Annals of Occupational and Environmental Medicine

Original Article

Relationship between visual display terminal working hours and headache/eyestrain in Korean wage workers during the COVID-19 pandemic: the sixth Korean Working Conditions Survey: Gayoung Kim, Seong-yong Cho, Jinseok Kim, Seongyong Yoon, Jisoo Kang, Si young Kim; Ann Occup Environ Med 2023;35:e8. Published online May 9, 2023; DOI: https://doi.org/10.35371/aoem.2023.35.e8

Abstract Abstract in Korean PDF PubReader ePub: Background
Prolonged use of visual display terminal (VDT) can cause eyestrain, dry eyes, blurred vision, double vision, headache and musculoskeletal symptoms (neck, shoulder, and wrist pain). VDT working hours among workers have greatly increased during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, this study aimed to investigate the relationship between VDT working hours and headache/eyestrain in wage workers using data from the sixth Korean Working Conditions Survey (KWCS) (2020–2021) conducted during the COVID-19 pandemic.
Methods
We analyzed the sixth KWCS data of 28,442 wage workers aged 15 years or older. The headache/eyestrain that occurred in the last year was assessed. The VDT work group included workers who use VDT always, almost always, and three-fourth of the working hours, while the non-VDT work group included workers who use VDT half of the working hours, one-fourth of the working hours, almost never, and never. To analyze the relationship between VDT working hours and headache/eyestrain, the odds ratios (ORs) and 95% confidence interval (CI) were calculated using logistic regression analysis.
Results
Among the non-VDT work group, 14.4% workers experienced headache/eyestrain, whereas 27.5% workers of the VDT work group experienced these symptoms. For headache/eyestrain, the VDT work group showed adjusted OR of 1.94 (95% CI: 1.80–2.09), compared with the non-VDT work group, and the group that always used VDT showed adjusted OR of 2.54 (95% CI: 2.26–2.86), compared with the group that never used VDT.
Conclusions
This study suggests that during the COVID-19 pandemic, as VDT working hours increased, the risk of headache/eyestrain increased for Korean wage workers.; 코로나 19 유행 시기의 임금근로자에서 영상표시단말기(VDT) 작업시간과 두통/눈피로의 연관성: 제 6차 근로환경조사(KWCS)
목적
영상표시단말기(VDT)를 장시간 사용하면 눈의 피로, 안구 건조, 시야 흐림, 복시, 두통 및 근골격계 증상(목, 어깨 및 손목 통증)을 유발할 수 있다. 코로나19의 유행 동안 근로자들의 VDT 근로시간이 크게 증가했다. 본 연구는 코로나19 유행 시기에 실시된 제6차 KWCS(2020-2021) 자료를 활용하여 임금근로자의 VDT 근로시간과 두통/눈피로의 연관성을 조사하고자 하였다.
방법
본 연구는 15세 이상 임금근로자 28,442명을 대상으로 제6차 KWCS 자료를 분석하였다. 두통/눈피로는 지난 1년 동안 발생 여부로 확인하였다. 근무시간 내내, 거의 모든 근무시간, 근무시간 3/4 동안 VDT를 사용할 경우 VDT 작업군으로 분류하였고, 근무시간 절반, 근무시간 1/4, 거의 없음, 전혀 사용하지 않는 경우 VDT 비작업군으로 분류하였다. VDT 근무시간과 두통/눈피로의 관계를 분석하기 위해 로지스틱 회귀분석을 이용하여 승산비(OR)와 95% 신뢰구간(CI)을 계산하였다.
결과
본 연구는 15세 이상 임금근로자 28,442명을 대상으로 제6차 KWCS 자료를 분석하였다. 두통/눈피로는 지난 1년 동안 발생 여부로 확인하였다. 근무시간 내내, 거의 모든 근무시간, 근무시간 3/4 동안 VDT를 사용할 경우 VDT 작업군으로 분류하였고, 근무시간 절반, 근무시간 1/4, 거의 없음, 전혀 사용하지 않는 경우 VDT 비작업군으로 분류하였다. VDT 근무시간과 두통/눈피로의 관계를 분석하기 위해 로지스틱 회귀분석을 이용하여 승산비(OR)와 95% 신뢰구간(CI)을 계산하였다.
결론
본 연구는 코로나19 세계적 유행 기간 동안 VDT 근로시간이 증가함에 따라 한국 임금근로자의 두통/눈피로 위험이 증가함을 시사한다.

