimately the problem that results in the
symptoms of CTS.

What Causes CTS and Who Can Get It

Trauma is only one of the many causes. Dr. Ralph C. Williams, Jr.,
Eminent Scholar of the Marcia Whitney Schott Chair in Rheumatoid
Arthritis, Department of Rheumatology at the University of Florida,
explains that "repetitive motions [such as those associated with using
a keyboard] can be a factor in triggering CTS, but usually a patient
can be found to have some other predisposing condition that seems
to set it off." Some of the predisposing conditions indlude low
thyroid, pregnancy or various hormonal imbalances (but not the use
of birth control pills), diabetes, fluid retention from heart disease,
liver disease, rheumatoid arthritis, and lupus. These medical
conditions, adds Dr. Thomas W. Wright, Assistant Professor in the
Department of Orthopedics at the University of Florida, who
specializes in workplace overuse injuries and CTS, may cause you to
have thickened flexor tenosynovium, which is the lining around the
flexor tendons. "As this lining thickens, one can imagine that the
space in the carpal canal will become relatively smaller, therefore
creating greater pressure on the median nerve," says Wright.

As for who can get CTS, it would be unfair to dispute the claims that
no computer user is immune. Under the right circumstances of
extreme overuse, almost anyone can develop CTS, but as mentioned
above, without doubt, certain individuals are more predisposed than
others.  It is difficult to determine the ratios of victims who have CTS
caused exclusively by repetitive motion and those who have it as a
result of a predisposition. This is probably because some overlap
exists. Many articles are printed which claim that more than 50% of
CTS sufferers developed CTS from work-related traumas. Keep in
mind that some of these cases most likely were predisposed by a
metabolic disorder. But without the statistics broken down
accurately, we can't be sure--and we still can't be sure of all the
predisposing factors. "Predicting who will get CTS is like predicting
who will have a heart attack--it's almost impossible," according to Dr.
Williams.

Detecting the Symptoms

Dr. Wright states that numbness and tingling can occur in any of the
digits, but patients usually notice it in the thumb, index and radial
half of the long finger. In some cases, the tingling sensation turns to
pain, which may even radiate as far as the shoulder. CTS is not,
however, always a painful disorder. In fact, in some of the worst
cases, where the median nerve is injured and a weakness develops in
the thumb, pain is not even a symptom. When pain does play a role,
it sometimes is not present until hours after a related work activity,
making it difficult for a victim to connect the symptoms to the
source. Computer users should be aware that any tingling sensation
in their hands or wrists may be a possible CTS symptom, even if it
doesn't occur until the middle of the night, or upon awaking in the
morning.

Treatment

Depending on the severity of the case, doctors treat CTS by
immobilizing the wrist with a rest splint, or prescribing anti-
inflammatory medication or steroid injections into the wrists.  Both
of these treatments often bring about a remission, but if not, the
patient may require a surgery which essentially "transects the
transverse carpal ligament allowing the contents of the carpal canal
some room to expand, taking the pressure off the median nerve,"
explains Dr. Wright. He adds that this operation, a carpal tunnel
release, has a satisfaction rate of 90 %. About 10% of patients who
receive the operation are usually not happy with the procedure
because of a persistent post-op disability.

Fighting Back--What You Can Do

The most common means of beating your chances of getting CTS is to
conform to proper work habits. This can range from taking a break
from your keyboard to establishing the recommended ergonomics in
your work station. Here's what you can do:

Probably the most obvious prevention is to ALLOW YOUR HANDS
AND WRISTS TIME TO RECOVER FROM EXERTING WORKOUTS. "Break
periods are really a good idea," according to Dr. Williams. Most
experts agree that for those who are constantly at the keyboard, it is
best to take about a 10-15 minute break every hour. This can mean
simply doing something other than typing--anything for "avoiding
long term exposure to the same repetitive movement," adds Dr.
Wright.

CERTAIN EXERCISES ARE RECOMMENDED (and are a good "break"
from typing):

Clench hands into tight fists, hold for one second, stretch fingers out
wide, hold for five seconds. Repeat several times.

Stretch arms out forward, raise and lower hands several times
(bending at wrists), rotate hands by making circles in air with
fingertips.

PROPER ERGONOMICS--adjust the best angles and heights for a safe
work station as recommended below (see Diagram 2).

