University of Leeds
SCHOOL OF COMPUTER STUDIES
RESEARCH REPORT SERIES
Report 1999.09
Health and Safety: Still an Issue for IT in the
Twenty-First Century?
by
Tom G Gough
ABSTRACT
Health and safety at work has been a concern over many years and in a variety of contexts. Particular concern has most recently been expressed (and reflected in legislation) about the health risks associated with the use of computer-based information systems. This concern has been heightened by an increase in the reported incidence of repetitive strain injuries (RSI) and other work-related upper limb disorders (WRULDS), and the anticipated increase in claims for compensation and the rising cost of challenging (or settling) such claims. However, it seems clear that the designers of computer-based information systems regard health and safety issues as of little importance. No attempt seems to be made to incorporate consideration of such issues into the information systems design process, an observation which applies across the range of information systems design methodologies. There is no evidence that information systems designers see addressing health and safety as their responsibility.
Taking the claims made above as its starting point this paper explores the likely consequences of regarding health and safety as an issue of little importance in information systems design to the exploitation of IT in the twenty-first century. It also considers ways in which the health problems associated with the use of computer-based information systems might be avoided.
1. Introduction
This paper is intended to the focus attention of information systems developers or the need to address health and safety issues during the development of computer-based information systems if individuals and organisations are to enjoy to the full the potential benefits of the effective exploitation of IT in the twenty-first century.
This paper begins with a brief review of the various aspects of health and safety in the electronic workplace to which the designers of computer-based information systems should pay attention if they are to build information systems that ‘fit safely’ into the context in which they are to be used.
The paper then looks briefly at the incidence of health and safety problems and considers the response to these problems of the information systems design community.
Section 5 considers the possible consequences of the continuing failure of information systems designers to address computer-related health and safety problems effectively and moves on to suggestions for remedial action.
An attempt is then made in the conclusions to highlight the need to take preventative measures now.
2. Health and Safety Issues
The importance of health and safety at work has been a subject of concern for many years. In fact, Hippocrates, ‘the father of medicine’, reputedly expressed concern about lead toxicity in the mining industry in the fifth century BC! More recently, Watson (1984) suggested:
“One of our highest priorities in public health is the protection of millions of Americans during their working lives”.
This concern for health and safety in employment has been reflected in legislation directed at that concern and focussed on the priorities at the time. Most recently in the UK, European Directives on health and safety in the workplace were implemented on 1 January 1993 via new regulations and codes of practice issued under the Health and Safety at Work etc Act of 1974, see, for example, the Health and Safety Commission (1992) and Health and Safety Executive (1992).
Health and safety issues in the office workplace may be grouped into four general categories: those associated with the workplace itself; those identified as related to fatigue; those that are stress related; and the range of risks associated with the use of workstations that incorporate VDUs. Many of these issues are interrelated and should be addressed together, though often research and the development of solutions has been addressed to one component out of many. Most attention has been paid to the problems perceived to be linked with the use of VDUs, largely because of the growth in VDU usage and the increase in the claimed incidence of repetitive strain injury (RSI) through similar usage. The increasing use of interactive systems, keyboard devices and VDU’s impact both muscular and visual fatigue. Probably the best summary on these issues is still to be found in Cakir, Hart and Stewart (1980) and there is also good coverage of the postural issues in Corlett, Wilson and Manenica (1986) and of a range of issues from ambient environment to posture in Grandjean (1984). A concise review of the health issues surrounding VDU work is to be found in Willcocks and Mason (1987) and a more detailed review in International Labour Office (1989). A detailed consideration of RSI is offered by Arksey (1998).
3. Incidence of Health and Safety Problems
There are problems in trying to determine the extent of the health and safety problems associated with the use of computer-based information systems, partly for the lack of agreement on the nature of the problems and their cause(s) and partly because of the lack of reliable data. However, the most widely quoted problem is that of RSI where the level of reported incidence has risen.
A Reuters’ press release of 11 February 1998 announced that British researchers (Greening and Lynn, 1998) had established that repetitive strain injury (RSI) is a real medical condition. Later in the same statement it was claimed that in Britain alone, RSI affects 200,000 people a year and that the disorder accounted for 60% of the 495,000 new cases of occupational illness reported in the USA in 1995. In the UK the Trade Union Congress has estimated that the annual cost of musculoskeletal disorders is of the order of one billion pounds (London Hazards Centre, 1997).
Another indicator of an increase in the incidence of RSI can be seen in the number of claims by employees for compensation for RSI and in the readiness of some employers (at least in the UK) to settle, preferably out of court.
