A Follow-up Survey on the Occupational Health Issue of Users of the Display Screen Equipment

A Follow-up Survey on the Occupational Health Issue of Users of the Display Screen Equipment Executive Summary The Occupational Safety and Health Council conducted a survey on the office environment and the occupational health of display screen equipme nt (DSE) users between July and October 1997. At that time, the Occupational Safety and Health Ordinance was just being enacted. The survey therefore served as a comprehensive baseline study to investigate the use of display screen equipment in the offices of various trades and industries, the workplace environment and common occupational health issues encountered by office workers. To follow up the study in 1997, the Council carried out another questionnaire survey of office workers in Hong Kong between July and September 2001 to gain an understanding of the awareness and attitude of office workers towards occupational safety and health and to carry out an ergonomics assessment of workplace design so as to explore the impact of office working environment on the occupational health of employees. The survey covered 368 office workers from different industries, including telecommunications, financial services, professional services and the service industry. The result indicated that, awareness of occupational health and safe operation of display screen equipment among the office workers had been increased through years of efforts in promoting and educating the workers in the industry. However, the prevalence of back pain and neck pain as a result from operating display screen equipment for extended period of time was still quite high (60% and 40% respectively). It is therefore recommended that there should be more training and promotion on proper use of display screen equipment in order to improve the occupational health among the office workers. Occupational Safety and Health Council 1

Introduction The rapid growth of information technology has already helped easing our life and daily living in a more convenience way as compared to years ago. In the new millennium, further advancement is made in the electronic media. Through the capacity of a telephone line or a small memory card, messages can be communicated or data can be stored. The speed of transmission and the volume of data storage further introduced the utilization of computer technology into our daily life. The human-machine interaction has become part of our work and life. Such interaction is already integrated as our basic needs without notice. Many countries have widely reported the impact of DSE operation on workers, such as the development of musculoskeletal disorders due to prolonged DSE operation, static posture or repetitive movement of upper limbs. In the eighties, office workers suffering from Repetitive Strain Injury (RSI) due to prolonged DSE operation were largely reported in Australia (Hadler, 1993). During the same period, similar cases of musculoskeletal disorders were reported from the group of office workers in the telecommunications and newspaper industries of America (Bernard, Sauter, Fine, Peterson, & Hales, 1992; Hales et al., 1994; National Institute for Occupational Safety & Health [NIOSH], 1992). Both situations indicated that repetitive and prolonged use of display screen equipment was the leading factor to develop the musculoskeletal disorders. In Hong Kong, the era of computerization was not in similar pace with the overseas countries but the use of display screen equipment in the industry has already been adopted for quite a substantial period. The related occupational safety and health issues in operating display screen equipment have been a major concern of the industry. The Occupational Safety and Health Council (OSHC) initiated a territorywide study in 1997 to investigate the impact of DSE operation and the office environment towards occupational health of office workers. The study not only provided objective data on the issue, but also established the positive initiatives for improving office environment as well as measure to prevent musculoskeletal disorders. Based on recommendations of the survey, the OSHC had implemented a series of strategic approach to promote and advocate safety and health training on use of DSE. Production of Office Safety Do-It- Occupational Safety and Health Council 2

Yourself (DIY) Kit was also introduced to the industry for identifying the potential hazards in the office environment and furniture such that further control of risk was possibly made by self assessment. As to follow up the results of promotional and training efforts on occupational safety and health among office workers, OSHC had conducted a follow-up survey in 2001, the objectives were: (1) to investigate the working environment of the local offices; (2) to identify the major factors which contribute most to the occupational safety and health hazards to the office workers; (3) to identify workers awareness and attitude towards occupational safety and health concern. Recommendations were also put forward to further enhance the standard of occupational safety and health. Occupational Safety and Health Council 3