TABLE: Typically, your table surface should be 27"-29" inches above
the floor, depending, of course on your height. Taller people will need
to increase the table height slightly.

CHAIR: Ensure that your chair comfortably supports your lower back.

WRIST ANGLE: Don't bend your wrists uncomfortably to reach the
keys. Try propping wrists up (maybe with a pillow, or the recently
marketed cushioned "wrist rests"). This is crucial--poor wrist angles
are very dangerous.

ELBOW ANGLE: The angle between your forearm and upper arm
should be 90 degrees. If less, raise the height of your chair, if
greater, lower the chair.

WAIST ANGLE:  Another 90 degree angle should exist between your
upper legs and your spine. This is again adjusted by either the height
of the chair and/or the backrest.

FEET: If all proper angles are established, your feet will lie flat on the
floor. However, if raising your chair to accommodate the proper
angles brings your feet too high, use a footrest.

EYES: Adjust height and tilt of screen to create a 35 degree viewing
angle from top to bottom (starting just slightly below eye level). Also,
place the screen about 27"-29" away from you.

Beware

Don't be misled. These preventive methods are not a magic cure.
Unfortunately, even though proper ergonomics will undoubtedly
improve symptoms and may prevent a long term disability, "there
are a number of individuals who, despite all of these good efforts,"
says Dr.  Wright, "will develop carpal tunnel syndrome."

Nevertheless, CTS specialists say they can't stress enough the simple
methods suggested. Hopefully, once proper ergonomics in the work
area are well established, the number of patients who get CTS from
their computers will become nil. But remember, the recommended
methods only work when they are routine. In other words, stress,
pressure and deadlines may cause you to deviate from your ordinary
preventive procedures, so be careful!  Also, with all this emphasis on
computers causing CTS, it is important to note that there are many
other activities (some of which you may very well be doing at home)
that involve repetitious motions, such as sewing, playing musical
instruments (especially violin, guitar, and piano), drafting, and
working on automobiles. CTS injuries from lines of work such as
these have been around a lot longer than your computer, and
sometimes proper ergonomics aren't the complete answer. But you
can take frequent breaks--just remember to avoid any excessive
repetitive motions. Above all, be sure to contact your physician at
the onset of any symptoms.

Author's Note: We thank Dr. Ralph Williams and Dr. Thomas Wright
for providing us with the medical information necessary to write this
article. Sources include:

McCarty, D.J. Arthritis and Allied Conditions. Tenth edition.
Philadelphia: Lea and Febiger, 1985. 1213-1214.

Sheehan, Mark. "Avoiding Carpal Tunnel Syndrome: A Guide for
Computer Keyboard Users."  University Computing Times. July-
August, 1990.  University Computing Services, Indiana University.
17-19.

Diagram 1: View of hand showing carpal tunnel (carpal bones, flexor
tendons, median nerve, and transverse carpal ligament) DIAGRAM 2:
Computer user at work station with all proper angles and heights

*************************************************************
CCNEWS Copyright Notice

If you use this article, in whole or in part, in printed or
electronic form, you are legally and morally obligated to
credit the author and the original publication name, date,
and page(s). We suggest that you also inform the author of
your intention to use this article, in case there are updates
or corrections that he or she might wish to suggest.

The ideas and opinions expressed in this article, as well as
articles obtained through CCNEWS and the CCNEWS Articles
Archive, do not necessarily reflect those of EDUCOM. EDUCOM
will not accept responsibility for misinformation, nor will
EDUCOM be responsible for misuse of information obtained
through the CCNEWS Articles Archive.

If space and format permit, we would appreciate your
crediting the "Articles database of CCNEWS, the Electronic
Forum for Campus Computing Newsletter Editors, a BITNET-based
service of EDUCOM." We would also appreciate your informing
us (via e-mail to CCNEWS@EDUCOM) when you use an article, so
we will know which articles have proven most useful.

