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Case study 4: - Upper Limb Disorder in an office environment

Summary of problem

Jane has worked as a customer service agent in a busy call centre for six months.

Her work requires her to:

This work requires repetitive use of a display screen, mouse and keyboard, while talking on the phone.

Early on, Jane noticed that her arms began to get tired towards the end of the shift. After a couple of months, she continued to experience fatigue in her right hand and wrist after work, but always recovered by Monday morning.

Jane was using the mouse with her right hand, and typically in an awkward position in which her wrist was bent backwards and the soft under-side of the wrist rubbed against the edge of her desk. The awkward wrist posture, repetitive wrist motions and direct pressure of the wrist against the desk are risk factors for ULDs.

Her doctor told her that she had carpal tunnel syndrome, which could need surgery if her work tasks were not improved.

Jane also experienced pain and tension in the left side of her neck. This was largely due to the awkward and static postures she adopted while cradling the telephone between her shoulder and ear for most of the work day. This was made worse by the fact that the height of her desk and position of her computer monitor was causing Jane to 'shrug' her shoulders to keep her arms high enough.

Action

Jane informed her line manager of the problems she was having. After discussing the issues with her manager and a health and safety representative, a risk assessment of the workstation and the job was carried out. To reduce the risks found, the following changes were made both to the workstation and the way the work was organised.

  • An adjustable keyboard tray was installed at Jane's workstation. Jane was taught how to adjust the height and tilt of this keyboard tray to enable her to keep her wrists in a comfortable and neutral posture, while allowing her to relax her neck and shoulder muscles.
  • Jane reduced the amount of time spent using the mouse by learning some of the more common keyboard short cuts. She also learned to use the mouse with her left hand and switches hands regularly to provide adequate rest time for her hands and wrists.
  • Jane trialed four different kinds of mouse/ input device. She found one that better suited the tasks she performs and allows a more comfortable wrist posture.
  • Jane adjusted her chair to increase the height and improve the support it provides her back. This allowed her to avoid shrugging her shoulders while working. However, it also meant that her feet were not firmly planted on the floor. A footrest solved this problem. Further action to help with her problem was to give Jane a headset. This meant that she didn't have to cradle the phone between her shoulder and ear.
  • Jane's work tasks were modified to allow her to spend part of the workday performing other duties for 15 minutes out of each hour. She was also encouraged to take frequent, short breaks from her work to perform a few simple exercises.

adjustable desk

adjustable seat

Advice

Because of these changes, Jane was able to continue to work productively, and the need for surgery was avoided.

Problems with DSE workstations can often be solved by a combination of measures, for example:

These steps can all help to prevent MSDs.

Action to prevent pain or discomfort is much more beneficial than trying to reduce it once it has occurred.

References