Literature review on physical stress related to remote screen work

Status:

completed 03/2023

Aims:

The digitalisation of the working world has led to an increase in remote screen work. Due to the COVID-19 pandemic, working from home in particular gained currency as a form of remote work and is expected to remain a popular mode of working after the pandemic as well. On the political level, remote work became a topic of public focus in Germany with the draft bill by Hubertus Heil and the coalition agreement for the 19th legislative term. Various occupational safety committees as well as the statutory accident insurance institutions are currently occupied with the health and safety aspects of remote work.

The fast-progressing technical development of information and communication technologies (ICTs) is enabling flexible remote work on screen devices outside of company premises, including at home, in the train or at the airport. Eye strain or stress on the musculoskeletal system are considered to be possible health risk factors for working with screen devices. It is unclear whether verified findings on the risks of screen work in fixed workstations can be transferred to remote screen work. As such, it is likewise not known to what extent regulations and recommendations on employee safety, for instance relating to the ergonomic setup of visual display unit workplaces, can be transferred to the various potential remote work scenarios. In Germany, there are currently few concrete recommendations and with regard to the ergonomic setup of an ICT-based remote work scenario. In contrast to telework, there are no specific regulations on remote work and employers only have a limited influence on the work conditions of remote work (location, time or duration of work). This makes it all the more important to provide employers, health and safety bodies and employees with adequate recommendations. The basis for this must be provided by verified findings on the effects of mobile screen work on health.

To date there has been no overview showing the extent to which different factors of ICT-based remote work (e.g. device type, usage duration, user interfaces, environmental factors) have an effect on physical health (musculoskeletal system, eyes). As such, the current state of international research on the influence of ICT-based remote work on physical health was compiled in the scope of a systematic literature review. Various ergonomic factors of influence were taken into account. These include the different devices that are typically used in remote work situations (laptop, tablet, smartphone), the duration of the work session, the user interfaces (input/output devices), the furniture used and the environmental factor of light. In terms of health outcomes, the focus is on the risk factors and prevalence of musculoskeletal issues such as pain and related disorders as well as issues relating to the eyes and eyesight.

Other objectives of the project included the review of scientific findings to provide a basis for practical recommendations on the ergonomic setup of remote visual display unit workstations and the identification of gaps in existing research for potential follow-up projects.

Activities/Methods:

In the scope of this systematic literature review, suitable search terms and selection criteria for the literature search were first defined, comprising technical terms in the field of ICT in conjunction with the form of work and ergonomics terms found in the context of professional activities.

Furthermore, common physical disorders of the musculoskeletal system and eyes were included. Where possible, the information obtained should provide scientific findings on physical stresses for typical remote work scenarios where employees have varying degrees of influence on their work environment. The literature review was carried out in selected national and international databases. Only peer reviewed journal articles in German and English were included in the literature selection. Suitable literature was selected based on a multi-stage, blind screening process performed by multiple individuals. The inclusion criteria were derived from the research question, which was formulated in accordance with the PICO framework. The literature search and selection process were carried out in accordance with the PICO framework. Firstly, the titles were analysed. Secondly, the abstracts of the pre-selection were reviewed in more detail. In the third step, the relevant articles were reviewed in their entirety and their findings investigated for any bias. The findings were then analysed and the results of the literature review published.

Results:

The literature overview shows that poor posture, certain work devices as well as poor environmental factors can lead to various physical issues even in comparatively short work times. Mostly, the increased complaints were found in comparison to working at a fixed desktop computer workstation. The three research questions (and their answers in summarised form) from the internally submitted publication are listed below:

1. What are the effects of mobile ICT devices (including input/output devices) on physical health? Findings: Two primary factors were found: fewer external devices led to more critical results + the work devices must suit the requirements of the task (task–technology fit), in which case fewer negative results are to be expected.
2. How do posture and usage duration effect physical health? Findings: Non-neutral posture and high exposure led to more problems; effects were even identified in studies with a short usage duration (5–10 minutes). The longer the work duration, the more frequent the problems.
3. What regions of the body are most affected? Findings: In most studies, the neck stood out as the most-affected part of the body, followed by the head, shoulders, upper back, lower back and eyes.

Longer, uninterrupted work sessions using only mobile work devices should be reconsidered and planned with special care. Changing the work device and task can help prevent issues, as can active breaks and changes of position. Unfavourable working positions can be improved, for instance by raising the work surface or supporting the arms. Care should be taken to select the right equipment for the tasks at hand. It is generally not recommended to work for long periods of time only with a touchscreen, for instance, or under unfavourable influences on optical perception (reflections, glare, font size, etc.).

Requirements and recommendations from an ergonomic point of view are to be derived from the results as a basis for the revision of DGUV-I 211-040 "Use of mobile information and communication technology in the workplace".

Precise quantitative values, e.g. the maximum amount of time that should be spent with which mobile device on which work task, cannot yet be derived from the study results reviewed. The Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA) is therefore planning further investigations in order to derive concrete indications for the risk assessment of remote work. There is also a need for research, derived from the results of the project, in the area of unusual postures, longer periods of use and especially in the comparison of differently equipped workplaces (e.g. laptop with and without additional devices).

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