*************************************************************

% ====== Internet headers and postmarks (see DECWRL::GATEWAY.DOC) ======
% Received: by us1rmc.ogo.dec.com; id AA29454; Fri, 15 Nov 91 13:51:11 -0500
% Received: by mts-gw.pa.dec.com; id AA22199; Fri, 15 Nov 91 10:51:21 -0800
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% Date:         Fri, 15 Nov 1991 13:47:17 -0500
% From: Revised List Processor (1.7a) <LISTSERV%[email protected]>
% Subject:      File: "CTS SPEDE_J" being sent to you
% To: Ed Fortmiller <VSSCAD::fortmiller>

    Boston Globe, Page 15, 17-Feb-1992:
    
    [portion of the article]
    
    "In a major step toward combatting the epidemic of repetitive stress
    disorders in the workplace, Massachusetts will soon require physicians
    to report all work-related cases of the potentially disabling ailment
    known as carpal tunnel syndrome."
    

    If anyone knows of a group in DEC which gets this please let me
    know as I would like to poke through a few issues.  I've been told
    that none of the DEC libraries receive it which kinda suprised me.
    
From:	VSSCAD::US1RMC::"[email protected]" "Computing and Health" 27-feb-1992 16:48
To:	Ed Fortmiller <VSSCAD::fortmiller>
CC:	
Subj:	Good information source on VDTs

 There is a publication called VDT NEWS (The VDT Health and Safety Report)
 published bimonthly which carries articles, stories, and news about
 health issues related to VDTs.  This includes repetitive strain injury,
 ergonomics, electromagnetic fields, etc.  Many larger libraries may be
 getting it already.  Cost is $87 per year, and the address is:

                      VDT NEWS
                      PO BOX 1799
                      Grand Central Station
                      New York, NY 10163
                      (212) 517-2802 or FAX (212)734-0316

 It is also a good source for manufacturers info through the advertisements
 for various products, and lists of meetings and publications related to
 VDT use.

 William Condon             "Another fine mess you've gotten us
 NYS Dept of Health          into Ollie"
 2 UNiversity Place
 Albany, NY 12203    (518) 458-6495

    Article in the Tuesday, March 3, 1992 New York Times on page C1:
    
    "Epidemic at the Computer:
     Hand and Arm Injuries
    
    Ills now account for up to 40 percent of workers' compensation
    claims..."
    
    

Extracted From RISKS DIGEST 13.26 5 Mar 92 22:48:33 GMT
------------------------------
Epidemic At The Computer: Hand And Arm Injuries
Computer Users' Injuries Are Often Preventable
 
Date: Wed, 04 Mar 92 15:05:05 EST
From: [email protected]
Subject: Repetitive stress injuries
 
By coincidence, the New York Times has just run a pair of articles on the
subject of repetitive stress injuries.  I've enclosed substantial extracts from
the two articles.  Speaking personally, I find that I have more trouble with my
wrist when I'm very tired to start with.  (I'm very tired right now, and I
almost didn't prepare this message because my tendonitis is acting up again.)
A wrist rest helps me immensely.  Conversely, too much mouse activity is
problematic, since I don't have effective support for my wrist then.  Typing on
too high a surface -- such as a regular desk, as opposed to a typing table --
is a sure-fire recipe for trouble (again, for me).  It's even worse if the desk
has a sharp edge I have to avoid.  Most important -- I've learned to listen to
my hands.  If I'm starting to feel pains, it's probably a good day to catch up
on journal articles, rather than to start writing a paper.
                                                             --Steve Bellovin
 
    [I don't think I ever mentioned to you all that I got one of our tech
    wizards to rig up foot pedals for the CONTROL and META keys, so that I
    could practice my organ-pedal action and keep my left wrist/pinky from
    spasming in EMACS.  It made a big difference.  
       The following is starkly excerpted by Steve, and is reproduced here
       despite its length, because of its importance to RISKS.  PGN]
 
