2002 Conference Proceedings

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Jane Berliss-Vincent, Director of Adult and Senior Services
Center for Accessible Technology
2547 8th St., Suite 12-A
Berkeley, CA 94710

Joni Breves, Executive Director
Joe Quinn, Director of Training
Computer Technologies Program
1918 Oxford St.
Berkeley, CA 94704


Although computers play an increasingly significant role in both the personal and work lives of many individuals, the use of computers has been associated with the onset and exacerbation of disabilities. While ergonomic design and "best practices" have been developed to prevent computer-related injuries among the general population, these developments may not meet the need to prevent injuries among individuals with pre-existing disabilities.

This need was noticed based on the anecdotal observations of two organizations: the Computer Technologies Program (CTP), which trains people with disabilities for computer-related jobs, and the Center for Accessible Technology (CforAT), which provides information and services on adaptive technology. Together we created a survey intended to document some of the complicating factors in the disabled/aging population regarding computer related injuries.

Survey Procedure

The survey was designed to gather the following information:

* Awareness of/attitude toward good ergonomic practices
* Incidence of computer-related disability unrelated to existing disability
* Incidence of aggravation of existing disability
* Success in finding useful accommodations
* Positive/negative attitudes about ergonomics heard from Department of Rehabilitation, employers, teachers, and peers

The survey was made available in a variety of media: printed copies, large print, and electronic versions (floppy disks). The survey was also posted on the Web, and the URL was advertised to Californians with disabilities. CTP staff assisted individuals who were not able to fill out the survey on their own.

Completed hard copies of surveys were submitted by CTP students and by participants in CTP-sponsored meetings. In addition, electronic copies of the surveys submitted via the Web were received anonymously. Press releases and notices marketing the survey were disseminated to and by the following entities:

* Department of Rehabilitation offices
* Independent Living centers
* California disability listservs
* Disabled Student Service offices
* Vendors of adaptive technology
* Disability organizations and media
* Personal contacts from the two participating organizations

In all, 98 survey responses were received. Of these, 86 met the baseline criteria for inclusion in this study: The respondents identified themselves as California computer users with one or more disabilities that predated any computer injuries.

Basic Survey Results

Computer Usage

* Seventy survey respondents (81%) identified themselves as having used computers for 6 or more years. Thirteen respondents (15%) said they had used computers for 1-5 years, and three respondents (4%) said they had used computers for less than a year.
* Sixty-nine respondents (80%) said they use computers on a daily basis. Thirteen (15%) said they used computers 3-5 times per week, and two (2%) said they used computers 1-2 times per week. The remaining two respondents said they used computers once a month or less.
* Twelve respondents (14%) said they used computers for six or more hours per session, while 13 (15%) said they used computers for four to six hours per session. The majority of users (37; 43%) said they used computers for two to four hours per session, while twenty-four (28%) said they used computers for fewer than two hours per session.

Disability Types and Computer Injury

* The disability types reported varied widely, with the most common being visual or hearing impairment (28; 32%), spinal disorder or injury (20; 23%), or neurological disability such as cerebral palsy or ALS (18; 21%). In all, 26 different types of disabilities were represented.
* Eighty respondents (93%) reported some injury from computer use. These injuries were reported as affecting the following functions or body parts: - Neck: 49 (61%)
- Arms/shoulders: 44 (55%)
- Wrists: 39 (49%)
- Back: 39 (49%)
- Hands: 38 (48%)
- Vision: 31 (39%)
- Voice: 2 (2%)
- Other: 8 (10%). Injuries reported included: exacerbation of pain, upper chest injury, finger injury or numbness, spinal discomfort, exacerbation of asthma or environmental illness, and leg circulation problems.
* Of the 85 respondents who answered the question about whether computer use aggravated their disability, 28 respondents (33%) said that computer use aggravated their disability, 46 (54%) said that it did not aggravate their disability, and 11 (13%) were unsure. The 28 respondents who found that computer use made their disability worse were individuals with spinal injuries/disorders, arthritis, or fibromyalgia who reported aggravation to their necks, backs, wrists, arms, hands, and shoulders.

Awareness and Implementation of Ergonomic Solutions

* Sixty-nine respondents (80%) said they had been able to find accommodations that minimized or somewhat minimized the effects of injury or discomfort due to computer use.
* Seventy-six respondents (88%) of respondents said they were aware or somewhat aware of good ergonomic practices (e.g., recommended hand positioning.). Of these respondents, twenty-nine (38%) said they incorporated these practices, while forty-five (59%) said they incorporated these practices somewhat or not at all. The primary reasons given for not incorporating these practices were the following:
- I haven't made time to implement adaptations: 19 (42%)
- My disability makes it difficult to incorporate them: 12 (27%)
- My physical environment doesn't allow me to incorporate them: 12 (27%)
- I am unable to afford adaptations: 12 (27%)
- Other: 15 (33%). The responses in this category were very interesting, including the following:
# "Have tried doctor recommended adaptations, but may need different solutions."
# "Lack of information regarding ergonomics"
# "Can't do it myself. Need someone who has the time."
* Forty-four respondents (51%) reported having heard generally positive attitudes expressed about ergonomic practices from counselors, employers, teachers, peers, etc. Eighteen respondents (21%) reported having heard mixed attitudes, and 17 (20%) reported having heard no attitudes expressed. Seven respondents (8%) reported having heard negative or neutral attitudes.

Survey Participant Comments

Some of the general participant comments were as telling as the responses to specific questions. These comments included the following:

"To get modifications paid for by medical, it has to go though the medical system, meaning an occupational therapist. OTs are typically very set in their ways of how they think things SHOULD be done, that they do not listen to the realities for a particular individual. For example, they have this bug up their butt about posture, not recognizing that for some people, to sit straight is to move into a position that makes it impossible for them to use certain muscles. One wanted to eliminate all the stress on my wrists and neck by having me all rigged up in a contraption with my arms floating above the keyboard, not hearing that that would put my hands in a position that I would be unable to type from. So, I have resigned myself to solving my own problems without professional 'help.'"

"When a person with less than 20/400 acuity vision requires large monitors, software magnification and low vision reading aids for viewing of computer-based material it is difficult to position him/her in front of the computer in ways that is ergonomically sound. Often the focal distance of the low vision reading devices forces a reading distance too short to allow sound positioning with chair, monitor and keyboard. This leads to back pain, eye strain and wrist injury."

"Only recently have I realized that my computer table at home is too high, and that my subsequent back, should and neck discomfort appear to be a direct result of that, plus obtaining a stand to put my 21 inch monitor at the proper eye level."

"Ergonomic education is extremely useful. There are a number of helpful adaptations to help reduce strain and stress on the body. One of these supports the elbows, but allows free movement of the arms. Being currently self-employed (and disabled), these solutions are too expensive to consider."

"Ergonomically correct equipment is a preventive measure for employees health problems acquired on the job. A company would better serve themselves in cost and manpower by providing a healthy work station and environment."


The results of this survey have helped to document a significant incidence of computer-related injury unrelated to pre-existing disability, as well as aggravation of existing disability due to computer use. Despite awareness of and a generally positive attitude toward good ergonomic practices (as defined for the general population), a significant number of computer users in this survey could not incorporate these practices due to their specific disabilities, the cost of adaptations, or their physical environment. There is a clear need for the development of new ergonomic guidelines and instructional materials developed toward prevention of computer-related injury, taking into account the particular needs of this population.

The research for this paper was funded under Grant # 20001399 from the California Endowment. Profound thanks go to Joni Breves and Joe Quinn, Computer Technologies Program, Berkeley, CA, and to all individuals who participated in the survey.

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