Health hazard among cash register operators and the effect of improved working conditions.

The health condition of female cash register operators in relation to their working conditions was investigated. A questionnaire study revealed that cash register operators more frequently complained of general fatigue, headache, sleeplessness, and low back pain than female office machine operators or other female workers. Dullness and pain in the shoulder, arm, hand, and fingers especially on the right side were characteristic of cash register operators. Physical examinations in 1973 showed that 31.3% of 371 cash register operators suffered from muscle rigidity or tenderness; 13 were severely afficted and, 69 operators had to be either laid off, reassigned to other jobs, or given shorter working hours. Occupational cervicobrachial disorders were suggested to have been caused by repetitive upper limb motions combined with static load, an unfavorable working environment, and mental stress. Implementation of some improvements including shorter operation time, worker rotation, and adoption of electronic registers proved effective in reducing the number of sufferers of cervicobrachial disorders found during the 1975 physical examinations. But the improvements were not effective enough to alleviate fatigue of the neck, shoulder, and back due presumably to sustaining upper limbs while operating the keyboard.     

Predictors of Incident and Persistent Neck/Shoulder Pain in Iranian Workers: A Cohort Study

Background

Pain in the neck and shoulder has been linked with various psychosocial risk factors, as well as with occupational physical activities. However, most studies to date have been cross-sectional, making it difficult to exclude reverse causation. Moreover, they have been carried out largely in northern Europe, and the relationship to psychosocial factors might be different in other cultural environments.

Methods

To explore causes of neck/shoulder pain, we carried out a longitudinal study in Iranian nurses and office workers. Participants (n  = 383) completed a baseline questionnaire about neck/shoulder pain in the past month and possible risk factors, and were again asked about pain 12 months later. Associations with pain at follow-up were explored by Poisson regression and summarised by prevalence rate ratios (PRRs).

Results

After adjustment for other risk factors, new pain at follow-up was more frequent in office workers than nurses (PRR 1.9, 95%CI 1.3–2.8), among those with worst mental health (PRR 1.8, 95%CI 1.0–3.0), in those who reported incentives from piecework or bonuses (PRR1.4, 95%CI 1.0–2.0), and in those reporting job dissatisfaction (PRR 1.5, 95%CI 1.0–2.1). The strongest predictor of pain persistence was somatising tendency.

Conclusions

Our findings are consistent with a hazard of neck/shoulder pain from prolonged use of computer keyboards, although it is possible that the association is modified by health beliefs and expectations. They also indicate that the association of low mood with neck/shoulder pain extends to non-European populations, and is not entirely attributable to reverse causation. Psychosocial aspects of work appeared to have relatively weak impact.     

Effects of VDT monitor placement and single versus bifocal glasses on somatic discomfort and postural profiles in data entry tasks

A study was conducted to determine the effects of VDT monitor positions and the use of single vision versus bifocal glasses on somatic elements in the data entry task. Eight male subjects performed data entry using a word processor in eight half-hour sessions with the four different monitor placements, i.e. "eye-level", "shoulder-level-front", "shoulder-level-side", and "sunken-level", wearing the two types of glasses. A subjective discomfort rating questionnaire covering 12 somatic elements was completed by the subject after each session. The head inclination and angle of gaze to the monitor were measured with a goniometer. The results revealed that the somatic elements which were affected significantly by the placement of the VDT monitor and the type of glasses were discomfort in the neck and back regions and eyestrain, respectively. The neck-back discomfort scores were highest at the "eye-level", lowest at the "sunken-level", and intermediate at the "shoulder-level-side" position. The "shoulder-level-front" position was not significantly different in the discomfort from other three positions. The eyestrain was significantly greater with the bifocal than with the single vision glasses. The lower the monitor was placed, the more forward was the head and gaze inclined. The head was inclined less forward, or even more backward, and the gaze was inclined more forward, with the bifocal than with the single vision glasses. As a conclusion, the VDT operators were advised to avoid the "eye-level" and "shoulder-level-side" positions and to prefer the "sunken-level" and "shoulder-level-front" positions as the first and second best choices, respectively. The preference becomes more critical for the wearers of bifocal glasses that suffer from postural constraints in viewing.     