In the USA many cases have reached the courts. COT (1998) published a table of 32 major cases since 1992. Business Week (1995) suggested that RSI could become the nightmare for
corporate America in the 1990’s that asbestos was in the 1980’s. According to the Bureau of Labor Statistics, North American businesses spent nearly $950 million in direct compensation costs for RSI in 1997.
It is worth noting that the amounts awarded in compensation represent only part of the costs incurred by employers (and the public purse) as a consequence of the health problems perceived to be associated with the use of computer-based information systems.
4. Response of Information Systems Designers
It is highly unlikely that information systems designers would disagree with the suggestion that one aim of information systems design should be to produce systems that do not put the health and safety of the users of such systems at risk. However, it is not clear that the design process is informed by this design objective. The impression given in the information systems literature is that health and safety is someone else’s responsibility. If health and safety is discussed at all it is seen as peripheral to the information systems design process, perhaps as one of a number of legal issues.
This criticism of lack of attention to health and safety is valid across the range of information systems design methodologies. An initial review of a sample set of methodologies to support this assertion will be found in Gough (1991). A subsequent review in Gough (1995) showed little improvement despite the intervening implementation of the Directives in the UK in 1993. Despite the increasing concern about the potential health and safety problems seen as being associated with the growth in the use of computer-based information systems, there is little sign of improvement since 1995.
For example, not one of some 40 papers at a 1996 conference on information systems methodologies (Jayaratna and Fitzgerald, 1996) addressed to “... issues ranging across the
spectrum from social to technical concerns” identifies health and safety as a key issue. It was
not an issue in any of some 70 papers at the recent UKAIS conference (Brookes and Kimble, 1999). There is no reference to health and safety issues in Turban, McLean and Wetherbe (1996) in a text, the aim of which is to improve quality and productivity. Failure to address these issues effectively is likely to impact both quality and productivity. In a text aimed at providing a foundation course in information systems (Avison and Shah, 1997) there appears to be no discussion of health and safety. Robson (1997) repeats the limited consideration in the first edition (Robson, 1994) as do Avgerou and Cornford (1993, 1998) suggesting that these authors see no need to encourage information systems to regard health and safety as integral to the information systems design process. Other recent editions on systems analysis and design continue to ignore health and safety, see, for example, Hawryszkiewycz (1998), Kendall and Kendall (1999).
In terms of human factors Smith (1997) contains no more than a brief reference to health and safety despite its focus on “the major user issues in information systems development”. A recent paper offering guidelines on user interface design (Maguire, 1999) is strong on the ‘technical’ aspects but ignores health and safety. In a recent exchange via email about the suggestion that health and safety might be considered a design issue in HCI, the following reply was received:
“Certainly an important issue, but I think … it would have to compete alongside other [issues] that may be considered more central to ‘mainstream’ HCI”.
It is surely difficult to imagine a more crucial issue in the interface between people and machines than the health and safety of the people who use the machines?
In the wide range of issues consider by the British Computer Society in looking towards the millennium health and safety does not seem to figure as an issue worth discussing (British Computer Society, 1999).
These examples are representative only and the authors are not being singled out for specific criticism. These three brief reviews with their illustrative examples are being used to support a general claim that for information systems designers, whatever the context, the health and safety of the users of the systems they design is an issue that they do not see themselves as required to address in the information systems design and development process.
It is perhaps particularly ironic that in a major area seen as benefiting from the use of IT, the delivery of healthcare, the focus is firmly on trying to ensure that computer-based information systems are used to deliver quality healthcare to patients, without, in pursuing the creation of the delivery mechanisms, giving any real attention to the ‘health’ of those who will be required to operate such systems.
5. The Possible Consequences
Most organisations of any size employ computer systems in the conduct of their affairs and computers are becoming omnipresent in the workplace. The prediction made by Williams (1988) may well now understate the case.
“Once a scientific tool and an aid to specialists in their work, the technology is becoming pervasive in factories, offices, educational institutions and homes. Before the end of the century, over half of the workers in industrial countries are expected to be working with visual display units or terminals as the central means of doing their jobs”.
(Williams, 1988)
The growth in the use of computers at home is perhaps even more dramatic.
“More people in Britain today choose to own a computer than a dog. A quarter of all households have a PC compared to one in five families who keep a pooch. Once in five homes even has two computers whilst one in 12 boasts three”
(Harrison, 1998).
If we continue to ignore the health and safety issues associated with computer use in the face of the evergrowing use of computers by an increasing percentage of the population at work and at home, we face the likelihood of an epidemic of computer-related health problems from RSI to visual problems to back pain to permanent disability. The evidence of both the health problems and the increasing numbers exposed to the risks of experiencing these problems is already available. Speculation about the possibilities is no longer necessary.
