Tuesday, June 17, 2003

More Ergo Follies

And the hits just keep on coming.

Correction: Dr. Szabo, mentioned in this article, was not an author of the study, but only an "expert" quoted by the Post. More on this study later.

Linked here is a Washington Post article about a study allegedly showing that "Frequent on-the-job use of a computer keyboard does not pose a major risk for carpal tunnel syndrome, according to the largest study of the topic to date. The findings were published June 11 in the Journal of the American Medical Association (JAMA)." According to the author of the study, Dr. Robert Szabo, surgeon and professor of orthopedic surgery at the University of California, Davis, School of Medicine,
"Computers causing [carpal tunnel syndrome] was a myth. No science has ever shown that any medical disorders are caused by using a keyboard," he said. "This is finally coming out in the mainstream."
While the article notes that he "sat on a seminal National Academy of Sciences panel on musculoskeletal disorders and the workplace in 2001," it doesn't mention that Szabo was the lone dissenter of the panel, the rest of whose members strongly supported the connection between working conditions and musculoskeletal disorders.

On the other hand, according to the Post,
David M. Rempel, a professor of occupational medicine at the University of California, San Francisco, School of Medicine and also a member of the National Academy of Sciences panel, says this level of use was insufficient to draw conclusions about either keyboard or mouse use. Usage under 20 hours a week, says Rempel, is not representative of people who do data entry or design for a living.

"The conclusions you can draw there are pretty limited," said Rempel. "What about graphic artists and reporters, who might be exposed to their computers for 20, 30 or 40 hours a week?"

In addition, said Rempel, the study didn't address any of a range of other ailments he said can result from prolonged computer use. These, he said, include tendinitis of the wrist and elbow -- inflammatory conditions often accompanied by stiffness, soreness and pain -- as well as trapezius muscle strain, which causes soreness around the shoulder blade; the latter condition can often be remedied by changing positions to better support the forearm. Prolonged computer use, said Rempel, will cause approximately 10 to 15 percent of workers to develop wrist tendinitis; 30 percent can expect trapezius muscle strain. "All eyes are on carpal tunnel syndrome, but we need to look at the whole gamut of problems that can come from repeated computer use," he said.
Szabo's dissent from the NAS study was highlighted in March 2001 Congressional testimony by the anti-labor LPA favoring repeal of the OSHA ergonomics standard.

According to the LPA, Szabo
criticized the panel for using inaccurate scientific literature, particularly regarding carpal tunnel syndrome. He highlighted the studies that indicated that personal factors, age, lifestyle and sex as more predictive of carpal tunnel syndrome than job exposure....Taken as a whole, the evidence cited by Dr. Szabo with respect to carpal tunnel syndrome casts doubt on the remainder of the NAS conclusions.
In a response to Szabo's dissent, members of the NAS panel accused him of misinterpreting some studies and using others that "did not meet the quality criteria (insufficient participation and inadequate exposure measures were common problems) used by the panel in selecting articles for the epidemiology review and so are not included in the report."

I think after a few more decades of study, we can possibly start to consider the advisability of thinking about the potential merits of an OSHA standard. Or maybe not.