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Home Forums Medical Management Strong Evidence keyboarding <7 hrs/day decreases risk for CTD?

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    I am on an advisory panel on Cumulative Trauma Conditions – Medical Treatment Guidelines  and need some help from our colleagues more versed in the literature.  Due to the important ramifications these guidelines will have for thousands of workers I am reaching out for help. 

    The DRAFT Guidelines state that "Computer Work:   Up to 7 hrs per day at an ergonomically designed workstation is NOT a risk factor"    citing the following studies:  

    Ali, et al.  Computer Professionals and Carpal Tunnel Syndrome  Int J Occup Safety Ergonom 2006 ;  Atroshi et al.  Carpal Tunnel Syndrome and Keyboard Use at Work. A Population-Based Study. Arthritis Rheum 2007 ; Anderson et al.  Computer Use and Carpal Tunnel Syndrome. A 1-year Follow-up Study JAMA 2003 ;  Stevens et al. The frequency of carpal tunnel syndrome in computer users at a medical facility. Neurology 2001 ; Roquelaure et al. Risk Factors for Upper Extremity Musculoskeletal Disorders (UEMSD) in the Working Population. Arthritis Rheum 2009.

    In the Diagnosis-Based Risk Factors for CTS they state:  "Strong evidence – Keyboarding less than or equal to 7 hrs in good ergonomic position is associated with a DECREASED risk."   Citing Atroshi, Anderson, and Stevens studies above.       They do state Strong Evidence (multiple high quality studies) for combo of force and repetition as a risk factor for CTS citing Shiri 2009, Silverstein 1987, Frost 1998, Mattioli 2009.

    I already have good info on why the Stevens and Anderson studies do not exactly support these conclusions.  I need help with QUALITY studies related to "computer use", "keyboarding", or "typing" being/not being risk factors for CTDs.

    Any input on the issue is welcomed, even if it is not directly tied to the research.  I am casting a wide net for info to help me end up with a very thorough and scientific response to these issues.

    Thanks in advance for your help!

    Chris Sorrells OTR, CHT, CEAS
    President, ErgonomicsSimplified.com


    Rick Goggins

    Hi Chris,

    For a review of some of the older research studies on the subject, you can look at the supporting materials for the former Washington State ergonomics rule (discussion of keyboard use starts on page 76): http://www.lni.wa.gov/wisha/ergo/rule_docs/ces/CES.524.PDF

    For the purposes of the rule, we set the limit on intensive keying at 7 hours without awkward postures, and 4 hours if awkward wrist postures were present.

    In the past few years the nature of computer work has shifted from being keyboard-based to being more mouse intensive. You might want to take a look at this HSE report that reviews issues around mouse use: http://www.hse.gov.uk/research/rrhtm/rr045.htm

    CTS is just one example of a cumulative trauma disorder, and it’s arguably not the best one to use when creating guidelines on computer use. A Google Scholar search for computer use and upper extremity disorders turns up a number of potential references: http://scholar.google.com/scholar?q=computer+use+upper+extremity+disorders&hl=en&as_sdt=100000000000001&as_sdtp=on 

    Best of luck in your search. 

    Rick Goggins, CPE

    Washington State Department of Labor and Industries

    Olympia, Washington

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