An assessment of ergonomic issues in the home offices of university employees sent home due to the COVID-19 pandemic

1Introduction

According to the United States (U.S.) Census Bureau, there were over 128 million full-time employees in the U.S. in 2019, with some employees working from home [1]. The U.S. Bureau of Labor Statistics states the number of people working a portion or all their hours from home increased from 19%in 2003 to 24%in 2015 [2]. While many occupations (e.g., manufacturing, construction, warehousing) were less likely to work from home, 38%of management, business, and financial operations and 35%of professional workers worked at least partially remote. Remote work, work from home, virtual work, or telecommuting (hereafter referred to as telework), which was developed in the 1970s, involves different work strategies using information and communication technologies such as desktop computers, laptops, tablets, or smartphones for work that is completed outside the employer’s buildings [3]. Telework has traditionally allowed workers to save time and money otherwise spent on commuting, but in the current environment, its value is also reducing the risks regarding employees gathering at work during the ongoing pandemic.

The spread of the novel coronavirus (COVID-19) was classified as a global pandemic by the World Health Organization on March 11, 2020 [4]. Following this, the United States declared health emergencies at the federal and state level, with every state individually declaring an emergency associated with the stay-at-home quarantine policy. These policies caused many U.S. workers to transition to work in a home office abruptly. Telework was thrust upon millions of people, some estimates of more than 55%of the U.S. workforce will work at home during the next two years [5].

Telework has been studied since the turn of the century, with findings ranging from both beneficial and detrimental outcomes [6, 7] In a survey of IBM employees who provided self-assessment of their subjective performance, those working in a virtual office were more likely to report a willingness to give extra effort towards helping their company succeed, more motivation, and higher job retention rates than those working in a traditional office [6]. Although telework implementation is thought to strengthen an individual’s work/life balance, a worsened work/life balance was found in prior research [6]. Here, the obstacles faced by teleworkers may be a combination of the ability to perform multiple, distinct (work/domestic) tasks at once and a lack of externally imposed physical boundaries, muddying the distinction between work-life and home-life areas/spaces [6].

Unfortunately, this transition to telework has become a “new normal” phenomenon which may ultimately result in emerging ergonomic issues. Regardless of where work is completed, poor posture while operating a computer or laptop can cause stiffness, soreness, back pain, sore neck, and eye fatigue. However, laptop use has been found to have a greater risk [8]. Additionally, the chair height and the armrest position has been associated with musculoskeletal pain if positioned or used improperly [9]. Current home office arrangements may range from a computer atop a kitchen table, a laptop used in a recliner, or work being completed while sitting in a bed or on the floor [10]. None of these workstations are geared for completing a full day of work, especially from an ergonomic perspective. For example, the use of a laptop while seated on a couch caused awkward wrist postures while typing on the keyboard or activation of the touchpad, arms not supported, placing stress on the upper back, and neck flexed to look down at the screen [11]. Individuals using external input devices such as a keyboard and mouse tend to report less computer-related discomfort than laptop devices [12].

While there is ample published evidence regarding the relationship between poor office ergonomics and a heightened risk of musculoskeletal injuries [13–17], there is not much evidence that exists regarding workstations in telework, including home-based work environments necessitated by the COVID-19 pandemic. The study’s goal was to survey the faculty, staff, and administrators at a large public urban Midwestern university about their home office, specifically the ergonomic stressors and muscular discomfort, to characterize the prevalence of these stressors and discomfort. In addition, correlation and regression analyses were conducted to investigate the relationship between office exposures and discomfort.

2Methods

3Results

3.1Workplace concerns

Overall, 843 surveys were completed (see Table 1). Most respondents were faculty (n = 577), followed by staff (n = 227) and administration (n = 20). A majority of the respondents were female (n = 509, 60%). More than half of the survey population (54%) were 50 years of age or under (n = 456).

Table 1

Demographic information of survey respondents

	Faculty	Staff	Administration	No response	Overall
Total	577	227	20	19	843
Age less than 30	7	29	0		36
Age 31 to 40	121	78	2		201
Age 41 to 50	162	52	5		219
Age 51 to 60	163	40	9		212
Age 61 to 70	99	25	4		128
Age 71 and above	21	3	0		24
No response	4	0	0	19	23
Male	223	60	6		289
Female	337	160	12		509
Other	0	1	0		1
No response	17	6	2	19	44

Device usage can be found in Fig. 1 and reveals laptops are widely used in home offices. Nearly 70%(n = 579) of the participants reported using a laptop “always”, while 15%(n = 115) and 3%(n = 23) reported always using a desktop and tablet, respectively. Another device, which was predominantly a mobile device, was used “often” or “sometimes” about 43%of the time.