Frequency and severity of musculoskeletal symptoms in humans during an outbreak of trichinellosis caused by Trichinella britovi

Musculoskeletal symptoms such as myalgia are well-known features in the course of trichinellosis; however, the characteristics of musculoskeletal findings have been described in detail in only 1 study. The present study was aimed to determine the joint and muscle symptoms in subjects diagnosed with acute trichinellosis at our rheumatology unit during a Trichinella britovi outbreak that occurred in Izmir, Turkey, in 2004. In total, 98 patients (55 females, 43 males; mean age 32.3 +/- 10.9 yr) were included in the study. A detailed history and full musculoskeletal examination were obtained in each patient. A self-administered questionnaire developed for recording the musculoskeletal symptoms was completed monthly until all the symptoms were resolved. Pain at the joints, restriction of movements (in shoulders, elbows, wrists, knees, ankles, and temporomandibular joints), myalgia, and muscle weakness (neck and shoulder girdle, muscles of the upper and forearm, back, thigh, and calf muscles) were assessed in every patient. Eosinophil counts, serum levels of creatine kinase, and lactate dehydrogenase also were analyzed. The most frequent musculoskeletal symptoms were muscle pain (86 cases [87.8%]), joint pain (83 [84.7%]), subjective muscle weakness (75 [76.5%]), and restriction of joint movements (63 [64.3%]). Calves, upper arm, neck and shoulder girdle, and forearms were the most affected muscle groups. Muscle pain was reported more frequently in the upper than in the lower extremities and during activity. The most frequent painful joints were shoulders, knees, wrists, and ankles. Upper extremity joints were affected more frequently than the lower extremity joints (77.6 vs. 70.4%). Joint pain occurred more frequently at rest. Both muscle weakness and restriction of joint movements were reported in and around the most frequently affected regions. No evidence of arthritis and objective muscle weakness was noted on physical examination in any patient. Musculoskeletal symptoms in the course of T. britovi infection are frequent but with an excellent prognosis. Joint pain in people suffering from acute trichinellosis may occur more frequently than reported previously.     

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.

Differential effects of mental concentration and acute psychosocial stress on cervical muscle activity and posture

Physical and psychosocial stressors in the workplace have been independently associated with the development of neck pain, yet interactions among these risk factors remain unclear. The purpose of this study was to compare the effects of mentally challenging computer work performed with and without exposure to a psychosocial stressor on cervical muscle activity and posture. Changes in cervical posture and electromyography of upper trapezius, cervical extensor, and sternocleidomastoid muscles were compared between a resting seated posture at baseline, a low stress condition with mental concentration, and a high stress condition with mental concentration and psychosocial stress in sixty healthy office workers. Forward head posture significantly increased with mental concentration compared to baseline, but did not change with further introduction of the stressor. Muscle activity significantly increased from the low stress to high stress condition for both the dominant and non-dominant upper trapezius, with no corresponding change in activity of the cervical extensors or flexors between stress conditions. These findings suggest that upper trapezius muscles are selectively activated by psychosocial stress independent of changes in concentration or posture, which may have implications for the prevention of stress-related trapezius myalgia in the workplace.     

