Michael Patkin's

Uncertain advice for the world

Publication history, Reflections & comments



Surgery & ergonomics


Information design

Editorials, book reviews



In opening Work with Display Units '92 in Berlin in September, the representative for Federal Minister Blum said that workers and authorities around the world were looking to experts there for guidance on design of jobs and equipment in computer workplaces.

Increasing numbers of people are working with video display terminals. In Germany, for example, 65% of workers (about 4 million people) will be using VDTs by the year 2000. Concern will continue about issues of occupational health and safety, productivity, psychosocial aspects of work, and managing technological change.

Unfortunately (and not for want of trying by the organisers) this third conference on Working with Display Units left unanswered many of the questions raised in 1986 (Stockholm), and 1989 (Montreal). There is still no satisfactory medical model of RSI. Questions of hazards to pregnancy from radiation are still not settled to general satisfaction. Only one of several studies (from Finland) suggested a correlation between total hours of exposure and the small rise in rate of congenital abnormalities above average - other studies didn't measure total hours of exposure, but showed no adverse effects. For those who seek to reassure worriers, the impossible task remains of proving a nul hypothesis.

The conference was a major event. It was attended by over 700 people from 30 countries, with 316 papers and 26 poster sessions. The abstracts are a useful summary of current developments, and relevant ones should be studied by Worksafe Australia and State regulatory authorities, and by ergonomists and serious occupational health professionals. Specialists in various areas should study the ones offered on optometry at work (which was a major theme) and lighting, where indirect ceiling reflection supplemented by task lighting was the subject of some important but expensive-looking trade displays.

Problems of structuring a conference

In his introductory speech, conference president Professor Luczak described the preparation for the conference as a scientific or engineering exercise in itself. The scientific committee had planned it in seven layers, from the highest (societal) to the most basic (anatomy, physiology, and biomechanics).

The logic was strong, but the time limit of four days and up to nine separate simultaneous streams meant conflict for delegates in some areas, who had to miss out on presentations of interest to them or scamper between lecture theatres. This was especially the case for epidemiology and the physical, social and cultural basis for musculoskeletal complaints. Fortunately, the message promoting a total systems approach was repeated often enough to reach everyone.

What emerged once again was that if people do boring repetitive work where they lack control, they are less happy and complain more of muscle pains, eye problems, and other symptoms. In Germany such problems are less common, perhaps because of variety introduced into the days' work, or perhaps because of a different culture and different work ethic.

HCl less integral to occupational health and safety now

Two streams dealt with HCI (Human-Computer Interaction) and applications of computing, including agriculture, education, and ways that visually challenged people can use computers. These areas are not of direct interest to practitioners of occupational health and safety, but developments in computer use help predict likely problems. They also show the fascinating promise of new aspects of technology for all professionals. One was the "feel-mouse", which can vibrate to convey information to the user, and needs more force to operate the button for some functions than others, aiding interaction.

Plans for the fourth WWDU conference, in Milan in October 1994, are to restrict the program, leaving HCI for specialist conferences in that field in the United States and Europe, and especially for two small specialist conferences in Japan next year. Such a split is inevitable because of the volume of material, but a pity.

Value for money

Important contributions again came from NIOSH, largely Steve Sauter and his co-workers, with typically careful research, relevance and recommendations. Both the Milan and Japanese teams had strings of papers on ergophthalmology [sic], though others contributed, including James Sheedy of San Francisco.

An international study called MEPS, energised by Aarasof Norway following the NIOSH workshop on Productivity in the Modern Office a couple of years ago, compared musculoskeletal symptoms in different countries. An instrument new to me, the physiometer, measures calibrated EMG's (using the trapezius muscle) and postural angles in two axes, and provided Aaras with valuable data. MEPS data is being collected from each country and processed on a 286 computer using "Paradox". In Singapore there were marked differences in types and levels of complaints between the three different ethnic communities.

Standards, and especially directives for the European Community to take effect in 1993, were a major theme, reflecting hard work by Tom Stewart, who explained the need for a slow process of consensus. These standards will be of importance worldwide.

The well-known Hawthorne effect was misquoted, as often it is, by no less than Kourinka, past president of the IEA. Another similar offender got a well-deserved rebuke from Gunella Wesdander who has compiled a detailed bibliography on the subject. (For a provocative critique of this and MacGregor's Theory Y, see Lee's book The Gold and the Garbage in Management Theories and Prescriptions [1]).

Contributions from the former USSR came thicker than at earlier conferences. The tyranny of English language presented problems, and the underlying concepts were unusual. Some appeared to be recycled from Western work 10 years earlier, but so did papers from South America. These workers are being helped by examples from Western Europe and the doors to fresh ideas seem wide open after the recent major political changes. (Indeed one of the highlights of being in Berlin in September was cycling before breakfast through the Tiergarten, past Check-point Charlie, the Brandenberg gate, and other memorials which now provide hope for the future).

