The influence of visual display terminal use on the physical and mental conditions of administrative staff in Japan

Visual display terminals (VDT) are standard equipment for many office workers. Their use, however, may increase the risk of developing adverse conditions related to vision, the musculoskeletal system, and mental health. We carried out a survey among 3070 workers aged 18 to 67 years (mean, 39.9 years) at a prefectural administrative office, in which 76% of subjects were visual display terminal (VDT) users. We examined the relationship between duration of daily VDT use and eyestrain, neck or upper extremity pain, back pain, and mental health, and estimated the effect of breaks and rest during VDT work on these symptoms. The 12-item General Health Questionnaire (GHQ-12: total scores ranged from 0 to 12) was used to identify potential poor mental health status, and subjects with 4 or more were considered to have symptoms of psychological distress. Seventeen percent of subjects reported eyestrain, 19.1% reported upper extremity pain, 11.6% reported back pain, and 17% of subjects had GHQ-12 scores of 4 or higher. Logistic regression analysis showed that duration of daily VDT use and lack of breaks and rest during VDT work were significantly associated with eyestrain, neck or upper extremity pain, back pain, and psychological distress. In order to protect users from the adverse effects associated with VDT work, reducing daily VDT exposure, taking breaks, and rest during VDT work are important.     

Effects of taurine supplementation on VDT work induced visual stress

Summary. In order to evaluate the effects of dietary taurine supplementation on visual fatigue induced by visual display terminals (VDT) work, 25 male college students aged from 20 to 24 years who were not engaged in VDT work were selected to participate in the study. Volunteers were randomly assigned to either the taurine supplementation (n=13) or the placebo supplementation control group (n=12). Before and after 12 days of taurine (3g/day) or placebo supplementation, two identical 2.5-hr VDT work tests were performed while recording the P100, N75 and N145 latencies and P100 amplitude of pattern visual evoked potential (PVEP) and the frequency of critical flicker fusion (CFF). Following 2.5-hr of VDT work, the P100 and N75 latencies of PVEP increased (P<0.01) while the P100 amplitude decreased significantly (P<0.01). The frequency of CFF also reduced significantly (P<0.01). After 12 days of taurine supplementation, the reduction in P100 amplitude after VDT work alleviated significantly (P<0.05). The results suggest that taurine supplementation alleviates visual fatigue induced by VDT work.     

Time factors in VDT-induced myopia and visual fatigue: an experimental study.

In an experimental design with two matched groups (n = 13 and n = 17) working 2 and 4 hr respectively, followed by a 15-min restitution time, the study examined the effect of continuous VDT work on 1) visual acuity, refraction and oculomotor functions (ZCSV: zone of clear, single vision) and 2) the effect of 15-min restitution time on the oculomotor functions (ZCSV). In both groups there were a significant reduction in visual acuity, refraction changes in myopic direction and reduced ciliar and vergence muscle capacity. The ZCSV changes were temporary and a 15-min restitution period restored approximately half of the ZCSV changes. There were no significant differences between 2 or 4 hr of VDT work on any of the variables examined.     

Lacrimal Hypofunction as a New Mechanism of Dry Eye in Visual Display Terminal Users

Background

Dry eye has shown a marked increase due to visual display terminal (VDT) use. It remains unclear whether reduced blinking while focusing can have a direct deleterious impact on the lacrimal gland function. To address this issue that potentially affects the life quality, we conducted a large-scale epidemiological study of VDT users and an animal study.

Methodology/Principal Findings

Cross sectional survey carried out in Japan. A total of 1025 office workers who use VDT were enrolled. The association between VDT work duration and changes in tear film status, precorneal tear stability, lipid layer status and tear secretion were analyzed. For the animal model study, the rat VDT user model, placing rats onto a balance swing in combination with exposure to an evaporative environment was used to analyze lacrimal gland function. There was no positive relationship between VDT working duration and change in tear film stability and lipid layer status. The odds ratio for decrease in Schirmer score, index of tear secretion, were significantly increased with VDT working year (P = 0.012) and time (P = 0.005). The rat VDT user model, showed chronic reduction of tear secretion and was accompanied by an impairment of the lacrimal gland function and morphology. This dysfunction was recovered when rats were moved to resting conditions without the swing.