Coffee intake and development of pain during computer work

ABSTRACT: BACKGROUND: The present study sought to determine if subjects who had consumed coffee before performing a simulated computer office-work task found to provoke pain in the neck and shoulders and forearms and wrists exhibited different time course in the pain development than the subjects who had abstained from coffee intake. FINDINGS: Forty eight subjects all working fulltime, 22 with chronic shoulder and neck pain and 26 healthy pain-free subjects, were recruited to perform a computer-based office-work task for 90 min. Nineteen (40%) of the subjects had consumed coffee (1/2 -1 cup) on average 1 h 18 min before start. Pain intensity in the shoulders and neck and forearms and wrists was rated on a visual analogue scale every 15 min throughout the work task.During the work task the coffee consumers exhibited significantly lower pain increase than those who abstained from coffee. CONCLUSIONS: Subjects who had consumed coffee before starting a pain provoking office work task exhibited attenuated pain development compared with the subjects who had abstained from coffee intake. These results might have potentially interesting implications of a pain-modulating effect of caffeine in an everyday setting. However, studies with a double blind placebo controlled randomized design are needed.     

Low-amplitude trapezius activity in work and leisure and the relation to shoulder and neck pain.

The aim of this study is to obtain evidence supporting or negating the hypothesis that muscle pain is associated with sustained activation of low-threshold motor units. Long-term surface electromyographic (EMG) recordings of trapezius activity pattern were related to subjectively reported shoulder and neck pain in work and leisure. Recordings from 118 female subjects (73 recorded both during work and leisure) were analyzed. Computer operators, secretaries, and health care and retail workers were represented in the material. The recordings were calibrated by the root-mean-square-detected response at maximal voluntary contraction (%maximum EMG). The analysis was performed by quantifying duration and amplitude of surface EMG activity exceeding 2% maximum EMG ("EMG bursts"). Three response categories were defined by duration of the burst periods during work: low- (<50%), intermediate- (50-70%), and high-response (>70%) groups. Shoulder and neck pain was assessed by hourly visual analog score throughout work and leisure and by pain score for the last 6 mo. Shoulder and neck pain was higher at work than leisure for subjects with long-term pain in both the high- and the low-response groups. Persistent pain, defined by the 6-mo score, was more prevalent in the high- than the low- and intermediate-response groups (73 vs. 37%); relative risk was 2.0. Trapezius activity was reduced from work to leisure for the high- but not the low-response group. The activity pattern is consistent with low-threshold motor unit overexertion for the high- but not the low-response group. We speculate that different mechanisms of muscle pain causation, dependent and independent of motor activity pattern, coexist.     

From confounders to suspected risk factors: psychosocial factors and work-related upper extremity disorders.

Psychosocial variables have recently been more prominent among epidemiologic risk factors for work-related upper extremity disorders (WRUEDs), but bio-behavioral mechanisms underlying these associations have been elusive. One reason is that the psychosocial domain has included many broad and disparate variables (e.g. mood, coping skills, job control, job satisfaction, job stress, social support), and this lack of specificity in the conceptualization of psychosocial factors has produced limited hypothesis testing opportunities. Therefore, recent research efforts have focused on identifying and conceptualizing specific psychosocial factors that might more clearly delineate plausible bio-behavioral mechanisms linking psychosocial factors to WRUEDs. One such factor is workstyle, a strategy that workers may employ for completing, responding to, or coping with job demands that might affect musculoskeletal health. Preliminary studies have provided support for measurable differences in workstyle among individual workers and an association with upper extremity pain and discomfort. An initial self-report measure of workstyle has been pilot tested among office workers and shown acceptable reliability and validity. Future studies are needed to study this construct among other working populations and to determine its relationship with other clinical endpoints. Nevertheless, early findings suggest workstyle may be a potential focus of WRUED prevention efforts.     

Mental health problems and influencing factors in Japanese women 4?months after delivery

Background

Postpartum mental health problems are a major public health issue; however, studies on the mental health status of mothers and its influencing factors between 8 weeks and 1 year postpartum are scarce. Furthermore, it would be necessary to examine the factors influencing mothers’ mental health in order to evaluate their physiological adaptations to the nursing environment.