There were some forthright contributions from Trade Union representatives such as David Legrande of the Communication Workers of America and Bob De Matteo of Ontario (author of Terminal Shock). Gabriele Bammer said she represented the Australian position, described doctors as "failing to get their act together" by not agreeing on a medical model, and said the Australian problem of RSI was being deliberately hidden. The Medical Journal of Australia, she said, refused to publish more papers or discussion on the subject, and workers in the area had suffered from burn-out. She and I. had a vigorous public disagreement on this when I proposed that there was little new to publish that wasn't being said elsewhere, and I took the opportunity to warn Americans against diagnosing Carpal Tunnel Syndrome in keyboard-workers, and especially against encouraging surgery for it.

Arguable science

Several contributions advertised commercial products, some without supporting evidence, and perhaps belonged in the trade display or among posters. Notably they included software for rest breaks, exercises, and eye exercises, including accommodation using red/green spectacles. One product got operators to measure and input their own body measurements and seated posture and then recommended any changes necessary.

Brian Pearce of Loughborough described media coverage of RSI in the United Kingdom, some of which has been inaccurate or fanciful, and misleading advertisements such as lead aprons for computer operators and "no-radiation monitors" which presumably showed nothing, as these were not new developments of liquid crystals. His complaints to the Press Council had led to legal action and withdrawal of advertisements in several cases.

Scandinavians were concerned with radiation and facial rashes. Ostberg was concerned about electric and magnetic sanitation of offices, and invoked the ALARA principle (As Low As Reasonably Possible). He described the "Association of Victims of VDUs and Electricity" in Sweden, which has 1,500 members with a variety of non-specific symptoms. Hamnerius described vagabonding currents carried by ordinary power supplies, and shielding costing $US 100,000 a room, using welded aluminium, to reduce environmental magnetic fields by a factor of 10 or 20. I didn't find other delegates who thought this was a serious concern. Alan Hedge, now at Cornell University, was concerned with Sick Building Syndrome and described over three hundred volatile organic pollutants, including evaporants from new computers which take three weeks to clear. He said artificial fibres in ceiling tiles are attracted to the electrical charge on screens, and they can deposit on the skin of the face.

By contrast, Chaos Theory and its application to organisational behaviour was presented by Susan Dray and colleagues in persuasive fashion. Organisations are not Newtonian in behaviour, and boundary conditions are especially troublesome. She presented examples and methods for dealing with them.

The Japanese flavour at the conference was heightened with papers on Kensei engineering. Several papers discussed colour in video displays, including highlighting with colour (red on green is best, reverse video is worst).

The book of abstracts, which took a full week of serious evening reading after the conference, was only a tantalising promise of the full papers to come once Qakir has got down to editing them! In common with other international conferences, there are serious problems of English language style, and at times legibility. Some graphics lacked adequate labelling of axes, and some references were missing. These are minor criticisms of a treasury of current work. One of the tasks of the chair for each session was assessment of papers presented for their value for publication. When the final volume of full papers appears, it should be a valuable addition for serious libraries devoted to occupational safety and health, especially in the field of office work, and also for those interested in the broader issues of HCI.


The venue and organisation were superb. The International Conference Centre in Berlin can hold up to 8,000 people, so the 700 or so attending were easily accommodated both in the plenary sessions and the eight simultaneous lectures and workshops, poster presentations, coffee and sitting areas, secretariat, restaurants, and display areas for posters and commercial exhibits. The ambience was circa 1970s Star Trek. The organisation by Ahmet Qakir (secretary of the conference) and his wife and colleague Gisela was efficient and unobtrusive.
Lessons for the next conference
One can't imagine how the content of the conference could have been improved. The muddled conclusions from this conference represent the muddled state of the art, and the different aspects and interest groups involved in work with display terminals. A world forum like this is essential every two or three years. It needs specialist streams, and it needs generalists.

With luck and more hard work, Professor Grieco's program at Milan in 1994 will start tying together the many loose threads still evident at present. In the meantime, there is a great deal of existing and new information to apply, to the benefit of the growing number of people at work with computers.


1. Lee J.A. The Gold and the Garbage in Management Theories and Prescriptions. Ohio University Press, 1980.
2. Luczak, H., Qakir, A. and Qakir, G. WWDU'92 Work with Display Units. Abstract book from the Third International Scientific Conference on Work with Display Units. Technische Universitat Berlin. September 1992.


Problems of    structuring a    conference
HCl less integral to    occ health, safety    now
Value for money
Arguable science


This was published in the JOHSANZ shortly after I came back to Australia following this conference in October 1992. It reports on a large and successful conference.

Uncertain advice for the world

Past president of the Ergonomics Society of Australia, is a general surgeon in private practice in Whyalla, South Australia.
WWDU '92


Working With Display Units was a large (>1000 attendees) trienniel conference, attended largely by professionals in Occupational Health and Safety, but also by trade unionists, managers, and the other usual suspects.

Organised expertly by Ahmed Cakir, the Berlin based super-ergonomist and a good personal friend, and his wife, the proceedings are a valuable resource in the area.

My own role as recent president of the Ergonomics Society of Australia and a clinician sceptical of much labelled as RSI, my prejudices were on display, together with disagreements largely with union people, though this was largely for my concern not to have their members misdiagnosed with carpal tunnel syndrome and then subjected to surgery with dismal reults and complications.

Worth following up is "The Gold and the Garbage in Management Theories and Prescriptions" listed in the references below.