Conclusions/Significance

These data suggest that lacrimal gland hypofunction is associated with VDT use and may be a critical mechanism for VDT-associated dry eye. We believe this to be the first mechanistic link to the pathogenesis of dry eye in office workers.     

Analytic and rule-based decision support tool for VDT workstation adjustment and computer accessories arrangement

One important factor that leads to the development of musculoskeletal disorders (MSD) and cumulative trauma disorders (CTD) among visual display terminal (VDT) users is their work posture. While operating a VDT, a user's body posture is strongly influenced by the task, VDT workstation settings, and layout of computer accessories. This paper presents an analytic and rule-based decision support tool called EQ-DeX (an ergonomics and quantitative design expert system) that is developed to provide valid and practical recommendations regarding the adjustment of a VDT workstation and the arrangement of computer accessories. The paper explains the structure and components of EQ-DeX, input data, rules, and adjustment and arrangement algorithms. From input information such as gender, age, body height, task, etc., EQ-DeX uses analytic and rule-based algorithms to estimate quantitative settings of a computer table and a chair, as well as locations of computer accessories such as monitor, document holder, keyboard, and mouse. With the input and output screens that are designed using the concept of usability, the interactions between the user and EQ-DeX are convenient. Examples are also presented to demonstrate the recommendations generated by EQ-DeX.     

Neural mechanisms of recovery following early visual deprivation

Natural patterned early visual input is essential for the normal development of the central visual pathways and the visual capacities they sustain. Without visual input, the functional development of the visual system stalls not far from the state at birth, and if input is distorted or biased the visual system develops in an abnormal fashion resulting in specific visual deficits. Monocular deprivation, an extreme form of biased exposure, results in large anatomical and physiological changes in terms of territory innervated by the two eyes in primary visual cortex (V1) and to a loss of vision in the deprived eye reminiscent of that in human deprivation amblyopia. We review work that points to a special role for binocular visual input in the development of V1 and vision. Our unique approach has been to provide animals with mixed visual input each day, which consists of episodes of normal and biased (monocular) exposures. Short periods of concordant binocular input, if continuous, can offset much longer episodes of monocular deprivation to allow normal development of V1 and prevent amblyopia. Studies of animal models of patching therapy for amblyopia reveal that the benefits are both heightened and prolonged by daily episodes of binocular exposure.     

Some problems and counter-measures in modern labour. From single causal factors assessment to the analysis of multiple forms of hardship at work

1. 1. Methods are needed through which work situations can be analyzed in terms of the complex set of circumstances which they in fact involve.

2. 2. A number of office workplaces were examined with respect to both physical aspects of the work premises and the content of work. The study of task-related complaints was limited to those which are related to aspects of office work conducted using computer terminals (VDT work).

3. 3. For the purpose of illuminating the combined importance of office design and working conditions of the VDT work, the study considered the occurrence of complaints related to both sources.

4. 4. A questionnaire study (containing about 250 questions) covering all employees in eight workplaces and 269 people in total, of which 195 were VDT operators.

5. 5. The concepts, source of complain, type of complaint and were used to provide an analysis of the composite picture of complaints.

6. 6. A combination of premises-related and VDT-related complaints applies to a large number of office workers and only a few people stated were wholly free from difficulties.

7. 7. The findings indicate that by also taking account of the design of office premiss as a source of hardship, we have obtained further report for the view that the pattern of complaints is rather complicated in the case of most people who devote themselves to VDT work.

8. 8. Climatic problems arise extremely frequently, as too do problems in obtaining an appropriate balance between privacy and social contact at work.

Mental imagery and visual working memory

Visual working memory provides an essential link between past and future events. Despite recent efforts, capacity limits, their genesis and the underlying neural structures of visual working memory remain unclear. Here we show that performance in visual working memory--but not iconic visual memory--can be predicted by the strength of mental imagery as assessed with binocular rivalry in a given individual. In addition, for individuals with strong imagery, modulating the background luminance diminished performance on visual working memory and imagery tasks, but not working memory for number strings. This suggests that luminance signals were disrupting sensory-based imagery mechanisms and not a general working memory system. Individuals with poor imagery still performed above chance in the visual working memory task, but their performance was not affected by the background luminance, suggesting a dichotomy in strategies for visual working memory: individuals with strong mental imagery rely on sensory-based imagery to support mnemonic performance, while those with poor imagery rely on different strategies. These findings could help reconcile current controversy regarding the mechanism and location of visual mnemonic storage.     