Furthermore our ability to treat effectively those suffering from the health problems associated with computer use is open to question. In general, the members of the medical profession may have moved from a position of outright scepticism about computer-related health problems, in particular those labelled ‘RSI’, and may no longer discuss those who
claim to be experiencing such problems as ‘eggshell personalities’. However, accurate diagnosis and effective treatment do not yet appear to be readily (or widely) available.
The author’s daughter, as have many others experiencing health problems associated with computer use, found her employer’s health and safety officer ill-equipped to provide effective advice and the medical specialists to whom she was referred lacking in any real understanding of both causes and possible curative action.
It is clear that in this field, as in others, prevention is better (and cheaper) than cure, whatever measures are used to assess the ‘costs’ of computer-related health and safety problems.
6. Remedial Action
Unfortunately, there seems to be no immediate prospect of a major improvement in resolving the health and safety problems associated with the use of computer-based information systems.
There are perhaps two main reasons for this. The first is that health and safety appears, generally, to be seen as someone else’s responsibility, despite the fact that legislation is often quite specific about where such responsibility lies, see, for example, for the UK, the Health and Safety Commission (1992). The second reason is that there is often a lack of understanding about the nature of the problems and uncertainty about the likely causes when problems occur, an area in which legislation may focus on the parts rather than the whole, inhibiting the acquisition of a clear picture of the totality, see, for example, again for the UK, the Health and Safety Executive (1992).
There are several courses of action that can be taken to try and address this unsatisfactory situation.
6.1. Action by Employers
Employers, recognising the costs associated with computer-related health problems, could do more. Arksey (1998) sees encouraging signs here of employers being persuaded to provide safe conditions for their employees. There are two caveats to bear in mind in assessing Arksey’s optimism. Firstly, both in the UK and the USA initial attempts to legislate on the question of health and safety in relation to the use of IT-related systems were strongly resisted by employers. The Confederation of British Industry in the UK was particularly vocal in its opposition to the European Directives, both when proposed and when it became clear that their implementation would result in legislation in the UK. Secondly, as noted earlier, meeting the requirements of the legislation, a likely route for employers to take, may result in partial and hence ineffective solutions. For example, in the UK, the regulations set out by the Health and Safety Commission (1992) and the Health and Safety Executive (1992) taken together provide reasonably comprehensive coverage of the health and safety issues. Unfortunately, anecdotal evidence supports the claim that a piecemeal approach is often being taken which results in partial and hence ineffective solutions. What is required is a set of guidelines which seek to address health and safety issues holistically. Such a set of guidelines is being proposed by Sharma (1999).
6.2. Educating Users
Educating users and potential users about health and safety and those elements of work practice and in the environment that are likely to give rise to problems is likely be a cost effective first step. The results of a small scale experiment demonstrating the effectiveness of such an approach are reported in Gough and Sharma (1998). For this approach to be effective it is essential that raising awareness of health and safety issues should form an integral part of any training associated with the introduction of new computer-based information systems.
Given the current level of ignorance of the issues in the information systems design community (as noted in section 4) it is difficult to see how these issues will be included by information systems designers in the training agenda. Perhaps with a growing awareness amongst the general public of the potential problems associated with the computer use, users will insist on health and safety training. In the UK, it is, after all, a legal right.
6.3. Job Design
The issue of job design is considered in some detail in Gough (1995) where it is argued that the six job design principles set out in Mumford (1993) as part of the ETHICS method provide a reasonable match for the health and safety requirements articulated in the UK regulations (Health and Safety Executive, 1992). The six principles provide a succinct summary of the main issues to be addressed in designing jobs: a good fit with the needs of the person doing the job; work variety and different skills; opportunity to use judgement and make decisions; opportunity to do a complete job; scope for learning; a worthwhile job. In Regulation 4 (Health and Safety Executive, 1992) there is a paragraph suggesting that wherever practicable users should be allowed some discretion as to how they carry out tasks and some control over the nature and pace of the work. Annex A to the Regulations points out that good design of the task can be as important as making correct choices in relation to the physical aspects of the work environment. It expands on this with references to designing jobs in a way that offers users variety, opportunities for learning and appropriate feedback. There is a later reference to allowing users “to participate in the planning, design and
implementation of work tasks whenever possible”. Further job design elements are to be
found in the discussion on the design, selection and modification of software.
The degree of correlation between the content of the UK legislation and the job design principles outlined suggests that incorporating sound principles of job design into the information systems development process would result in systems that did not put the health and safety of their users at risk.
Unfortunately, job design seems to paid little more attention than health and safety in most information systems design theory and practice.