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Randomized Controlled Trial

Effects of the Use of the Hold Relax Technique to Treat Female VDT Workers with Work-related Neck-shoulder Complaints: Young Min Kim; Korean Journal of Occupational and Environmental Medicine 2009;21(1):18-27. Published online March 31, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.1.18

OBJECTIVES
The purpose of this study was to investigate the effects of encouraging exercise to treat work-related neck-shoulder pain by mobile phone messages after training individuals to use the holdrelax technique.
METHODS
Subjects were randomly allocated into an exercise (n=20) and a control (n=21) groups. The exercise group was taught stretching exercise methods known as the hold-relax technique for the upper trapezius, levator scapula, scalenus, and suboccipitals. They then received mobile phone messages encouraging them to do the exercises twice a week for eight weeks. The visual analog scale (VAS) of neck and shoulder pain, the pressure pain threshold (PPT) for the four muscles, and the cervical ROM were measured at baseline and at the end of the study.
RESULTS
The VAS decreased significantly in the exercise group from 3.35 to 1.65 (p<0.001) for the neck, and from 4.55 to 2.05 for the shoulder (p<0.001). In addition, the PPT of the four muscles increased (p<0.001) in the exercise group. However, no significant changes in the VAS and the PPT of the control group were observed. Furthermore, the ROM did not differ significantly between the exercise and control groups after intervention.
CONCLUSION
Teaching patients to use the hold-relax technique and encouraging exercise using mobile phone messages can reduce work-related neck-shoulder pain.

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Original Article

Effects of Thoracic Spinal Exercise Program in VDT Workers: Pain Relief and Increased Flexibility: Young Ae Yang, Young Hee Kim, Yong Kwon Kim, Jin Gang Hur, Jae Cheol Song, Yoon Shin Kim; Korean Journal of Occupational and Environmental Medicine 2004;16(3):250-261. Published online September 30, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.3.250

Abstract PDF

OBJECTIVES
The purpose of this study of the Thoracic Spinal Exercise Program was to evaluate its effects on VDT workers. These effects were found to include a decrease thoracic kyphosis, increase thoracic spine mobility and decrease in the VAS (visual analog scale). These measures provide a means of assessing the muscle endurance and muscle strength of the subjects.
METHODS
This study was conducted during the period from July 1 to August 31, 2003, and involved 58 VDT workers belonging to a company located in Seoul who were working seated in front of a computer for most of the day. After applying the thoracic exercise program, we examined the changes in the of thoracic kyphosis angle, spinal length (C7-S3), TFED (thoracic flexibility in the extension direction), MEBH (maximal elevation with both hands in the overhead direction) and CE (chest expansion).
RESULTS
Obtained f om this study are as follows. 1. A significant reduction in the VAS was observed in the exercise group (pre-exercise 5.90 +/- 0.88 points, post-exercise 4.23+/- 0.82 points), as compared with the control group (pre-exercise 6.00+/-0.90 points, post-exercise 5.93+/-0.81 points). 2. A significant reduction in thoracic kyphosis (pre-exercise 36.97+/-7.49, post-exercise 31.83 +/-5.90) and a significant increase in thoracic flexibility in the extension direction (pre-exercise 7 . 4 7+/-2.30, post-exercise 11.77+/-3.65) were observed in the exercise group. The thoracic kyphosis angle showed a significant reduction in the exercise group, as compared to the control group. The thoracic flexibility in the extension direction showed a significant increase in the exercise group, as compared to the control group. 3. There was a significant increase in the spinal length in the exercise group (pre-exercise 494 +/-27.66 mm, post-exercise 518.60+/-27.95 mm).
CONCLUSIONS
The Thoracic Spinal Exercise Program results in an increase in thoracic spine mobility and a decrease in pain. In practical terms, the effects of the exercise program are good health and posture.

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Original Article

Association between Musculoskeletal Subjective Symptoms and the MMPI (Minnesota Multiphasic Personality Inventory) Profile of Female VDT Operators: Jae Cheol Song, Weon Young Lee, Young Jun Kwon, Mo Ran Ki, Soo Jin Lee, Si Bok Park, Jung Hyun Nahm; Korean Journal of Occupational and Environmental Medicine 1998;10(4):599-609. Published online December 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.4.599

Abstract PDF

A study was conducted to assess the association between musculoskeletal subjective symptoms and the MMPI(Minnesota Multiphasic Personality Inventory) profile. The study subjects were 539 female operators of telecommunication company in Seoul, and were interviewed with subjective symptom questionnaire and MMPI. Results were as follows 1. 77.5% of the study subjects complained subjective symptoms on the shoulder, 73.8% on the neck, 71.8% on the lower back, 67.5% on the arm, 67.2% on the hand, 39.8% on the elbow, respectively. According to NIOSH symptom criteria, 63% complained on the shoulder, 57.4%, 54.6% on the lower back, 53.2% on the hand, 45.9% on the arm, 29.8% on the elbow, respectively. 2. Among the MMPI clinical scales, Hs(Hypochondriasis), Hy(Hystria) and Dep (Depression) scales showed significant differences according to the numbers of subjective symptom(NIOSH criteria), VAS(Visual Analogue Scale), and the experience of sick leave (each by ANOVA, p<0.05). 3. The association between the numbers of subjective symptom site for NIOSH symptom criteria, the personal history of sick leave and the MMPI profile that has more than 70 points in anything of Hs, Dep and Hy scales was showed significantly (each by x(2)-test, p<0.05).