Providers and staff respond to Medicaid managed care: the unintended consequences of reform in New Mexico

In 1997 a new Medicaid managed care (MMC) program called Salud! was implemented by the State of New Mexico. This article serves as an introduction to a special issue of Medical Anthropology Quarterly that assesses the unintended consequences of this reform and its impact on providers and staff who work in clinics, physician offices, and emergency rooms where Medicaid patients are served. MMC fused state and corporate bureaucracies, creating a complex system where enrollment and access was difficult. The special issue focuses on providers' responses to these new structures, including ways in which staff buffer the impact of reform and the role of the discourses of medical necessity and accountability in shaping the way in which MMC functions.     

The unique role of sentinel trees,botanic gardens and arboreta in safeguarding global plant health

The ever increasing threat from new and emerging plant pests and pathogens poses a significant threat to plant health on a global scale. Once an organism is introduced and establishes itself in a new region, it is incredibly costly, both in terms of environmental impact and economic loss, to manage it. In most cases, eradication and containment programmes are most effective when the organism is identified early on. Further to this, the most cost effective management of all is preventing introduction in the first place. Therefore, the role for early warning systems in plant health is becoming more evident. Botanic gardens and arboreta are unique resources that can help provide such early warning and are, currently, often overlooked within plant health. The staff and volunteers that work within these botanical institutes are knowledgeable and passionate people, who if made aware of current threats, can become additional ‘eyes and ears’ for first detection of new introductions. Gardens can also help to increase available information on organisms and, potentially, identify the ‘unknown’ organisms through sentinel research. Plant collections provide a large range of exotic hosts (so-called ‘sentinels’) growing in diverse regions around the world which can be studied to determine susceptibility to potential pests that have not been introduced to their native ranges. The International Plant Sentinel Network (IPSN) has been developed in order to support such work and bring together botanical institutes with organisations working within plant health.     

Vulnerability and strength--giving voice to the voiceless

This article examines the requisites of working with people who are interpersonally, institutionally, and politically oppressed and therefore vulnerable. To work successfully with them requires that we understand their vulnerability, appreciate their strengths and resources, and recognize the remarkable heroism of their daily lives. This insight is especially useful for professionals in the fields of health, mental health, public welfare, and family services.     

蟋蟀视觉系统的解剖结构与生理机能

蟋蟀视觉系统由单眼、复眼、视叶三部分组成。蟋蟀的单眼为背单眼,由角膜、角膜生成细胞、视网膜等组成,是提高昆虫复眼所感知的视觉刺激的兴奋水平部位;复眼是最主要的视觉器官,由角膜、晶锥、感杆束和网膜细胞、基膜组成,是光电转导和视觉级联反应的中心;视叶由神经节层、外髓和内髓组成,是视觉神经系统的中心。     

Meibomian Gland Dysfunction Determines the Severity of the Dry Eye Conditions in Visual Display Terminal Workers

Objective

To explore meibomian gland dysfunction (MGD) may determine the severity of dry eye conditions in visual display terminal (VDT) workers.

Methodology

Prospective, case-control study carried out in China.106 eyes of 53 patients (VDT work time >4 hour per day) were recruited as the Long time VDT group; 80 eyes of 40 control subjects (VDT work time ≤4 hour per day) served as the Short time VDT group. A questionnaire of Ocular Surface Disease Index (OSDI) and multiple tests were performed. Three dry eye tests: tear film breakup time (BUT), corneal fluorescein staining, Schirmer I test; and three MGD parameters: lid margin abnormality score, meibum expression assessment (meibum score), and meibomian gland dropout degree (meiboscore) using Keratograph 5 M.

