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Gro Gade Haanes,1 Marit Kirkevold,2 Dag Hofoss,2 Gunnar Horgen,1 Grethe Eilertsen1 1Department of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway; 2Institute of Health and Society, University of Oslo, Oslo, Norway Background: Vision and hearing impairments in the elderly (aged over 80 years) and poor indoor lighting conditions in a home-care setting are risk factors for functional decline, reduced social participation, withdrawal, and accidents. Objective: We aimed to evaluate the changes in vision, hearing, and lighting conditions in the homes of participants aged over 80 years after implementation of a clinical intervention. Methods: We undertook an exploratory randomized, controlled experimental study of sensory impairments and lighting conditions in the homes of elderly aged over 80 years who received home care. The intervention group (IG) received advice and encouragement to improve their vision, hearing, and indoor lighting conditions in the home, with a 10-week follow-up period. The control group (CG) received their usual care and underwent the same vision and hearing tests but were provided no intervention. Results: Vision and hearing (self-assessed) and tested by Wilcoxon rank-sum test were significantly better (P=0.025 and P=0.008, respectively) in the IG after the intervention and follow-up. The test between the groups showed a significance of P=0.026 for visual acuity and P=0.098 for pure-tone average. The maximum and minimum lighting levels were significantly improved in the IG after the intervention (P=0.002 and P=0.039, respectively) but were unchanged in the CG. Conclusion: Several of the IG participants did not follow all of the advice; however, among those who did, vision, hearing, and lighting conditions were all significantly improved. It appears that modest interventions have great potential for improving vision and hearing. Older patients in the home-care setting cannot be expected to take the necessary action to improve their sensory impairments by themselves. They require close monitoring, help from a specialist, and help to improve the indoor lighting conditions in their homes. Keywords: vision and hearing impairments, home lighting conditions, old people, home care

Gro Gade Haanes,1 Marit Kirkevold,2 Gunnar Horgen,1 Dag Hofoss,2 Grethe Eilertsen1 1Buskerud and Vestfold University College, Kongsberg, Norway; 2University of Oslo, Oslo, Norway Background: Hearing and vision impairments increase with age and are common risk factors for functional decline reduced social participation and withdrawal. Objective: Describe the hearing and vision of home care patients older than 80 years. Methods: Ninety-three older adults (80+ years) receiving home care were screened for hearing and vision in their homes. Data were collected using a HEINE Mini 3000® Otoscope to examine the eardrum and presence of earwax, an Entomed SA201-IV portable pure-tone audiometer to measure the pure-tone average (PTAV), a logarithm of the minimum angle of resolution chart to measure visual acuity (VA), and the Combined Serious Sensory Impairment interview guide. Results: Slight and moderate hearing impairments were found in 41% and 47% of the population, respectively (mean PTAV =40.4 dB for the better ear), and 40% and 56% had impaired and slightly impaired vision, respectively (mean VA =0.45 for the better eye). The participants' self-assessments of hearing and vision were only weakly correlated with PTAV and VA values. The visual function was significantly worse in men than in women (P=0.033). Difficulty in performing instrumental activities of daily living because of hearing and vision impairments was experienced by 17% of the participants, whereas 76% experienced no difficulties. When many people were present, 72% of the participants found it difficult to understand speech. Nearly 30% found it tiring to read, and 41% could not read very small print. Conclusion: The patients’ self-assessments of their hearing and vision did not correlate strongly with their VA and PTAV scores. Asking the elderly about their overall hearing and vision ability is not sufficient for detecting sensory impairment, and asking more specific questions about what they could not hear and see was not an adequate indicator of the patients’ hearing and vision problems. To detect hearing and vision impairments among elderly home care patients, standardized measurements of their hearing and vision are necessary. Keywords: dual sensory impairment, home care, vision, hearing, elderly