EPIDEMIC AT THE COMPUTER: HAND AND ARM INJURIES, by JANE E. BRODY
c.1992 N.Y. Times News Service
   Work-related injuries, long the plague of those who do heavy manual labor,
have become a scourge among white-collar workers, too.
   Experts say hundreds of thousands of office workers are being disabled each
year in an epidemic of motion-related damage to the hands and arms that is
costing the nation many billions of dollars annually.
   The problem is expected to worsen in the current recession as businesses
demand greater output from fewer employees and workers ignore symptoms for fear
of losing their jobs.
   Over the last decade disorders caused by movements repeated many thousands
of times a day, long a plague on assembly lines and in processing plants, have
invaded the once low-risk environment of the office worker along with the
computer.
   Computer operators spend many hours in the same position doing the same task
without breaks or variation, giving no time for stressed tissues to recover.
   Over time, this behavior can induce crippling changes in the sensitive
tissues of the wrist and hand.
   High rates of injury have been reported among data entry workers, telephone
operators and newspaper reporters and editors who work for many hours a day
typing on a computer keyboard.  ...
   People with the disorders, which can sometimes be permanent, can find
themselves unemployable or forced to change careers. Favorite sports
activities, housework, carrying groceries, or even holding a coffee cup may
become difficult or impossibly painful.
   The disorders have many names -- repetitive stress or repetitive motion
injuries, cumulative trauma disorders, of which carpal tunnel syndrome is one,
and most recently, work-related musculoskeletal disorders, the designation of
the World Health Organization.
   But it all boils down to damage caused principally to tissues within the
hand and arm by seemingly innocent actions that are repeated perhaps thousands
of times each work day, like typing on a computer, cutting meat or poultry or
etching glass.  ...
   The American Academy of Orthopedic Surgeons estimated in 1984 that the
problem cost the nation more than $27 billion a year in lost wages and medical
care, an amount that could well have doubled by now since there has been more
than a doubling in reported cases.
   Dr. Marvin J. Dainoff, a psychologist who is the director of the Center for
Ergonomic Research at Miami University in Oxford, Ohio, has called repetitive
stress injury the ``occupational disease of the 90s'' similar to the asbestos
crisis of the 1980s.  ...
   ``Those with problems that are caught early can expect to recover in a few
months,'' said Dr. Emil Pascarelli, director of ambulatory care at [St.
Luke's-Roosevelt Medical Center]. ``But workers with severe injuries can take a
year or more to get better.''
   In some parts of the country, workers diagnosed with carpal tunnel syndrome
are often treated with surgery to reduce pressure on the nerve that is
compressed by swollen or enlarged tissue passing through the wrist.
   While some surgeons say the procedure is remarkably helpful to 60 to 80
percent of patients, other experts say it is abused by doctors who do not try
more conservative remedies first. Carpal tunnel surgery is now the second most
common operation performed in this country.  ...
   But repetitive motion disorders received only a flicker of expert attention
until they began striking white-collar workers and especially newspaper
reporters, who had been all but immune to the job-related injuries that other
laborers have endured for centuries.
   Some of the rise in cases is widely attributed to increased
recognition of the problem and a new willingness to report it.
   Dr. Laura Punnett, an ergonomist and epidemiologist at the University of
Massachusetts at Lowell, said ``historically there's been lots of
underreporting'' of these disorders. As she explained, ``Many workers did not
recognize the problem as being job-related; others who did worried about losing
their jobs if they reported their injuries.''  ...
   A common experience of workers in America who report hand and wrist injuries
to their employers is to find themselves suspected of malingering.
   Employers' doubts are bolstered by the fact that victims of repetitive
stress injury take longer to recover and are less likely to return to work if
they have filed worker's compensation claims, according to a study of 28,000
workers conducted by Dr. Gary Franklin, a neurologist who serves as medical
director for Washington State's Department of Labor and Industries.
   Franklin also noted that the disabilities suffered by many workers were
``out of proportion'' to measurable abnormalities in their wrists, a widely
acknowledged finding that has prompted Nortin M. Hadler, a rheumatologist at
the University of North Carolina, to dispute whether the problem is real.
   Hadler maintains that musculoskeletal activity that is ``reasonable,
comfortable and customary and which can be repeated without undue distress,''
such as typing on a computer, is unlikely to result in tissue damage.
   Others, like Silverstein, report that although dissatisfied workers are
prone to exaggerate their injuries or discomforts, she found in studying
workers with problems at Newsday that the most devoted and talented reporters
typically suffered the most.
   ``These are high-production people who don't listen to their bodies,''
Silverstein said. ``They don't stop working when they start hurting. The same
with musicians. It is the high-performance people who are at highest risk of
musculoskeletal disorders. And one could hardly accuse musicians of seeking to
get paid without working, since they don't.''
   In a seven-industry study of factory workers, she also found no differences
in overall job satisfaction and in views about work in general among employees
afflicted with hand-wrist disorders and those who were not.
   Still, she and Franklin agreed that psychological and social factors can
make work-related muscular stress worse by increasing muscular tension.  ...
   Among the physical factors Dainoff lists as raising a worker's risk of
hand-wrist disorders are these:
    High rates of repetition of the same action. A computer operator who types
60 words a minute can make 18,000 keystrokes in an hour.
    Awkward or unnatural posture while working. The ideal position of the wrist
is flat and straight, which positions the hand level with the arm and extended
in a straight line from it. Those who work with hands bent up, down or to the
side risk damage to the tissues in the wrist.
    Use of excessive force while working. In Silverstein's factory study,
workers who had to use high force and a high rate of repetition had 29 times
the rate of hand-wrist disorders as workers using low force and a low rate of
repetition.
    Lack of adequate rest periods or recovery time. Experts estimate that hands
should be relieved of repetitive motion for at least 15 minutes every 2 hours
to reduce the risk of injury.
   ``Try telling that to a reporter writing against a deadline,'' Silverstein
