How to prevent health risks to “nomadic” workers

nomadic-workers

Workers are becoming increasingly “nomadic” in where they work thanks to the availability of mobile technology. But employers are not providing the same risk assessments and support for these employees as they do for those in traditional office-based work. Miranda Thew reports on a recent large-scale European survey. 

A report published in May 2014 provides strong evidence that employees are placing themselves at risk of a range of health-related conditions while working on a computer away from the office and, in particular, while working at home. The report was based on the findings of a European survey of more than 4,000 workers aged 18 and over who use a computer for work in a variety of environments. The study was commissioned by office supplies specialist Fellowes and carried out by the Faculty of Health and Social Sciences at Leeds Metropolitan University.

There is a lack of research in the UK in particular and growing concern within ergonomic specialist organisations such as the European Agency for Health and Safety at Work that ‘‘Little research has been conducted to understand how safety guidelines are designed and implemented to prevent injuries, minimize ergonomic risk factors and other personnel losses” (Robertson et al, 2012).

Increasingly, people are becoming “nomadic” in their working practices so this report considers these workers to be “nomadic workers” or “nomads”. In the traditional work setting those with a workstation and computer are highly aware of appropriate ergonomics and are usually assessed for their health and safety while working at a computer, but it appears that the same does not apply when it comes to working in contexts that are not usually associated with the world of work.

Close to one in two employees no longer has their own personal desk at the company’s premises that no one else occupies but them.

UK employees spend on average 6.7 hours a day sitting down working at a computer, laptop or tablet, irrespective of where that is, and the median figure is close at 6.5 hours.

Nomadic workers spend equal amounts of time at a computer as those at a personal desk.

Just 46% have had a workplace assessment, most of which are for people with a specific personalised desk that no one else uses except them, and the percentages fall with increasing nomadic working style.

The results indicate that nearly half of the sample no longer work at any one traditional computer “workstation” that has usually been individually assessed and adapted for health and safety purposes. Workers are not considering their needs or risks when not working at the office desk, echoing previous studies, such as Robertson et al, in 2012; and Luise in 2000.

Agencies for ergonomics (European Agency for Health and Safety at work, 2014) state that despite national organisations like the Health and Safety Executive (HSE) in the UK publishing guidelines (HSE, 2011) employers are routinely not providing employees who use computers with appropriate ergonomics training, workstations, chairs, and lighting within all the contexts that the employee is working within (Rempel et al, 2006). The nomadic worker is at considerable risk and this is set to increase with the changes in workplace technology and contexts (Robertson et al, 2012).

Musculosketal disorders

The many causes of work-related musculoskeletal disorders (WRMSDs) is commonly acknowledged. Different groups of risk factors including physical and mechanical factors, organisational and psychosocial factors, and individual and personal factors may contribute to WRMSDs (European Agency for Health and Safety at work, 2014). More days are lost within the UK from sickness absence due to musculoskeletal causes (Office for National Statistics, 2014) than any other condition.

Conditions arising from poorly adapted computer-based workstations range from sore muscles to chronic pain or carpal tunnel syndrome, repetitive strain injury, eye strain, headaches and chronic fatigue (HSE, 2002; Kuorinka and Forcier, 1995). Such conditions can, in turn, lead to reduced quality of life and therefore further reduce capacity for work (Santos et al, 2011).

By sitting in unnatural positions, or prolonged static postures together with repetitive movements can lead to a muscle imbalance, which leads to neuropathic disorders and chronic pain (Mackinnon and Novak, 1994; Higgs and MacKinnon, 1995).

Chronic pain is the most common complaint in outpatient clinics, with back pain alone accounting for up to 20% of the UK’s healthcare expenditure. With chronic pain, there is a high incidence of co-morbidity with depression, both of which can lead to decreased function, and, if the problems are indeed co-existing, treatment is expensive, complex and not always successful (Surah et al, 2014). Results of this study include:

  • 80% of employees have suffered from ailments in the past three years as a direct result of using computers for work.
  • 80% of employees who use such devices have suffered from ailments in the past three years as a direct result of using such devices, and nomadic workers are just as likely to have suffered as other employees
  • Top of the ailment list is backache (40%), this is followed closely by aching or tense shoulders (37%) and headaches (35%).
  • 18% of employees have suffered from depression in the past three years (either minor or serious depression) as a result of their ailments.
  • One in five sufferers has had to take time off work in the past year as a direct result of such problems, on average, this is 14.4 days per sufferer in the past 12 months.