Methodology This survey study was the follow-up study of Office Environment and the Occupational Health of Visual Display Terminals (VDTs) Users conducted in 1997. Sample selection was determined by the same criteria set forth in previous study, which was to stratify companies according to the nature and size of business and to take samples randomly from the stratified sectors accordingly. Based on the registered list of organizations obtained from the Census and Statistics Department of the Hong Kong Special Administrative Region, the target surveyed group was sampled from service industry, communications industry, financing and business services and professional business. These industries covered the businesses of airline companies and travel agencies, telecommunications companies, banking, financial and investment companies, stock and share companies, legal firms, accounting firms and architectural design companies. Samples from data processing and tabulating companies and advertising agencies were also recruited in this follow-up survey but not included in sample of the survey study in 1997. The major consideration in selecting those companies was that they employed comparatively more office workers with frequent operation of display screen equipment in their routine duties. According to the scale of business, the companies were divided into three categories: companies with 100 or more employees were classified as large companies; with 50 to 90, medium-sized; less than 50, small. Number of sample was selected from different nature of business in various sizes of companies so as to eliminate bias and to warrant a representative sample for the study. For the small companies sampled, three employees were interviewed; medium-sized companies, five employees; large companies, 10 employees. Each selected company was notified in writing of the survey and arranged for interviews. A standardized questionnaire was designed and administered to the subjects through face-to-face interviews. The questionnaire was used to collect information on demographic characteristics, office environment and the arrangement of office layout, the experience of musculoskeletal discomforts during the past year, working postures, and the general condition regarding office safety and health as well as the viewpoints of the employee on occupational safety and health. Occupational Safety and Health Council 4

Results I. Occupational Details of Interviewees 368 office workers from 90 companies were interviewed for the follow-up survey study. 28.8% (106) were males and 71.2% (262) were females. About half of the interviewees were aged from 26 to 35 (Table 1). They were mainly recruited from the financial services and professional services (53.8% and 22.0% respectively) (Table 2). The positions held were mainly clerical and middle management (Table 3). A majority of them had work experience ranged from 1 to 5 years. However, 13% of the interviewees had less then one year work experience (Table 4). A vast majority of the office workers operated display screen equipment in their routine job duties and the hours of operation varied. Results indicated that 72% of the interviewed workers had to operate display screen equipment for more than 4 hours on daily basis, 16% of them even had to operate display screen equipment for more than 8 hours daily (Table 5). The sample characteristics in terms of demographics and occupational details were identical in the 1997 survey and this follow-up survey. Although it was not possible to follow up the same subject group of the 1997 survey, the subjects for both surveys were selected by random sampling in order to obtain a representative sample. The reason for not possibly following up the interviewed subjects in the survey 1997 was that many companies had closed down or re-structured after the Asian financial crisis and the identities of the interviewed subjects were kept anonymous, and it was not feasible to contact and interview the same group of office workers. Despite that, backgrounds of the interviewed office workers for both survey studies were identical. Therefore, this survey study was to serve as a follow-up study on the occupational safety and health progress among the group of office workers. Occupational Safety and Health Council 5

Table 1 Gender and Age of Office Workers Interviewed Gender Age (years) Male (%) Female (%) Total (%) Under 26 22 (20.7) 62 (23.7) 84 (22.8) 26 to 35 54 (50.9) 145 (55.4) 199 (54.0) 36 to 45 24 (22.7) 52 (19.9) 76 (20 7) Above 45 6 (5.7) 3 (1.1) 9 (2.4) Total (%) 106 (100.0) 262 (100.0) 368 (100.0) Table 2 Type of Business and Size of Company Size of Company Type of Business Small (%) Medium (%) Large (%) Total (%) Communications 1 11 (6.7) 5 (9.4) 11 (7.3) 27 (7.3) Finance & business 93 (56.4) 16 (30.2) 89 (59.3) 198 (53.8) services 2 Professional services 3 35 (21.2) 17 (32.1) 29 (19.3) 81 (22.0) Servicing 4 26 (15.8) 15 (28.3) 21 (14.0) 62 (16.8) Total (%) 165 (100.0) 53 (100.0) 150 (100.0) 368 (100.0) Types of companies included: 1. Telecommunications companies 2. Banking, financial investment companies, securities companies 3. Legal firms, accounting firms, architecture firms, data processing and tabulating companies, advertising companies 4. Airlines, travel agencies Table 3 Job Position of Office Workers Interviewed Job Position Frequency (%) Clerical 207 (56.2) Middle management 58 (15.8) Senior management and executive 44 (12.0) Technical and professional 59 (16.0) Total 368 (100.0) Occupational Safety and Health Council 6