Methods

We examined the mental health status of postpartum women and the factors influencing poor mental health at 4 months after delivery. A cross-sectional study of 584 postpartum women was conducted. Information on mental health status, delivery, and other factors was collected using a self-administered questionnaire. Women were asked about their age, height, weight, gestational or marital status, whether they were eating regular meals, appetite, frequency of going out, financial difficulty, stressful life events, and history of depression. The Japanese version of the 12-item General Health Questionnaire (GHQ-12) was used to identify potential poor mental health status. Participants with GHQ-12 scores of ≥4 were classified as the high GHQ-12 score group (poor mental health status) and participants with GHQ-12 scores of ≤3 were classified as the low GHQ-12 score group (good mental health status).

Results

Forty-five women (7.7%) were classified as having high GHQ-12 scores. Multiple logistic regression analysis revealed that older age, not eating meals regularly, and history of depression were significantly associated with poor mental health. Financial difficulty had a borderline association with poor mental health in this model.

Conclusions

These risk factors might help practitioners identify women at high risk of poor mental health after delivery.     

Visual load of working with visual display terminals--introduction of VDT to newspaper editing and visual effect.

In the Japanese newspaper industry, since the late 1970s, computerization has been started in large scale. The system, called Computerized Typesetting System (CTS), has been introduced. With this system, all information in the newspaper is input into a computer, called up on a cathode ray display (CRT) to edit, and then output to film or printing plates by CTS. Thus, the work of newspaper production has undergone a major transformation from industrial work to clerical work. It was reported that newspaper production staff working with VDTs complained more than staff working with the older key system about visual and physical problems which affected their job and their daily life. The complaint rates were highest for editors, who used VDT constantly throughout the day. This study was performed to clarify the health impact of VDT use and to prevent health disorders caused by the introduction of CTS. It is concluded that 5 m corrected vision and sphere refraction of CTS workers who used CTS over 2 or 4 hr daily, significantly became worse in a year after the introduction. Therefore, it is indicated that the control of CTS work time is important to prevent the visual disorder.     

Types of activities and body parts affected in the recommended exercises for VDT operators.

This paper presents results of an analysis of recommended exercises proposed for the reduction of musculoskeletal stress in VDT operation and similar types of work. Fifteen exercise programs consisting of 123 individual exercises were reviewed. Most of the programs exhibited some redeeming features from a practical and a professional standpoint. It was found that recommendations concerning exercises have been directed primarily to muscle stretching and relaxation. The body parts targeted by various exercises were back, leg, neck, shoulder, side and upper extremities. Maximum number of exercises were available for shoulder (35.8%) and upper extremities (17.9%). The exercises reviewed consisted of combinations of thirteen different activities. It was found that rotation (26.8%), stretching (20.3%), and flexing or bending (18.7%) were the most frequently employed activities.     

Threshold of Musculoskeletal Pain Intensity for Increased Risk of Long-Term Sickness Absence among Female Healthcare Workers in Eldercare

Purpose

Musculoskeletal disorders increase the risk for absenteeism and work disability. However, the threshold when musculoskeletal pain intensity significantly increases the risk of sickness absence among different occupations is unknown. This study estimates the risk for long-term sickness absence (LTSA) from different pain intensities in the low back, neck/shoulder and knees among female healthcare workers in eldercare.

Methods

Prospective cohort study among 8,732 Danish female healthcare workers responding to a questionnaire in 2004–2005, and subsequently followed for one year in a national register of social transfer payments (DREAM). Using Cox regression hazard ratio (HR) analysis we modeled risk estimates of pain intensities on a scale from 0–9 (reference 0, where 0 is no pain and 9 is worst imaginable pain) in the low back, neck/shoulders and knees during the last three months for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks) during one-year follow-up.

Results

During follow-up, the 12-month prevalence of LTSA was 6.3%. With adjustment for age, BMI, smoking and leisure physical activity, the thresholds of pain intensities significantly increasing risk of LTSA for the low back (HR 1.44 [95%CI 1.07–1.93]), neck/shoulders (HR 1.47 [95%CI 1.10–1.96]) and knees (HR 1.43 [95%CI 1.06–1.93]) were 5, 4 and 3 (scale 0–9), respectively, referencing pain intensity of 0.