remarked.
   People who work on computers, which do not require much force to
operate, may nonetheless fall victim to repetitive stress injuries.
   Dainoff explained that in many computer-reliant offices like newsrooms,
almost every activity is done with the keyboard, including writing, editing,
taking notes, searching for information and sending messages.  ...
   Some computer-based jobs are ``the sweatshops of the 90s,'' said Dr. John
Kella, a musician and biomechanic who directs a rehabilitation and retraining
program for injured workers at the Miller Institute in New York.
   He pointed out that computer keyboards are unforgiving and many operators
press the keys too hard, causing an almost imperceptible kickback as the
fingertips hit the keyboard's rock-hard bottom.  [In my own personal opinion,
keyboard feel has gone vastly downhill since the days of the IBM Selectric
typewriter.  --smb]
   His colleague, Pascarelli, likened it to dancers performing day after day on
a concrete floor. ``Eventually, they are going to get injured,'' he said.
   The injuries that he treats are often not ``classical'' syndromes with
readily identifiable pathological changes in structures of the hands and
wrists.
   Some, perhaps a quarter of those complaining of symptoms, have clear cases
of carpal tunnel syndrome.
   Some have tendinitis, an inflammation of the tendon that passes through the
wrist, and others have tenosynovitis, an inflammation of the sheath around the
tendon. But many fit no recognized classification.
   Dr. Lawrence Fine, an occupational medicine specialist for the National
Institute of Occupational Safety and Health in Cincinnati, said: ``Yet these
people are in a lot of pain and are forced to take time off from work. It's
hard for me as a physician to say it's all in people's heads, especially when
the frequency and severity of the disorders abates when the risk factors are
reduced.''
   Even when a rational remedy is applied, the workplace setting can sometimes
cause it to backfire.
   Silverstein gave on-the-job exercises to workers in a dental floss
manufacturing plant.
   A year into the program she found no improvement in the rate of repetitive
stress injuries because the workers, forced to meet production quotas, had
worked harder to make up for the time lost during their exercise sessions.
		====
COMPUTER USERS' INJURIES ARE OFTEN PREVENTABLE
By JANE E. BRODY
c.1992 N.Y. Times News Service
....
   Researchers who have analyzed the conditions that seem to lead up to
hand-wrist problems and clinicians who treat them have identified factors both
within and outside the workplace that when properly adjusted can help prevent
hand-wrist injuries.
   Dr. Marvin J. Dainoff, director of the Center for Ergonomic Research and a
professor of psychology at Miami University in Oxford, Ohio, insists that
physiologically sensible use of the computer starts with the user's chair.
   A well-designed chair not only helps protect your back but also reduces
strain on your shoulders, neck and arms and ultimately your hands.
   Most experts recommend a chair that allows you to adjust the height of the
seat and the tilt of the back and possibly also of the seat. An adjustable
table may also be necessary for people who are very tall or very short.
   You should be able to sit with your feet flat on the floor (or on a
footrest), your thighs at right angles to your torso, your arms and hands
parallel to the floor or perhaps slightly elevated, your head erect and your
eyes looking slightly down (about 15 degrees below the horizontal) to see the
screen.
   To minimize stress, the chair should support your lower back and should
swivel and roll on casters. To allow for relaxation of muscles and shifts in
working postures, the seat back should be able to tilt backward to an angle of
15 degrees or more from the vertical.
   The desirability of arm rests is a matter of debate. Some experts suggest
they can aggravate wrist problems and encourage poor posture if the arms are
rested on them while typing. Others laud their usefulness as a resting place
when not typing.
   Next comes the surface on which the computer keyboard rests.  When sitting
properly in your chair, you should be able to type with a flat wrist. Avoid
bending your wrist up or down or twisting it sideways when you type.
   If the keyboard is very wide or deep, learn to lift your hand to reach
outlying keys instead of trying to stretch your fingers to them, which distorts
your wrist position.
   While typing, avoid resting your wrists on the edge of the work surface; to
reduce pressure on the wrists, consider using a padded wrist and palm rest in
front of the keyboard. Keep fingernails trimmed; long nails force you to extend
your fingers to hit the keys.
   Try to avoid other potentially wrist-damaging activities when you are not
typing. Dainoff cautions against moves that bend the wrist, especially if force
is involved, like pushing a heavy door, opening jars, holding a telephone
handset at an angle or resting your head in your hand.
   Also think about home and recreational activities that might aggravate a
sore wrist, including excessive use of a kitchen knife, playing a musical
instrument with a distorted wrist, skating with the hand bent up at the wrist
or pushing a power mower.
   Use your whole hand (not just thumb and forefinger) and minimal force when
gripping, grasping or lifting an object.
   Take frequent brief rests while typing. Switch to another activity that uses
the hands differently. Do not use more force than necessary to hit the keys.
When taking notes or writing an original work, avoid holding your hands in a
tensed ``ready'' position when waiting to type.
   Do exercises that strengthen hand and arm muscles and improve circulation in
the upper extremities, like squeezing a handgripper and swimming. When typing,
try to rely more on the larger, stronger muscles of the arms and shoulders to
reduce strain on the wrists and hands.
   When detected and intercepted in their early stages, hand and wrist problems
are relatively easy to reverse. Experts caution against trying to work through
pain, since that will only make the injury worse and could result in
irreversible damage to the nerve that passes through the wrist into the hand.
   Therapy may involve analysis of your typing technique and retraining,
adjustments in your office furniture and keyboard, physical conditioning and
the use of wrist splints at night to prevent abnormal wrist positions during
sleep.
   Dr. Emil Pascarelli, director of ambulatory care at St.  Luke's-Roosevelt
Medical Center in New York, who established a hand clinic to treat injured
keyboard users, said that anti-inflammatory drugs, like ibuprofen, do not seem
to work well in treating work-related injuries to the wrists and hands.
   He also maintains that surgery, which has become a very popular remedy
nationwide, should be considered a treatment of last resort, when more
conservative measures seem unable to relieve the problem or when the nerve is
becoming scarred or is degenerating.
 