Table 4 Years of work experience of Office Workers Interviewed Years of work Gender experience Male (%) Female (%) Total (%) < 1 year 9 (8.2) 40 (15.3) 49 (13.2) 1 to < 5 years 51 (48.1) 117 (44.6) 168 (45.7) 5 to < 10 years 27 (25.5) 61 (23.2) 88 (23.8) > 10 years 19 (17.7) 44 (16.9) 63 (17.3) Total (%) 106 (100.0) 262 (100.0) 368 (100.0) Table 5 Daily Hours of DSE Operation Daily hours of DSE operation Frequency (%) < 2 hours 28 (7.6) 2 to < 4 hours 75 (20.4) 4 to < 6 hours 117 (31.8) 6 to < 8 hours 90 (24.5) > 8 hours 58 (15.8) II. Musculoskeletal Discomforts High prevalence of musculoskeletal discomforts was reported by the interviewed workers in past 12 months. Presentations of symptoms included pain, cramp, muscle stiffness and soreness. Complaints of musculoskeletal discomforts were found in neck (62.5%), shoulders (60.1%), elbows (16.0%), forearms (11.4%), wrists (25.0%), fingers (13.0%), upper back (40.1%), and low back (40.2%). Complaints of eye discomforts were consistently high (62.0%) (Table 6). Majority of the complaints was reported by the interviewed workers in professional services and communications, followed by those in finance and business services. Most of the musculoskeletal complaints were found among the interviewed workers between the age of 26 and 35 years old and female workers showed more symptoms of musculoskeletal discomforts than male workers (Table 7). Comparison of the prevalence of musculoskeletal discomforts was made between the 1997 survey and the follow-up survey. It revealed that high prevalence in reporting neck, Occupational Safety and Health Council 7

shoulder, low back and eye discomforts remained unchanged. There was an increasing trend in neck and shoulder discomforts (Table 6). Moreover, office workers from the finance and business services consistently showed more complaints among the interviewed workers and female workers obviously had more reporting of musculoskeletal discomforts (Table 7). Occupational Safety and Health Council 8