A prospective epidemiological field study covering a 2 years period has earlier been published. The study has a parallel group design with two intervention groups (T and S) and one control group (C) of Visual Display Unit (VDU) operators. The present paper covers the period from 2 to 6 years of the study. After 3.5 years, the C group got the same intervention in terms of new lighting system, new workplaces and at last an optometric examination and corrections if needed. The C group reported a significant reduction in visual discomfort after interventions while the two groups (T and S) continued to report significant reduction of visual discomfort after 6 years. By supporting the forearm on the table top, the C group reported significant reduction of shoulder and neck pain while the T group reported significant reduction in shoulder and back pain after 6 years. Organizational and psychosocial factors at work and outside work did not show any significant changes during the study period. [ABSTRACT FROM AUTHOR]

The study has a parallel group design with two intervention groups (T and S) and one control group (C) of VDU operators. Three serial interventions were carried out in the T and S groups, first a new lighting system, then new workplaces and last an optometric examination and corrections if needed. The new lighting gave significantly increased illuminance levels, increased luminances of the room surfaces and better luminance distribution. The two intervention groups reported significant improvement of the lighting conditions, as well as of the visual conditions and significantly reduced visual discomfort and glare. Significant reduction of headache was found in one of the intervention groups. Optometric corrections reduced the visual discomfort in both the intervention groups. When looking at those given new corrections, a significant reduction was found in the T group and a clear tendency was also found in the S group. The C group reported no improvements for any of these health outcomes. The workplace intervention gave the operator the possibility to support the whole forearm and hand on the table top. Before the intervention there were no significant differences between the three groups regarding shoulder pain and static trapezius electromyographic (EMG) load. Two years after the intervention, a significant reduction of shoulder pain was reported in the T and S groups in parallel with a significant reduction in static trapezius load, while no such reduction was found in the C group. At the same time, both static trapezius load and shoulder pain were significantly lower in the T and S groups compared with the C group. Pain in the forearm and hand showed no significant changes in any of the groups during the study period. However, there seem to be a relationship between pain in the forearm and hand and the time the operator used the mouse. The C group reported significantly higher intensity of pain and used the mouse significantly more than the S group. [ABSTRACT FROM AUTHOR]

Aim: The studies have shown that infants with prenatal OMT exposure had smaller brain volumes than non-exposed controls, but long-term outcome data are lacking. We examined 5-13-year-old OMT-exposed children with brain MRI and tested motor and visual-motor functions and possible associations between brain morphology and outcome., Methods: To this retrospective cohort study, we recruited 55 children with prenatal OMT exposure and 59 age- and gender-matched controls. They were examined with brain MRI, Movement-ABC and Beery-VMI. MRI images were processed with the Free Surfer® software to obtain volumetrics and estimates of cortical surface area and thickness. We used a general linear regression model (GLM) to calculate group differences., Results: The children in the OMT group had smaller mean total intracranial volume (ICV), 1407 cm 3 (CI 95% 1379-1434) versus 1450 cm 3 (CI 95% 1423-1476) in the control group (p = 0.026). After adjusting for ICV, significant group differences persisted for volumes of amygdala, basal ganglia and mid-posterior part of corpus callosum. Cortical surface area was smaller in the left caudal middle frontal gyrus and the right inferior parietal lobule in the OMT-group. Visual-motor function was significantly correlated with ICV., Conclusion: Prenatal OMT exposure may alter early brain development with possible negative long-term functional consequences., (© 2024 The Author(s). Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Purpose: Orbicularis oculi muscle tension and muscle blood flow have been shown to be objective measures of eyestrain during visually demanding activities, such as computer work. In line with this, positive associations between eye-related pain and muscle blood flow in orbicularis oculi have been observed. A hypothesis regarding work situations with cognitive tasks and low-level muscle activity, such as computer work, proposes that muscle pain originates from the blood vessel-nociceptor interactions of the connective tissue of the muscle. Noninvasive muscle blood flow measurements in the orbicularis oculi muscle are preferable to using an invasive technique. The aim of this study was to test reproducibility and stability of muscle blood recordings in orbicularis oculi using photoplethysmography., Methods: In the reproducibility tests, 12 subjects were tested twice within 1 to 5 weeks. To study the stability of the method, six of the subjects were randomly selected and tested four more times within 2 to 6 weeks. Test subjects were doing identical visually demanding computer work for 10 minutes in each test., Results: The short-term repeatability of muscle blood flow measurements was considered good, but the stability of blood flow recordings over time in orbicularis oculi was low because of a greater within-subject maximum variability compared with between-subject average variability., Conclusions: Investigators should be aware of the effect of time, possibly attributed to confounding factors such as environmental changes and mental stress, when comparing photoplethysmography muscle blood flow recordings.

