For anyone who has to work at a computer monitor most of the time, the symptoms of discomfort are all too familiar. By the afternoon, the reading material begins to blur, eyes burn and neck and shoulders ache. A decade ago, a panel of experts assembled by the Research Council of the National Academy of Science estimated that more than 50 percent of VDT (video display terminal) users experienced visual discomfort. Another study, Vision Comfort at VDTs, by ergonomic expert Stewart B. Leavitt, Ph.D., puts the number as high as 90 percent to 95 percent of all workers.

Leavitt cites study after study that shows improper VDT use is fast becoming a health problem:

* Over 90 percent of VDT users complained of eyestrain versus 60 percent of non-VDT users.

* The number of hours spent each week at a VDT increases reported health problems from 33 percent for 15 hours of VDT work per week to 63 percent for 30 or more hours per week.

* At least 10 million patients consult eye care specialists for VDT-related eye symptoms each year.

* A Louis Harris survey found that 47 percent of all office workers consider eyestrain a very serious problem.

These figures are sobering for government agencies and departments planning to implement an imaging system. Imaging works best when all major elements of a paper-based process are converted to an electronic document process, where document images viewed on monitors become the workers' work load. In many cases, an imaging system is a worker's first exposure to computer technology and monitors.

Without proper attention given to ergonomics, workers can quickly plunge into a world of discomfort from trying to read document images on a computer screen eight hours a day. When this happens, agencies start suffering a real loss -- not from health costs, which overall are low, but from significant drops in productivity, explained Leavitt. "Workers are going to make more mistakes and they are going to take more breaks because of eye discomfort and neck and shoulder pain," he said.

Unfortunately, these productivity problems aren't always connected to bad ergonomics because few workers are willing to complain about aches and eyestrain, added Leavitt, so they suffer in silence. To reduce some of the eyestrain problems, vendors have been building better monitors. Today, an agency can purchase monitors with extremely high resolution and very little flicker. But monitor resolution is only one of many VDT issues affecting ergonomics.

One of the reasons VDT-related problems aren't going away has to do with the premise that a monitor should be an arm's length away from the viewer with the top of the monitor at eye level. "That's too close and too high," said Leavitt, who recommends that monitor heights be lowered with the top tilted away from the viewer. The monitor should also be least 30 inches away for greater viewing comfort.

For imaging viewers, who typically work with large 19-inch to 21-inch monitors so they can view two images side by side, changing the height and distance of their monitors is not easy. Big monitors are a problem, said Leavitt, because the typical work space is too small to adjust the height and distance of a large-screen monitor.


Brian Perry, data processing manager at the California State Compensation Insurance Fund (SCIF), agreed that big monitors are a big issue. The Fund, the largest of its kind in California, provides insurance for Workers' Compensation to more than 250,000 employers. The agency is in the midst of designing and developing a vast imaging system that will be deployed at its headquarters in Sacramento and in 24 district offices, and will eventually be used by more than 3,000 workers to process claims and track policies. For three years now, Perry's department has been working on the requirements, design and construction of the imaging system. In