Mouse Injury

Can you become ill by using a mouse? The debate is on but there are no certain conclusions.

Throughout the last decade there has been a lively debate on possible health risks in connection with the use of a computer. The term mouse injuries is often used as a common description for pains and aches in the back of the neck, the shoulders and the arms. The debate reflects the increasing use of computers.

In 1995 11% of the workforce spent more that 75% of the day working with computers. In 1990 this applied to 4% of the workforce. The amount of people working with computers is greatly increasing. It is estimated that 120 million people in the US are working with computers on a daily basis.

Population studies have shown that the share of pains originating from the motor apparatus is still increasing. Approximately half of all reported work related sufferings come from the motor apparatus. Every third consultation with a personal doctor concerns the motor apparatus.

However, work related pains in the arm and the back of the neck have been known for many years. There are many accounts from the eighteenth century of secretaries complaining of pains and fatigue in the arms, which were attributed to the monotonous movements of the pen on the paper.

Outbreaks of writer's cramp in the beginning of the nineteenth century were blamed on the introduction of the steel pen. Similar problems have been recorded in other professions: shoemakers, musicians and dairymen, among others. Thus there are numerous historical accounts of symptoms which are very similar to the mouse injuries of today.

No Certain Knowledge About Mouse Injuries
Our knowledge today about injuries caused by computer related work is primarily based on comprehensive surveys and, to a lesser extent, experimental studies of the body's reaction to computer work.

The conclusion of the numerous studies draws the following picture:
1. Many hours of computer work daily (more than approximately four hours per day) may cause problems in the wrists, elbows, shoulders or the back of the neck. At present, however, no studies have shown that computer work should cause chronic symptoms that continue if the work is terminated or if a change in the working situation takes place. This does not mean that there are no incidents of chronic problems. In that case the amount of incidents is limited.

2. Today there is no evidence that the computer mouse is especially harmful to work with. It has been proven that different types of mice equipment (ordinary mouse, joystick mouse and trackball) strain different muscle groups in the shoulders and forearms. Shifting between types of mice may help increase the work variation and perhaps decrease the strain.

3. In spite of large investments in presumably ergonomic improvements, it has not been possible to give an answer to which keyboards, mice, tables or chairs prevent pains in connection with computer work most adequately. The key issue, however, seems to be the importance of the individual having an influence on the arrangement of his or her workplace itself, i.e. adjustment of the equipment, the table and the chair. The importance of ergonomics seems to lie mainly in the fact that the individual has the possibility of adjusting his or her own workplace. The equipment chosen is of less importance.

Advice On Working With A Mouse

The following general guidelines are provided:
A. The height of the chair and table should be adjusted so that the elbows are 90 degrees bent during work and the shoulders are in a relaxed position.
B. The work of the hands should primarily take place in the area in front of the body and not to the sides.
C. The monitor should be in position with the centre of the body and in appropriate distance from the eyes.

Perhaps Something Else Is The Matter!
The fact that the expected decrease in problems has not come about in spite of considerable ergonomic improvements at the workplace, has increased the awareness of psychosocial factors such as the relations between management and employees and employees in between, the organisation of work, education and career possibilities - factors which most likely influence the conception and the beginning of symptoms greatly.

Future research must therefore focus both on possible psychosocial stress factors in the work itself and the physical strain caused by computer work.
New computer programmes will make it possible to collect data from the individual computer workplace about the number of taps on the keyboard and mouse-clicks and continuously collect weekly questionnaires concerning problems. Advanced MR scans will reveal any injuries to the soft tissue caused by computer work.

It may, however, be more beneficial to society to focus on the physical inactivity that nowadays starts in early childhood and is influenced by sedentary computer work at school, at home and at work. The computer work is moreover accompanied by snacks and soft drinks which result in other social problems such as becoming overweight.

Sources: Price essay - Gigtforeningen år 2000 (The Danish Rheumatism Association year 2000) "What we know about musculoskeletal disorders relating to computer use (mouse injuries). Johan Hviid Adnersen et al.

By Dr. Peter Kryger, MD. Department of Rheumatology at Hvidovre Hospital

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