The role of the science of ergonomics in WRULDs.

I was delighted to read Burton et al.’s timely paper on work-relevant upper limb disorders and causation, impact and case management in the workplace [1]. Could I make some comments directed primarily at the huge numbers of workers covered by the Display Screen Equipment (DSE) Regulations etc. While I fully endorse the need for a full history and examination (always starting at the neck), in my opinion most workers can be accommodated by reasonable adjustments in the ergonomics of their workstation. My working definition of ergonomics is that ‘its common sense but only when it is pointed out’. I remain concerned at the lack of understanding of most health and allied support professionals of the need for a reasonably detailed knowledge of anthropometrics and its implications—it is the individual ‘matchstick’ components that are important in the DSE setting rather than stature—and the biodynamics of the upper limbs and shoulder girdle in the individuals’ interactions with the DSE data handling devices. This is especially true of the types of keyboard and mouse and making recommendations to ensure maximal comfort and minimal strain. A classic is forearm-related problems, when a ‘cure’ can be easily obtained in many cases by altering the mouse functions, notably speed of movement, to avoid users gripping the mouse which inevitably will result in strain of both forearm compartments. It is sad that this key factor remains largely unrecognized in formal guidance [2]. Similarly, using the appropriate motionless mouse will help significantly in shoulder/neck scenarios. Mouse options can minimize use of any specific inflammatory tendonitis component. The same can be achieved assessing tasking (typing, mouse use, use of hard copy, phones etc.), anthropometrics, to recommend the best type and functions of keyboards. Modern phone headsets avoid and manage problems with workers who use the phone regularly and ‘cradle’ the phone. As always the key is early intervention to avoid a developing chronic state and maintaining workers at the workplace for all the positive reasons, so long known but recently endorsed [3].