A total of 85 VDU operators, in three main Scandinavian Alcatel-Lucent headquarters, were followed in a process moving from single occupancy offices to an office landscape. This paper discusses the visual challenges and implications in such a transfer. In the oral presentation recommendation on how to avoid visual problems will be given.

A functionally optimized housing development designed to meet the demands in different phases of living (universal design) may result in the elderly living longer in their own homes. In this study a total of 165 healthy persons were included out of a total of approximately 320 persons turning 75 years of age in 2009 living in Drammen municipality. They went through a quantitative, questionnaire-based interview (including VAS and SF-36) and 20 participants were then selected for a qualitative in depth interview. The lighting conditions in the kitchen, living room, bathroom, bedroom and staircase were measured according to a simplified procedure. The overall lighting conditions were evaluated to be rather low, with means between 35 and 121 Lux, but the quantitative interviews showed that on most questions the scores were rather low, indicating that the overall thriving is good regardless of rather low lighting values.

This study investigated the effect of moving from single occupancy offices to a landscape environment. Thirty-four Visual Display Unit (VDU) operators reported significantly worsened condition of lighting and glare in addition to increased visual discomfort. For visual discomfort, the difference with 95% confidence interval was 10.7 (1.9-19.5) Visual Analog Scale (VAS) as group mean value. The most reasonable explanation for these results may be that the operators were glared from high luminance from the windows, when the Venetian blinds were not properly used. Glare was significantly correlated with visual discomfort, rs=0.35. Both illuminance and luminance in the work area, and contrast reduction on the VDU screen were in line with recommendations from CIE for VDU work. In a regression analysis, the visual discomfort explained 53% of the variance in the neck and shoulder pain. In the office landscape, the eye blink rate during habitual VDU work was recorded for 12 randomly selected operators from the 34 participants. A marked drop in eye blink rate during VDU work was found when this was compared to "easy conversation" (VDU work, mean=9.7 blinks per minute; "easy conversation," mean=21.4 blinks per minute). Participants reported many of the organizational and psychosocial conditions and work factors worse when landscape office was compared to single occupancy office. These factors may have influenced the musculoskeletal pain. However, the pain level was still low at 6 years and not significantly different when compared with the start of the study period, except for a small but significant increase in shoulder pain. In this study, visual discomfort is clearly associated with pain in the neck and shoulder area.

This study investigated the effect of moving from single-occupancy offices to a landscape environment. Thirty-two visual display unit (VDU) operators reported no significant change in visual discomfort. Lighting conditions and glare reported subjectively showed no significant correlation with visual discomfort. Experience of pain was found to reduce subjectively rated work capacity during VDU tasks. The correlation between visual discomfort and reduced work capacity for single-occupancy offices was rs=.88 (p=.000) and for office landscape rs=.82 (p=.000). Eye blink rate during habitual VDU work was recorded for 12 operators randomly selected from the 32 participants in the office landscape. A marked drop in eye blink rate during VDU work was found compared to eye blink rate during easy conversation. There were no significant changes in pain intensity in the neck, shoulder, forearm, wrist/hand, back or headache (.24

Three groups of data entry female visual display terminal (VDT) workers from Norway (n = 30), Poland (n = 33) and the USA (n = 29) were compared. Before intervention, the Norwegian group reported more neck pain compared with the Polish group. The Polish group reported less shoulder pain than both the U.S. and the Norwegian groups. The clinical examination documented fewer symptoms and signs of musculoskeletal illness among the Polish participants compared with the Norwegian and the U.S. groups. After intervention, the Norwegian group reported a reduction in neck pain while the U.S. group reported a reduction in shoulder pain. The Polish group reported an increase in neck, shoulder and forearm pain at follow-up compared to after intervention. The Polish group recorded higher flexion of the upper arm at follow-up parallel with an increase of pain in the upper part of the body. Visual discomfort showed variable results in the 3 countries.