------------------------------
 
End of RISKS-FORUM Digest 13.26
************************

    Does anyone use or know about these new keyboards that sort of fold in
    the middle (like this /\) such that you type sideways like on accordian? 
    This type of keyboard suppoedly puts less strain on your wrists, once 
    you get used to typing like that. 
    
    I believe these are called "articulated" keyboards. The previous use of
    that term is perhaps a misnomer in that it refers to an adjustable
    shelf type of thing that extends from your desk. The keyboard sits
    on it.
    
    Anyone know about them? Can you use one on a DEC workstation, PC,
    VT-series char. cell? Does DEC procure them for employees?
    
    Thanks.
    
    - Bob 

    I think they are also called 'chord' or 'cord' keyboards.  I've read
    some articles on Usenet about them, but don't know if anyone makes them
    for VT's or workstations.  I'm pretty sure there are keyboards for PC's
    (Mac's and IBM's).
    
    --- Gavin

        `chord' keyboards are different from articulated keyboards.

        Articulated (and other strangely shaped) keyboards have the same
        number of keys as standard keyboards, but the key locations (and
        sometimes patterns) are different.

        Chorded keyboards require `chords' of keys to be pressed (as
        opposed to a single key) to generate a typed character.  A
        simple chorded keyboard to generate 7-bit ASCII could have eight
        keys--one for each bit in 7-bit ASCII and one for send.  Send a
        character by pressing the 0-7 keys corresponding to the one bits
        in the ASCII representation and the send key.  A chorded keyboard
        that handles all of the function keys of the LK201 is harder.