Conclusion

The threshold of pain intensity significantly increasing the risk for LTSA among female healthcare workers varies across body regions, with knee pain having the lowest threshold. This knowledge may be used in the prevention of LTSA among health care workers.     

Low-back pain among electric power supply workers and their attitude toward its prevention and the treatment.

Low-back pain among electric power supply workers and their opinions about the ways to prevent and relieve the disorder were investigated. A questionnaire study revealed that 38.7% of 6,272 electric power supply workers were suffering from low-back pain, including severe pain resulting in frequent absenteeism or requiring occasional rest from work. Chronological analysis of the occurrence of the disorder revealed that the incidence of gradually developing pain has increased and that improper working posture and overwork have become more important as etiological factors. Rest from work was found to be the most effective way of relieving pain, while any medical treatment which did not include rest was useless. Low-back pain among these workers is believed to have resulted from rapid and intensified work as required by increasing demand and mechanization, greater mental stress and improper working posture. As preventive measures, it is necessary to improve working hours and to lighten the rate of work. In order to relieve pain, the employers should permit the workers to absent themselves from work quickly following an attack. Discrepancy between workers' opinions and both actual causation of low-back pain and actual effectiveness of medical treatment is discussed.     

The effects of double-shifts (15.5 hours) on sleep, fatigue and health

The aim of the present study was to investigate how "double-shifts" (15.5 hours) affects sleep, fatigue and self-rated health. The study was carried out on male construction workers of which 80% were long-distance commuters. The schedule involved two work periods and each work period involved two double shifts in a row. The subjects filled in a sleep/wake diary at 8 times across a year and a questionnaire at 3 times. They also wore an actigraph during one shift cycle. The results showed that sleepiness, and to a certain extent, mental fatigue increased during double shifts and accumulated across days. The short rest time (8.5 hours) between days caused insufficient sleep and approximately 5.5 hours of sleep was obtained between double shifts. Questionnaire data showed that complaints of insufficient sleep, exhaustion on awakening and pain symptoms increased across the year. It was concluded that a shift system involving double shifts has a negative effect on fatigue, recovery and health-related well-being.     

The CUPID (Cultural and Psychosocial Influences on Disability) study: methods of data collection and characteristics of study sample

Background

The CUPID (Cultural and Psychosocial Influences on Disability) study was established to explore the hypothesis that common musculoskeletal disorders (MSDs) and associated disability are importantly influenced by culturally determined health beliefs and expectations. This paper describes the methods of data collection and various characteristics of the study sample.

Methods/Principal Findings

A standardised questionnaire covering musculoskeletal symptoms, disability and potential risk factors, was used to collect information from 47 samples of nurses, office workers, and other (mostly manual) workers in 18 countries from six continents. In addition, local investigators provided data on economic aspects of employment for each occupational group. Participation exceeded 80% in 33 of the 47 occupational groups, and after pre-specified exclusions, analysis was based on 12,426 subjects (92 to 1018 per occupational group). As expected, there was high usage of computer keyboards by office workers, while nurses had the highest prevalence of heavy manual lifting in all but one country. There was substantial heterogeneity between occupational groups in economic and psychosocial aspects of work; three- to five-fold variation in awareness of someone outside work with musculoskeletal pain; and more than ten-fold variation in the prevalence of adverse health beliefs about back and arm pain, and in awareness of terms such as “repetitive strain injury” (RSI).

Conclusions/Significance

The large differences in psychosocial risk factors (including knowledge and beliefs about MSDs) between occupational groups should allow the study hypothesis to be addressed effectively.     

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.     

