HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Harisinghani, M. G. Articles by Mueller, P. R. Search for Related Content PubMed PubMed Citation Articles by Harisinghani, M. G. Articles by Mueller, P. R. Related Collections Informatics

Importance and Effects of Altered Workplace Ergonomics in Modern Radiology Suites¹

¹ From the Department of Radiology, Division of Abdominal Imaging & Intervention, Massachusetts General Hospital, 55 Fruit St, White 289, Boston, MA 02114. Presented as an infoRAD exhibit at the 2002 RSNA scientific assembly. Received March 31, 2003; revision requested June 10 and received August 11; accepted August 18. Address correspondence to M.G.H. (e-mail: mharisinghani@partners.org).

View larger version (131K): [in a new window]   Figure 1. Routine daily radiology practice requires access to the PACS system as well as to ancillary equipment such as the dictation system, telephone, and hospital intranet.

View larger version (145K): [in a new window]   Figure 2a. Monitor placement. (a) If the PACS monitor is placed too high, the radiologist must extend the neck, which may cause fatigue and pain. (b) If the PACS monitor is placed too close to the radiologist, he or she may experience increased eye strain and fatigue. (c) Improper seating of the radiologist and poor positioning of the PACS monitor results in repetitive neck twisting and undue muscle strain. (d, e) It is currently recommended that the top edge of the PACS monitor be 15°-50° below eye level (black line in d). Alternatively, the monitor can be placed as shown in e to achieve the recommended viewing angle. This position is better suited for simultaneous interaction with patients and computer-related processes and reduces eye and neck strain.

View larger version (140K): [in a new window]   Figure 2b. Monitor placement. (a) If the PACS monitor is placed too high, the radiologist must extend the neck, which may cause fatigue and pain. (b) If the PACS monitor is placed too close to the radiologist, he or she may experience increased eye strain and fatigue. (c) Improper seating of the radiologist and poor positioning of the PACS monitor results in repetitive neck twisting and undue muscle strain. (d, e) It is currently recommended that the top edge of the PACS monitor be 15°-50° below eye level (black line in d). Alternatively, the monitor can be placed as shown in e to achieve the recommended viewing angle. This position is better suited for simultaneous interaction with patients and computer-related processes and reduces eye and neck strain.

View larger version (146K): [in a new window]   Figure 2c. Monitor placement. (a) If the PACS monitor is placed too high, the radiologist must extend the neck, which may cause fatigue and pain. (b) If the PACS monitor is placed too close to the radiologist, he or she may experience increased eye strain and fatigue. (c) Improper seating of the radiologist and poor positioning of the PACS monitor results in repetitive neck twisting and undue muscle strain. (d, e) It is currently recommended that the top edge of the PACS monitor be 15°-50° below eye level (black line in d). Alternatively, the monitor can be placed as shown in e to achieve the recommended viewing angle. This position is better suited for simultaneous interaction with patients and computer-related processes and reduces eye and neck strain.

View larger version (149K): [in a new window]   Figure 2d. Monitor placement. (a) If the PACS monitor is placed too high, the radiologist must extend the neck, which may cause fatigue and pain. (b) If the PACS monitor is placed too close to the radiologist, he or she may experience increased eye strain and fatigue. (c) Improper seating of the radiologist and poor positioning of the PACS monitor results in repetitive neck twisting and undue muscle strain. (d, e) It is currently recommended that the top edge of the PACS monitor be 15°-50° below eye level (black line in d). Alternatively, the monitor can be placed as shown in e to achieve the recommended viewing angle. This position is better suited for simultaneous interaction with patients and computer-related processes and reduces eye and neck strain.

View larger version (166K): [in a new window]   Figure 2e. Monitor placement. (a) If the PACS monitor is placed too high, the radiologist must extend the neck, which may cause fatigue and pain. (b) If the PACS monitor is placed too close to the radiologist, he or she may experience increased eye strain and fatigue. (c) Improper seating of the radiologist and poor positioning of the PACS monitor results in repetitive neck twisting and undue muscle strain. (d, e) It is currently recommended that the top edge of the PACS monitor be 15°-50° below eye level (black line in d). Alternatively, the monitor can be placed as shown in e to achieve the recommended viewing angle. This position is better suited for simultaneous interaction with patients and computer-related processes and reduces eye and neck strain.

View larger version (67K): [in a new window]   Figure 3. Computer screen shows the tab setting for adjusting the refresh rate for the monitor.

