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Volume 19, Number 8
December 2002

SELF-DEFENSE FOR OFFICE WORKERS

Workstations: Friend or Foe?
By Stephen Tamaribuchi

The work environment has changed within the past 20 years-we have moved from a predominantly paper culture to one of electronically recorded data. Advances in technology have promoted improved productivity in an ever more complex world, but they've also brought increased workloads that in turn have led to development of new forms of workplace injuries. We have gone from paper cuts and headaches to injuries like carpal tunnel syndrome, cumulative trauma, extensor tendonitis, thoracic outlet, and cervical outlet.

What was once a headache has become a migraine. These types of injuries are expensive in terms of both efficiency and human suffering, and employers have seen the clear benefits of preventing them before they affect productivity. They now consult with and employ ergonomics experts to modify workstations to fit individual users. This helps reduce the number and severity of many workplace injuries-and has made ergonomics part of the corporate culture as well as a marketing tool.

The marketplace is inundated with all sorts of products that claim to be "ergonomically designed." Although we hope these products will resolve our problems, more often than not, they don't perform to our expectations. The limitations of office furniture, space, and equipment can make it difficult to properly fit a workstation to its user. Cost is another limitation. It's possible to spend in excess of $10,000 for a workstation-not including the computer and peripherals-which is cost prohibitive for many businesses. On the other hand, simple steps can sometimes eliminate minor discomforts.

The simple fact is that one size or position does not fit all. Workstations should be fitted to particular users, and a number of factors should contribute to designing a workspace. The most important determinant is that bodies are proportioned differently. A workstation cannot be positioned to fit everyone in the office, or even different individuals who are the same height; some have shorter legs and longer torsos, and vice versa; arm length is not consistent, both overall and comparing upper and lower arm.

As an example, years ago I was sitting alongside another man in a bar in San Francisco. As we sat, we were close to being the same height. After I stood up (I am 5 feet, 8 inches), the other man rose from his stool. Standing, he was easily recognizable as Nate Thurmond-at the time center for pro basketball's Golden State Warriors. He probably stood 6 feet, 11 inches in basketball shoes. Clearly, proportional extremes in one segment of our anatomy (in this case, his significantly longer legs) create difficulties in positioning a workstation.
Not all suggestions for improving your workstation will help everyone. This article covers only a few basics of many workstation variables: chair, desk, keyboard, and monitor. In most cases, specific dimensions for height, elevation, and distance are not given because they vary for each individual.

Chair
The chair is often the starting point for most ergonomic evaluations. Chair prices range from less than $50 to more than $1,000. In general, stay away from low-priced chairs; the seat padding usually is thin to start with and, as time goes on, becomes even more uncomfortable. Inexpensive chairs tend not to hold up well over time. Remember, you (or a member of your staff) will be sitting in this chair, hour after hour, for years.
The most comfortable chairs allow approximately two inches between the front edge of the seat pan and the back of the knees for proper thigh support. If the seat hits the back of the knees, you will probably roll your hips under and round your shoulders and back. Insufficient thigh support results in increased back fatigue.
Also, the seat pan should be wide enough to support you, but too wide a pan may not provide enough support and will result in increased back fatigue. Because people come in different sizes, one style or size of chair to create a uniform "corporate look" just does not work.
When purchasing a new chair, check the following-even an expensive chair from a reputable company can produce problems:
-Stand behind the chair and check to see that its back is parallel with the front edge of the seat pan. I have seen skewed backs even on chairs costing more than $600! You can't rely on name alone because some chairs are hand assembled or manufactured and/or assembled improperly. Also, chairs break down over time.
-Wiggle the seat pan to see whether it wobbles; if it does, it might tilt from side to side every time you shift your weight.
-Check that the gas cartridge in the chair's stem operates properly and allows you to move the seat up and down.
-Check the back of the chair for stability. I prefer a chair with an adjustable back support.
-The chair should have five contact points with the floor. Check the casters to make sure they're in good operating condition. Check for stability.
-Task chairs should be armless, or the arms should be removed, especially for typing. Placing forearms on the armrests leads to rounding the shoulders. Typing with armrests seems to encourage lifting the elbows, which increases stress on the neck, shoulders, back, arms, and hands.
-Here's a simple test: Sitting in your current chair, place your arms on the armrests and reach out to your keyboard. Look at the position of your elbows and check for shoulder and neck tension. Then repeat the exercise, this time starting with your elbows in front of your rib cage. When you reach for the keyboard, you should notice a difference in elbow position, as well as less tension in the shoulders and neck.
-The best chair height allows feet to be flat on the floor, with the thighs parallel or close to parallel with the floor and lower legs near a 90-degree angle with the thighs.
-Turning your palms upward while sitting down and standing up allows you to use your legs more efficiently and helps stabilize your back. Turning palms up while standing from a seated position removes much of the pressure on your back during this action.
-After you buy a chair, place a sticker under the seat noting purchase date, warranty length, and seller (or tape a copy of the receipt and warranty to the seat bottom). Most chairs have warranties of several years. Having this information handy can save an individual hundreds of dollars and a large law office, thousands of dollars.