Table 6 Frequency of musculoskeletal discomforts in last 12 months Frequency (%) Body Parts * 1997 Survey 2001 Survey Neck 387 (56.3) 230 (62.5) Shoulders 393 (57.1) 221 (60.1) Elbows 62 (9.0) 59 (16.0) Forearms 85 (12.4) 42 (11.4) Wrists 154 (22.4) 92 (25.0) Fingers 116 (16.9) 48 (13.0) Upper back 322 (46.8) 147 (40.1) Lower back 332 (48.3) 148 (40.2) Eyes 509 (74.0) 227 (61.7) Symptoms of musculoskeletal discomforts included pain, cramp, muscle stiffness, muscle soreness. Table 7 2001 Survey: Muscle Discomforts in the Last Twelve Months by Different Businesses, Age and Sex (The % represents the cases in the respective groups) Muscle Discomforts ( N=368 ) Business Neck (%) Servic ing 32 (51.6) Shoulder (%) 30 (48.4) Upper back (%) 22 (34.5) Low back (%) 19 (30.6) Eyes (%) 32 (51.6) Elbows (%) 3 (4.8) Forearms (%) 4 (6.5) Wrists (%) 12 (19.4) Fingers (%) 7 (11.3) Telecommunications 17 (63.0) 17 (63.0) 12 (44.4) 14 (51.9) 19 (70.4) 7 (25.9) 2 (7.4) 11 (40.7) 1 (3.7) Financial services 122 (61.6) 121 (61.1) 77 (38.9) 82 (41.4) 120 (60.6) 22 (11.1) 23 (11.6) 38 (19.2) 29 (14.6) Professional services 59 (72.8) 53 (65.4) 36 (44.4) 33 (40.7) 56 (69.1) 27 (33.3) 13 (16.0) 31 (38.3) 11 (13.6) Age (Male) Under 26 15 (68.2) 26 to 35 32 (59.3) 36 to 45 14 (58.3) Above 45 3 (50.0) Age (Female) 14 (63.6) 24 (44.4) 8 (33.3) 1 (16.7) 6 (27.3) 21 (38.9) 7 (29.2) 1 (16.7) 10 (45.5) 23 (42.6) 7 (29.2) 1 (16.7) 17 (77.3) 31 (57.4) 10 (41.7) 3 (50.0) 4 (18.2) 9 (16.7) 7 (29.2) 1 (16.7) 3 (13.6) 6 (11.1) 4 (16.7) 1 (16.7) 7 (31.8) 20 (37.0) 7 (29.2) 0 (0.0) 1 (4.5) 8 (14.8) 2 (8.3) 0 (0.0) Under 26 40 (64.5) 26 to 35 95 (65.5) 36 to 45 30 (57.7) Above 45 1 (33.3) 38 (61.3) 100 (69.0) 34 (65.4) 2 (66.7) 29 (46.8) 59 (40.7) 23 (44.2) 1 (33.3) 26 (41.9) 54 (37.2) 25 (48.1) 2 (66.7) 39 (62.9) 91 (62.8) 34 (65.4) 2 (66.7) 8 (12.9) 22 (15.2) 8 (15.4) 0 (0.0) 4 (6.5) 16 (11.0) 8 (15.4) 0 (0.0) 9 (14.5) 35 (24.1) 14 (26.9) 0 (0.0) 10 (16.1) 20 (13.8) 7 (13.5) 0 (0.0) Occupational Safety and Health Council 9

Frequency and occasion of symptoms presentation were followed up in the survey. It revealed that many of the interviewed workers experienced symptoms of musculoskeletal discomforts after work (62.8%). 57.6% of the interviewed workers experienced discomforts during DSE operation while 45.4% still experienced musculoskeletal discomforts even they were not operating DSE. Most of the reports of musculoskeletal discomforts were occasional experience but 21.9% of the interviewed workers indicated frequent experience of musculoskeletal discomforts at work (Table 8). The pattern of musculoskeletal discomforts and frequency of symptoms presentation were identical in both 1997 survey and the follow-up survey (Table 8). Table 8 Characteristics of symptoms presentation Occasion of Frequency (%) Frequency of Frequency (%) symptoms present 1997 survey 2001 survey symptoms present 1997 survey 2001 survey During operating DSE After operation DSE During work but not operating DSE 368 (53.5) 212 (57.6) Constant 15 (2.3) 6 (1.9) 298 (43.3) 189 (51.4) Frequent 123 (18.8) 70 (21.9) 289 (42.0) 167 (45.4) Occasional 516 (78.9) 244 (76.2) After work 459 (66.7) 231 (62.8) III. Work Environment and Working Posture It revealed from the results of the follow-up survey that the work environment of the offices had improved in comparison with the previous study. Most of the furniture had adjustable features. 94% of the interviewed workers indicated that the sitting chairs had adjustable feature. Majority of the interviewed workers (95.9%) had sitting chairs with back supports. However, there were 20% of the interviewed workers complained of insufficient legroom under the desks and a vast majority of them (87.5%) did not use footrest. On comparing the results of the two surveys, there was a marked increase in the use of chairs with armrest (from 36.0% in 1997 to 56.5% in 2001) and of wrist supports Occupational Safety and Health Council 10