Fig. 1

Frequency of use for each computer type.

The type of chair used in the home office seemed to vary widely between participants (see Fig. 2). While 44.6%(n = 347) of the participants reported “always” or “often” using an office chair with armrests—the recommended seat from an ergonomic perspective, many use chairs with no armrests as 44.7%(n = 348) reported never using an office chair with armrests. The extensive usage of chairs without armrests was widely prevalent as respondents reported “always”, “often” or “sometimes” for usage of dining chair 56.6%(n = 427), couch 36.6%(n = 266), folding chair 7.2%(n = 50), bed 12.0%(n = 84), and armchair 15.7%(n = 110). Additionally, these chairs were often sub-optimal with no adjustable arms and lumbar support. Indeed, only 21.6%(n = 182) of the respondents reported using a chair with adjustable armrests and 30%(n = 253) reported using a chair with either built-in lumbar support or lumbar support which had been added to the chair. Another chair related factor that can cause problems to the worker is the lack of proper support to the back from the chair. Roughly two-thirds of respondents (n = 534, 64.4%) noted they “sometimes”, “seldom”, or “never” have their back in contact with their chair.

Fig. 2

Frequency of use for each chair type.

Regarding the screen options used in the home office, many respondents reported “always” using a built-in laptop screen (n = 435, 55.1%) while also reporting “never” using alternative (external monitor, n = 426 or 60.4%, two external monitors, n = 554, 83.1%) or supplemental monitor to the laptop (n = 414, 56.6%) (as seen in Fig. 3). Similarly, regarding input devices, many responded “always” using a laptop keyboard, albeit with an external mouse, but never using more ergonomically friendly tools such as an external keyboard. As seen in Fig. 4, 46.7%(n = 394) of respondents reported “always” using a laptop keyboard compared to 21.8%(n = 187) “always” using an external keyboard. A similar pattern was observed with the use of a mouse as 36.4%(n = 307) of respondents reported “always” using a traditional mouse, 21.1%(n = 178) reported “always” using a laptop mouse.

Fig. 3

Frequency of use for each screen type.

Fig. 4

Frequency of use for each input device.

The results were fairly mixed with regard to the type of workstation being utilized while in the home office (Fig. 5). While greater than half of the respondents (n = 434, 54.8%) stated they “always” or “often” use a traditional desk, the remainder appear to work from either makeshift desks (n = 316, 41.0%) or no worksurface at all (n = 90, 12.3%). Few respondents utilized a sit-stand workstation “always” or “often” (store bought n = 41, 5.7%, makeshift n = 39, 5.5%). With many of the workstations, users often had to type in the presence of a hard-front edge of the worksurface. Nearly half of the respondents (n = 390, 52.1%) noted their desk had a sharp edge along the front.

Fig. 5

Frequency of use for each workstation type.

Many of the workstations and working practices yielded poor body postures. There were many participants who perceived poor postures when working at home such as roughly 40%(n = 323) stated their backs were bent “always”, “often”, or “sometimes” and nearly three-fourths (n = 625) reported their head/neck being tilted forward “always”, “often”, or “sometimes”. In addition,18%(n = 153) and 28%(n = 234) of respondents reported their head/neck was tilted backward or sideways, respectively.

Approximately half of the respondents (n = 426) reported glare was present on their worksurface and/or screen “always”, “often”, or “sometimes”. Nearly three-fourths of respondents (n = 603) reported they work for a duration greater than one hour without taking a break. Two-thirds of the respondents (n = 570) reported they only walk one to four times during the day for more than five minutes. Regarding whether the participant wears glasses, the answers were comparable between “yes, bifocal”, “yes, non-bifocal”, and “no” with 30.01%, 32.41%, and 37.58%, respectively.

3.2Adverse impact on workers

Fig. 6

Frequency of time spent in a poor body posture for back and head/neck.

Many of the responses from the home office workers raise concern for impacts on their long-term health. More than half of the survey respondents reported their stress levels and tiredness levels have increased since the transition to a home office work environment. Specifically, 54.2%(n = 457) of respondents stated their stress level had either increased slightly more than usual, somewhat more than usual, or a lot more than usual. Regarding fatigue, 50.9%(n = 429) of the respondents stated their tiredness level had either increased slightly more than usual, somewhat more than usual, or a lot more than usual as compared to prior to working at home due to COVID-19.

Discomfort was very prevalent in the faculty and staff completing the survey (see Fig. 7). More than three-fourths of the respondents (n = 652, 78.5%) stated they experienced little to no discomfort while working in their normal office setting prior to COVID-19, and 21.5%of these workers had moderate to severe discomfort in at least one region of the body. As the faculty and staff were compelled to telework, discomfort seemed to increase. While teleworking, greater than 40%of survey respondents noted moderate to severe discomfort levels in the eyes/neck/head, upper back/shoulders, and lower back regions (46.98%(n = 396), 49.70%(n = 419) 42.82%(n = 361), respectively).