Desk
Desks have not changed in most office environments, especially the law office, where confidential interactions with clients make cubicle arrangements inappropriate. Desks still used in many offices were manufactured BC-before computers-but that hasn't stopped people from plunking CPUs and monitors right on top of them. A number of companies still use huge Steelcase desks dating from the '60s that have a top surface 30 inches from the floor and, in today's workplace, mostly make great earthquake shelters.
Most office furniture is built according to anatomical norms, which means it is designed for someone approximately 5 feet, 9 inches tall. On the West Coast, in fact, large numbers of office staff are composed of women from Pacific Rim and Latin American countries who average 5 feet, 4 inches or shorter. Even without such obvious regional differences, torso and leg length can vary to incredible degrees.
When seated at a desk, you should be able to lower your elbows only slightly before they reach the surface. If you cannot sufficiently lower your desk, you might be able to elevate your chair for a more correct balance. If you elevate the chair height, however, be sure to use a footrest. The Yellow Pages work as well as, if not better than, most footrests on the market and have the advantage of being adjustable simply by adding or subtracting pages. (Wrapping them with duct tape helps hold them together and keeps them from sliding around on the floor.) If you're buying furniture for use with computers, consider a bilevel workstation that allows the user to adjust the height of both the keyboard and the monitor.

Keyboard and Mouse
Because many people add computers to already existing office configurations, the physical act of typing can create numerous stresses and strains on the body. Ideally, the keyboard should sit one to two inches below the elbows, which allows the user to maintain a neutral wrist and hand position while typing. One of the worst things you can do is to type for extended periods of time with your hands in a hyperextended position (at an angle above the keyboard), because you have to torque your hand and wrist to strike a key. The neutral position allows you to strike a key using primarily finger movement. In addition, the monitor and keyboard should align with the vertical midline of your body. The middle of the keyboard is at the H key.

Mice and keyboards take up a lot of additional space on a desktop, so many people add keyboard trays to move the items to a different surface. Even today, trays are sold that do not provide room for the mouse, and the mouse usually ends up perched on the desktop-several inches higher than the keyboard and several inches beyond it. This position forces the user to move the arm, shoulder, and back to articulate the mouse. The mouse should be on the same surface as the keyboard and positioned so the hand can move in an arc from the keyboard to the mouse.

Monitor
The computer monitor should sit directly in front of you, not off to the side so you have to twist to look at it. Even a few minutes of this aggravates joints and muscles in the neck, back, arms, and hands. The top edge of the monitor screen should be even with your eyebrows-unless you wear bifocals, in which case you may want the screen a little lower. Try not to place the monitor directly under overhead lighting. This creates glare on the screen that leads to eyestrain and neck and shoulder tension. If you cannot avoid overhead lighting, a monitor hood can help cut down glare. For an inexpensive do-it-yourself hood, use folders or cardboard to create a shade around the monitor, which will dramatically improve your view.

Because the practice of law requires extensive reading and paperwork, place your reading material and papers on a slant. Law offices tend to be among the largest purchasers of three-ring binders, and I find that placing papers on the cover of an empty three-inch binder provides a nice slant from which to read and write.
A number of other things can be done to help reduce the possibility of cumulative trauma, such as taking frequent breaks and periodic stretching sessions throughout the day. Implementing some of the ergonomic changes suggested in this article can help ensure that small discomforts don't mature into medical conditions. As with legal problems, the advice of a professional injury prevention specialist often can help.