The findings regarding mental health issues are particularly significant, as the main causes of long-term sickness absence in the UK are those related to stress, anxiety and depression (Confederation of British Industry, 2013). Further, the evidence from this study suggests that people are not engaging in preferred activities due to musculoskeletal problems that could act as de-stressors.

Ergonomic support

Of those who have ailments and have received help, certain products have been used to ameliorate symptoms. The use of ergonomic supports to address pain and musculoskeletal tension, indicates further that workers need advice, and to use the equipment both as a preventative factor, as well as a remedy. The fact that so many need the support and may only obtain ergonomic support and assessment after problems occur is worrying. Given the substantial evidence of this study and the empirical evidence reviewed; it is suggestive of a cyclical link between mental health and chronic pain, in that one can be the cause of the other and that chronic pain can often arise from musculoskeletal problems brought on by poor ergonomics. This being the case, with increasingly poor ergonomics and inadequate adaptation within nomadic working environments, the problem is likely to worsen as workers adopt more flexible working practices.

There is a lack of empirical evidence prior to this study that establishes how people adapt their environment for themselves to make it more comfortable to work at their computer. The findings here suggest that a number of people are experiencing discomfort, not only spending time adjusting their position to work, but also fidgeting, which is a sign that muscles are fatiguing and comfort is being compromised and interfering with concentration. The relative ill-effects of unsuitable aids to facilitate working at the computer are hard to measure, but what they do indicate is a need for suitable equipment that has been ergonomically designed.

The findings also suggest that nomadic workers feel their employer is not supportive of providing a more comfortable environment in which to work, and 16% of people assert that there is no help from the company to provide a comfortable workspace. More nomadic workers (24%) work in such companies and 20% of those in large companies say such support is lacking, whereas just 14% of those in SMEs agree.

Where there has been investment or provision for workers, 68% of employees use purpose-built ergonomic products of one sort or another. The most common are:

  • a desk lamp (39%);
  • a document stand (19%);
  • a footrest and a special back support added to their chair (both 17%);
  • a wrist support (16%); and
  • a specific PC riser (14%).

Those with a permanent, personal desk in the office tend to have more of these purpose-built ergonomic supports, and the same applies to those who work mainly from a home office, whereas nomadic workers have slightly fewer.

There is guidance within the UK for employers regarding risk assessing the computer or workspace; in addition resources for this assessment are readily available (HSE, 2002, 2011). Yet the results of this study indicate that less than 50% of employees have received such an assessment and that this becomes worse with nomadic workers. Collectively:

  • 22% of workers have had an assessment in a location other than a main desk at the company premises.
  • 43% of those who mainly work from their own personalised desk in the office have had that workspace assessed.
  • 32% of people who mainly work from a home office have had such an assessment there
  • 23% of hot-deskers have had an assessment for all the hot-desks they use in the office.
  • 10% of true nomads have had an assessment at desks in other offices where they sometimes work.

Workplace assessments are also more common in large companies (54%), compared to in SMEs (43%). Industry sectors where assessments are more frequently done include retail (51%), financial services (52%) and the regulation-conscious public sector (54%). The public sector, however, does not frequently fund the purchase of ergonomic products, compared to other sectors.

Working at home may reduce stress and injury risk by harmonising work and family demands and minimising daily commutes. In terms of chronic pain such as the high incidence of back pain, commonly associated with poor posture as mentioned above, keeping people active and continuing “normal” activity is considered to be the best strategy for prevention in becoming a chronic problem (Weiner and Nordin, 2010). It is, therefore, relevant that keeping people in work and active in their lives is critical, but elimination of the constant poor posture that people normally adopt has to be encouraged by the employer, and awareness of static poor posture needs to be increased in the employee.

When the context of work has moved to a home environment that has not been assessed or adapted to meet the demands of work, a number of potential health hazards could potentially reduce the enhancement to wellbeing and productivity that the flexibility of home working produces (Bracher and Brooks, 2010).

There are a number of tools that can be used to assess the workplace to ensure that it is “fit for purpose” (HSE, 2011). It should not be a reactionary response after the employee’s sickness absence forces the employer to take action.

Where support has been given to employees for ergonomic awareness and adjustment, symptoms of upper-extremity fatigue and strain have improved (Bohr et al, 1997).

It appears illogical that despite the risks to health in terms of musculoskeletal disorder, fatigue, pain and related depression/ mood disorders, that there is scant regard for home risk assessments, especially when these can be provided via web-based training for employees, which costs very little, and has been seen to reduce ill effects (Meinert et al, 2013).