Fig. 7

Discomfort in the home office by body area.

4Discussion

Of the population employed by the University of Cincinnati, 843 individuals returned the surveys. From this data, an alarming proportion of employees (more than 40%) noted discomfort in various body areas, such as the: eyes/neck/head, upper back/shoulders, and lower back while teleworking. Comparing this percentage to the fact more than 75%of respondents stated they experienced little to no discomfort in their typical office setting prior to COVID-19, it is clear there has been a dramatic increase in discomfort symptoms following the transition to telework. This increase in symptoms could certainly be explained by the transition of on-site office work to remote telework. One of the most prominent office concerns would be the extensive use of laptops (∼70%reported “always” using a laptop). Previous studies have shown usage of laptop computers, oftentimes in sub-optimal workstations caused awkward wrist postures during typing on keyboard or activation of touchpad, arms not supported placing stress on the upper back, and neck flexed to look down at the screen [11]. However, it is important to note due to the nature of the pandemic recall bias could impact the results of discomfort within the participants’ responses. In a sub-set of the survey participants, pictures of the workstations for 41 faculty/staff (self-selected) were analyzed to identify actual ergonomic concerns [10]. These pictures revealed laptops were often used, resulting in poor postures due to too low of a monitor, no external keyboards, and makeshift workstations.

Correlation analysis showed strong relationships between laptop usage and suboptimal workstation conditions, namely lack of a good chair with adjustable armrests and lumbar support and reduced use of a desk or other furniture that allowed the monitor to be correctly positioned while working. Prior research has shown laptop computer usage, which is typically coupled with suboptimal workstation setups, results in awkward wrist placements while typing on a keyboard or using the touchpad, a lack of support for the arms, which in turn places stress on the upper back, and increased strain on the neck which is flexed to look down at the screen [11]. An external monitor properly positioned with top of screen at eye height and directly in front of the worker would reduce the awkward postures of arms, neck, and back likely contributing to the high levels of discomfort. Further, the benefits of an external mouse and keyboard would enable an individual to maintain proper more neutral hand postures as well as when an external monitor is not available would allow laptop monitor to be elevated to an appropriate height. The impact of a poor monitor height maybe further exacerbated by high number of people with bifocals (30%) which was significantly higher than previous studies (10%) [19].

A proper workstation should consist of an external monitor positioned with top of screen directly in front of the worker at eye level and would correct the awkward postures of the arms, neck, and back likely contributed to the high levels of discomfort [10]. Additionally, the use of an external mouse and keyboard would enable an individual to maintain more neutral hand postures, and (in the absence of an external monitor) would allow a laptop monitor to be elevated to the appropriate height [10]. Another major potential contributor to adverse health was the lack of a good ergonomic chair that includes adjustable armrest, five casters, good back with a lumber support, and adjustable seat height. Respondents using a laptop were statistically more likely to make a poor selection in seating such as a dining chair, a couch, or a bed, if they used a worksurface at all, as opposed to a traditional desk.

Laptop use was strongly correlated with non-traditional workstations such as a bed or couch which did not provide adequate lumbar support or proper elevation of the monitor. Seating positions that did not provide good back support (measured as frequent back contact with a chair back) showed a higher likelihood of discomfort in the eyes, neck, and head; upper back and shoulders, lower back; hips and upper legs; and knees and lower legs. On the other hand, laptops were inversely correlated with adequate lumbar support, glare, and chairs without armrests. This indicates not only is there a high level of use of laptops but oftentimes they are utilized in less than optimal ergonomic conditions such as the back bent forward, neck bent forward or sideways, and was also correlated with experiencing increased levels of stress and tiredness since beginning work from home.

The use of a desktop had positive associations with office chairs with armrests, a chair with armrests, and a chair with lumbar support. As a result, while traditional office workstations (e.g. desktop computer, external monitor, external keyboard and mouse, and office chair with adjustable armrests) were not widely used, they were associated with less poor ergonomic concerns (e.g. glare, no lumbar support). Desktop use also showed a higher likelihood of using one or more external monitors, an external keyboard, and traditional mouse, as well as a traditional or sit/stand desk–all of which contributed to a decrease in physical discomfort particularly in the lower arms, wrists, and hands, as well as areas affected by the head and neck being bent forward. In a time of expedited shift to the home and limited resources due to the down turn in the economy, many individuals have shifted to makeshift workstations which many not adequately protect workers [20].