Impact of pain,psychological-distress,SARS-CoV2 fear on adults’ OHRQOL during COVID-19 pandemic

Corona virus disease (COVID-19) has crippled life, families and oral health care delivery. Hence, we assessed the impact of dental pain, fear of COVID-19 and psychological distress during lockdown on the oral health related quality of life of individuals visiting a tertiary dental care center during COVID-19 pandemic. Cross sectional study conducted among patients between 18 and 60 years. Demographics, access to pain killers, dental care (yes/no), duration (</> 15 days) and intensity of pain were self reported. Fear of COVID-19 was assessed using fear of corona virus scale (FCV-19S); psychological distress in the last 30 days and oral health related quality of life was evaluated. Oral examination was performed and dental caries status (DMFT) was assessed using the world health organization method. Univariate and multivariate regression analysis was conducted to evaluate significant predictors and 5% was set as level of significance. 2966 patients visited our dental emergency due to painful decayed tooth between March-June 2020. Mean age was 42.7 years, 53.97% were males and most common cause of painful teeth was upper right third molar (7.7%). 73.4% reported lack of pain medication; 95% reported closure of dental clinics close to home. Almost 79% suffered from dental pain for >15 days. Higher self reported pain (OR 2.1; 95% CI 1.36–14.71), >15 days of suffering from pain (OR 6.8; 95% CI 2.18–23.14), greater fear of COVID-19 (OR 4.14; 95% CI 1.98–16.07) and psychological distress (OR 4.41; 95% CI 1.09–16.76) were associated with poorer OHRQOL of adults during COVID-19 pandemic. Our findings strongly suggest that COVID-19 pandemic negatively impacts the mental and oral health of individuals affecting their overall health.     

AIDS-Related Stigma and Mental Disorders among People Living with HIV: A Cross-Sectional Study in Cambodia

Background

AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV). We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.

Methods

A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12) was used to measure mental disorders. Multivariate logistic regression analysis was conducted.

Results

The reported experiences of discrimination in communities in the past 12 months ranged from 0.8% for reports of being denied health services to 42.3% for being aware of being gossiped about. Internal stigma was also common ranging from 2.8% for avoiding going to a local clinic and/or hospital to 59.6% for deciding not to have (more) children. The proportions of PLHIV who reported fear of stigma and discrimination ranged from 13.9% for fear of being physically assaulted to 34.5% for fear of being gossiped about. The mean score of GHQ-12 was 3.2 (SD = 2.4). After controlling for several potential confounders, higher levels of mental disorders (GHQ-12≥ 4) remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% CI = 1.4–2.6), higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2–2.3), and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1–2.2).

Conclusions

AIDS-related stigma and discrimination among PLHIV in Cambodia are common and may have potential impacts on their mental health conditions. These findings indicate a need for community-based interventions to reduce stigma and discrimination in the general public and to help PLHIV to cope with this situation.     

Influence of VDT monitor positions on discomfort and performance of users with or without bifocal lenses

The difficulty of video display terminal users with bifocal lenses through a traditional workstation increases the complaints and risks for upper extremity cumulative trauma disorders. Furthermore, the regular and no lens users also have problems with traditionally designed workstations over prolonged periods of video display terminal use. A study was conducted on 14 subjects to investigate the effect of computer monitor location for video display terminal users with or without bifocals on subjective assessment and performance. The two monitor locations were 15 degrees and 40 degrees below horizontal eye level. The experimental task consisted of reading words from computer screens and typing them from the reverse side to the next column. Each experimental session lasted one hour. Males with bifocal lenses had less discomfort in the neck, shoulders, forearms, and wrists, less tiredness and eyestrain and higher performance with a 40 degrees angle monitor than with a 15 degrees angle monitor. A similar conclusion has been reached for females. Users with bifocal lenses had significantly higher neck discomfort and lower performance than nonbifocal users. The 40 degrees angle monitor caused less neck discomfort than the 15 degrees angle monitor did. Overall, females had less physical discomfort, less tiredness, and higher performance than males.