Key points

A range of risks to health and wellbeing arise from many hours sitting in awkward or unsuitable positions working at a computer; these risks will rise with increasing flexibility in workplace contexts.

Without suitable risk assessments, the costs to the employer in lost productivity outweighs the investment in wellbeing and ill-health preventative strategies. Simple strategies to assess a range of work contexts would raise awareness of risk for the employee, and protect the employer from knowingly exposing employees to risk.
Employees may be investing in their own products or strategies, which have not been deemed suitable nor have they been adequately assessed for by their employer.

Despite awareness of risk assessment in ergonomic terms and the legal underpinning of this, risk assessment within the home environment and provision of suitable equipment remains low. The cyclical link of chronic pain leading to depression and vice-versa, and the risk of potential absences is a cause for concern.

Public-sector workers appear to receive less support by their employers in terms of their wellbeing when working in a range of workplace contexts, and have higher rates of sickness absence than in private industry.

References

Bracher M and Brooks A (2010). “Moving and Handling Strategies in: Curtin M, Molineux M, and Supyk-Mellson J (Eds) (2010). Occupational therapy and physical dysfunction: Enabling occupation”. Edinburgh: Churchill Livingstone/Elsevier.

Confederation of British Industry (CBI) (2013). “Fit for purpose?: Absence and workplace health survey 2013”. London: Confederation of British Industry.

European Agency for Health and Safety at Work (2014). Available at: https://osha.europa.eu/en/. Accessed 03/04/2014.

Health and Safety Executive (2011). “Homeworkers: Guidance for employers on health and safety”. Norwich, HMSO.

Health and Safety Executive (2002) “Upper limb disorders in the workplace” HSG60 (Second edition) retrieved from: www.hse.gov.uk/pubns/books/hsg60.htm. Accessed 01/04/2014.

Higgs PE and MacKinnon SE (1995). “Repetitive motion injuries”. Annual Review of Medicine; 46, pp.1-16.

Kuorinka I and Forcier L (1995). “Work related musculoskeletal disorders (WMSDs): a reference book for prevention”. London: Taylor & Francis.

Luise V (2000). Managing homeworking: health and safety responsibilities. Employee Relations, 22, (6), pp.540-554.

Mackinnon SE and Novak CB (1994). Clinical commentary: pathogenesis of cumulative trauma disorder. The Journal of Hand Surgery 19,(5), pp.873-883.

Office for National Statistics (2014). “Sickness Absence in the Labour Force”. Retrievable from: www.ons.gov.uk/ons/rel/lmac/sickness-absence-in-the-labour-market/2014/rpt—sickness-absence-in-the-labour-market.html. Accessed 02/04/2014.

Rempel DM, Krause N, Goldberg R, Benner D, Hudes M and Goldner GU (2006). “A randomised controlled trial evaluating the effects of two workstation interventions on upper body pain and incident musculoskeletal disorders among computer operators”. Occupational and Environmental Medicine; 63, pp.300-306.

Robertson MM, Schleifer LM, and Huang YH (2012). Examining the macroergonomics and safety factors among teleworkers: development of a conceptual model. Work 41; pp.2611-5.

Santos AC, Bredemeier MR, Amantéa VA, Rosa, KF and Xavier RM (2011). “Impact on the guality of life of an educational program for the prevention of work-related musculoskeletal disorders: a randomized controlled trial”. BioMed Central Ltd.

Surah A, Baranidharan G and Morley S (2014). “Chronic pain and depression. Continuing Education in Anaesthesia, Critical Care and Pain”. 14(2), pp.85-89.

Weiner SS and Nordin M (2010). “Prevention and management of chronic back pain”. Best Practice & Research. Clinical Rheumatology; 24(2), pp.267-79.

This article is adapted from Miranda Thew’s more comprehensive paper on the Fellowes study. For more information on workplace ergonomics, please visit the Fellowes website at www.fellowes.com

2 Responses to How to prevent health risks to “nomadic” workers

  1. Toni Ivergard 23 Dec 2014 at 8:07 pm #

    I agree. The working conditions are still of very low conditions.

  2. J Carter 10 Jan 2015 at 5:25 am #

    Pointing out these risks to our increasingly mobile workforce is the first step to keeping ourselves healthy. The amount of pain that can be caused by bad ergonomics when you are trying to work cannot be understated.