Several key results were found from the regression analyses, many of which centered around the idea the principles of good workstation seem to disappear as more elements not designed for the specific task are introduced. First, glare was a dominant stressor for having body discomfort in most of the body regions (exception upper leg and hips). Glare appeared to impact several body postures which produced more flexion in the neck and back as well as neck bent sideways. These postural responses were also found to be related to the discomfort, thus, glare seems to perpetuate through body adjustments that lead to the increased discomfort. Second, lack of having contact with the back of the chair was found to impact the discomfort in most body regions (all but upper arms and elbow; lower arms, wrist, and hands; ankles and feet). Less than half of respondents always or often used an office chair with armrests and less than a quarter of respondents used an office chair with adjustable armrests. The relationship between lack of back support and discomfort would likely be driven by the increased muscle stress required to support the different body regions. Moreover, while a slight majority of respondents reported typically using a traditional desk to complete work, many utilized makeshift or improvised work surfaces, such as a kitchen table or counter, card tables, or from living room furniture or bed. When a workstation becomes more and more makeshift, the principles of good office ergonomics appear to dissipate, resulting in poor postures and increased discomfort. Makeshift workstations may have led to uses of components in manners for which they were not originally designed or not fully adjusted to the worker appropriately [20].

Third, the significant effect of sharp edge for upper back and shoulder would likely be due to changes in arm posture in response to contact stress on the forearms. Fourth, distal upper extremity discomfort was reduced by adjustable armrests and use of external keyboard. Finally, dining room chair was significantly related to middle back discomfort where more time in the chair increased pain, likely due to the lack of back support. In all, many of the poor ergonomic conditions were related to increased discomfort.

A couple of other negative outcomes for home office work is the increase in stress and tiredness. This increase in adverse responses may reflect additional complexities workers face in a work-home environment, such as less work/life balance and reduced personal/family success compared to individuals in a typical office setting [6]. The slight majority of respondents stating their tiredness levels have increased since the transition to telework began and the slight majority who reported increased stress levels may reflect the complexities workers face in a work-home environment. Prior research showed working at home caused less work/life balance and reduced personal/family success compared to individuals in a typical office setting [6]. This could be caused from employees lacking satisfactory physical boundaries at their residence. Possibilities of working towards stress minimization could come in the form of discussing with one’s supervisor the opportunity to modify one’s own daily schedule, creating a more “results-oriented” mindset [7]. Again, glare appears to be a contributor to both stress and tiredness. Lack of breaks was also found to significantly increase stress. Individuals could also find ways to integrate more physical activity into the day as roughly two-thirds of respondents reported they only walk for more than a five-minute interval up to four times a day [7]. It is important to move every 30 minutes to increase large muscle activation and reduce static postures, and most likely reduce stress [21]. Increase time working on the bed also increases the tiredness, likely due to poor static postures that need to be held.

The results of this study demonstrate there are opportunities for improvement in ergonomics within the home office. Proper training in ergonomics has been found to be effective in reducing discomfort in teleworkers and in-person office workers alike [22, 23]. With 25–40%of respondents noting they typically use dining chairs, recliners, a laptop keyboard, or poor worksurfaces, the importance of increasing office ergonomic awareness, as well empowering home office workers to make positive changes is certain [24]. As the effects of the pandemic on workforces continue to evolve with little certainty, there is a strong case that improved workspaces will not only be beneficial for the workers but may also be financially advantageous for employers. Providing better support for the physical and mental health of their employees could reduce potential downtime and compensation claims attributed to injuries from sustained strain in non-ergonomic conditions.

5Conclusion

The results from this study illustrate the apparent level in discomfort experienced by university faculty, staff, and administration brought about by the ongoing COVID-19 pandemic. Large increases in discomfort levels following the stay-at-home orders were observed. Many potential sources of this increase in discomfort were reported such as wide use of laptops, working at sub-optimal workstations such as couches, beds, and kitchen countertops. Telework has led to many adverse working conditions such as laptops with monitors too low, chairs without armrests, hard edge on desktops surfaces, and long static postures due to lack of routine breaks. As we have converted to home offices, employees don’t have the resources to adequately set up workstations at home. Companies and institutions need to ensure workers have proper equipment including an adjustable office chair with armrests, a monitor that can be set to eye height, and an external keyboards and mouse. Additionally, it is recommended companies and institutions provide proper ergonomic training to their employees to prevent potential musculoskeletal disorders from developing.

6Recommendations

A few recommendations that could be helpful for the home-office worker:

Conflict of interest

The authors have indicated they have no potential conflicts of interest to disclose.

Funding

This work was supported by the National Institute for Occupational Safety and Health through the University of Cincinnati Education and Research Center (#T42OH008432).