6.4. Requirements Specification
Increasing emphasis is rightly being placed on the importance of all the people engaged in the information systems development process and it is now widely recognised that ‘people factors’ have a greater influence on the success or failure of computer-based information systems than technical factors. However, this recognition of the centrality of the potential
user of information systems has not yet been reflected in the advice provided by the proponents of the range of information systems development methodologies. These are still focussed on the data, the processes or the task, the latter in terms of task content rather than the implications of the ‘doing’ of the task for the person engaged in it. The continuation of these approaches, even if supported by increased user involvement (as widely advocated), seems unlikely to reduce the incidence of the problems associated with the use of VDUs. Similarly, more attention is being paid to the importance of the organisational context in the effective operation of computer-based information systems. Little attention is addressed to the physical context in which such systems operate, apart from the occasional discussion of the physical components of the workstation. Continuing to ignore the other aspects of the environment in which users work is likely to lead to the users continuing to experience computer-related problems since, as noted earlier, many health and safety issues are interrelated and all of them ought to be addressed within the information systems design process.
Using the advice offered by the Health and Safety Executive (1992) as a template for the initial specification of requirements and a basis for the implementation and installation of the resulting information system would offer the opportunity to build ‘better’ systems. If the advice on the health and safety issues were followed within the specification process, the resulting system built to meet such a specification could reasonably be expected not to put the health and safety of its users at risk. The arguments in favour of the efficacy of such an approach are the same as those for ensuring that audit and security provisions are integral to information system specification rather than less effective (and more expensive?) later post-implementation additions. Insisting that the physical context is given equal weight with the organisational context would require designers to be aware of the physical implications of their design for their clients in the workplace, not merely as a visual representation on a screen. Designers would need to re-acquire the broader understanding of the systems environment which was lost with the adoption of a narrow technical systems analysis approach in the late sixties and has never been fully recovered. Designers would then be in a good position to assist their clients with advice on making the physical environment one which did not put the health and safety of its occupants at avoidable risk.
6.5. Attitudinal Change
The general response of the information systems design community has already been reviewed in section 4 and the argument advanced that to date this response remains inadequate across the spectrum of approaches to the design and development of computer-based information systems. An improved response can only come from a change in attitude on the part of information systems designers to the health and safety issues raised by the use of computer-based information systems. This change of attitude can only come from changes in the education and training of information systems designers.
Those responsible for the education and training of information systems designers need to accept that health and safety is a design issue of first importance and then to incorporate addressing health and safety requirements into the mainstream of the information systems design educational process. Although this action looks to change in the longer term, a start needs to be made now if we are to avoid an epidemic of health problems with the further exploitation of IT in the twenty-first century.
In support of this drive to change attitudes writers of ‘how to’ texts on information systems design and development should re-examine the advice offered on information systems building to ensure that potential designers are aware of the health and safety issues to be addressed in the design of any information system in order that the resulting system can be operated safely in both its organisational and physical context. In the well-intentioned endeavour to get the most out of the technology from the mid-sixties, attention to both organisational and physical context tended to get overlooked. Although the importance of the organisational context was subsequently recognised and is reflected in both information systems design theory and practice, the importance of the physical context remains largely unappreciated.
7. Conclusions
Despite the concerns expressed about the health risks associated with the use of computer-based information systems and their articulation in legislation, health and safety continues to be regarded by the information systems community as a design issue of little importance. The costs to individuals, employers and communities of the lack of attention to health and safety at the design stage will continue to rise unless there is a significant change in design practice, until the focus shifts from some generalised vision of the wealth of opportunities made possible by IT to a detailed examination at the operational level of how such opportunities can be exploited without significant health and safety ‘costs’ being incurred by an increasing number of users of IT.
Short term remedial action is available to users of computer systems and their employers but the long term solution rests with the information systems designers. Though as yet the designers do not seem ready to accept their share of responsibility for the problems and their resolution, the time for action is now. Tomorrow may be too late.
Almost thirty years ago Rothery (1971) wrote:
“The well-intentioned made computer professional simply does not take time to consider what motivates the masses of people outside his computer centre, or how they are going to adjust to the kind of world he is bringing about. When they start to throw rocks at the windows of his computer centre, it may be too late for him to find out what is going on”.
More recently Mason and Willcocks (1994) noted:
“No information system can work without the willing co-operation of the people involved”.
Unless proper account is taken in information systems design of the health and safety of the users of the computer-related systems being designed, at best, the potential for everyone’s betterment will not be realised, at worst, for those users crippled by poorly designed systems the IT vision for the twenty-first century will become their personal nightmare.
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