        The last time I saw a picture of a chorded keyboard was years
        ago--before most terminals had function keys or numeric keypads
        that generated escape sequences and before 8-bit ASCII was
        defined.

        					B.J.

    
    
    If it is the keyboard that came with the VT1200's...
    
    I had to revert back to the LK201 keyboard.
    
    After I used the new VT1200 keyboard for a few months both my wrists
    started bothering me.
    
    After reverting back to the 201 style, the problem seems to be clearing
    up....
    
    
    Lou
    

    The patent on the folding keyboard is held by a gentleman who refuses
    to license it to anybody who intends to manufacture the keyboards
    outside the USA.
    
    Last I heard, he had no takers.

    For users who despise the extra distance that the little fingers must
    stretch to reach the RETURN and CONTROL key on the LK201 you might want
    to consider the LK421-AA (Unix Keyboard) which was recently released.
    I ordered one from DECDirect and got it in a few days.
    
    Ctrl A S D F G H J K L ; ' Return
    
    Please do not start a keyboard war here, take that to the keyboard
    conference.
    
    PS: Even though I said "Unix Keyboard" it does work on a Vaxstation
        running VMS.

>    If it is the keyboard that came with the VT1200's...


That's the LK401 (now LK450)  that has a gentle curve to the face of the 
keyboard, shorter and fatter than the LK201 with attached swivel feet.

If anyone has one (British Layout), and wants an LK201 (British Layout) I'll
swap ! 


BTW - British Layout = [] keys side-by-side

    Actually, I'm using an LK401, which is somewhat better than a 201.
    
    I'm not into "keyboard wars" either and have entered my query in the
    keyboard notes file as well. However, in the context of helping carpal 
    tunnel sufferers, if any of you do come upon info about this articulated
    keyboard, please enter it here or send me mail.
    
    Thanks.
    
    - Bob

    
    Announcing the Repetitive Stress Injury Conference at
    
    	DANGER::BMA$DISK:[FORTMILLER.RSI]RSI
    
    "Repetitive Strain Injury, or RSI, is being called the occupational
    disease of the 1990s."
    
    "RSI is a general class of disorders resulting from sprain/strain to
    upper limbs (shoulders, arms, hands) which occurs gradually over a
    period of time.  Other terms which mean about the same thing are
    Cumulative Trauma Disorder, Repetitive Motion Injury and Overuse
    Syndrome.  RSI is the result of four risk factors acting in
    combination:
    
    	(1) high rates of repetition
    	(2) awkward posture / position
    	(3) use of excessive force
    	(4) lack of adequate rest / recovery 
    
    There are several specific RSI disorders, including tendinitis,
    tenosynovitis, and a particularly a serious wrist disorder called
    carpal tunnel syndrome (CTS)."
    
    
    Ed Fortmiller, moderator
    DANGER::Fortmiller  DTN 293-5076
    BXB2-2/E6
    

    This RSI conference has moved to:

        CADCTL::LABATT:[HKOLK.RSI]RSI

    If you have the RSI conference in your notebook do the following
    notes command to get the new conference:

    Notes> Modify entry RSI /File=CADCTL::LABATT:[HKOLK.RSI]RSI
    Notes> Open RSI

    The new host is Herb Kolk in LTN2 and his
    Email address is CADCTL::KOLK

    Ed Fortmiller
    DANGER::Fortmiller

    As this conference is more widely read than the RSI conference,
    I would like to ask if anyone has experienced the lowered (called
    articulated) keyboard shelf as making their condition worse?
    
    I have had mine for only a week, but both my wrists hurt much more
    than they did before. I know a week is not a lot of time to judge,
    but I can't point to anything else that could have made the pain
    worse. 
    
    I have tendonitis in both wrists since early December, just
    after I finished a project that required me to work about 60 hours 
    a week for three months. At first only typing hurt, and I got much
    better over the holidays, but the pain got bad again as soon as I
    started typing. Now driving and lifting things also hurts.
    