(from 3.5% in 1997 to 17.1% in 2001) (Table 9). It indicated that requests for appropriate facilities for DSE operation had increased and that more employers were aware to improve the facilities to ensure the occupational safety and health of their employees so as to facilitate the work efficiency and productivity. Moreover, this positive change had also shown that both employers and employees were better aware the safety and health issues at workplaces. On the aspects of working posture in operating DSE, the follow-up survey revealed that a greater proportion of the office workers had kept their elbow and knee positions at about 90 (47.8% and 66.0% respectively). 45.9% adopted sitting with straight back posture when operating DSE and 62% indicated viewing the monitor at eye level. However, about 70% of the interviewed workers placed display screens on either right or left side rather than putting in the front of the work surfaces (Table 10). It might be due to the limited space in the workstation which led to place the display screen on sideways. The office workers were likely to twist their bodies in order to accommodate the position of the display screen on the sideways. Prolonged body twisting would lead to develop musculoskeletal discomfort and result in bodily injury. The follow-up survey also investigated the drives for the interviewed workers to adopt poor posture at DSE work. Most of the feedback revealed that lack of office space and facilities or equipment were the major limitation for them to achieve best posture at work. Because of limited space available, one-third of the interviewed workers simply ignored adopting proper posture at work for just the sake of convenience (Table 11). Table 12 showed about 40% of the interviewed workers perceived excessive workload, long working hours and high cognitive demand. Some of them even perceived poor control over work (35.1%) and lack of job satisfaction (30.4%). In comparison with the results obtained in the 1997 survey, there was a marked increase in indication of poor communication with colleagues and lack of peer support (17.7% and 14.4% respectively). There was also a significant increase in the fear of job security (from 19.1% in 1997 to 35.1% in 2001). It vividly presented the worries among the employees in the present economic situation. Occupational Safety and Health Council 11

Table 9 Characteristics of office furniture Characteristics of office Frequency (%) furniture 1997 Survey 2001 Survey Adjustable desk height 7 (1.0) 17 (4.6) Adjustable chair height 651 (94.6) 346 (94.0) Sitting chair with back rest 680 (98.8) 353 (95.9) Sitting chair with arm rest 248 (36.0) 208 (56.5) Sufficient leg room 556 (80.8) 292 (79.3) Footrest 86 (12.5) 37 (10.1) Use of anti-glare filter 400 (58.1) 202 (54.9) Tilted keyboard 495 (71.9) 212 (57.6) Wrist support 24 (3.5) 63 (17.1) Document holder 123 (17.9) 73 (19.8) Table 10 Working posture Frequency (%) Working posture 1997 Survey 2001 Survey Elbow position while 90 elbow flexion 280 (40.7) 176 (47.8) operating DSE: > 90 elbow flexion 82 (11.9) 38 (10.3) < 90 elbow flexion 326 (47.4) 154 (41.8) Sitting position at: 90 knee flexion 468 (68.0) 243 (66.0) Position in viewing DSE: > 90 knee flexion 170 (24.7) 97 (26.4) < 90 knee flexion 50 (7.3) 26 (7.1) sitting straight 267 (38.8) 169 (45.9) leaning forward 261 (37.9) 136 (37.0) leaning backward 160 (23.3) 63 (17.1) Top line of DSE: at eye level 453 (65.8) 228 (62.0) above eye level 65 (9.4) 23 (6.3) below eye level 170 (24.7) 117 (31.8) Position of DSE: right in front 262 (38.1) 97 (26.4) on the right side 190 (27.6) 130 (35.3) on the left side 236 (34.3) 141 (38.3) Occupational Safety and Health Council 12

Table 11 Frequency and factors affecting office workers to adopt poor working postures in operating DSE Working Postures Frequency (%) Factors Frequency (%) Adopt poor working postures 194 (52.7) Insufficient work space 52 (14.1) Not adopting poor working postures 174 (47.3) Lack of training 15 (4.1) Lack of mechanical aids 30 (8.2) Low awareness 48 (13.0) For convenience 117 (31.8) Table 12 Frequency of psychological demand experienced by office workers in the last 12 months Frequency (%) Psychological demands 1997 Survey 2001 Survey Excessive workload 342 (49.7) 153 (41.6) Long working hours 292 (42.4) 157 (42.7) High cognitive demands 323 (46.9) 157 (42.7) Poor control over work 224 (32.6) 129 (35.1) Poor communication with colleagues 54 (7.8) 65 (17.7) Lack of job satisfaction 201 (29.2) 112 (30.4) Lack of peer support 60 (8.7) 53 (14.4) Fear of job security 131 (19.0) 129 (35.1) Occupational Safety and Health Council 13

