Upper limb pain and dysfunction caused by work (usually of a repetitive nature) is not a new phenomenon and has been well documented for 300 years in jobs such as clerical work and telegraphy. However, from the late 1970s countries as diverse as Australia, Russia, Japan, Finland, the US and the UK reported dramatic increases in musculoskeletal conditions; this period of time was significant as it oversaw the widespread replacement of typewriters with computers and a consequent increase in the automation of work. Many workers spent long periods in a fixed position, performing a range of tasks without moving from their workstation and using only a limited range of movement to operate their keyboard. This trend has continued over the last 20 years with rapid technological advance and the rise of the service industries, with large numbers of workers spending their entire working day inputting data onto computers, often at a rapid pace.
Musculoskeletal disorders of the upper and lower limbs (RSIs) are a major problem in the workplace and a significant cause of lost production, with an estimated cost to industry in the UK of up to £3bn/year. Major research projects conducted by the European Agency for Safety and Health at Work, and the Agency's Europe-wide campaign to lift the burden of work-related musculoskeletal disorders in October 2000, are a clear indication of the serious nature of the problem and the importance of identifying future needs and priorities. According to a recent European survey, 45% of workers reported working in painful or tiring positions, while 17% of workers complain of muscular pain in the arms and legs.
There is no doubt that, while RSI has been reported for a long time, exact prevalence is unclear for a number of reasons including under-reporting and misdiagnosis. However, the regular Labour Force Survey on work-related ill health, last conducted by the Health and Safety Executive (HSE) in 1995, found that slightly more than half a million people in Great Britain have a work-related neck or upper limb disorder and an estimated 36,000 workers were reported to have Vibration-induced White Finger, for example, a cumulative condition related to hand-held power tools. Findings now suggest that this may be a significant under-estimate.
A report from the first systematic survey of occupational exposure to hand-transmitted vibration, conducted by Southampton University's Medical Research Council Environmental Epidemiology Unit for the HSE and published in 1998, revealed that over a million people in Britain have symptoms of tingling and numbness in their hands associated with vibrating tools. Of those, 515,000 have disturbed sleep and 355,000 find it difficult to "do up buttons". The new prevalence of Vibration White Finger alone (one of the 20 or so specific RSI conditions) is over eight times greater than the HSE's previous estimate. In addition, ongoing research in Sweden reveals that around half of those who work with computers have pains in their neck, shoulders, arms or hands. A recent study by Dr Leon Straker at Curtin University of Technology in Australia found that 60 per cent of children suffered discomfort when using laptop computers. In Britain, the Government's recently professed aim was to put a laptop on the desk of every school child. We risk rendering thousands of children unable to work unless the problem of RSI is taken seriously.