    I went to MGH, and they put a splint on my right wrist, but it hasn't
    improved things. I take breaks every 20 minutes, too. They told me at 
    MGH to rest my arms on a soft surface at the proper height while typing 
    (I used mouse pads and a wrist rest), so that my wrists would not be 
    bearing any weight, but that is not feasible with the lowered keyboard. 
    
    I have driven much less than usual this week and I haven't been lifting
    anything, except a small amount of snow shoveling, so I can't figure
    out what it could be except the keyboard. And yet these keyboards are
    supposed to help, so I am reluctant to stop using it. 
    
    One of the worst things about this type of problem is that you
    can only communicate with other people who are familiar with it
    through typing, and it hurts to type.
    
    Thanks for any information anyone can give on the keyboard.
    

    I haven't experienced it (my lowered keyboard shelf cured my
    wrist-ache, once I'd bolted a large wooden platform in place
    so that the shelf was actually large enough for keyboard
    and mouse-run), but I *have* read that there ain't no
    single answers in the workstations ergonomics business.
    What's right for most people might be all wrong for you.
    
    Here in LKG, you can have an ergonomics "expert" come and
    advise you in your cube.  Have you tried that?  Apart from
    the posture advice which you could admittedly read about
    anywhere, I learned that I have a bad habit of resting my
    elbows on the arms of my chair, which contributed to
    forearm-ache.

    >anything, except a small amount of snow shoveling, so I can't figure
    
    Now *that* really does make my wrists ache.  It's much
    more stressful than typing.
    
    

    Thanks for your reply. The experts at ZK did come to my cube, and
    several weeks later the lowered shelf came and was installed. Maybe
    it will work for me as it has for you, and one other person I know.
    
    The problem for me is that it does not allow me to follow MGH's
    instructions: to rest my whole arm on the table on a soft surface
    in front of the keyboard. I notice that the person in .20 of this
    note said she got better by doing the same thing as MGH said. That
    woman's name last name (or first name) is Penney, and I would love
    to talk to her if she is still with the company. I know several
    people who had tendonitis as bad as mine, and none of them were
    helped until they got voice-activated software, not even by giving
    up typing for a year. That's why I'm so interested in .20. I wonder
    if her job requires her to type as much as a software engineer or
    a technical writer, which seems to be the two most frequent occupations
    in this company in repetitive motion injuries.
    
    
    The keyboard does improve my posture, which is supposed to be a big factor.
    
    Snow shoveling is bad for me, too, but what I did last week was only
    to clear a space in front of the car, taking a long time to do it,
    as the plow had done the rest. I live alone and have not yet found
    a way of paying someone to do it. My near neighbors are all elderly.
    
    Thanks again for your reply. This problem can be isolating (doctors
    don't seem to understand it very well), and it's good to talk to other 
    people who are dealing with it.
    
     Eileen

    
    If I were you I would take immediate action to design
    and build your own workstation work area.  Test it at
    home and then transport it to work.  I have constructed such a 
    system at home and am currently working on one for work.
    It looks like this (excuse the crude nature of the picture.
    
    Note that the main work surface is at the exect height
    to sit up erfectly straight and still rest your elbows
    on the table and that the keyboard is recessed into the
    the padded surface.
    
    Note also that the entire surface is padded.  Also the
    monitor is raised to the exact height for your eyes.
    
    Also the raised montior should 18-24 inches to your eyes.
    
    -----------------------------------------------------------
    |                                                         |
    |                  ----------------                       |
    |                  |              |                       |
    |                  |  Raised      |                       |
    |                  |  Monitor     |                       |
    |                  |              |                       |
    |                  |              |                       |
    |                  |              |                       |
    |                  ----------------                       |
    |                                                         |
    |                                                         |
    |                                                         |
    |                                                         |
    |                                                         |
    |             ---------------------------                 |
    |             |   Keyboard              |                 |
    |             |   Imbedded              |                 |
    |             |   In the padded surface | Area for mouse  |
    |             ---------------------------                 |
    |                                                         |
    |                                                         |
    |                                                         |
    |              |------------------------|                 |
    |Full arm rest |                        |                 |
    |              |                        |                 |
    |              |  Place where you sit   |                 |
    |              |                        |                 |
    |              |                        |                 |
    |              |                        |                 |
    |              |                        |                 |
    |---------------                        ------------------|
    
    
    
    
    Send me mail for additional detailes at CAM::ARENDT.