IV. Overview of Occupational Safety and Health in Office Workplace The occupational safety and health in office workplace was also investigated in the follow-up survey. Suggestion for improvement of occupational safety and health was obtained from the interviewed workers. Their feedback had enabled us to further understand the awareness and attitude of office workers towards occupational safety and health issues. According to the feedback from the interviewed workers, the most common type of accident in office workplace was injuries caused by stationeries and equipment. 58.4% had been injured by stationeries and equipment. Other common types of accidents included striking against fixed or stationery object (47.6%), injured whilst lifting and carrying (13.6%), striking against or struck by moving object (12.8%), slip, trip or fall (12.0%), and struck by falling object (3.5%). Accidents in exposure to and or contact with harmful substance (1.1%), contact with moving machinery (1.6%), and contact with electricity or electric discharge (1.6%) were relatively less reported (Table 13). Although there was no serious accident reported in majority of the office workplace, the list of minor accidents had already demonstrated that office workplace was not as safe as perceived by the general public. About the occupational safety and health situation in office workplace, 52.7% of the interviewed workers considered good practice; 41.3% considered it as acceptable; but a few regarded it as bad (Table 14). The overall comments indicated that they were satisfied with their own working environment. Despite that the interviewed workers were generally satisfied with the occupational safety and health situation in office workplaces, they still suggested that there were areas for improvement. Indoor air quality (49.5%) and the ventilation system that directly affected the air quality (38.6%) were the key issues among the list of concerns. Other areas for improvement included housekeeping (29.3%), work stress (26.9%), operation of display screen equipment (23.1%) and operation of office equipment (22.8%) (Table 15). Occupational Safety and Health Council 14

Indoor temperature and lighting were considered as the major variables in evaluating the working environment. 60% of the interviewed workers indicated that indoor temperature was appropriate but some of them considered the temperature was too low (34.5%). It might be due to the fact that most of the offices were under central air conditioning system, causing a substantial difference between indoor and outdoor temperatures. Therefore, some office workers found it too cold inside. This phenomenon was common in Hong Kong and it should receive due regard. As to the indoor lighting, a great majority indicated the lighting was appropriate (91.6%) and only a small group found it too bright or too dim (Table 16). On exploring the knowledge and awareness of office workers towards occupational safety and health, 88.6% of the interviewed workers indicated that they would take the initiatives to seek for assistance upon encountering occupational safety and health problems in the office. However, most of the interviewees would not opt for assistance from doctors (55.2%) or their supervisor or colleagues (51.4% and 40.5% respectively). Only 15.5%of the interviewees indicated that they would ask for assistance from the Labour Department and the Occupational Safety and Health Council (Table 17). The results showed that office workers still remained in the traditional belief in seeking for medical assistance, even in the issues of occupational safety and health arose from office workplace. Although there were about 40% to 50% of the office workers had expressed their willingness to discuss occupational safety and health issues with their supervisors or colleagues, it was very rare for them to seek assistance from the union workforce of the trade industry. Attitude towards the issues of occupational safety and health also played an important role in extending workers concerns on continuing improvement of the office workplace. Workers attitude towards occupational safety and health was investigated on the perspective of signifying important regards on the issues in office workplace. The result indicated about 40% of the office workers indicated that they placed high regard on the occupational safety and health issues and they also reckoned that their employers (40%) regarded occupational safety and health as important in the office workplace (Table 18). As to the responsibility for occupational safety and health, a larger proportion (53.5%) of Occupational Safety and Health Council 15