View larger version (52K): [in a new window]   Figure 4a. Comparison of LCD and CRT monitors. (a) Drawing illustrates how an LCD monitor (light area) with its compact design occupies far less desk space than a CRT monitor (dark area). (b) Drawings of CRT (left) and LCD (right) monitors (top view) illustrate the smaller viewing angle of the LCD monitor. However, notice the narrower footprint of the LCD monitor.

View larger version (38K): [in a new window]   Figure 4b. Comparison of LCD and CRT monitors. (a) Drawing illustrates how an LCD monitor (light area) with its compact design occupies far less desk space than a CRT monitor (dark area). (b) Drawings of CRT (left) and LCD (right) monitors (top view) illustrate the smaller viewing angle of the LCD monitor. However, notice the narrower footprint of the LCD monitor.

View larger version (131K): [in a new window]   Figure 5. Constantly looking at reference materials placed to the side of the primary viewing screen can lead to undue neck and upper back strain.

View larger version (160K): [in a new window]   Figure 6. Constantly lowering the neck to look at the keyboard will result in undue strain and cumulative trauma to the neck.

View larger version (118K): [in a new window]   Figure 7. Optimal positioning of the PACS monitor and keyboard directly in front of the radiologist with an adjacent document holder results in an ergonomically sound posture, thereby minimizing neck and upper back strain.

View larger version (155K): [in a new window]   Figure 8a. Hand posture. (a) Absence of elbow rests causes the elbows to hang downward. (b) Sitting too close to the keyboard causes the arms to be raised to the sides. (c) Sitting too far from the keyboard causes the arms to be overextended. (d) Keeping the monitor and keyboard at an angle creates a bad angle for the wrists. (e) Keeping the mouse far from the keyboard causes undue stretch during use. (f) With optimal posture, the upper arms are relaxed at the sides with the elbows as close to the body as possible. The forearms should be horizontal and at right angles to the upper arms (black lines).

View larger version (139K): [in a new window]   Figure 8b. Hand posture. (a) Absence of elbow rests causes the elbows to hang downward. (b) Sitting too close to the keyboard causes the arms to be raised to the sides. (c) Sitting too far from the keyboard causes the arms to be overextended. (d) Keeping the monitor and keyboard at an angle creates a bad angle for the wrists. (e) Keeping the mouse far from the keyboard causes undue stretch during use. (f) With optimal posture, the upper arms are relaxed at the sides with the elbows as close to the body as possible. The forearms should be horizontal and at right angles to the upper arms (black lines).

View larger version (160K): [in a new window]   Figure 8c. Hand posture. (a) Absence of elbow rests causes the elbows to hang downward. (b) Sitting too close to the keyboard causes the arms to be raised to the sides. (c) Sitting too far from the keyboard causes the arms to be overextended. (d) Keeping the monitor and keyboard at an angle creates a bad angle for the wrists. (e) Keeping the mouse far from the keyboard causes undue stretch during use. (f) With optimal posture, the upper arms are relaxed at the sides with the elbows as close to the body as possible. The forearms should be horizontal and at right angles to the upper arms (black lines).

View larger version (143K): [in a new window]   Figure 8d. Hand posture. (a) Absence of elbow rests causes the elbows to hang downward. (b) Sitting too close to the keyboard causes the arms to be raised to the sides. (c) Sitting too far from the keyboard causes the arms to be overextended. (d) Keeping the monitor and keyboard at an angle creates a bad angle for the wrists. (e) Keeping the mouse far from the keyboard causes undue stretch during use. (f) With optimal posture, the upper arms are relaxed at the sides with the elbows as close to the body as possible. The forearms should be horizontal and at right angles to the upper arms (black lines).

View larger version (132K): [in a new window]   Figure 8e. Hand posture. (a) Absence of elbow rests causes the elbows to hang downward. (b) Sitting too close to the keyboard causes the arms to be raised to the sides. (c) Sitting too far from the keyboard causes the arms to be overextended. (d) Keeping the monitor and keyboard at an angle creates a bad angle for the wrists. (e) Keeping the mouse far from the keyboard causes undue stretch during use. (f) With optimal posture, the upper arms are relaxed at the sides with the elbows as close to the body as possible. The forearms should be horizontal and at right angles to the upper arms (black lines).

View larger version (152K): [in a new window]   Figure 8f. Hand posture. (a) Absence of elbow rests causes the elbows to hang downward. (b) Sitting too close to the keyboard causes the arms to be raised to the sides. (c) Sitting too far from the keyboard causes the arms to be overextended. (d) Keeping the monitor and keyboard at an angle creates a bad angle for the wrists. (e) Keeping the mouse far from the keyboard causes undue stretch during use. (f) With optimal posture, the upper arms are relaxed at the sides with the elbows as close to the body as possible. The forearms should be horizontal and at right angles to the upper arms (black lines).

