Comfort Zone

Ergonomic workstations promote healthier postures in today’s reading rooms

It starts as a sore back, a stiff neck, or a numb wrist. But what seems like a minor discomfort could be much more serious. Unchecked, musculoskeletal disorders and repetitive stress injuries not only affect the long-term health of employees but also negatively impact productivity. The risk of these complications is very real, especially for professionals such as radiologists, who spend a good portion of the day in front of a computer.

Not long ago, the term “desk job” would never have applied to the task of reading images?most radiologists constantly moved between their benches, light tables, and alternators throughout the day. But digital technology is changing all of that. With the convenience of storing data electronically comes a spike in consecutive working hours at the computer.

A height-adjustable workstation from Wright Line allows users to preset the height of monitors for up to four individuals with the push of a button.

“[Radiologists are] looking at up to six LCD monitors at a time,” said Mike Graham, account manager for Anthro Corp, a workstation manufacturer based in Tualatin, Ore. “They’re doing this for a very long period of time, and they are definitely developing musculoskeletal injuries.”

The good news is that these injuries can be avoided. In fact, the number of work-related musculoskeletal injuries has been declining across the country, according to the Occupational Health and Safety Administration (OSHA), which reported that missed work days related to carpal tunnel syndrome alone dropped 39% between 1992 and 1999. OSHA attributes this decrease to growing public awareness and voluntary efforts by employers to meet ergonomic needs. In keeping with these trends, many radiologists address issues from back pain to eye strain by incorporating ergonomically designed workstations into their reading rooms.

“Radiologists are very proactive about seeking out good ergonomics,” Graham said. “If they have to have neck surgery or wrist surgery, that’s going to put them out of work for a long period of time. Their production can be enhanced if they’re comfortable.”

Monitoring Progress

To keep up with changing reading room technology, workstations have evolved significantly from their “bench” predecessors, which often housed three CRT monitors weighing 100 pounds apiece. “That’s more than 300 pounds on a work surface,” Graham said. “So benches had to be pretty big, and they weren’t adjustable.”

Integrated keyboard platforms adjust independently from the desktop in this workstation from Wright Line.

Today’s sleek flat-panel monitors give workstations more flexibility, and adjustable articulating arms allow radiologists to set monitor height, angle, and position easily. “You may have to raise or lower your monitor 1 or 2 inches,” Graham said. “You may want to bring the monitors forward or back a little bit; you may want to put them at a tilt. You want to be able to adjust them very easily.”

Finding the perfect balance can take time. “A lot of radiologists use more than one monitor, and it can be time-consuming for them to adjust each one separately,” said Amir Rotlevi, president of AFC Industries, College Point, NY. To address this issue, AFC Industries’ Ergo Deluxe unit allows radiologists to adjust multiple monitors simultaneously.

Knowing where to set your monitors can be easier on the eyes as well. “If you maintain the right eye-to-monitor relationship, you’re going to be a lot more comfortable at the end of the day and be able to produce more,” Graham said. He recommends sitting at arm’s length from the monitor and keeping your eye level at approximately 2 to 3 inches below the top of the screen. If you have a large monitor or wear glasses, you should take that into consideration, too. “If you’re wearing bifocals or trifocals, you’re going to have to lower the monitor a few inches,” he said.

Lighting is another key ergonomic consideration. To prevent eye strain, the area behind your diagnostic monitors should have the same light intensity as the monitor itself. “If the image is really bright, then you’re going to want the light behind your diagnostic monitors to be brighter,” Graham said. “If you look at a darker image, you want to have it darker. But you don’t want to keep doing that, so if you had that built in, that would be a nice feature.”

Making Adjustments

In addition to positioning your monitors, you need to be able to adjust the height and angle of the work surface as well as raise, lower, and tilt the keyboard tray. Graham recommends sitting with your stomach touching the leading edge of the workstation, so that both arms rest at a 90-degree angle on the work area, which will protect your wrists. “You’ll notice you’re actually letting the work surface hold your arms up,” he said.

Workstation from AFC Industries (left), rises and tilts for the technologist’s comfort. Corrugated wire hose, at right, keeps wires and cables from tripping up workers.