the interviewed workers considered that employers should bear the greatest responsibility in managing occupational safety and health in the workplace. Government should be the next responsible party. 16.6% of the interviewed workers reckoned that employees should also bear part of the responsibility (Table 19). The feedback suggested the employers not only to take the autonomy in managing occupational safety and health, but also to take effort in protecting and improving workers health. Table 13 Types of Accidents in Office Workplace Types of Accidents Frequency (%) Injured whilst lifting or carrying 50 (13.6) Slip, trip or fall 44 (12.0) Striking against fixed or stationary object 175 (47.6) Striking against or struck by moving objects 47 (12.8) Contact with hot surface or substance 3 (0.8) Injured by stationeries or office equipment 215 (58.4) Contact with moving machinery 6 (1.6) Exposure to and or contact with harmful substance 4 (1.1) Struck by falling object 13 (3.5) Contact with electricity or electric discharge 6 (1.6) Table 14 Comment on Occupational Safety and Health Situation in Office Workplace Comments Frequency (%) Very poor 1 (0.3) Poor 15 (4.1) Acceptable 152 (41.3) Good 194 (52.7) Very good 6 (1.6) Occupational Safety and Health Council 16

Table 15 Suggested Improvements on Occupational Safety and Health in the Workplace Areas for Improvement Frequency (%) Housekeeping 108 (29.3) Indoor air quality 182 (49.5) Ventilation system 142 (38.6) Noise 31 (8.4) Lighting facilities 24 (6.5) Work stress 99 (26.9) Electric safety 23 (6.3) Prevention of fire 25 (6.8) Office equipment 84 (22.8) Display screen equipment 85 (23.1) Manual lifting and handling 22 (6.0) Chemical safety 5 (1.4) Table 16 Comments on Temperature and Lighting in Office Workplace Temperature Frequency (%) Lighting Frequency (%) Too cold 127 (34.5) Too bright 12 (3.3) Suitable 209 (56.8) Suitable 337 (91.6) Too hot 32 (8.7) Too dim 19 (5.2) Table 17 Inclination and Avenues for Seeking Assistance on Occupational Safety and Health Issues Seeking assistance Frequency (%) Would actively seek assistance 326 (88.6) Avenues for assistance: Superior 189 (51.4) Colleagues 149 (40.5) Trade unions 3 (0.8) Labour Department/OSHC 57 (15.5) Doctor 203 (55.2) Occupational Safety and Health Council 17

Table 18 Degree of Importance Placed on Occupational Safety and Health by Employers and Employees Frequency (%) Degree of importance Employers Employees Extremely not important 7 (1.9) 1 (0.3) Not important 38 (10.3) 21 (5.7) Average 151 (41.0) 189 (51.4) Important 160 (43.5) 150 (40.8) Extremely important 12 (3.3) 7 (1.9) Table 19 Responsibility for Occupational Safety and Health Greatest responsibility lies with Frequency (%) Employers 197 (53.3) Employees 61 (16.6) Government 110 (29.9) Occupational Safety and Health Council 18

Discussion This follow-up survey was another comprehensive study after the survey conducted in 1997 in exploring the occupational health issues in office workplace and computer operation. The 1997 survey provided valuable information on how to ensure the occupational health of office workers whom required frequent computer operation. At that time, the Occupational Safety and Health Ordinance was just enacted and was about to come into effect. The survey was thus provided baseline information for presenting the situation of occupational safety and health in the workplace. In order to evaluate the progress made in the last four years in promoting occupational safety and health as well as to follow up on computer-related health issues, especially the musculoskeletal complaints, this follow-up survey in 2001 was worth investigating. Adopting the same sampling approach in the follow-up survey, stratified random sampling with consideration of categorized groups ranged from large, medium and small companies was followed. In addition, most of the business types involving use of display screen equipment were included, e.g. airline companies, travel agencies, telecommunication companies, banks, financial investment companies, securities companies, legal firms, accounting firms, architectural firms, data processing and analysis companies and advertising companies. Findings of the follow-up survey indicated that it was representative and effectively followed according to the previous survey, in terms of the demographics and occupational characteristics of the sample workers. It indicated that office workers had demonstrated a greater awareness on occupational safety and health. They showed a larger extent of alertness to the musculoskeletal discomforts due to prolonged use of display screen equipment. Employers were more willing to provide appropriate peripheral equipment on computer desks, e.g. chairs with armrest, wrist supports, and even height adjustable desks. It directly helped to improve the working posture in operating display screen equipment. It affirmed that the enactment of the Occupational Safety and Health Ordinance had positive influence through the promotion and training efforts of the government and the Occupational Safety and Health Council. Similar to the results of last survey, reports of musculoskeletal discomforts in past 12 months was still high, especially in the neck, shoulder, low back and upper back. Over Occupational Safety and Health Council 19