View larger version (123K): [in a new window]   Figure 9a. Back posture. (a) Slouching constitutes suboptimal and ergonomically poor posture and puts undue strain on the lower back and intervertebral disk spaces. (b, c) A chair that is adjusted too high may cause the radiologist to either slide forward or slump (b) or to sit upright with the back unsupported and the ankle joints hyperextended (c). Note also the inadequate lower back support resulting from improper placement of the backrest. (d) Proper placement of the backrest offers good lumbar ergonomics, precluding injury to the lower back.

View larger version (123K): [in a new window]   Figure 9b. Back posture. (a) Slouching constitutes suboptimal and ergonomically poor posture and puts undue strain on the lower back and intervertebral disk spaces. (b, c) A chair that is adjusted too high may cause the radiologist to either slide forward or slump (b) or to sit upright with the back unsupported and the ankle joints hyperextended (c). Note also the inadequate lower back support resulting from improper placement of the backrest. (d) Proper placement of the backrest offers good lumbar ergonomics, precluding injury to the lower back.

View larger version (110K): [in a new window]   Figure 9c. Back posture. (a) Slouching constitutes suboptimal and ergonomically poor posture and puts undue strain on the lower back and intervertebral disk spaces. (b, c) A chair that is adjusted too high may cause the radiologist to either slide forward or slump (b) or to sit upright with the back unsupported and the ankle joints hyperextended (c). Note also the inadequate lower back support resulting from improper placement of the backrest. (d) Proper placement of the backrest offers good lumbar ergonomics, precluding injury to the lower back.

View larger version (171K): [in a new window]   Figure 9d. Back posture. (a) Slouching constitutes suboptimal and ergonomically poor posture and puts undue strain on the lower back and intervertebral disk spaces. (b, c) A chair that is adjusted too high may cause the radiologist to either slide forward or slump (b) or to sit upright with the back unsupported and the ankle joints hyperextended (c). Note also the inadequate lower back support resulting from improper placement of the backrest. (d) Proper placement of the backrest offers good lumbar ergonomics, precluding injury to the lower back.

View larger version (136K): [in a new window]   Figure 10a. Sound-related ergonomics. (a) A large filmless reading room with many radiologists sitting close together and dictating reports can lead to objectionable levels of ambient noise. (b) Multiple dictation stations placed close together with no dividing panels can lead to increased noise levels that may adversely affect productivity and efficiency.

View larger version (102K): [in a new window]   Figure 10b. Sound-related ergonomics. (a) A large filmless reading room with many radiologists sitting close together and dictating reports can lead to objectionable levels of ambient noise. (b) Multiple dictation stations placed close together with no dividing panels can lead to increased noise levels that may adversely affect productivity and efficiency.

View larger version (149K): [in a new window]   Figure 11. Lack of individual control over the ambient lighting in a reading room can hamper the performance of simultaneous tasks by different radiologists. In this photograph, the lighting that allows one radiologist to write adversely affects the other radiologist’s ability to read studies on the PACS monitor.

View larger version (136K): [in a new window]   Figure 12. Optimal chair height. The height should be adjusted so that the forearms and hands are horizontal, with the elbows directly under the shoulders and no angle formed at the wrist.

View larger version (150K): [in a new window]   Figure 13. Use of a footrest can help overcome the ergonomic shortcomings of an overly high desk and chair.

View larger version (118K): [in a new window]   Figure 14. Adjusting the angle and height of the backrest or the length of the seat cushion can help support the lower back.

View larger version (132K): [in a new window]   Figure 15. Adjustable-height armrests offer valuable support, taking some of the weight of the arms off the shoulder and neck muscles.

View larger version (136K): [in a new window]   Figure 16. The monitor should be about 22-26 inches (55-65 cm) away so that the eye focus muscles are not strained.

View larger version (141K): [in a new window]   Figure 17. The keyboard should be placed directly in front of the user and parallel to the edge of the desk.

View larger version (155K): [in a new window]   Figure 18. The mouse should be positioned and manipulated as close to the user as possible. The elbow should be positioned directly under the shoulder and right by the side or on the armrest.

View larger version (126K): [in a new window]   Figure 19. During routine daily work, radiologists often have to settle for poor ergonomic posture and equipment placement.

View larger version (153K): [in a new window]   Figure 20. Note the optimal angle of the elbow and wrist joints, good back support, and ergonomically correct position of the LCD monitor.