Making adjustments like these used to involve cumbersome knobs, screws, and other levers that often frustrated users. But many of today’s workstations incorporate electronic lifts that users have no trouble activating with a one-button press. “You can have a dual lift so that your monitor desk and your keyboard platform move up and down independently of each other with the press of one button, as well as a single lift that incorporates both,” said Maribeth Pacillo, product manager at Wright Line, Worcester, Mass.

In many facilities, more than one radiologist will use the same workstation throughout the course of the day. To ease the transition between shifts, models like the Profile from Wright Line offer up to four preset options. When you press the numbered button assigned to your shift, the workstation automatically returns to your preferred settings in a matter of seconds. “Depending on which solution a customer goes with, it ranges from a low of 23 inches to a high of 50.3 inches,” Pacillo said.

Even if you opt for presets, it’s likely that you will need to readjust periodically. “Our body’s ergonomic needs change throughout the course of the day,” Graham said. “Maybe what was perfect in the morning is not going to be perfect in the afternoon.”

One-touch adjustable Carl’s Table from Anthro Corp allows users to tilt and raise the workstation. Integrated lighting adopts automatically to screen images.

Clamps secure cables under desktop.

These readjustments can range from minor tweaks, such as changing monitor or keyboard angles, to more dramatic shifts, such as raising the work surface so that you can stand to read for part of the day. Some radiologists even opt to recline while reading?Carl’s Table from Anthro Corp tilts up to 15 degrees so that radiologists can lean back in their chairs. “You can actually be just like you’re at home in your easy chair, except you are reading,” Graham said.

Fitting Your Needs

When it comes to ergonomics, there is no “one size fits all” solution. Ergonomic considerations vary depending on each radiologist’s work habits and equipment, as well as the characteristics of the room itself. “You’ve got to look at the lighting, sound, ease of adjustment of your chair and table, and the equipment you’re using,” Rotlevi said.

Before purchasing an ergonomic setup, radiologists should consider their workflow carefully. Rotlevi says that even details such as the type of mouse or the kind of dictation equipment you have can influence ergonomic decisions. Other considerations include lighting, foot traffic through the room, the number of people working in the area, the room temperature, and the noise level. Manufacturers also offer options such as privacy panels and acoustic panels to reduce noise.

With so many devices attached to one workstation, cable management becomes a high priority to help avoid the “spaghetti” effect of tangled cords beneath the work space. Even this can be an ergonomic issue, as loose or messy cables can be a tripping hazard or hinder access when switching out hardware.

Workstations can be tied together back-to-back or anchored to walls, preserving work space and still making users comfortable.

Cable management systems usually separate power from data cables in neatly organized trays that can be accessed individually. “IT can take off a panel to work on computer or cabling issues, while the radiologist is still operating at the console or reading,” said Christopher Devaney, director of marketing communications for Wright Line.

As the technology in reading rooms continues to evolve, workstation design will need to adapt quickly?and this means maintaining flexibility. Consider modular units when making a purchase. “Because of the modularity of our system, we may come up with a new way to house a new piece of technology,” Pacillo said. “That doesn’t mean you have to go out and replace your entire system?all that would typically mean would be taking out one specific area to add a new modular component.”

Once you have chosen your ergonomic setup, you have to learn how to use it. During the installation, most manufacturers help with the setup and provide demonstrations. Radiology facilities sometimes hire an occupational therapist or other ergonomic expert to consult on proper positioning, and some manufacturers offer their own ergonomic experts for an in-house training session. “[The radiologists] really do listen because they are tired of having their backs, necks, or wrists hurt,” Graham said.

No matter which model you choose, make sure it is the right fit. Before you sign on the dotted line, keep in mind that finding your ideal ergonomic setup doesn’t always mean buying the product with the most bells and whistles. Test the workstations with your staff and learn what works best for you?for example, sometimes a modestly priced chair might actually be a better fit than a fancier, more expensive model. “Think of what is important to you,” Rotlevi said. “Just be comfortable with your environment.”

Ann H. Carlson is a contributing writer for Medical Imaging. For more information, contact .