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Original Article

The Effect of VDT Work on Work-related Musculoskeletal Disorder: Dorn Q Kim, Soo Hun Cho, Tai Ryoon Han, Ho Jang Kwon, Mina Ha, Nam Jong Paik; Korean Journal of Occupational and Environmental Medicine 1998;10(4):524-533. Published online December 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.4.524

Abstract PDF

As use of the visual display terminal (VDT) is becoming more generalized as a result of office automation, the so-called 'VDT syndrome' which is often observed with the workers using VDT has emerged as a serious occupational health problem. However, few comparative study with control group using not only subjective symptom but also physical examination hag been conducted. We have conducted a study comparing prevalence rates of musculoskeletal disorder between 113 VDT operators of a telecommunication company and the control groups of housewives and office ladies through a review of subjective symptoms as well as physical examination by physiatrist to understand the magnitude of problem and relative risk of VDT worker. The symptom rates of upper extremity disability in VDT operators were higher than those of controls especially in neck and shoulder area. Fifty-four(47.8%) of 113 VDT operators met our case definition of upper extremity disorder by subjective symptom and physical examination. Myofascial pain syndrome of neck and shoulder muscles were the most common(46.9%). The odd ratio of using VDT operation for developing myofascial pain syndrome in the neck or shoulder area were 2.52(compared to controls of office ladies) and 2.64 (compared to controls of housewives). Other anatomical lesion such as elbow, hand and wrist shows slight higher prevalence rates of musculoskeletal disorder than control groups but not statistically significant.

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Original Article

Relationship between the Serum CPK and the Shoulder Muscle Disorder in VDT Workers: Soo Keun Kim, Hae Kwan Cheong; Korean Journal of Occupational and Environmental Medicine 1998;10(2):172-179. Published online May 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.2.172

Abstract PDF: VDT workers are often exposed to static load in the shoulder stabilizing muscle due to repetitive work over long periods. Many investigations were reported the relationships between static load due to repetitive work and regional muscle disorder. However, diagnostic approach to work-related muscle disorder is difficult due to the absence of objective diagnostic tools. This study was performed to investigate the relationship between the serum CPK (creatine phosphokinase) concentrations and the shoulder muscle disorders. Results are as follow. 1. Mean serum CPK in total VDT workers was 67.6+/-28.4 IU/l and workers with abnormal serum CPK were 35 (21.5%). 2. Comparison between cases and controls did not show significant difference in the serum CPK level and the distribution of abnormal findings. 3. Sensitivity and specificity of the CPK test was 23.0% and 82.0%, respectively. Above results, in accordance with literatures, show that while serum CPK measure menu can be useful for the diagnosis of acute muscle injury, it does not adequately reflect the muscle disorders developed by the repetitive work of low tension over long time, such as VDT works.

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Original Article

Factors Affecting the Complaints of Subjective Symptoms in VDT Operators: Kye Yeoul Park, Ki Joo Bak, Jung Gun Lee, Yeon Soo Lee, Jae Hoon Roh; Korean Journal of Occupational and Environmental Medicine 1997;9(1):156-169. Published online February 28, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.1.156

Abstract PDF

In order to investigate symptoms prevalence related to visual display terminal (VDT) syndrome, and to evaluate the variables affecting the development of the VDT syndrome, a questionnaire survey was conducted on 119 (92 men and 27 women) VDT operators who had been engaged in one plant design company in Seoul. The results were as follows : The average age of questionnaire respondents was 30. The average years of service were 4.3 years, and the working hours per day with VDT for half of them were more than 4 hours with the average being about 4.7 hours. The majority of subjects (71 persons) were working at computer aided design (CAD) or computer programming tasks. Subjective symptoms of VDT syndrome were divided into 4 groups with musculoskeletal, eye, skin, and industrial fatigue according to their major affected organ. 4 high incidence of complaints of eye discomfort was observed. In the 3 subgroups of industrial fatigue symptom, the highest average group score was accounted for by 'dullness and sleepiness', followed by 'difficulty in concentration', 'bodily projection of fatigue' in the order of sequence, suggesting the heavier mental stress of VDT work rather than physical burden. Relationship among these 4 groups of symptoms showed statistically significant correlations one another. This result suggests that VDT syndrome is a multi-organ disease composed of these 4 symptom groups which were commonly caused by the use of VDT. Multiple regression analysis were used to examine the relationship between risk factors and these symptom groups of VDT syndrome. As the result of analysis, the most important risk factor for VDT syndrome was the average daily VDT working hours. The longer was VDT working hours, the higher was symptom prevalence of VDT syndrome. In addition, daily total working hours including VDT working hours and shift of work also affected the health of VDT users. In order to protect workers from VDT syndrome, it is urgently required to implement standard management recommendations including restriction of VDT working hours and allowance of more sufficient resting time for VDT workers.

