Table 1 Characteristics and results of the included articles.
| Cohort (first author) quality score | Study population | Assessment duration of computer use | Case definition(s) | Results | Results continued |
|---|---|---|---|---|---|
| BIT, Jensen20 (42%) | Employees from Danish companies and institutions.Selected companies provided employees with different types of computer work (data entry, word processing, graphic work, etc).Analyses were restricted to subjects working full time (32–41 hours(week), who had not changed jobs during follow‐up.n = 203–916 | Self‐report“How much of your work time do you work with your computer (including overtime and working at home)”Response categories: Seldom; 25%; 50%; 75%; 100% | Self‐reported symptoms for more than 7 days within the last year of the follow‐up period.Body regions studied: neck and hand‐wrist | NeckTotal computer use:—0–25% of work time OR 1—50% of work time OR 1.5 (0.7–3.1)—75% of work time OR 1.3 (0.6–2.7)—100% of work time OR 1.6 (0.8–3.3)Mouse use:—Seldom OR 1.3 (0.4–4.3)—25% of work time OR 1—50–100% of work time OR 1.7 (0.5–5.7) | Hand‐wristTotal computer use:— 0–25% of work time OR 1.5 (0.7–2.4)—50% of work time OR 1—75% of work time OR 2.0 (1.1–3.9)—100% of work time OR 2.3 (1.2–4.3)Mouse use:—Seldom OR 4.0 (1.1–14.4)—25% of work time OR 1—50–100% of work time OR 4.0 (1.0–15.5) |
| BIT, | See Jensen | See Jensen | Duration outcome: | Shoulder duration outcome | Elbow duration outcome: |
| Juul‐Kristensen21 (42%) | Analyses restricted to workers who held the same job during follow‐up.n = 2002 | Self‐reported symptoms <8 days in the past 12 months at baseline and >7 days during follow‐upIntensity outcome:Self‐reported symptom intensity <4 (scale 0–9) during last 3 months at baseline and ⩾4 during last 3 months at baseline + non‐symptomatic at both sides (left and right) and non‐symptomatic in nearby body regionsBody regions studied: elbow and shoulder | Total computer use:—0–25% of work time OR 1—50% of work time OR 1.23 (0.63–2.40)—75% of work time OR 1.00 (0.51–1.94)—Almost all work time OR 0.69 (0.34–1.39)Shoulder intensity outcomeTotal computer use:—0–25% of work time OR 1—50% of work time OR 1.07 (0.60–1.90)—75% of work time OR 0.95 (0.53–1.70)—Almost all work time OR 0.78 (0.43–1.43) | Total computer use:—50% of work time OR 1.11 (0.51–2.40)—75% of work time OR 0.95 (0.43–2.10)—Almost all work time OR 1.08 (0.48–2.39)Elbow intensity outcome:Total computer use:—50% of work time OR 1.12 (0.58–2.18)—75% of work time OR 0.90 (0.47–1.74)—Almost all work time OR 1.08 (0.48–2.39) | |
| NUDATAAndersen22 50% | Employees from the Danish Association of Professional Technicians, ie,—technical assistants (draughtsmen) and machine technicians from 3527 public and private companies. Job tasks included technical drawing tasks, administrative and graphical tasks.n = 5658 | Self‐reportParticipants estimated their average hours per week doing specified work tasks during the past four weeks (separately for tasks using the computer and tasks not using the computer). Questions for keyboard use and mouse use separately. Computer use ( = mouse use +keyboard use) not used in the analysis due to high correlation with mouse use. | Possible carpal tunnel syndrome (CTS):Self‐reported tingling or numbness in the right hand at least once a week within the last 3 months, with no or minor tingling/numbness at baseline.Body regions studied: wrist (possible CTS) | Wrist (possible CTS)Mouse use:—0–<2.5 hrs/wk* OR 1—2.5–<5 hrs/wk OR 0.7 (0.3–1.9)—5–<10 hrs/wk OR 1.9 (0.9–4.0)—10–<15 hrs/wk OR 1.6 (0.8–3.3)—15–<20 hrs/wk OR 2.0 (0.9–4.2)—20–<25 hrs/wk OR 2.6 (1.2–5.5)—25–<30 hrs/wk OR 3.2 (1.3–7.9)Keyboard use:—0–<2.5 hrs/wk OR 1 | |