Principal Findings

OSDI and corneal fluorescein score were significantly higher while BUT was dramatically shorter in the long time VDT group than the short time VDT group. However, the average of Schirmer tear volumes was in normal ranges in both groups. Interestingly, the three MGD parameters were significantly higher in the long time VDT group than the short time one (P<0.0001). When 52 eyes with Schirmer <10 mm and 54 eyes with Schirmer ≥10 mm were separated from the long time VDT workers, no significant differences were found between the two subgroups in OSDI, fluorescein staining and BUT, as well as the three MGD parameters. All three MGD parameters were positively correlated with VDT working time (P<0.0001) and fluorescein scores (P<0.0001), inversely correlated with BUT (P<0.05), but not correlated with Schirmer tear volumes in the VDT workers.

Conclusions

Our findings suggest that a malfunction of meibomian glands is associated with dry eye patients in long term VDT workers with higher OSDI scores whereas some of those patients presenting a normal tear volume.     

Perspectives on the relevance of the circadian time structure to workplace threshold limit values and employee biological monitoring

The circadian time structure (CTS) and its disruption by rotating and nightshift schedules relative to work performance, accident risk, and health/wellbeing have long been areas of occupational medicine research. Yet, there has been little exploration of the relevance of the CTS to setting short-term, time-weighted, and ceiling threshold limit values (TLVs); conducting employee biological monitoring (BM); and establishing normative reference biological exposure indices (BEIs). Numerous publications during the past six decades document the CTS substantially affects the disposition – absorption, distribution, metabolism, and elimination – and effects of medications. Additionally, laboratory animal and human studies verify the tolerance to chemical, biological (contagious), and physical agents can differ extensively according to the circadian time of exposure. Because of slow and usually incomplete CTS adjustment by rotating and permanent nightshift workers, occupational chemical and other contaminant encounters occur during a different circadian stage than for dayshift workers. Thus, the intended protection of some TLVs when working the nightshift compared to dayshift might be insufficient, especially in high-risk settings. The CTS is germane to employee BM in that large-amplitude predictable-in-time 24h variation can occur in the concentration of urine, blood, and saliva of monitored chemical contaminants and their metabolites plus biomarkers indicative of adverse xenobiotic exposure. The concept of biological time-qualified (for rhythms) reference values, currently of interest to clinical laboratory pathology practice, is seemingly applicable to industrial medicine as circadian time and workshift-specific BEIs to improve surveillance of night workers, in particular. Furthermore, BM as serial assessments performed frequently both during and off work, exemplified by employee self-measurement of lung function using a small portable peak expiratory flow meter, can easily identify intolerance before induction of pathology.     

Work of the human visual system. II. Color]

In the first part of this work [1] the author presented the expression for so called adequate visual stimulus. This expression describing the change of relative space - time differences of light actions in different retinal points defines the conditions necessary for producing visual sensations. In this paper author makes a statement that the quality of visual sensation (the percieved colour) can be evaluated by integrating the expression for the adequate visual stimulus both in time and in space. The integration in space is fulfilled starting from the extreme periphery of the retina, which is usually illuminated by scattered light averaged over the whole visual field. Human visual system works in such a way that the light action in the extreme periphery plays a role of the unit for scaling of visual sensations.     

B.M.A. Planning Unit Survey of General Practice 1969

A postal survey of 776 principals representative of general practice in Britain is described. Doctors working in health centres are compared both with colleagues in other group practices and with doctors who have no group practice allowance. Young doctors are mainly in group practice, especially health centres; the proportion of doctors who are not in groups is diminishing steadily, and they are mainly older. With some notable exceptions health centres provide most space, equipment, and staff; group practitioners in privately-owned premises spend more of their money on their practices, more often use appointment systems, and tend to make more efficient use of premises and staff. Overall, however, the picture is still one of general practice geared to the needs of practitioners working alone. Premises with space for sophisticated organization and for future teaching needs are unusual.Scotland, the North of England, and Wales have fewer young doctors. Average lists are higher in the North of England, and less money is invested in practice premises.Young doctors look for modern premises and the tools and staff for the job. If their career expectations are to be met the tremendous improvements made in some practices must be extended rapidly to the remainder.     