This special issue of the International Journal of Occupational Safety and Ergonomics (JOSE) reports the results from an extensive multinational and multidisciplinary collaborative investigation of the impacts on visual display terminal (VDT) work of musculoskeletal, visual, ergonomic, and psychosocial factors. For brevity, this effort has been referred to as the MEPS project (musculoskeletal--eyestrain--psychosocial--stress). This paper lays out the basic methodological structure of the study. The study was conducted in 4 countries utilizing VDT data entry workers as the primary subject population. A battery of objective and subject assessment measures, including muscle load, visual function, physical and visual strain, postural, ergonomic and psychosocial factors, were assessed at 3 different points in time. A pre-test was given prior to an ergonomic intervention. Two post-tests were given 1 month and 1 year after the ergonomic intervention.

The Norwegian MEPS (musculoskeletal--visual--psychosocial--stress) study included 3 groups: data entry, data dialogue (female) and data dialogue (male). Before intervention, the data entry group reported significantly more symptoms and signs of musculoskeletal illness and had longer periods in front of the video display terminal (VDT) without a break. The ergonomic intervention consisted mainly of ergonomic information and training. After intervention, the data dialogue female group reported a significant reduction in shoulder pain in parallel with a reduction in trapezius load. Increasing the understanding in how to adjust the work stand and chair may have been contributing factors to reducing the pain level. There was a significant reduction in eye problems in all groups; the greatest reduction in eye symptoms was seen in the groups who had new optometric corrections.

Purpose: Three types of progressive additions lenses (PAL) specially designed for VDU-work and one single vision lens were compared in a prospective field study. The aim was to investigate if these progressive lenses created a difference in the development of visual discomfort compared to single vision lenses when working on an optimized VDU-workstation., Methods: The study had a prospective, parallel group design, with four groups of VDU-workers. Approximately 40 subjects in each group, selected after careful task analysis with special attention towards the visual angles and distances to the work tasks. The groups were followed over one year. A questionnaire concerning visual conditions, working conditions, discomfort in different body areas, the status of the subjects' optometric corrections, psychological factors both at work and at home, amount, frequency and duration of VDU-work etc. was filled in before the intervention, after six months and after one year. No other contact was made with the subjects. The VDU-lenses included were Interview (Essilor), Gradal RD (Zeiss) and Technica (American Optical). Pain intensity and duration were assessed on a 100 mm Visual Analogue Scale (VAS) before the intervention, and six and twelve months after the intervention. All subjects were given a complete optometric examination., Results: Only small changes in the development of headache and visual discomfort were registered. However, the subjective evaluation of area of clear vision and overall satisfaction was significantly improved for the Interview and Gradal RD lens (p < 0.05). There were no significant changes for Technica and single vision lenses., Conclusion: Lens designs that cover viewing distances from near and out to approximately 2 meters work well compared to lens designs trying to cover greater range of clear vision. When tasks analysis shows that single vision correction may be used, this is still an acceptable solution.

Three different types of spectacle lenses, specially designed for visual display unit (VDU) work, were compared with single-vision lenses regarding postural load. The different corrections effect on postural load was measured by using electromyography. Muscle loads were recorded from the trapezius muscle and the infraspinatus muscle. Continuous measurements of body posture were measured by using three dual axis inclinometers attached to the head, back, and upper arm. No significant differences were found between the single-vision lenses and the specially designed VDU lenses regarding muscle load. Small differences were found regarding the head angle. The study concludes that these new lens designs create interesting opportunities for the optometrist to optimize the visual conditions for VDU workers.

In an initial study, 18 VDT operators were found to have a higher muscle load in the neck/ shoulder region when using progressive lenses compared with single-vision lenses, while working on a VDT unit. For single-vision lenses, a higher flexion angle in the neck was also discovered. The present study investigates whether this higher muscle load is reduced when a progressive correction is worn for a three-month period. Adaptation in terms of reduced muscle load measured by electromyography (EMG) was not discovered. Head flexion angle was smaller when using progressive correction as compared with single-vision lenses. Some practical implications for occupational optometry are discussed.