| —2.5–<5 hrs/wk OR 0.9 (0.4–1.8) | |||||
| —5–<10 hrs/wk OR 0.8 (0.4–1.5) | |||||
| —10–<15 hrs/wk OR 1.2 (0.6–2.5) | |||||
| —15–<20 hrs/wk OR 0.8 (0.4–1.5) | |||||
| —> = 20 hrs/wk OR 1.4 (0.5–4.3) | |||||
| NUDATAKryger23 42% | See Andersen | Self‐reportSee Andersen | At least moderate to severe self‐reported pain in the forearm within the past 7 days combined with quite a lot pain/discomfort during the past 12 months and at baseline none or less than moderate pain in the forearm in the past 7 days combined with less than “some” pain/tenderness during the past 12 monthsBody regions studied: forearm | ForearmMouse use:—0–9 hrs/wk OR 1—10–19 hrs/wk OR 2.2 (1.0–4.7)—20–29 hrs/wk OR 2.6 (1.0–6.6)—> = 30 hrs/wk OR 8.4 (2.5–29)Keyboard use:—0–4 hrs/wk OR 1—5–9 hrs/wk OR 1.2 (0.5–2.9)—10–14 hrs/wk OR 1.3 (0.5–3.4)—> = 15 hrs/wk OR 2.6 (0.9–7.3) | |
| NUDATABrandt24 42% | See Andersen | Self‐reportSee Andersen | Self‐reported pain in the last 7 days of at least moderate degree and pain during the last 12 months of follow‐up that bothered at least quite a lot and no complaints in the region during the 12 months prior to the baseline examination and less than moderate pain in the regional area during the last 7 days at baselineBody regions studied: neck and shoulder | NeckMouse use:—0–9 hrs/wk OR 1—10–19 hrs/wk OR 1.1 (0.6‐1.9)—20–29 hrs/wk OR 0.9 (0.4–1.9)—> = 30 hrs/wk OR 2.4 (0.8–6.8)Keyboard use: | ShoulderMouse use:—0–9 hrs/wk OR 1—10–19 hrs/wk OR 1.2 (0.7–2.1)—20–29 hrs/wk OR 1.9 (1.0–3.5)—> = 30 hrs/wk OR 3.3 (1.2–8.9)Keyboard use: |
| —0–4 hrs/wk OR 1—5–9 hrs/wk OR 1.1 (0.5–2.2) | —0–4 hrs/wk OR 1—5–9 hrs/wk OR 1.3 (0.7–2.6) | ||||
| —10–14 hrs/wk OR 1.0 (0.4–2.2) | ‐ 10–14 hrs/wk OR 1.6 (0.8–3.3) | ||||
| —> = 15 hrs/wk OR 1.8 (0.8–3.9) | —> = 15 hrs/wk OR 2.2 (1.0–4.9) | ||||
| NUDATA | See Andersen | Self‐report | Case | Elbow case | Hand‐wrist case |
| Lassen25 42% | See Andersen | Any self‐reported pain or discomfort during the past 12 months, but not at baselineSevere caseSelf‐reported pain or discomfort lasting for >30 days and causing at least “quite a lot of trouble” during the past 12 months at follow‐up, but not at baselineBody region studied: elbow and hand‐wrist | Mouse use:—<2.5 hrs/wk OR 1—20–<25 hrs/wk OR 3.21 (2.03–5.17)—25–<30 hrs/wk OR 4.83 (2.79–8.40)—> = 30 hrs/wk OR 4.74 (2.51–8.95)Keyboard use:—0–<2.5 hrs/wk OR 1—2.5–<5 hrs/wk OR 1.04 (0.65–1.69)—5–<10 hrs/wk OR 1.47 (0.98–2.26)—10–<15 hrs/wk OR 1.33 (0.85–2.11)—15–<20 hrs/wk OR 1.29 (0.78–2.17)—> = 20 hrs/wk OR 1.98 (0.96–3.95)Hand‐wrist caseKeyboard use (continued):—10–<15 hrs/week OR 0.80 (0.53–1.20) | Mouse use:—<2.5 hours/week OR 1—2.5–<5 hrs/wk OR 1.57 (0.99–2.51)—5–<10 hrs/wk OR 2.16 (1.46–3.22)—10–<15 hrs/wk OR 2.05 (1.37–3.07)—15–<20 hrs/wk OR 2.46 (1.65–3.72)—20–<25 hrs/wk OR 2.07 (1.32–3.26)—25–<30 hrs/wk OR 3.16 (1.82–5.46)—> = 30 hrs/wk OR 3.05 (1.63–5.67)Keyboard use:—Increase of 10 hrs/wk OR 1.29 (1.06–1.57)—0–<2.5 hrs/wk OR 1—2.5–<5 hrs/wk OR 0.63 (0.41–0.98)—5–<10 hrs/wk OR 0.73 (0.50–1.07) | |
