1999 Conference Proceedings

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Beyond ergonomics: strategies for accommodating computer overuse injuries

Alan Cantor

Copyright © Alan Cantor 1998. All rights reserved.


A significant occupational health and safety concern of the 1990s is the alarming increase of injuries caused by computer use. Overreliance on keyboards, mice, trackballs and other input devices has resulted in hundreds of thousands of people developing one of many painful — and sometimes incapacitating — conditions known collectively as repetitive strain injuries (RSI). Studies by industry and occupational health physicians reveal that 20% to 25% of keyboard operators, both vocational and recreational, have symptoms that are attributable to their computer activities (Pasquarelli and Quilter, vii). A study done at the San Francisco Chronicle found that one-third of editors and reporters at the newspaper had RSI. (Toronto Star, 9 July 1994).

Those of us with disabilities who rely on computer-based assistive technologies may be more susceptible to RSI than people without disabilities (Cantor, 1995). A university student who uses a screen reader, for example, is likely to spend many more hours per day at the keyboard than a nondisabled classmate. Alternative and augmentative communication (AAC) system users may be especially at risk (Cantor, 1996). Lee et al (1995) reported that system users complain of pain and numbness in their wrists and hands, and back pain that appears to result from the awkward positions many users must adopt to control athetoid movements while operating their devices.

Whether or not an individual has a pre-exiting condition or disability, RSI is a difficult condition to accommodate. Many people become reinjured at some point during rehabilitation or accommodation. Kambeyanda, Singer and Cronk (1997) found evidence that persons with RSI may be the most susceptible to serious vocal injuries when they switch from keyboards and mice to discrete voice recognition systems.

Popular misconceptions about accommodating RSI abound, and individuals with RSI who are seeking a technological panacea are legion. Many seem to believe, for example, that fast and accurate voice recognition software inoculates against RSI, or that using "ergonomic" equipment — wrist rests, keyboards, mice, adjustable chairs, and the like — reverses the effects of an overuse injury. These perceptions are reflected in this not atypical posting to the sorehand list:

In addition to Voice Recognition technology, I am also looking for Ergonomic equipment. In particular, I am looking for a good keyboard and mouse. Windows Magazine (Feb 94) mentioned the Kenesis keyboard and I was wondering if anybody has experience with this product or company. Any comments or recommendations for keyboard or mouse would be appreciated.

If solutions to RSI were purely technical, it would not be the fastest-growing category of occupational injury. Accommodating computer injuries requires a wide view of the problem.

This paper describes an approach to accommodating people with computer-induced repetitive strain injuries. Crucial to the approach is the idea that four distinct factors that contribute to the development of RSIs must be considered when planning accommodations: the ergonomics of the individual’s work station, their work habits, their working conditions, and their activities outside work.

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