60% of the interviewed workers experienced symptoms of pain, stiff muscle, aches and cramps in neck and shoulder. More than 40% complained of pain in low back and upper back. Furthermore, over 60% of the interviewed workers complained of eye strains and visual discomforts. In connection with the reporting of musculoskeletal discomforts, prolonged operation of display screen equipment in awkward or sustained postures was related to development of muscle fatigue and injuries. It indicated that more than half of the interviewed workers admitted adopting incorrect postures at work. Poor awareness of safety concepts, for the sake of convenience, and insufficient work space were the major reasons for the adopting incorrect postures at work. Moreover, long hours of work, excessive workload and high cognitive demand were the factors leading to the musculoskeletal complaints. There were more than 40% of the interviewed workers claimed to work with display screen equipment for six hours or longer on a daily basis whilst about 40% even had to work for eight hours everyday. Recently there had been widespread discussions on the possible increase in operational cost of employers if legislation was to be enacted to protect the occupational safety and health of display screen equipment users. In fact, control measures in developing musculoskeletal disorders does not necessarily increase the operational cost as the survey has revealed that most of the workstation and office furniture were conformed with the requirement. The key is to place the display screen in a correct position so as to maintain a suitable and comfortable viewing between the screen and the operator. The display screen is better placed in the position that no reflection directly from the screen is resulted and the keyboard should be correctly positioned to fit the physical needs of the operator. Moreover, with height adjustable chairs, the operators are able to fit in the workstation with appropriate seating height and to allow proper posture to work. Attention should also be paid to the work pace of operating display screen equipment. It is better to rotate different types of jobs and to have intermittent rest breaks during the day of routine of work pattern. These simple administrative arrangements are helpful in improving the occupational safety and health among the office workers and there are seemingly no additional facilities or increase in costing required to achieve the purpose. Occupational Safety and Health Council 20

Target to the recommendations mentioned above, Occupational Safety and Health Council will continuously produce the do-it-yourself training kits as well as the guides for DSE risk assessment to assist the proprietors of office workplaces in implementing their own risk assessment. Following the DIY training kits, employers can make use of the materials to launch the control measures in order to protect the occupational health of their employees and also enhance the overall work productivity in office workplaces. The results indicated on the other hand that work stress among office workers has been increasing from time to time. Lack of peer support, lack of communication with colleagues, fear of job security and lack of job satisfaction were the major psycho-social factors leading to the direct impact on symptoms presentation of musculoskeletal discomforts. It is therefore very important for organizations to manage work stress in office workplaces properly. Reports of accidents in office workplaces are also concerned other than the issue of work stress. Accidents are commonly reported in most of the office workplaces. About 50% of the interviewed workers had suffered injuries caused by office equipment or struck by stationary objects. Employers should take due regard to manage safety and health in office workplaces in order to effectively minimize the accident rate. The Occupational Safety and Health Ordinance has been enacted for more than four years. It is necessary to evaluate the safety and health situation in office workplaces as well as the office workers. This follow-up survey affirmed that promoting occupational safety and health in the workplaces was achieved. However, it also demonstrated the hurdles in improving the workplace environment and in heightening the safety and health awareness of employees. We need to fortify both training and promotion on occupational safety and health in DSE operation. Production of practical guides and training kits further assist employers and employees in the industry to self-assess workplace hazards as well as to implement control measures such that workers occupational safety and health can be protected in every respect. Occupational Safety and Health Council 21

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