| —15–<20 hrs/week OR 0.87 (0.55–1.38)—> = 20 hrs/week OR 1.04 (0.51–2.04)Severe elbow caseMouse use:—<2.5 hrs/wk OR 1—2.5–<5 hrs/wk OR 1.16 (0.34–3.54)—5–<10 hrs/wk OR 1.42 (0.58–3.64)—10–<15 hrs/wk OR 2.14 (0.93–5.32)—15–<20 hrs/wk OR 1.45 (0.59–3.78)‐ 20 to <25 hrs/wk OR 2.88 (1.18–7.54)—25 to <30 hrs/wk OR 4.16 (1.45–12.13)—> = 30 hrs/wk OR 6.91 (2.21–22.53)Keyboard use:—<2.5 hrs/wk OR 1—2.5–<5 hrs/wk OR 1.09 (0.44–3.00)—5–<10 hrs/wk OR 1.58 (0.71–4.03)—10 to <15 hrs/wk OR 2.49 (1.08–6.53)—15 to <20 hrs/wk OR 2.86 (1.08–8.12)—> = 20 hrs/wk OR 3.79 (0.91–14.11) | Severe hand‐wrist caseMouse use:—<2.5 hrs/week OR 1—2.5–<5 hrs/wk OR 0.73 (0.23–2.01)—5–<10 hrs/wk OR 1.55 (0.74–3.34)—10–<15 hrs/wk OR 1.40 (0.68–3.01)—15–<20 hrs/wk OR 1.68 (0.82‐3.58)—20 to <25 hrs/wk OR 4.21 (2.12–8.85)—25 to <30 hrs/wk OR 4.81 (2.18–10.99)—> = 30 hrs/wk OR 2.30 (0.83–6.26)Keyboard use:—<2.5 hrs/wk OR 1—2.5–<5 hrs/wk OR 1.14 (0.58–2.38)—5–<10 hrs/wk OR 0.99 (0.54–1.95)—10 to <15 hrs/wk OR 1.46 (0.76–2.98)—15 to <20 hrs/wk OR 1.89 (0.90–4.10)—> = 20 hrs/wk OR 1.60 (0.43–4.94) | ||||
| Bergqvist et alBergqvist19 42% | Employees working for seven companies in Stockholm, Sweden: travel agencies, a newspaper production company, postal office, and an insurance company. Included employees worked at least 75% of a full time contract.n = 341 | Self‐report“How many hours per week did you work at the Visual Display Terminal?”Responses were categorized into three categories: no or occasional; <30 hours/week; >30 hours/week | Current self‐reported pain or discomforts. Symptoms that occurred only occasionally and were of insignificant intensity were not taken into account.Body regions studied:neck‐shoulder; hand‐wrist | Neck‐shoulderTotal computer use:—>30 hrs/wk versus no or occasional total computer useRR 1.25 (0.76–2.05) [univariate analysis]Hand‐wristTotal computer use—>30 hrs/wk versus no or occasional total computer use | |
| RR 3.75 (0.89–15.81) [univariate analysis] | |||||
| Marcus et alMarcus26 75% | Newly hired workers who 1) anticipated using a computer for at least 15 hrs/wk, and 2) anticipated using a computer keyboard for at least as many hrs/wk as in their previous job. Job sectors included insurance, finance, food production, health care, and education.n = 436–520 | Self‐report, daily diary on hours spent keying | Musculoskeletal symptoms Self‐reported discomfort in weekly diary which was present at least one day during previous week and pain score (VAS) >6 or using medication for control of the discomfort.Musculoskeletal disordersPositive if case definition for musculoskeletal symptoms was met and physical examination was positive.Body regions studied:hand‐arm, neck‐shoulder | Neck‐shoulder symptomsTotal computer use:—Increase of 1 hr/wk HR 1.01 (0.99–1.03)—35 hrs/wk versus 15 hrs/wk HR 1.22 (0.82–1.81)Neck‐shoulder disordersTotal computer use:—Increase of 1 hr/wk HR 1.01 (0.99–1.04)—35 hrs/wk versus 15 hrs/wk HR 1.22 (0.82–2.19) | Hand‐arm symptomsTotal computer use:—Increase of 1 hr/wk HR 1.04 (1.02–1.06)—35 hrs/wk versus 15 hrs/wk HR 2.19 (1.49–3.20)Hand‐arm disordersTotal computer use:—Increase of 1 hr/wk HR 1.04 (1.02–1.06)—35 hrs/wk versus 15 hrs/wk HR 2.19 (1.49–3.20) |
| Korhonen et alKorhonen27 50% | Full time working employees from three municipal administrative units.n = 138 | Estimate how many percent of your working time during the preceding month you have used for each task of the following tasks (VDU work includes using keyboard or other input or control device, including short thinking periods and checking the results on the screen). Response categories: <50%, >50% of work time | Local or radiating self‐reported neck pain at follow‐up for at least 8 days during the last 12 months AND experiencing local or radiating neck pain <8 days at baseline.Body regions studied: neck | NeckTotal computer use:—<50% of work time OR 1—> = 50% of work time OR 1.0 (0.6–2.9) [univariate analysis] | |
*hours per week