Selective visual processing across competition episodes: a theory of task-driven visual attention and working memory

The goal of this review is to introduce a theory of task-driven visual attention and working memory (TRAM). Based on a specific biased competition model, the ‘theory of visual attention’ (TVA) and its neural interpretation (NTVA), TRAM introduces the following assumption. First, selective visual processing over time is structured in competition episodes. Within an episode, that is, during its first two phases, a limited number of proto-objects are competitively encoded—modulated by the current task—in activation-based visual working memory (VWM). In processing phase 3, relevant VWM objects are transferred via a short-term consolidation into passive VWM. Second, each time attentional priorities change (e.g. after an eye movement), a new competition episode is initiated. Third, if a phase 3 VWM process (e.g. short-term consolidation) is not finished, whereas a new episode is called, a protective maintenance process allows its completion. After a VWM object change, its protective maintenance process is followed by an encapsulation of the VWM object causing attentional resource costs in trailing competition episodes. Viewed from this perspective, a new explanation of key findings of the attentional blink will be offered. Finally, a new suggestion will be made as to how VWM items might interact with visual search processes.     

Effects of industrialization on working schedules.

Recent increase in industrialization has resulted in attention being drawn to diversity of working schedules and their interrelation with content of work. The results of joint research revealed that adaptation to industrial jobs is made difficult because of urban conditions and modern work-control systems, such as workers in flexible-working-time systems who apparently favored regular daily working cycles. Long overtime work in smaller undertakings and the spread of shift systems are two important features of industrial work schedules, each being dominant among skilled and non-skilled jobs. Another important facet is the problem of intra-shift work-rest schedules significant for machine operations and vigilance tasks. It is suggested that phases of work that become intolerable are correlated with unnatural work rhythms. More emphasis should thus be laid on both phase-shifted work and non-self-governing work, the key factor being the relevance of attained data to real work in the whole course of schedules of work and rest.     

Case holding in patients with tuberculosis in Botswana.

OBJECTIVE--To evaluate the effectiveness of daily supervised short course chemotherapy in a national tuberculosis programme. DESIGN--Observation of programme during 1984-90. In October 1986 short course chemotherapy was introduced with patients receiving treatment daily from staff in their nearest health facility. SETTING--Botswana national tuberculosis programme. SUBJECTS--All patients with tuberculosis. MAIN OUTCOME MEASURES--Proportions of patients complying with and defaulting from treatment (missing > or = 43 days'' treatment). RESULTS--2938 cases of tuberculosis were recorded in 1990, 1528 of which were of sputum positive pulmonary disease. 2711 (92.3%) patients complied with treatment and 227 (7.7%) defaulted. Before introduction of short course chemotherapy compliance was about 60% compared with over 90% in 1987-90. CONCLUSIONS--A programme using daily supervised short course chemotherapy integrated into the primary health care system is an effective method of treating tuberculosis. The costs of the programme need to be evaluated.     

The corticofugal pathways of the visual system

Cortical neurons belonging to the same topological ensemble send axons to thalamic and mesencephalic structures and also to contra and ipsilateral cortical areas. The projections are called the corticofugal system. This review addresses the organization and the functions of the efferent cortical fibers within the visual network. For example, the cortico-geniculate fibers participate in shaping the structure of the concentric receptive fields of geniculate cells. Namely, the size of the surround area depends on descending impulses from the cortex. By contrast, cortico-mesencephalic fibers have a more global influence on visual responses. Following the interruption of cortical activity all responses to visual stimuli decline; although in rodents and lagomorphs cortical inactivation does not eliminate those visual responses that are sent to the superior colliculus or pretectum directly from the retina. In each hemisphere it has been demonstrated that contra-lateral cortico-cortical fibers participate in the continuity of the two visual hemi-fields, as the interruption of the callosal impulses results in a truncated field in which the contralateral part of the receptive field is missing., overlaps the vertical meridian is missing. Finally, ipsilateral cortico-cortical fibers allow a consolidation of visual properties of cortical cells. It must be added that there are considerable differences among species in the organization of cortico-cortical relationships. However, this survey seems to indicate that all corticofugal axons are excitatory.