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Original Article

Cumulative Trauma Disorders among Telephone Directory Assistance Operators: Hae Kwan Cheong, Byung Soon Choi, Ji Yong Kim, Sun Hee Yu, Hyun Sul Lim, Yong Min Kim, Kyung Yun Uh, Yong Wook Kwon; Korean Journal of Occupational and Environmental Medicine 1997;9(1):140-155. Published online February 28, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.1.140

Abstract PDF

To evaluate the prevalence of cumulative trauma disorders in relation to ergonomic evaluation of their work, 260 female directory assistance operators employed in three branch facilities of the nation-wide telecommunication company. Ergonomic evaluation of the work status was done by two industrial hygienists through inspection. Workers were surveyed with standardized self-administered questionnaire and examined by family physicians and an orthopaedician for cumulative trauma disorders. Laboratory examination of serum aspartate aminotransferase(AST), creatinine phosphokinase(CPK), aldolase and rheumatoid factor was done and X-ray of cervical spine and both shoulders was taken from all subjects and nerve conduction velocity test was done on 57 subjects with suspected nerve entrapment cases. Cumulative trauma disorders were categorized into 3 category according to work-relatedness of the disorders. On ergonomic evaluation of the working posture and work environment, improvement of work posture revealed inappropriate postures and devices. Mean age of the subjects were 39 years old and more than 80% graduated high school or above. Ninety-eight percent of the workers employed in the company for more than 15 years and 74.6% of the workers worked at the VDT job for more than 4 years. Mean daily work hours was 8.0 hours per day and mean break hours was 90.5 minutes per day with mean extra work hours of 10.7 hours per month. Mean daily calls were 1128.6 calls in maximum and 864.8 calls in minimum. On laboratory examination, 13 (5.0%) workers had abnormal AST, 53(20.4%) had abnormal CPK, and 1 (0.4%) had abnormal aldolase level. On x-ray examination of cervical spine, 111 (42.7%) had loss of or reversed normal cervical lordosis, 10(3.8%) had narrowing of intervertebral space. Nerve conduction velocity test was abnormal in 11 (19.2%) among 57 workers. Among disorders categorized as work-related, 131 (50.4%) were diagnosed to have fatigue myalgia of levator scapulae, 108 (41.5%) had cervical strain or sprain, 47 (18.1%) had fatigue arthralgia of phalangeal joints, and 47 (18.1%) had probable carpal tunnel syndrome, in 10 (3.8%) of those diagnosis was confirmed electrophysiologically. Age, seniority, work duration at present job, workload nor location of facilities were associated with the prevalence of symptoms nor specific diagnoses on simple statistical analysis and multiple logistic regression, which deems to be due to highly selected and homogeneous characteristics of the study subjects. Above results shows that cumulative trauma disorders are very prevalent among directory assistance operators and elaborate effort is needed to reduce the cumulative trauma disorders among the operators.

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Original Article

A Study on the Relationship between Subjective Symptoms and Psychosocial Well-being Status of VDT Operators: Bong Suk Cha, Sang Baek Ko, Sei Jin Chang, Chang Sik Park; Korean Journal of Occupational and Environmental Medicine 1996;8(3):403-413. Published online December 31, 1996; DOI: https://doi.org/10.35371/kjoem.1996.8.3.403

Abstract PDF

This study was undertaken to identify the relationship between the subjective symptoms and the psychosocial well-being status of VDT operators. The study subjects of this study were 89 female telephone operators in Korea Telecom. The mean age of study subjects was 37.7 (s.d.; 3.1), and 91% of them were the married and 9% were the single. The mean values of psychosocial well-being status by general characteristics were not statistically significant. Of the 89 operators, 98.9% felt musculoskeletal subjective symptoms in shoulder, 91.2% in neck, 89.9% in hand, 89.9% in lowback, 88.9% in arm, 87.8% in back, and 85.6% in leg, respectively. The mean scores of the psychosocial well-being status by three categories of subjective symptoms were significant in shoulder, neck, arm, hand, and leg, but were not significant in back and lowback. Correlations between the subjective symptoms and the psychosocial well-being status were significant in discomfort scale, leg, arm, neck, shoulder, lowback, and hand, but were not significant in back. Multiple regression analysis were used to determine whether the independent variables (age, discomfort, and subjective symptoms) contributed to explaining the psychosocial well-being status. Discomfort and the subjective symptoms in leg were a correlate of the psychosocial well-being status.

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